Background: The purpose of this study was to evaluate prospectively the efficacy of a topical carbonic anhydrase inhibitor in macular edema after vitrectomy.
Цель: оценка перспективы использования топического ингибитора карбоангидразы для профилактики развития макулярного отека после витрэктомии.
http://ophthalmolog.kiev.ua/
Comparative study of the results of 0.04%da mitomycin c and simple conjunctiv...Apollo Hospitals
Pterygium recurrence is one of the most common complications following simple pterygium excision. Mitomycin-C and conjunctival autograft are the two procedures known to decrease the recurrence rate. Comparing the results of the two procedures is the purpose of this study.
This study evaluated the use of multiple trabecular micro-bypass stents combined with cataract surgery in 53 eyes of patients with open-angle glaucoma and cataract. The study found that using 2 or 3 micro-bypass stents led to a mean postoperative intraocular pressure of 14.3 mm Hg, significantly lower than the preoperative pressure of 18.0 mm Hg. Patients were also able to achieve their target pressure control with significantly fewer glaucoma medications, with a 74% reduction in the mean number of medications used from 2.7 preoperatively to 0.7 at the 1-year follow up. Patients who received 3 stents were on significantly fewer medications than those who received
This document summarizes a presentation on surgical techniques for treating macular pucker. It discusses the history of macular pucker surgery, comparisons of outcomes between traditional membrane peeling versus internal limiting membrane peeling techniques, debates around the use of dyes like indocyanine green, and proposals for future studies. The presentation concludes that en bloc removal of the internal limiting membrane and epiretinal membrane complex may reduce recurrence rates compared to membrane peeling alone, but larger multicenter trials are still needed to definitively determine differences in visual and anatomical outcomes.
Dr. Guilherme Rocha, Dr. Paulo Ferrara, Dr. Leonardo Torquetti, Dra. Luciene Barbosa analisam os resultados dos implantes de Anel de Ferrara de Arco longo no pós operatório de 6 meses
Abstract—Cataract is the main cause of blinding and Diabetes Mallitus (DM) is the one of major cause of early cataract. Patents of DM has poor So this study is aimed to assess the corneal endothelial cell count in patients of DM (Type 2)after phecoemulsification and intra-ocular lens implantation. This study was conducted on 66 patients of cataract, out of which 33 patients with and 33 without DM (Type 2). Both groups underwent pre operative investigation and ophthalmological assessment and then undergo phacoemulsification done by same surgeon. After phacoemulsification all cases were followed up on 1st day ,1st week,1 month and 3 months and Uncorrected visual acquity (UCVA), Best corrected visual acquity (BCVA),corneal thickness, endothelial cell count and morphometric analysis were recorded. Both groups parameters were compared with unpaired 't' test. At the end of 3 months it was found that the mean endothelial cell loss in Group A(Diabetic) was 6.9% ± 0.6 and in Group B (control) was 2.4% ± 0.3 suggesting that the corneal endothelium in diabetic patients is under metabolic stress, and weaker against mechanical loads, such as phacoemulsification, than that in non-diabetic subjects. Despite good glycemic control and no corneal abnormalities before surgery. Endothelium in diabetic subjects is more vulnerable to surgical trauma and has a lower capability in the process of repair. These findings should be considered when planning cataract surgery in patients with diabetes.
1) A study evaluated clinical outcomes after implantation of a new 320°-arc length intrastromal corneal ring segment (320-ICRS) in 138 eyes of 130 patients with keratoconus.
2) Results found that mean uncorrected and corrected distance visual acuity significantly improved, and mean keratometry, corneal volume, and asphericity values were significantly modified to a more physiologic shape.
3) The 320-ICRS was found to efficiently and safely improve visual acuity in keratoconus by modifying the corneal shape. Complications included segment migration in 4 cases and intraoperative perforation in 2 cases using the manual technique.
Comparative study of the results of 0.04%da mitomycin c and simple conjunctiv...Apollo Hospitals
Pterygium recurrence is one of the most common complications following simple pterygium excision. Mitomycin-C and conjunctival autograft are the two procedures known to decrease the recurrence rate. Comparing the results of the two procedures is the purpose of this study.
This study evaluated the use of multiple trabecular micro-bypass stents combined with cataract surgery in 53 eyes of patients with open-angle glaucoma and cataract. The study found that using 2 or 3 micro-bypass stents led to a mean postoperative intraocular pressure of 14.3 mm Hg, significantly lower than the preoperative pressure of 18.0 mm Hg. Patients were also able to achieve their target pressure control with significantly fewer glaucoma medications, with a 74% reduction in the mean number of medications used from 2.7 preoperatively to 0.7 at the 1-year follow up. Patients who received 3 stents were on significantly fewer medications than those who received
This document summarizes a presentation on surgical techniques for treating macular pucker. It discusses the history of macular pucker surgery, comparisons of outcomes between traditional membrane peeling versus internal limiting membrane peeling techniques, debates around the use of dyes like indocyanine green, and proposals for future studies. The presentation concludes that en bloc removal of the internal limiting membrane and epiretinal membrane complex may reduce recurrence rates compared to membrane peeling alone, but larger multicenter trials are still needed to definitively determine differences in visual and anatomical outcomes.
Dr. Guilherme Rocha, Dr. Paulo Ferrara, Dr. Leonardo Torquetti, Dra. Luciene Barbosa analisam os resultados dos implantes de Anel de Ferrara de Arco longo no pós operatório de 6 meses
Abstract—Cataract is the main cause of blinding and Diabetes Mallitus (DM) is the one of major cause of early cataract. Patents of DM has poor So this study is aimed to assess the corneal endothelial cell count in patients of DM (Type 2)after phecoemulsification and intra-ocular lens implantation. This study was conducted on 66 patients of cataract, out of which 33 patients with and 33 without DM (Type 2). Both groups underwent pre operative investigation and ophthalmological assessment and then undergo phacoemulsification done by same surgeon. After phacoemulsification all cases were followed up on 1st day ,1st week,1 month and 3 months and Uncorrected visual acquity (UCVA), Best corrected visual acquity (BCVA),corneal thickness, endothelial cell count and morphometric analysis were recorded. Both groups parameters were compared with unpaired 't' test. At the end of 3 months it was found that the mean endothelial cell loss in Group A(Diabetic) was 6.9% ± 0.6 and in Group B (control) was 2.4% ± 0.3 suggesting that the corneal endothelium in diabetic patients is under metabolic stress, and weaker against mechanical loads, such as phacoemulsification, than that in non-diabetic subjects. Despite good glycemic control and no corneal abnormalities before surgery. Endothelium in diabetic subjects is more vulnerable to surgical trauma and has a lower capability in the process of repair. These findings should be considered when planning cataract surgery in patients with diabetes.
1) A study evaluated clinical outcomes after implantation of a new 320°-arc length intrastromal corneal ring segment (320-ICRS) in 138 eyes of 130 patients with keratoconus.
2) Results found that mean uncorrected and corrected distance visual acuity significantly improved, and mean keratometry, corneal volume, and asphericity values were significantly modified to a more physiologic shape.
3) The 320-ICRS was found to efficiently and safely improve visual acuity in keratoconus by modifying the corneal shape. Complications included segment migration in 4 cases and intraoperative perforation in 2 cases using the manual technique.
This meta-analysis evaluated the effectiveness of bevacizumab (Avastin) treatment on corneal neovascularization (NV) based on 7 clinical human studies and 18 animal studies. The results showed that bevacizumab significantly reduced the area of corneal NV in both human and animal studies. Specifically, bevacizumab reduced the neovascularized area in human studies by an average of 36% overall, with 32% reduction for subconjunctival injections and 48% for topical treatment. Bevacizumab also improved best-corrected visual acuity in human studies. In animal studies, bevacizumab significantly reduced the area of corneal NV compared to controls.
This study examined the correlation between central corneal thickness (CCT) and results from Frequency Doubling Technology Perimetry (FDT) in 180 patients aged 40 or older with high intraocular pressure (IOP) but normal optic discs. The average CCT across both eyes was 531 microns. Abnormal FDT results were found in 18 subjects, who had thinner average CCT of 519 microns, compared to 532 microns in 162 subjects with normal FDT results. The study concludes that among patients with high IOP but normal discs, thicker corneas are associated with a lower risk of early glaucomatous damage detected by FDT, compared to patients with thinner corneas.
Optic Disc and Macula Localization from Retinal Optical Coherence Tomography ...IJECEIAES
This research used images from Optical Coherence Tomography (OCT) examination as well as fundus images to localize the optical disc and macular layer of retina. The researchers utilized the OCT and fundus image to interpret the distance between macular center and optic disc in the image. The distance will express the area of macula that can be employed for further research. This distance could recognize the thickness of macula parameters diameter that will be used in localizing process of optic disc and macula. The parameters are the circle radius, the size of window’s filter, the constant value and the size of optic disc element structure as well as the size of macula. The results of this study are expected to improve the accuracy of macula detection that experience the edema.
Multimodal evaluation of macular function in age related macularAbdallah Ellabban
- The study evaluated macular function in eyes with age-related macular degeneration (AMD) using visual acuity testing, microperimetry, and focal macular electroretinography (fmERG).
- Eyes with neovascular AMD showed marked deterioration of macular function on all tests as well as changes in the neurosensory retina.
- Eyes with large drusen only showed minimal retinal changes but decreased retinal sensitivity at the central point on microperimetry testing.
- Eyes with drusenoid pigment epithelial detachment (PED) had preserved retinal structure but significantly increased foveal thickness and decreased visual acuity, fmERG amplitudes, and retinal sensitivity,
A Comparative Study of Age Related Macular Degeneration In Relation To SD-OCT...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
:Extraocular foreign bodies (EOFBs) are a common presentation to the emergency
department (ED). Given that inadequate management can result in severe complications including visual
impairment, ED clinicians may be overly cautious and often schedule patient reviews in the ED even
where it is unnecessary, placing a burden on hospital resources.
1) The study assessed the efficacy of half-dose photodynamic therapy (PDT) in treating patients with chronic central serous chorioretinopathy (cCSC) who had subretinal fluid (SRF) accumulation outside the fovea causing visual symptoms.
2) In 47% of patients, PDT led to a reduction in visual symptoms at the first follow-up visit. SRF resolved in 88% of eyes at the first visit and completely resolved in all eyes by the final visit.
3) Choroidal thickness decreased statistically significantly after PDT both under the fovea and at the location of extrafoveal SRF accumulation. No complications from PDT were observed
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
This Journal publishes original research work that contributes significantly to further the scientific knowledge in pharmacy.
This study examined the 1-year results of treating myopic choroidal neovascularization (CNV) with intravitreal bevacizumab injections. Twenty-nine patients received three initial monthly injections, with additional injections for persistent or recurrent CNV. At 1 year, visual acuity improved on average by 2.4 lines from baseline. Twenty-one patients (72.4%) gained over 2 lines of vision. Optical coherence tomography showed a reduction in central foveal thickness following treatment. The study demonstrates the long-term effectiveness of intravitreal bevacizumab for myopic CNV.
Purpose: To evaluate the corneal volume (CV) before and after Ferrara intrastromal corneal ring segments (ICRS) implantation and its influence in clinical outcomes in keratoconus patients.
This study evaluated the long-term safety and efficacy of Ferrara intrastromal corneal ring segments for keratoconus treatment. The records of 36 eyes of 30 patients who received ICRS from 1996-2002 were reviewed. At the 5-year follow-up, uncorrected and corrected visual acuity significantly improved, and keratometry and corneal thickness values significantly decreased. At the 10-year follow-up, these improvements were maintained without significant changes, demonstrating the long-term effectiveness and stability of ICRS for keratoconus. This is the longest reported follow-up of ICRS for keratoconus correction.
PURPOSE: To analyze the long-term corneal endothelial profile after Ferrara ring implan- tation in keratoconus, post-LASIK ectasia and pellucid degeneration eyes.
penetrating ocular trauma,
case series of 60 patient 1 year study,
classification of ocular injury, types & classification of eye injury (BETT Classification ),
investigations
management
Detection of Glaucoma using Optic Disk and Incremental Cup Segmentation from ...theijes
The document presents a new approach for detecting glaucoma using optic disk and incremental cup segmentation from retinal images. It proposes segmenting the optic disk using an automatic parameterized technique and modeling the cup region as enclosing pallor enclosed by vessel bends (r-bends). An incremental cup segmentation method uses 3D spline interpolation to derive the cup boundary considering anatomical knowledge from glaucoma experts. Results are compared to existing methods on different retinal images and show improved cup segmentation, especially in regions without depth cues where inter-observer variability is high. The approach integrates appearance and anatomical information for more accurate glaucoma assessment through optic disk and cup segmentation.
Has AMD management changed these days-DR AJAY DUANIAjayDudani1
This document discusses the evolution of treatments for neovascular age-related macular degeneration (nAMD) over time, from no treatment to anti-VEGF therapies like ranibizumab and aflibercept. It summarizes real-world evidence comparing ranibizumab and aflibercept, showing comparable visual and anatomical outcomes between the two. It also outlines ongoing development of new anti-VEGF treatments like brolucizumab that aim to further improve outcomes for nAMD patients by requiring fewer injections.
Comparative Study of Visual Outcome between Femtosecond Lasik with Excimer La...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Background: Nowadays, ICRS are a step in the treatment of keratoconus. The purpose of this study was to evaluate the refractive effect and the tomographic and biomechanical parameters in keratoconus patients implanted with Ferrara ICRS, and their stability after 18 months.
This meta-analysis evaluated the effectiveness of bevacizumab (Avastin) treatment on corneal neovascularization (NV) based on 7 clinical human studies and 18 animal studies. The results showed that bevacizumab significantly reduced the area of corneal NV in both human and animal studies. Specifically, bevacizumab reduced the neovascularized area in human studies by an average of 36% overall, with 32% reduction for subconjunctival injections and 48% for topical treatment. Bevacizumab also improved best-corrected visual acuity in human studies. In animal studies, bevacizumab significantly reduced the area of corneal NV compared to controls.
This study examined the correlation between central corneal thickness (CCT) and results from Frequency Doubling Technology Perimetry (FDT) in 180 patients aged 40 or older with high intraocular pressure (IOP) but normal optic discs. The average CCT across both eyes was 531 microns. Abnormal FDT results were found in 18 subjects, who had thinner average CCT of 519 microns, compared to 532 microns in 162 subjects with normal FDT results. The study concludes that among patients with high IOP but normal discs, thicker corneas are associated with a lower risk of early glaucomatous damage detected by FDT, compared to patients with thinner corneas.
Optic Disc and Macula Localization from Retinal Optical Coherence Tomography ...IJECEIAES
This research used images from Optical Coherence Tomography (OCT) examination as well as fundus images to localize the optical disc and macular layer of retina. The researchers utilized the OCT and fundus image to interpret the distance between macular center and optic disc in the image. The distance will express the area of macula that can be employed for further research. This distance could recognize the thickness of macula parameters diameter that will be used in localizing process of optic disc and macula. The parameters are the circle radius, the size of window’s filter, the constant value and the size of optic disc element structure as well as the size of macula. The results of this study are expected to improve the accuracy of macula detection that experience the edema.
Multimodal evaluation of macular function in age related macularAbdallah Ellabban
- The study evaluated macular function in eyes with age-related macular degeneration (AMD) using visual acuity testing, microperimetry, and focal macular electroretinography (fmERG).
- Eyes with neovascular AMD showed marked deterioration of macular function on all tests as well as changes in the neurosensory retina.
- Eyes with large drusen only showed minimal retinal changes but decreased retinal sensitivity at the central point on microperimetry testing.
- Eyes with drusenoid pigment epithelial detachment (PED) had preserved retinal structure but significantly increased foveal thickness and decreased visual acuity, fmERG amplitudes, and retinal sensitivity,
A Comparative Study of Age Related Macular Degeneration In Relation To SD-OCT...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
:Extraocular foreign bodies (EOFBs) are a common presentation to the emergency
department (ED). Given that inadequate management can result in severe complications including visual
impairment, ED clinicians may be overly cautious and often schedule patient reviews in the ED even
where it is unnecessary, placing a burden on hospital resources.
1) The study assessed the efficacy of half-dose photodynamic therapy (PDT) in treating patients with chronic central serous chorioretinopathy (cCSC) who had subretinal fluid (SRF) accumulation outside the fovea causing visual symptoms.
2) In 47% of patients, PDT led to a reduction in visual symptoms at the first follow-up visit. SRF resolved in 88% of eyes at the first visit and completely resolved in all eyes by the final visit.
3) Choroidal thickness decreased statistically significantly after PDT both under the fovea and at the location of extrafoveal SRF accumulation. No complications from PDT were observed
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
This Journal publishes original research work that contributes significantly to further the scientific knowledge in pharmacy.
This study examined the 1-year results of treating myopic choroidal neovascularization (CNV) with intravitreal bevacizumab injections. Twenty-nine patients received three initial monthly injections, with additional injections for persistent or recurrent CNV. At 1 year, visual acuity improved on average by 2.4 lines from baseline. Twenty-one patients (72.4%) gained over 2 lines of vision. Optical coherence tomography showed a reduction in central foveal thickness following treatment. The study demonstrates the long-term effectiveness of intravitreal bevacizumab for myopic CNV.
Purpose: To evaluate the corneal volume (CV) before and after Ferrara intrastromal corneal ring segments (ICRS) implantation and its influence in clinical outcomes in keratoconus patients.
This study evaluated the long-term safety and efficacy of Ferrara intrastromal corneal ring segments for keratoconus treatment. The records of 36 eyes of 30 patients who received ICRS from 1996-2002 were reviewed. At the 5-year follow-up, uncorrected and corrected visual acuity significantly improved, and keratometry and corneal thickness values significantly decreased. At the 10-year follow-up, these improvements were maintained without significant changes, demonstrating the long-term effectiveness and stability of ICRS for keratoconus. This is the longest reported follow-up of ICRS for keratoconus correction.
PURPOSE: To analyze the long-term corneal endothelial profile after Ferrara ring implan- tation in keratoconus, post-LASIK ectasia and pellucid degeneration eyes.
penetrating ocular trauma,
case series of 60 patient 1 year study,
classification of ocular injury, types & classification of eye injury (BETT Classification ),
investigations
management
Detection of Glaucoma using Optic Disk and Incremental Cup Segmentation from ...theijes
The document presents a new approach for detecting glaucoma using optic disk and incremental cup segmentation from retinal images. It proposes segmenting the optic disk using an automatic parameterized technique and modeling the cup region as enclosing pallor enclosed by vessel bends (r-bends). An incremental cup segmentation method uses 3D spline interpolation to derive the cup boundary considering anatomical knowledge from glaucoma experts. Results are compared to existing methods on different retinal images and show improved cup segmentation, especially in regions without depth cues where inter-observer variability is high. The approach integrates appearance and anatomical information for more accurate glaucoma assessment through optic disk and cup segmentation.
Has AMD management changed these days-DR AJAY DUANIAjayDudani1
This document discusses the evolution of treatments for neovascular age-related macular degeneration (nAMD) over time, from no treatment to anti-VEGF therapies like ranibizumab and aflibercept. It summarizes real-world evidence comparing ranibizumab and aflibercept, showing comparable visual and anatomical outcomes between the two. It also outlines ongoing development of new anti-VEGF treatments like brolucizumab that aim to further improve outcomes for nAMD patients by requiring fewer injections.
Comparative Study of Visual Outcome between Femtosecond Lasik with Excimer La...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Background: Nowadays, ICRS are a step in the treatment of keratoconus. The purpose of this study was to evaluate the refractive effect and the tomographic and biomechanical parameters in keratoconus patients implanted with Ferrara ICRS, and their stability after 18 months.
This document summarizes minimally invasive glaucoma surgery (MIGS) procedures. MIGS offers more modest intraocular pressure (IOP) lowering than traditional glaucoma surgery, but with a safer risk profile. The document describes various MIGS procedures including the iStent, Hydrus, CyPass, and XEN gel stent. It provides details on the mechanism of action, surgical technique, efficacy and safety data from clinical studies for each procedure. MIGS provides an alternative treatment option for glaucoma patients to lower IOP and reliance on eye drops without the risks of more invasive surgeries.
The document summarizes several studies on angle recession glaucoma following blunt ocular trauma.
The first study found that ultrasound biomicroscopy is useful for detecting angle pathology when the media is hazy. Surgical treatment resulted in more stable and normal intraocular pressure compared to medical treatment alone.
The second study in Bangladesh found that conservative treatment controlled intraocular pressure in most cases, while a small percentage required surgery.
The third study found that trabeculectomy with antimetabolic drugs was most effective for uncontrolled angle recession glaucoma, but carried a higher risk of late bleb infection.
This document contains information about the European Society of Ophthalmology (SOE) Congress held from 8-11 June 2013 in Copenhagen, Denmark. It includes the scientific programme committee members, abstracts from free paper and rapid fire presentations, and electronic poster presentations. The abstracts cover a wide range of topics within ophthalmology including oculoplastics, cataract surgery, uveitis, retina, glaucoma, cornea and external disease, and neuro-ophthalmology. Over 250 abstracts from the congress are included in the document.
Treatment of Diabetic Macular Edema with Aflibercept and Micropulse Laser (DA...haha haha
This clinical trial investigated the safety and efficacy of combining intravitreal aflibercept injections with micropulse laser treatment for diabetic macular edema. Thirty patients were randomized to receive either injections with sham laser (Group 1) or injections with micropulse laser (Group 2). Both groups showed improvements in visual acuity and macular thickness after 48 weeks, with no significant differences between groups. While micropulse laser did not reduce the number of injections needed or further improve outcomes, it also did not cause any adverse effects when combined with anti-VEGF therapy.
Incidence of Glaucoma & Diabetic Retinopathy in Patients with Diabetes Mellit...QUESTJOURNAL
Background: Vision is a means of communication of man with the external world. The impact of visual loss due to various ocular morbidities has profound implications for the person affected and the society as a whole. Diabetes has become one of the world’s most important public health problems & WHO indicate that 19% of world’s diabetic population lives in India. Diabetes related microvascular complications cause visual disability even in younger age group individuals. Aim: To estimate the magnitude of Glaucoma and diabetic retinopathy in diabetic patients in our institution. To create awareness about avoidable blindness in diabetic patients.To enlighten and thereby motivate the patient for further evaluation and follow up. Materials and methods: The study is a hospital- based , non- interventional, cross-sectional study. The ocular disorders are evaluated in 500 consecutive diabetic patients attending ophthalmology out patient department of Kanyakumari medical college hospital. Estimation of visual acuity, slit lamp examination, intraocular pressure, retinoscopy & fundus examination, visual field analysis , gonioscopy are done to detail the defective vision. Result analysis Data is analysed using SPSS. The common manifestations are cataract- 346 (69%), diabetic retinopathy- 94 patients (18.8%), glaucoma– 34 (6.8%). Patients with cataract are well managed by cataract extraction techniques. Prime importance is to create awareness and also diagnose the early changes of retinopathy and glaucoma.Treatment of glaucoma if instituted early will go a long way in preventing avoidable blindness Therefore periodic visual screening along with control of hyperglycemia and associated risk factors is needed to ensure good quality of vision.
Journal of Ophthalmology & Visual Sciences is an open access, peer reviewed, scholarly journal dedicated to publish articles covering all areas of Ophthalmology & Visual Sciences.
The journal aims to promote research communications and provide a forum for doctors, researchers, physicians and healthcare professionals to find most recent advances in all areas of Ophthalmology & Visual Sciences. Journal of Ophthalmology & Visual Sciences accepts original research articles, reviews, mini reviews, case reports and rapid communication covering all aspects of Ophthalmology & Visual Sciences.
Journal of Ophthalmology & Visual Sciences strongly supports the scientific up gradation and fortification in related scientific research community by enhancing access to peer reviewed scientific literary works. Austin Publishing Group also brings universally peer reviewed journals under one roof thereby promoting knowledge sharing, mutual promotion of multidisciplinary science.
Pterygium Excision with Free Conjunctival Limbal Autograftiosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Nepafenac 0.1% in macular thickness in patients who had undergone cataract su...Rama vadapalli
This study evaluated the effect of nepafenac 0.1% on macular thickness in patients who underwent cataract surgery, as determined by OCT. 50 patients were given standard care only, while 50 received standard care plus nepafenac. OCT scans on postoperative day 1 and at 4 weeks found less macular thickening at 4 weeks in the nepafenac group. No patients using nepafenac developed cystoid macular edema, suggesting nepafenac is effective in preventing postoperative cystoid macular edema.
- An article describes what is the impact of refractive error on a layer of retina ( nerve fiber layer) in myopic subjects, Download its full text from Isra Medical Journal.
Objective: To evaluate myopic impact on thickness of nerve fiber layer of the retina in healthy myopic subjects.
Study Design: Prospective Observational study.
Place and Duration: Investigative Department of Ophthalmology of Al-Ibrahim Eye Hospital, Karachi from 1st May 2018 to 30th October 2018.
Methodology: In this study 80 eyes of myopic subjects (SE -0.5 to -11.0 DS) were enrolled. Each eye underwent through comprehensive ocular examination beginning with visual acuity, refraction, fundoscopy by slit lamp and ending up to optical coherence tomography of Nidek. Mean average peripapillary thickness of nerve fiber layer and thickness in superior, inferior, nasal and temporal quadrants was taken into consideration, calculated by Spectral Domain Optical Coherence Tomography (version 1.5.5.0).
Results: Forty subjects volunteered for study protocol among which 21 were male and 19 were female with a degree of refractive breakdown of 30% mild myopic, 50% moderately myopic and 20% highly myopic. The calculated average age was 25.0 ± 5.0 years (range 16-40 years). The average total nerve fiber layer thickness in myopic respondents was 90.85μm; superiorly 112.37μm; inferiorly 117.52μm; temporally 71.85μm and in nasal quadrant was 61.55μm. Retinal nerve fiber layer thickness was statistically significant in superior and temporal quadrant. In high myopes thickness was clinically significant in inferior quadrant in terms of quantity as compared to mild and moderate myopia
Conclusion: Average retinal nerve fiber layer thickness was significantly decreased in high myopia as compared to mild myopia while moderate group had slightly thicker thickness than high myopic group. Hence impact of dioptric power on nerve fiber layer thickness in myopic patients is significant.
HISTORY
History regarding duration of diabetes, pastglycemic control (hemoglobin A1c), Medications used (especially insulin, oral hypoglycemics, antihypertensives, and lipid-lowering drugs), systemic history (e.g., renal disease, cardiovascular events, systemic hypertension, serum lipid levels, pregnancy)(Konno et al.,2001).
History related to drugs causing macularedema (Thiazolidinediones, fingolimod (used inMS), tamoxifen, taxanes, niacin, interferons and prostaglandin analogs).Ocular examination
Detailed patient assessment and diagnosis should include a complete ophthalmic examination, including visual acuity (preferably by a ETDRS/Log MARchart) INVESTIGATIONS OCT
All patients with DME should undergo OCT (Both Raster and radial scans). Retinal thickening (Central subfield and inner ETDRS ring thickness measurement), presence of vitreomacular adhesion or traction and morphological characteristics like presence of neurosensory detachment, cystic spaces, foveal contour should be noted(Massin et al.,2001).
The features suggestive of prognosis-like horizontal and vertical extent of IS-OS disruption, ELM disruption and hyper reflective foci (HFs)within the neurosensory retina should be noted. In the presence of gross cystoids macular edema, often it is difficult to assess these features.
Reduction in visual acuity in association with diabetic retinopathy commonly occurs from diabetic macular edema. Traditional methods of assessing DME include contact and non-contact slit-lamp biomicroscopy, indirect funduscopy, fluoresce in angiography and fundus streo-photography. However, given the relative deprival of ability of these methods to detect and to quantify DME, alternative objective methods have been applied. The introduction of OCT allows an objective evaluation of DME with effectiveness in both qualitative and quantitative description of this pathology. That is why it becomes a standard tool in the management of patients with DME .More than ten years after ETDRS, OCT greatly enhanced our ability to detect and analyse macular thickening and has brought new insights on the morphology of DME and on the presence of vitreo-retinal interface abnormalities.
Corneal Endothelial Cell Density Loss after Glaucoma Surgery Alone or in Comb...MahendraMNurmawan
This systematic review analyzed 39 studies on corneal endothelial cell density (ECD) loss after various glaucoma surgeries. The review found:
- Suprachoroidal microinvasive glaucoma surgery resulted in a mean ECD loss of 282 cells/mm2 at 12 months, while Schlemm's canal procedures without implants led to 64 cells/mm2 loss.
- Glaucoma drainage implants were associated with greater ECD loss than trabeculectomy or Schlemm's canal procedures without implants. Express implants led to 121 cells/mm2 loss at 12 months.
- There is low certainty that glaucoma surgeries involving long-term implants cause greater ECD loss than procedures without implants.
Profile of secondary glaucoma cases in a tertiary eye care centre.iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
This study compared outcomes of four surgical techniques for treating large macular holes: inserted flap, classic inverted flap, free flap, and temporal inverted flap. 36 eyes were divided among the four groups. Post-operatively, mean visual acuity improved in all groups except inserted flap at 1 and 3 months. Macular hole closure rates ranged from 87.5-100% with no significant differences. While all techniques achieved closure, the inserted flap was found to potentially compromise outer retinal layer integrity and functional results despite closure. The classic, free, and temporal flap techniques provided comparable good functional and anatomical outcomes.
1) The study evaluated the efficacy and safety of topical tacrolimus 0.03% eyedrops in treating dry eye associated with graft versus host disease in patients resistant to cyclosporine.
2) 14 patients were treated with tacrolimus eyedrops once daily for a minimum of 3 months. Various tests were conducted to evaluate dry eye symptoms and signs.
3) 71% of patients showed significant improvement based on test results. Tacrolimus improved Schirmer test, meniscometry, tear break-up time, and reduced artificial tear use. Some patients experienced local intolerance.
1) Trabeculectomy is the most common glaucoma surgery but scarring can lead to bleb failure. OloGen collagen implant may help control wound healing to maintain drainage.
2) This study compares outcomes of trabeculectomy with and without OloGen implant in 60 eyes over 6 months. Success rates and complications were similar between groups with no significant differences.
3) While OloGen did not provide clear advantages in this pilot study, larger trials with longer follow up are needed to fully evaluate its safety and efficacy in trabeculectomy.
Resultados preliminares do implante de um novo anel associado ao PRK para pre...Ferrara Ophthalmics
Dr. Sandro Coscarelli, Dr. Pablo Rodrigues, Dr. Guilherme Rocha e Dr. Leonardo Torquetti compilaram e compartilham seus resultados com o uso de Segmentos de Anel de Ferrara HM associado ao PRK para a correção da miopia de pacientes com corneas finas e contra indicados para as técnicas de Excimer Laser apenas.
Similar to Topical dorzolamide for macular edema in the early phase after vitrectomy and epiretinal membrane removal (20)
This study compared the daytime efficacy and safety of two glaucoma medications: latanoprost 0.005%/timolol maleate 0.5% given once daily vs dorzolamide 2%/timolol maleate 0.5% given twice daily. In 33 patients, the mean daytime intraocular pressure was not statistically different between the two medications. Both medications were well tolerated, though latanoprost/timolol caused more conjunctival redness and dorzolamide/timolol caused more reports of bitter taste. This study suggests the two fixed-combination medications have similar efficacy in lowering intraocular pressure over the day.
Comparison of latanoprost, bimatoprost and travoprostAvaleks-Kiev
This study compared the 24-hour intraocular pressure (IOP) lowering effects of latanoprost, travoprost, and bimatoprost in 45 patients with exfoliation syndrome and ocular hypertension over 3 months. All 3 drugs significantly lowered IOP from baseline at all time points measured. At 1 week, travoprost lowered IOP more than latanoprost and bimatoprost. By 3 months, bimatoprost lowered IOP more than travoprost, while travoprost produced the lowest mean 24-hour IOP range, significantly lower than latanoprost and bimatoprost. The study suggests travoprost may provide better 24-hour I
http://ophthalmolog.kiev.ua/
ВСЕУКРАИНСКИЙ АЛЬЯНС ОФТАЛЬМОЛОГОВ
Цель исследования: оценить эффективность применения глазных капель на основе гиалуроновой кислоты и экстракта календулы (Окухил С) в лечении син- дрома сухого глаза (ССГ) у пациентов после факоэмульсификации ката- ракты с имплантацией интраокулярной линзы (ФЭК + ИОЛ).
This document summarizes a report on the prevalence, incidence, and healthcare needs related to retinal diseases in Europe. Key points include:
- Age-related macular degeneration (AMD) currently affects around 34 million people in the European Union and is expected to increase by 25% by 2050 due to aging populations.
- Diabetic eye disease (DED) currently affects nearly 4 million people in the EU, and this number is also expected to rise significantly due to increased diabetes rates. Nearly 1 million people require treatment for severe DED.
- Over 1 million Europeans have retinal vein occlusions.
- Retinal diseases already cause most blindness and severe vision loss in Europe and these problems will increase dramatically if
Фармакокинетика дорзоламида и бринзоламида в тканях глаза после однократного ...Avaleks-Kiev
This study compared the ocular pharmacokinetics of dorzolamide and brinzolamide, two carbonic anhydrase inhibitor drugs used to treat glaucoma, in rabbits. After both single and multiple doses, dorzolamide achieved higher concentrations than brinzolamide in ocular tissues like the retina, vitreous humor, and optic nerve. Specifically, dorzolamide levels were 1.4 to 9 times higher than brinzolamide levels in various tissues after a single dose. After multiple doses over weeks, dorzolamide levels remained higher in several tissues, though the difference was only statistically significant for the aqueous humor, vitreous humor, and optic nerve.
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central19various
Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central Clinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa CentralClinic ^%[+27633867063*Abortion Pills For Sale In Tembisa Central
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
One health condition that is becoming more common day by day is diabetes.
According to research conducted by the National Family Health Survey of India, diabetic cases show a projection which might increase to 10.4% by 2030.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
2. Clinical Ophthalmology 2013:7
nutritional and metabolic diseases, as well as after surgery.
Recently, clinical interest has focused on retinal disorders
as an indication for this drug. Since the first report by Cox
in 1988,8
several authors have described a positive effect
of acetazolamide on the resolution of macular edema from
various etiologies, including uveitis and postoperative inflam-
mation after cataract extraction,9
retinitis pigmentosa,10
and
serpiginous choroiditis,11
and in conjunction with epiretinal
membrane.12
Findings on optical coherence tomography
and improvement in visual acuity have demonstrated that
dorzolamide has a curative effect on the macular cystic
cavities found in congenital X-linked retinoschisis,13
chor-
oideremia,14
and retinitis pigmentosa.15
The pathogenesis of
macular edema often involves a multifactorial background.
We have reported that dorzolamide had an anti-inflammatory
effect in a comparative study of eye drops in the treatment
of glaucoma.16
In that research, we studied the efficacy of
dorzolamide in the treatment of macular edema and inflam-
mation, based on our experience of administration of dorzo-
lamide eye drops to treat ocular hypertension after vitreous
surgery.To study the efficacy of a drug for macular edema, an
ideal subject should have macular edema that results from a
single cause, and the cause should be removed. In this study,
we chose patients who underwent vitrectomy and removal
of epiretinal membrane. The purpose of this study was to
determine the efficacy and safety of topical dorzolamide for
treating macular edema.
Materials and methods
Forty patients with macular edema following removal of
epiretinal membrane and who fulfilled the criteria for this
study were enrolled. Any patients with pre-existing ocular
disease (glaucoma, high myopia, chronic inflammatory, or
neoplastic disorders), a systemic disorder (eg, diabetes or
uncontrolledhypertension),oraknownlife-threateningdisease
were excluded prior to enrolment.The study was approved by
the institutional review board at our institution. Patients were
informed of the purpose of our study and provided their signed
consent to participate. This study prospectively evaluated the
primary outcomes of visual acuity, intraocular pressure, central
macular thickness, and aqueous flare. The surgical technique
used was 23-gauge pars plana vitrectomy. All patients under-
went phacoemulsification and polyacrylic intraocular lens
implantation (AN6K, Kowa, Tokyo, Japan). A vitrectomy
was done with prior application of triamcinolone acetonide
(Kenacort-A®
, Bristol Pharmaceuticals, Tokyo, Japan). In all
eyes, the posterior hyaloid membrane was separated from the
retinal surface with suction from the vitreous cutter. In the
present study, the epiretinal membrane was removed using
microforceps intraoperatively, but intentional removal of the
internal limiting membrane was not performed in all cases.
However, we could not exclude accidental removal of the
internallimitingmembraneduringsurgery.Postoperativetreat-
ment consisted of levofloxacin 0.5%, dexamethasone 0.02%,
and diclofenac 0.1% eye drops applied topically three times
daily for 1 month and oral cefcapene pivoxil hydrochloride
75 mg or 100 mg three times daily for 5 days, in all cases,
in both groups. Twenty patients were randomly assigned in a
prospective manner to receive dorzolamide three times a day.
To evaluate the effects of treatment, all patients underwent a
detailed ophthalmic examination, including slit-lamp biomi-
croscopy, optical coherence tomography, and a laser flare cell
meter test (FC-2000, Kowa). Foveal configuration and retinal
thickness were determined by optical coherence tomography,
and retinal thickness was defined as the distance between the
vitreoretinal interface and the retinal pigment epithelium in
the center of the fovea. Aqueous flare was evaluated using a
slit-lamp as well as a laser flare cell photometer, as described
in detail in previous studies.17,18
Calibration was performed
each day according to the manufacturer’s instructions, to
ensure accurate measurements. Measurements were taken in
a standardized fashion by the same experienced technician
who was blinded as to the medical condition of the patients.
From each eye, three individual measurements were averaged,
and measurements contaminated by artifacts were discarded.
Flare reading was expressed as photon counts per millisecond
(pc/ms). Best-corrected visual acuity was examined using the
decimal visual acuity system in 40 eyes, which was converted
to the logarithm of the minimum angle of resolution (logMAR)
scale. Goldmann tonometry was used to determine intraocular
pressure. Safety was evaluated by determining the incidence
of treatment-related complications and adverse reactions for
both the treatment and control groups.The differences between
the treatment group and the control group were assessed for
statistical significance using the Student’s t-test when appro-
priate. A level of P , 0.05 was accepted as being statistically
significant.
Results
Mean logMAR best corrected visual acuity preoperatively,
and at 2 weeks, 1 month, and 3 months after surgery was
0.48 ± 0.23, 0.60 ± 0.16, 0.40 ± 0.29, and 0.24 ± 0.32, respec-
tively, in the treatment group, and 0.40 ± 0.09, 0.44 ± 0.12,
0.32 ± 0.10, and 0.16 ± 0.09, respectively, in the control
group. No statistically significant difference between the
two groups was observed (Figure 1). The difference in mean
submit your manuscript | www.dovepress.com
Dovepress
Dovepress
550
Suzuki et al
3. Clinical Ophthalmology 2013:7
intraocular pressure preoperatively, and at 2 weeks, 1 month,
and 3 months after surgery between the treatment group and
the control group was not statistically significant. Intraocular
pressure never exceeded 21 mmHg (Figure 2). Mean central
macular thickness preoperatively and at 2 weeks, and 3 months
after surgery was 572.6, 427.2, and 333.4 µm, respectively,
in the treatment group, and 571.4, 485.2, and 388.4 µm,
respectively, in the control group. No statistically significant
difference between the two groups was observed, except that
the difference in mean central macular thickness at 1 month
after surgery was statistically significant (P , 0.05, see Fig-
ures 3 and 4) between the treatment group (358.8 µm) and
the control group (467.8 µm).
Mean aqueous flare preoperatively and at 1 month, and
3 months after surgery was 8.6, 34.2, and 23.5 pc/ms, respec-
tively, in the treatment group, and 9.7, 24.7, and 23.4 pc/ms,
respectively, in the control group. No statistically significant
difference was observed between the two groups, but the dif-
ference in mean aqueous flare at 2 weeks after surgery was
statistically significant (P , 0.05) between the treatment
group (36.8 pc/ms) and the control group (64.0 pc/ms, see
Figure 5). Patients were monitored for any possible adverse
effects that could be attributed to the drugs throughout the
study. No significant systemic or ocular complications or
adverse events occurred during the study.
Discussion
Epiretinal membrane traction is believed to stimulate inflam-
mation, exudates, and a leukocyte response in the macula,
leading to macular edema.The efficacy of anti-inflammatory
agents, including triamcinolone acetonide and topical
nonsteroidal anti-inflammatories, has been demonstrated
0.8
1
BCVA(logMAR)
: Dorzolamide (+)
: Dorzolamide (−)
Before
vitrectomy
2 W after
vitrectomy
1 M after
vitrectomy
3 M after
vitrectomy
0.6
0.4
0.2
−0.2
0
Figure 1 The mean logMAR best-corrected visual acuity preoperatively and at
2 weeks (W), and 1 and 3 months (M) after surgery was not significantly different
between the treatment and control groups.
Abbreviations: BCVA, best corrected visual acuity; logMAR, logarithm of the
minimum angle of resolution.
Before
vitrectomy
: Dorzolamide (+)
: Dorzolamide (−)
2 W after
vitrectomy
Intraocularpressure(mmHg)
3 M after
vitrectomy
1 M after
vitrectomy
25
20
15
10
5
0
Figure 2 The mean intraocular pressure preoperatively and at 2 weeks (W), and 1
and 3 months (M) after surgery was not significantly different between the treatment
and control groups, and intraocular pressure never exceeded 21 mmHg.
Figure 3 Fundus photography (A and B), and horizontal optical coherence
tomography (OCT) macular scans (a and b) before and 1 month after vitrectomy
and removal of epiretinal membrane (nontreatment). Fundus photography (C
and D), and horizontal OCT macular scans (c and d) before and 1 month after
vitrectomy and removal of epiretinal membrane (dorzolamide treatment).
Note: White lines indicate central macular thickness.
Abbreviation: OCT, optical coherence tomography.
in several studies, both for the prevention and treatment of
inflammatory macular edema.19
We have previously reported
that dorzolamide suppresses production of the proinflam-
matory cytokine, interleukin-6, which is a major participant
in the inflammatory process.16
It has been reported that
in patients with rheumatoid arthritis already on 25 mg/
submit your manuscript | www.dovepress.com
Dovepress
Dovepress
551
Topical dorzolamide for macular edema
4. Clinical Ophthalmology 2013:7
macular edema with epiretinal membrane. Epiretinal mem-
branes are not usually associated with changes in the retinal
pigment epithelium, so carbonic anhydrase inhibitors may
act little through facilitation of transport across the retinal
pigment epithelium. In addition, use of a topical carbonic
anhydrase inhibitor decreases the risk of the well known
systemic side effects of oral carbonic anhydrase inhibitor
preparations.21
Our study demonstrates that topical dorzolamide may
reduce central macular thickness and aqueous flare in the early
period following vitrectomy.Although further investigation of
more cases is needed, this study suggests that topical dorzo-
lamide can be efficacious in reducing macular edema during
the early period following vitrectomy via its anti-inflammatory
effects.
Disclosure
The authors report no conflicts of interest in this work.
References
1. Fine S, Brucker AJ. Macular edema and cystoid macular edema. Am J
Ophthalmol. 1981;92:466–481.
2. Yanoff M, Fine S, Brucker AJ, Eagle RC, Jr. Pathology of human
cystoid macular edema. Surv Ophthalmol. 1984;28 Suppl:505–511.
3. Gass JMD, Anderson DR, Davis EB. A clinical, fluorescein angio-
graphic, and electron microscopic correlation of cystoids macular
edema. Am J Ophthalmol. 1985;100:82–85.
4. Bresnick GH. Diabetic maculopathy. A critical review highlighting
diffuse macular edema. Ophthalmology. 1983;90:1301–1317.
5. Bird AC. Retinal edema. Introduction to the first international cystoid
macular edema symposium. Surv Ophthalmol. 1984;28 Suppl:433–436.
6. Tso MOM. Pathology of cystoid macular edema. Ophthalmology.
1982;89:902–915.
7. Schepens CL, Avila MP, Jalkh AE, Trempe CL. Role of the vitreous in
cystoid macular edema. Surv Ophthalmol. 1984;28 Suppl:499–504.
8. Cox SN, Hay E, Bird AC. Treatment of chronic macular edema with
acetazolamide. Arch Ophthalmol. 1988;106:1190–1195.
9. Farber MD, Lam S, Tessler HH, Jennings TJ, Cross A, Rusin MM.
Reduction of macular edema by acetazolamide in patients with
chronic iridocyclitis: a randomized prospective crossover study. Br J
Ophthalmol. 1994;78:4–7.
10. Fishman GA, Gilbert LD. Acetazolamide for treatment of chronic
macular edema in retinitis pigmentosa. Arch Ophthalmol. 1989;107:
1445–1452.
11. Chen JC, Fitzke FW, Bird AC. Long-term effect of acetazolamide in
a patient with retinitis pigmentosa. Invest OphthalmolVis Sci. 1990;31:
1914–1918.
12. Marmor MF. Hypothesis concerning carbonic anhydrase treatment
of cystoid macular edema: example with epiretinal membrane. Arch
Ophthalmol. 1990;108:1524–1525.
13. Apushkin MA, Fishman GA. Use of dorzolamide for patients with
X-linked retinoschisis. Retina. 2006;26:741–745.
14. Genead MA, McAnany JJ, Fishman GA.Topical dorzolamide for treat-
ment of cystoid macular edema in patients with choroideremia. Retina.
2012;32:826–833.
15. Ikeda Y, Hisatomi T, Yoshida N, et al. The clinical efficacy of a
topical dorzolamide in the management of cystoid macular edema in
patients with retinitis pigmentosa. Graefes Arch Clin Exp Ophthalmol.
2012;250:809–814.
CMT(µm)
650
600
550
500
450
400
350
300
Before
vitrectomy
2 W after
vitrectomy
1 M after
vitrectomy
3 M after
vitrectomy
*
: Dorzolamide (+)
: Dorzolamide (−)
Figure 4 Mean CMT preoperatively and at 2 weeks (W), and 1 and 3 months (M)
after surgery was not significantly different between the treatment and control
groups, but the difference was statistically significant 1 month after surgery.
Note: *Significant at P , 0.05.
Abbreviation: CMT, central macular thickness.
Before
vitrectomy
: Dorzolamide (+)
: Dorzolamide (−)
3 M after
vitrectomy
1 M after
vitrectomy
2 W after
vitrectomy
*
Flarevalue(pc/ms)
90
80
70
60
50
40
30
20
10
0
Figure 5 Mean aqueous flare preoperatively and at 2 weeks (W), and 1 and
3 months (M) after surgery was not significantly different between the treatment
and control groups.
Notes: Mean aqueous flare at 2 weeks after surgery between the treatment group
and the control group was statistically significant. *Significant at P , 0.05.
day of oral prednisone and 20 mg/week of intramuscular
methotrexate, addition of tocilizumab, an anti-interleukin-6
receptor antibody, improved the acute-phase response
(erythrocyte sedimentation rate and C-reactive protein) after
3 months of treatment.20
In the present study, dorzolamide
reduced aqueous flare at 2 weeks after surgery. Topical dor-
zolamide may suppress postsurgical inflammation, and it has
been reported that subretinal fluid is removed by inhibition
of membrane-bound carbonic anhydrase IV in the retinal
pigment epithelium.
However, it has also been reported that the response to
carbonic anhydrase inhibitor therapy is better in patients
with diffuse retinal pigment epithelial disease than in those
with overt retinal vascular disease, such as diabetes or retinal
vein occlusion.21
In this study, we chose patients who had
submit your manuscript | www.dovepress.com
Dovepress
Dovepress
552
Suzuki et al
5. Clinical Ophthalmology
Publish your work in this journal
Submit your manuscript here: http://www.dovepress.com/clinical-ophthalmology-journal
Clinical Ophthalmology is an international, peer-reviewed journal
covering all subspecialties within ophthalmology. Key topics include:
Optometry; Visual science; Pharmacology and drug therapy in eye
diseases; Basic Sciences; Primary and Secondary eye care; Patient
Safety and Quality of Care Improvements. This journal is indexed on
PubMed Central and CAS, and is the official journal of The Society of
Clinical Ophthalmology (SCO). The manuscript management system
is completely online and includes a very quick and fair peer-review
system, which is all easy to use. Visit http://www.dovepress.com/
testimonials.php to read real quotes from published authors.
Clinical Ophthalmology 2013:7
16. Kawai K, Ohashi H, Suzuki T, Kitagaki H, Fujisawa S. ヒトおよびマ
ウス末梢血単核球の炎症性サイトカイン産生に及ぼす緑内障治
療薬の作用. [Effect of anti-glaucoma drugs on inflammatory cytokine
production by human and murine peripheral blood mononuclear cells.]
Nippon Ganka Gakkai Zasshi. 2010;114:669–677. Japanese.
17. Yang P, Fang W, Jin H, et al. Clinical features of Chinese patients with
Fuchs’ syndrome. Ophthalmology. 2006;113:473–480.
18. Ladas JG, Wheeler NC, Morhun PJ, et al. Laser flare-cell photometry:
methodology and clinical applications. Surv Ophthalmol.
2005;50:27–47.
19. Wolfensberger TJ, Herbort CP. Treatment of cystoid macular edema
with non-steroidal anti-inflammatory drugs and corticosteroids. Doc
Ophthalmol. 1999;97:381–386.
20. Savino S, Daniela R, Dario R. Interleukin 6 blockade as steroid-sparing
treatment for 2 patients with giant cell arteritis. J Rheumatol. 2011;38:
2080–2081.
21. Wolfensberger TJ. The role of carbonic anhydrase inhibitors in the
management of macular edema. Doc Ophthalmol. 1999;97:387–397.
submit your manuscript | www.dovepress.com
Dovepress
Dovepress
Dovepress
553
Topical dorzolamide for macular edema