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Shaheen AR, Ashkenazy N, Iyer PG, Flynn HW, Sridhar J, Yannuzzi NA. NATIONWIDE DEMOGRAPHIC DISPARITIES IN UNITED STATES EMERGENCY DEPARTMENT VISITS IN PATIENTS WITH RHEGMATOGENOUS RETINAL DETACHMENT. Retina 2023; 43:1936-1944. [PMID: 37870908 DOI: 10.1097/iae.0000000000003897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
BACKGROUND/PURPOSE Within the evolving landscape of healthcare in the United States (US), delineating the demographic nuances and financial implications of emergent conditions, such as rhegmatogenous retinal detachment (RRD), is paramount. This study seeks to analyze the demographic and hospital billing amount/cost of service disparities in RRD visits to emergency departments (EDs) nationwide. METHODS We conducted a retrospective, cross-sectional, population-based study using International Classification of Diseases, 10th revision , and Current Procedural Terminology codes in the 2016 to 2019 Nationwide Emergency Department Sample databases to identify RRD visits. The analysis included demographics, hospital billing amount, and cost of service of RRD ED management. RESULTS A total of 12,492 RRD encounters were identified with men constituting 64% and a prominent age group being 50 to 64 years (49.3%). Most patients (90%) were managed in metropolitan teaching hospitals, predominantly in the southern U.S. region (56.1%). Private insurance covered 45% of patients. Same-day RRD repair odds increased in November and December. Whites had a higher likelihood for same-day treatment. Hospital billing amount rose from $23,600 in 2016 to $30,354 in 2019, with stable mean total cost of service. Rhegmatogenous retinal detachment ED visit incidence did not show seasonal variation ( P = 0.819). CONCLUSION Most patients with RRD in U.S, EDs were middle-aged men, with Whites more likely to receive same-day repair. There was no sex bias observed in same-day repair decision-making. Although hospital billing amount increased over the study period, total cost of service remained stable. The incidence of RRD ED visits showed no seasonal variation.
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Affiliation(s)
- Abdulla R Shaheen
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Noy Ashkenazy
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas; and
| | - Prashanth G Iyer
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
- Department of Ophthalmology, Tufts Medical Center, Boston, Massachusetts
| | - Harry W Flynn
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Jayanth Sridhar
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Nicolas A Yannuzzi
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
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Moghadas Sharif N, Hoseini-Yazdi H, Daneshvar R, Radhakrishnan H, Shoeibi N, Ehsaei A, Collins MJ. Seasonal variations in anterior segment angle parameters in myopes and emmetropes. Clin Exp Optom 2023:1-7. [PMID: 37751623 DOI: 10.1080/08164622.2023.2251478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 04/17/2023] [Indexed: 09/28/2023] Open
Abstract
CLINICAL RELEVANCE Seasonal variations are known to occur in a range of ocular parameters and in conditions including refractive error and glaucoma. It is of clinical importance to know if seasonal changes also occur in anterior segment angle parameters, given that they can influence these conditions. BACKGROUND The study aimed to examine the seasonal variations in anterior segment angle parameters in healthy young adults. METHODS Twenty-three emmetropic participants with a mean age of 26.17 ± 4.43 years and 22 myopic participants with a mean age of 27.27 ± 4.47 years completed four seasons of data collection. Anterior segment angle parameters were measured using swept-source anterior segment optical coherence tomography. Intraocular pressure (IOP) and objective refraction were also measured. Repeated-measures analysis of variance was used to determine the effect of season and refractive error on the various ocular parameters. RESULTS A significant main effect of season was found for the majority of anterior segment angle parameters, including the angle opening distance at 500 and 750 µm from the scleral spur (p = 0.02, p = 0.006, respectively), angle recess area at 500 and 750 µm from the scleral spur (both p = 0.002), and trabecular iris space area at 500 and 750 µm from the scleral (p = 0.02, p = 0.008, respectively). However, measures of anterior chamber depth and trabecular iris angle did not exhibit statistically significant seasonal variations (all p > 0.05). A significant main effect of season was also found for the changes in IOP (p = 0.004) and objective refraction (p < 0.001). There was no season by refractive group interaction for any anterior segment angle parameter or IOP (all p > 0.05). CONCLUSION There is a small but significant seasonal changes in the anterior segment angle parameters, refractive error, and IOP in healthy young adult males, in which the anterior segment angle dimensions are narrower, the IOP is higher, and the refraction is more myopic during winter.
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Affiliation(s)
- Nasrin Moghadas Sharif
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Optometry and Visual Science, University of London, London, UK
| | - Hosein Hoseini-Yazdi
- Contact Lens and Visual Optics Laboratory, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Ramin Daneshvar
- Eye Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Ophthalmology, University of Florida, Gainesville, FL, USA
| | | | - Nasser Shoeibi
- Eye Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Asieh Ehsaei
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Optometry and Visual Science, University of London, London, UK
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, Queensland University of Technology, Brisbane, Queensland, Australia
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Driban M, Chhablani J. Clinical findings in acute posterior vitreous detachment. Graefes Arch Clin Exp Ophthalmol 2022; 260:3465-3469. [PMID: 35622141 DOI: 10.1007/s00417-022-05708-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/13/2022] [Accepted: 05/06/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To analyze the typical presentation of acute posterior vitreous detachment (PVD), including demographics and prevalence of various treatable findings in the same and fellow eye. METHODS Retrospective analysis of medical records from 2346 patients with acute PVD. Descriptive statistics were generated on age, sex, contact date, visual acuity, and slit lamp, and fundoscopy findings. Multivariate regressions were used to generate odds ratios with 95% confidence intervals (CI) to quantify associations between variables. RESULTS A total of 4692 eyes from 2346 patients were analyzed. Most patients were female (60.5%) with an average age of 62.8 years old. Overall, 605 patients (25.8%) had any additional ocular finding on fundus exam, including pigmentation (N = 184, 7.8%), lattice degeneration (N = 158, 6.7%), tear (N = 131, 5.6%), and hole (N = 131, 5.2%). Unilateral retinal detachment was present in 26 patients (1.1%), and these patients demonstrated a similar rate (26.9%) of additional ocular findings compared to the entire sample size. Female sex (OR 1.21, 95% CI 1.03-1.43, p = 0.020) was independently associated with presentation during spring or summer. CONCLUSION Acute PVD is associated with a number of risk factors and peripheral lesions. These findings may be useful in treating and predicting the course and development of PVD.
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Affiliation(s)
- Matthew Driban
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
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Echevarría-Lucas L, Senciales-González JM, Medialdea-Hurtado ME, Rodrigo-Comino J. Impact of Climate Change on Eye Diseases and Associated Economical Costs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137197. [PMID: 34281132 PMCID: PMC8297364 DOI: 10.3390/ijerph18137197] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/25/2021] [Accepted: 07/02/2021] [Indexed: 01/22/2023]
Abstract
Climate change generates negative impacts on human health. However, little is known about specific impacts on eye diseases, especially in arid and semi-arid areas where increases in air temperatures are expected. Therefore, the main goals of this research are: (i) to highlight the association between common eye diseases and environmental factors; and (ii) to analyze, through the available literature, the health expenditure involved in combating these diseases and the savings from mitigating the environmental factors that aggravate them. Mixed methods were used to assess the cross-variables (environmental factors, eye diseases, health costs). Considering Southern Spain as an example, our results showed that areas with similar climatic conditions could increase eye diseases due to a sustained increase in temperatures and torrential rains, among other factors. We highlight that an increase in eye diseases in Southern Spain is conditioned by the effects of climate change by up to 36.5%; the economic burden of the main eye diseases, extrapolated to the rest of the country, would represent an annual burden of 0.7% of Spain’s Gross Domestic Product. In conclusion, the increase in eye diseases has a strong economic and social impact that could be reduced with proper management of the effects of climate change. We propose a new concept: disease sink, defined as any climate change mitigation action which reduces the incidence or morbidity of disease.
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Affiliation(s)
- Lucía Echevarría-Lucas
- Ophthalmology Service of Axarquía Hospital, 29700 Vélez-Málaga, Spain; (L.E.-L.); (M.E.M.-H.)
| | | | | | - Jesús Rodrigo-Comino
- Department of Regional Geographical Analysis and Physical Geography, University of Granada, 18010 Granada, Spain
- Department of Physical Geography, University of Trier, 54296 Trier, Germany
- Correspondence:
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Ben Ghezala I, Mariet AS, Benzenine E, Gabrielle PH, Baudin F, Bron AM, Quantin C, Creuzot-Garcher CP. Incidence of rhegmatogenous retinal detachment in France from 2010 to 2016: seasonal and geographical variations. Br J Ophthalmol 2021; 106:1093-1097. [PMID: 33658231 DOI: 10.1136/bjophthalmol-2020-318457] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/28/2021] [Accepted: 02/17/2021] [Indexed: 11/03/2022]
Abstract
AIMS To investigate the annual and monthly hospital incidence rate of rhegmatogenous retinal detachments (RRDs) from 2010 to 2016 in France at the national and regional levels. METHODS In this nationwide database study, we identified hospital and clinic admissions of French residents for a first episode of RRD in France during 2010-2016 from the national administrative database. The annual and monthly hospital incidence rates of RRD per 100 000 population were calculated for the whole country and for each region. RESULTS The average annual national hospital incidence rate of RRD was 21.97±1.04 per 100 000 population. The annual national hospital incidence rate of RRD was the lowest in 2010 (20.91 per 100 000 population) after which it increased until 2015 (23.55 per 100 000 population). The average monthly national RRD hospital incidence rate was the highest in June (2.03±0.12 per 100 000 population) and the lowest in August (1.60±0.09). The average annual age-standardised and sex-standardised regional hospital incidence rate was the highest in Guadeloupe and Pays de la Loire (28.30±2.74 and 26.13±0.84 per 100 000 population, respectively) and the lowest in French Guiana and Martinique (15.51±3.50 and 17.29±2.12 per 100 000 population, respectively). CONCLUSIONS The average annual national hospital incidence rate of RRD increased from 2010 to 2015. The hospital incidence rate of RRD seemed to vary according to season and geographical location.
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Affiliation(s)
- Inès Ben Ghezala
- Ophthalmology Department, Dijon University Hospital, Dijon, France
| | - Anne Sophie Mariet
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, Bourgogne Franche-Comté University, Dijon, France.,INSERM, CIC 1432, Dijon, France.,Clinical Epidemiology/Clinical Trials Unit, Clinical Investigation Center, Dijon University Hospital, Dijon, France
| | - Eric Benzenine
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, Bourgogne Franche-Comté University, Dijon, France
| | - Pierre-Henry Gabrielle
- Ophthalmology Department, Dijon University Hospital, Dijon, France.,Eye and Nutrition Research Group, Centre des Sciences du Goût et de l'Alimentation, UMR1324, INRAE, 6265 CNRS, Dijon, France
| | - Florian Baudin
- Ophthalmology Department, Dijon University Hospital, Dijon, France
| | - Alain M Bron
- Ophthalmology Department, Dijon University Hospital, Dijon, France.,Eye and Nutrition Research Group, Centre des Sciences du Goût et de l'Alimentation, UMR1324, INRAE, 6265 CNRS, Dijon, France
| | - Catherine Quantin
- Biostatistics and Bioinformatics (DIM), Dijon University Hospital, Bourgogne Franche-Comté University, Dijon, France.,INSERM, CIC 1432, Dijon, France.,Clinical Epidemiology/Clinical Trials Unit, Clinical Investigation Center, Dijon University Hospital, Dijon, France.,Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Institut Pasteur, Université Paris-Saclay, Paris, France
| | - Catherine P Creuzot-Garcher
- Ophthalmology Department, Dijon University Hospital, Dijon, France.,Eye and Nutrition Research Group, Centre des Sciences du Goût et de l'Alimentation, UMR1324, INRAE, 6265 CNRS, Dijon, France
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The Association between the Frequency of Rhegmatogenous Retinal Detachment and Atmospheric Temperature. J Ophthalmol 2020; 2020:2103743. [PMID: 32774898 PMCID: PMC7396048 DOI: 10.1155/2020/2103743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/29/2020] [Accepted: 06/02/2020] [Indexed: 11/18/2022] Open
Abstract
Rhegmatogenous retinal detachment (RRD) frequency was observed to be higher with an increase in the daily temperature range. This showed that a wide daily range of temperature, rather than the absolute value of the temperature, is associated with the occurrence of RRD. Purpose. To investigate the association between the frequency of rhegmatogenous retinal detachment (RRD) and the atmospheric temperature. Method. A retrospective review of consecutive eyes that had undergone primary RRD surgery from 1996 to 2016 at Chungbuk National University Hospital was conducted. Temperature data (highest, lowest, and mean daily temperatures and daily temperature range) in Chungbuk Province were obtained from the Korean Meteorological Administration database. We investigated the relationship between the daily temperature range and the frequency of RRD surgery. We also analyzed the association between various temperature data and the frequency of RRD surgery. Result. There were 1,394 RRD surgeries from 1996 to 2016. Among them, 974 eyes were included in this study. The monthly average number of RRD operations showed a bimodal peak (in April and October) throughout the year. With the same tendency as the frequency of RRD, the monthly average of the daily temperature range over 1 year also showed a bimodal peak in April and October. There was a significant positive correlation between the monthly average of the daily temperature range and the number of RRD surgeries (r = 0.297, P < 0.001). However, there were no associations between RRD frequency and the mean temperature, highest temperature, and lowest temperature. Conclusion. The higher the daily temperature range, the higher was the RRD frequency observed. We speculated that dynamic changes in temperature during the day may affect degrees in chorioretinal adhesion and liquefaction of the vitreous, which may eventually result in retinal detachment. Therefore, further experimental studies on the correlation between temperature changes and retinal detachment are needed.
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Bond-Taylor M, Jakobsson G, Zetterberg M. Posterior vitreous detachment - prevalence of and risk factors for retinal tears. Clin Ophthalmol 2017; 11:1689-1695. [PMID: 29075095 PMCID: PMC5609787 DOI: 10.2147/opth.s143898] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose The present study aimed to describe clinical characteristics of patients with posterior vitreous detachment (PVD), to determine the prevalence of retinal tears in PVD patients, and to find predictors for retinal tears in this patient group. Methods Retrospective analysis of medical records on patients diagnosed with PVD, retinal tears, or vitreous hemorrhage at the Department of Ophthalmology at Sahlgrenska University Hospital, a tertiary eye center. Results Between February and July 2009, 365 patients consulted the Department of Ophthalmology for PVD-related symptoms. The incidence of retinal tears was 14.5% (n=53) and that of vitreous and/or retinal hemorrhage was 22.7% (n=83). For analysis of possible predictors for complications to PVD, patients diagnosed with retinal tears or vitreous hemorrhage between May and July 2009 were also included in the study, resulting in a total of 426 patients. Predictors of a retinal tear were symptoms of visual impairment (P=0.024), the presence of vitreous or retinal hemorrhage at examination (P<0.001), and a duration of symptoms for <24 hours (P=0.004). Symptoms of flashes did not constitute an extra risk of retinal tears (P=0.135). Subsequent retinal pathology (follow-up time 4.5 years), including vitreous detachment/hemorrhage or retinal tears/detachment, occurred more often in patients presenting with a retinal tear. For patients with a retinal tear, the relative risk of having a retinal detachment in the same eye during the follow-up time was 17.7 when compared to patients without a retinal tear (risk ratio 17.7, 95% confidence interval 2.2–145). Conclusion Patients seeking care on the first day have a higher risk of retinal tears. Also, symptoms of visual loss or a history of previous PVD-related pathology and vitreous/retinal hemorrhage at examination indicate a substantially higher risk of retinal complications. These findings may lead to better management and order of priority among these patients.
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Affiliation(s)
| | - Gunnar Jakobsson
- Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal.,Department of Clinical Neuroscience/Ophthalmology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Madeleine Zetterberg
- Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal.,Department of Clinical Neuroscience/Ophthalmology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Qassim A, Viki M, Ng SK, Jersmann H, Casson RJ. Climate and season: the effects on ophthalmic diseases. Clin Exp Ophthalmol 2017; 45:385-392. [PMID: 27894161 DOI: 10.1111/ceo.12883] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 11/22/2016] [Accepted: 11/23/2016] [Indexed: 12/11/2022]
Abstract
Seasonal changes and climate have a significant impact on human health. Diseases influenced by temperature and climate conditions are likely to undergo dynamic pattern shifts with consequent impact on human health. A number of infectious and non-infectious ophthalmic diseases are influenced by temperature and seasonality. Awareness of this is important from public and global health perspective in addition to resource allocation strategies. We examine the evidence for a seasonal pattern to ophthalmic diseases and assess the possible impact of climate change.
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Affiliation(s)
- Ayub Qassim
- University of Adelaide, Adelaide, South Australia, Australia
| | - Mthulisi Viki
- University of Adelaide, Adelaide, South Australia, Australia
| | - Soo Khai Ng
- University of Adelaide, Adelaide, South Australia, Australia.,South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Hubertus Jersmann
- Lung Research, Hanson Institute and Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Robert J Casson
- University of Adelaide, Adelaide, South Australia, Australia.,South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Therapeutic Effect of Intrastromal Voriconazole, Topical Voriconazole, and Topical Natamycin on Fusarium Keratitis in Rabbit. J Ophthalmol 2016; 2016:8692830. [PMID: 27298734 PMCID: PMC4889827 DOI: 10.1155/2016/8692830] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 03/27/2016] [Accepted: 04/18/2016] [Indexed: 11/24/2022] Open
Abstract
Purpose. Evaluating the therapeutic effect of topical and intrastromal voriconazole and topical natamycin on Fusarium keratitis. Methods. 24 rabbits were selected. The stroma of their corneas was inoculated with suspension of Fusarium solani species complex. Seven days after injection they were divided into 4 groups randomly: the first group was treated with topical voriconazole (TV) 1% for one week, the second one with one-time intrastromal injection of voriconazole (ISV) 50 microgram/0.1 mL, and the third group with topical gel of natamycin (TN) for one week, and the last one did not receive any antifungal treatment. Finally the eyes were enucleated and sclerocorneal buttons were sent for histological and microbiological examinations. Results. After treatment the ISV group and TN group showed significantly lower clinical score and colony forming units than the control group (P = 0.040 and P = 0.026, resp.), but there was statistically no significant difference between control and TV groups (P = 0.249) or between ISV and TN groups (P = 0.665). In pathological evaluation, fewer chronic inflammations were reported in 2 of the 3 buttons from TV group and 3 of the 3 buttons from ISV and TN groups in comparison with the control group. Conclusion. Intrastromal injection of voriconazole seems to be effective in treatment of Fusarium keratitis as much as topical natamycin and these are more effective than topical voriconazole.
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Effectiveness of posaconazole in recalcitrant fungal keratitis resistant to conventional antifungal drugs. Case Rep Ophthalmol Med 2014; 2014:701653. [PMID: 25184064 PMCID: PMC4144149 DOI: 10.1155/2014/701653] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 08/01/2014] [Indexed: 11/17/2022] Open
Abstract
Purpose. To present the success of posaconazole in two cases with recalcitrant fugal keratitis that were resistant to conventional antifungal drugs. Method. We presented two cases that were treated with posaconazole after the failure of fluconazole or voriconazole, amphotericin B, and natamycin therapy. Case 1 was a 62-year-old man with a history of ocular trauma. He had been using topical fluorometholone and tobramycin. His best corrected visual acuity (BCVA) was hand motion. He had 5.0 × 4.5 mm area of deep corneal ulcer with stromal infiltration. Case 2 was a 14-year-old contact lens user. He had been using topical moxifloxacin, tobramycin, and cyclopentolate. His BCVA was 20/200. He had a 4.0 × 3.0 mm area of pericentral corneal ulcer with deep corneal stromal infiltration and 2 mm hypopyon. Results. Both patients initially received systemic and topical fluconazole or voriconazole and amphotericin B and topical natamycin that were all ineffective. But the response of posaconazole was significant. After posaconazole, progressive improvement was seen in clinical appearance. BCVA improved to 20/100 in case 1 and 20/40 in case 2. Conclusion. Posaconazole might be an effective treatment option for recalcitrant fusarium keratitis and/or endophthalmitis resistant to conventional antifungal drugs.
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Riddell J, Comer GM, Kauffman CA. Treatment of Endogenous Fungal Endophthalmitis: Focus on New Antifungal Agents. Clin Infect Dis 2011; 52:648-53. [DOI: 10.1093/cid/ciq204] [Citation(s) in RCA: 149] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Leffler CT, Davenport B, Chan D. Frequency and seasonal variation of ophthalmology-related internet searches. Can J Ophthalmol 2010; 45:274-9. [PMID: 20436544 DOI: 10.3129/i10-022] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To use internet search activity to reveal the intensity of public interest and seasonal variation in ophthalmology-related diseases, symptoms, and treatments. DESIGN Time-series analysis of internet search data. METHODS Google trend data for ophthalmology terms for the United States, the United Kingdom, Canada, and Australia from 2004 through 2008 were studied. Mean population-weighted temperature and fraction of schools in session were estimated from databases, and relative potential sunlight intensity was calculated. Multivariable linear regression was used to predict search term frequency based on environmental variables. RESULTS Relative to diabetes searches (100%), common US eye-related searches were: "glasses" (44%), "Lasik" (16%), "contact lenses" (12.4%), "pink eye" (9.5%), "glaucoma" (5.9%), "cataract" (4.1%), "dry eyes" (2.1%), "eye twitching" (1.9%), and "eye pain" (1.9%). Seasonal nature was high for "conjunctivitis" (r(2) = 0.37), "pink eye" (r(2) = 0.32), "eye floaters" (r2 = 0.26), and "stye" (r(2) = 0.19), moderate for "glaucoma" (r(2) = 0.09) and "eye twitching" (r(2) = 0.06), and low for "uveitis" (r(2) = 0.02) and "macular degeneration" (r(2) < 0.01). Heat was associated with "stye" and cold was associated with "pink eye," "conjunctivitis," and "glaucoma" (all p < 0.002). Sunlight intensity was associated with "dry eyes" and "eye floaters" (p < 0.01). School sessions were associated positively with "eye twitching" (p >= 0.001) and negatively with "eyeglasses." "Eye allergy," "itchy eyes," and "watery eyes" were highly seasonal (r(2) = 0.75-0.38) and associated with "pollen" searches. CONCLUSIONS Internet ophthalmology searches relate (in decreasing order) to refractive correction, eye diseases, and eye symptoms. Search study reveals the seasonality and environmental associations of interest in health terms.
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Affiliation(s)
- Christopher T Leffler
- Department of Ophthalmology, Virginia Commonwealth University, MCV Campus, Richmond, VA 23298, USA.
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13
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Spriet I, Delaere L, Lagrou K, Peetermans WE, Maertens J, Willems L. Intraocular penetration of voriconazole and caspofungin in a patient with fungal endophthalmitis. J Antimicrob Chemother 2009; 64:877-8. [PMID: 19684077 DOI: 10.1093/jac/dkp306] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Raad II, Hachem RY, Herbrecht R, Graybill JR, Hare R, Corcoran G, Kontoyiannis DP. Posaconazole as Salvage Treatment for Invasive Fusariosis in Patients with Underlying Hematologic Malignancy and Other Conditions. Clin Infect Dis 2006; 42:1398-403. [PMID: 16619151 DOI: 10.1086/503425] [Citation(s) in RCA: 216] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2005] [Accepted: 01/11/2006] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Conventional amphotericin B-based antifungal therapy for invasive fusariosis in patients with a hematologic malignancy results in a > or = 70% failure rate. Posaconazole is a broad-spectrum antifungal agent with in vitro and in vivo activity against Fusarium species. METHODS In this retrospective analysis of patients from 3 open-label clinical trials, we evaluated posaconazole for the treatment of invasive fusariosis. Twenty-one patients with proven or probable invasive fusariosis who had disease refractory to or who were intolerant of standard antifungal therapy received oral posaconazole suspension (800 mg per day in divided doses) as salvage therapy. RESULTS Successful outcome occurred in 10 (48%) of all 21 patients. Among patients with leukemia who received posaconazole therapy for >3 days, the overall success rate was 50%; for patients who recovered from myelosuppression, the success rate was 67%, compared with 20% for those with persistent neutropenia. CONCLUSION These results suggest that posaconazole is useful for the treatment of invasive fusariosis.
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Affiliation(s)
- Issam I Raad
- The M. D. Anderson Cancer Center, Houston, Texas 77230-1402, USA.
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Klont RR, Eggink CA, Rijs AJMM, Wesseling P, Verweij PE. Successful Treatment ofFusarium Keratitis with Cornea Transplantation and Topical and Systemic Voriconazole. Clin Infect Dis 2005; 40:e110-2. [PMID: 15909252 DOI: 10.1086/430062] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2004] [Accepted: 01/27/2005] [Indexed: 11/03/2022] Open
Abstract
A case of invasive Fusarium keratitis in a previously healthy male patient was treated successfully with cornea transplantation and systemic and topical voriconazole after treatment failure with topical amphotericin B and systemic itraconazole. Topical voriconazole was well tolerated, and, in conjunction with the oral administration, it resulted in a high level of the drug in the anterior chamber of the eye (which was 160% of the plasma drug level).
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Affiliation(s)
- Rocus R Klont
- Department of Medical Microbiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
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