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Fang Y, Li Z, Hu H, Ye Z. Treating adolescent pseudomyopia and elevated intraocular pressure using chiropractic and moxibustion: A CARE-compliant case report. Medicine (Baltimore) 2024; 103:e37564. [PMID: 38489700 PMCID: PMC10939627 DOI: 10.1097/md.0000000000037564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 02/08/2024] [Accepted: 02/20/2024] [Indexed: 03/17/2024] Open
Abstract
RATIONALE This case report aims to provide clinical evidence on the effectiveness of integrating chiropractic and moxibustion techniques for treating pseudomyopia accompanied by elevated intraocular pressure resulting from cervical spine issues because the application of complementary medicine modalities for managing such vision disorders currently lacks adequate investigations. PATIENT CONCERNS A 6-year-old patient presented with blurred vision, intermittent ocular discomfort, and upper cervical discomfort. DIAGNOSES Spine-related increased intraocular pressure and pseudomyopia. INTERVENTIONS The patient received integrative treatment of chiropractic and walnut-shell moxibustion 3 times a week for a total of 10 treatment sessions. OUTCOMES The patient exhibited progressive improvements in visual acuity and reductions in intraocular pressure over the treatment period, with unaided vision exceeding 2 lines of improvement in visual acuity charts and normalized intraocular pressure after 10 treatment sessions. These therapeutic effects were sustained at 3-month follow-up. LESSONS The integrative use of chiropractic and walnut-shell moxibustion demonstrates considerable potential in alleviating symptoms of pseudomyopia, reducing intraocular pressure, and restoring visual function in spine-related pseudomyopia cases.
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Affiliation(s)
- Yiyan Fang
- Zhejiang Chinese Medical University, Hangzhou City, China
- Department of Acupuncture and Moxibustion, Pujiang County Traditional Chinese Medicine Hospital, Jinhua City, China
| | - Zengtu Li
- Department of Tuina, the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou City, China
| | - Hantong Hu
- Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou City, China
| | - Ziyu Ye
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou City, China
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2
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Dogiparthi J, Teru SS, Bonitz TJ, Buzas C. Craniopharyngioma in a 58-Year-Old Adult Male: A Case Report and Review of Literature. Cureus 2023; 15:e45493. [PMID: 37859914 PMCID: PMC10584385 DOI: 10.7759/cureus.45493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
Craniopharyngiomas are benign epithelial tumors derived from the suprasellar region of the brain. The classical presentation of midline craniopharyngiomas includes bitemporal hemianopsia. However, atypical presentations can lead to diagnosis delays and challenges in managing associated visual and endocrine deficits. The persistence of visual deficits and tumor regrowth despite surgical intervention emphasizes the intricacies of craniopharyngioma management. This underscores the significance of timely diagnosis in patients with visual disturbances and hormonal imbalances related to mass effect. Here, we present a case of a unique and rare recurrent craniopharyngioma in a 58-year-old male, featuring progressive and atypical visual disturbances, along with the development of endocrine dysfunction following multiple tumor resections.
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Affiliation(s)
| | - Smaran S Teru
- Medical Education, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Thomas J Bonitz
- Medical Education, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Chris Buzas
- Ophthalmology, Lake Erie College of Osteopathic Medicine, Erie, USA
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3
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Ying Y, Zhai R, Sun Y, Sheng Q, Fan X, Kong X. The occurrence of acute primary angle closure triggered, aggravated, and accelerated by COVID-19 infection: retrospective observational study. Front Public Health 2023; 11:1196202. [PMID: 37645709 PMCID: PMC10461000 DOI: 10.3389/fpubh.2023.1196202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 07/31/2023] [Indexed: 08/31/2023] Open
Abstract
Introduction The aim of this study is to demonstrate the relevance of primary acute angle closure (APAC) and COVID-19 infection, compare the demographic features and manifestations between COVID-19 positive and negative patients with APAC, and infer the underlying mechanism. Methods This study is based on all patients diagnosed with APAC at the glaucoma center of Eye, Ear, Nose and Throat Hospital of Fudan University (Fenyang road center) from 15th December 2022 to 11th January 2023. Totally 171 APAC cases were categorized into COVID-19 positive and negative group. Demographic features and final treatment level of the patients were compared between the two groups. Clinical manifestations, intraocular pressure, and anterior chamber configuration were also compared between the two groups. Results In the COVID-19 positive group, the number of cases with APAC onset spiked in 22nd December 2022, which coincided with the spike of COVID-19 antigen positive people. Compared to the COVID-19 negative group, COVID-19 positive APAC patients were younger with a lower percentage of APAC history. Additionally, more eyes of COVID-19 positive APAC patients showed keratic precipitates. COVID-19 positive eyes had significantly larger anterior chamber depth with a more dilated pupil. Therefore, COVID-19 infection could probably act as a triggering factor of APAC. Discussion The onset of APAC might be accelerated by COVID-19 infection for patients with younger age and milder anatomical configuration. Additionally, COVID-19 related APAC cases might have a more abrupt and fierce onset. Ophthalmic emergent services should not be neglected during the epidemic period.
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Affiliation(s)
- Yue Ying
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Ruyi Zhai
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Yanan Sun
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Qilian Sheng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xintong Fan
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
| | - Xiangmei Kong
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
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4
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Richardson-May J, Alnuaimi R, Elbably A, Walker L, Thulasidharan S, Dacombe R, Jacob A. Our Experience of Deep Sclerectomy at a Tertiary Center in the United Kingdom Over 14 Years. Cureus 2023; 15:e43366. [PMID: 37701011 PMCID: PMC10494555 DOI: 10.7759/cureus.43366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2023] [Indexed: 09/14/2023] Open
Abstract
Background Deep sclerectomy (DS) is a non-penetrating surgical procedure for glaucoma, reducing the resistance to aqueous outflow and lowering intraocular pressure while maintaining a physiological barrier between the anterior chamber and the sub-scleral space. This offers a lower complication profile than penetrating procedures, though with less intraocular pressure (IOP) reduction. Methods We retrospectively reviewed the electronic record for all DS undertaken at our hospital (a tertiary care center) over 14 years, collecting data on demographics, diagnosis, IOP, visual acuity, complications, medications, and further procedures required. Results Eighty eyes of 69 patients underwent DS, with a mean follow-up period of 53.5 months. The mean pre-operative IOP was 23.55 mmHg (range 11-52, standard deviation 8.46); the mean final IOP was 13.61 mmHg (range 5-35, SD 4.73), with a mean reduction of 42.21%. The mean change in glaucoma medications was -1.64. 78.40% experienced a reduction in glaucoma treatment. Post-operatively, 43.80% had no complications; this improved to 85.0% when numerical hypotony and raised IOP without visual sequelae were excluded. Further procedures required included Nd:YAG goniopuncture (10%), bleb needling (13.75%) or revision (7.5%), iridectomy (3.75%), goniosynechiolysis (1.25%), and autologous blood injection (1.25%). Two eyes were converted to trabeculectomy peri-operatively, with seven overall (8.75%) requiring trabeculectomy over the course of follow-up. 3.75% underwent glaucoma drainage device implantation, and 3.75% underwent cyclodiode laser. Conclusion We have found DS to be a safe, effective procedure for selected patients where trabeculectomy has a high likelihood of failure or where a higher IOP can be tolerated.
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Affiliation(s)
- James Richardson-May
- Ophthalmology, University Hospital Southampton National Health Services (NHS) Foundation Trust, Southampton, GBR
| | - Rawdha Alnuaimi
- Ophthalmology, University Hospital Southampton National Health Services (NHS) Foundation Trust, Southampton, GBR
| | - Ahmed Elbably
- Ophthalmology, University Hospital Southampton National Health Services (NHS) Foundation Trust, Southampton, GBR
| | - Lawrence Walker
- Ophthalmology, University Hospital Southampton National Health Services (NHS) Foundation Trust, Southampton, GBR
| | - Suresh Thulasidharan
- Ophthalmology, University Hospital Southampton National Health Services (NHS) Foundation Trust, Southampton, GBR
| | - Richard Dacombe
- Clinical Outcomes, University Hospital Southampton National Health Services (NHS) Foundation Trust, Southampton, GBR
| | - Aby Jacob
- Ophthalmology, University Hospital Southampton National Health Services (NHS) Foundation Trust, Southampton, GBR
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5
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Daka Q, Špegel N, Atanasovska Velkovska M, Steblovnik T, Kolko M, Neziri B, Cvenkel B. Exploring the Relationship between Anti-VEGF Therapy and Glaucoma: Implications for Management Strategies. J Clin Med 2023; 12:4674. [PMID: 37510790 PMCID: PMC10380425 DOI: 10.3390/jcm12144674] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 07/03/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
A short-term increase in intraocular pressure (IOP) is a common side effect after intravitreal anti-VEGF therapy, but a sustained increase in IOP with the development of secondary glaucoma has also been reported in some studies after repeated intravitreal anti-VEGF injections. The aim of this review is to present and discuss the possible pathophysiological mechanisms and factors contributing to a sustained rise in IOP, as well as treatment strategies for patients at risk. Close monitoring and adjustable IOP-lowering treatment are recommended for high-risk patients, including those with glaucoma, angle-closure anomalies, ocular hypertension or family history of glaucoma; patients receiving a high number of injections or at shorter intervals; and patients with capsulotomy. Strategies are needed to identify patients at risk in a timely manner and to prevent sustained elevation of IOP.
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Affiliation(s)
- Qëndresë Daka
- Department of Pathophysiology, Medical Faculty, University of Prishtina, 10000 Prishtina, Kosovo
- Eye Clinic, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo
- Department of Ophthalmology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Nina Špegel
- Department of Ophthalmology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | | | - Tjaša Steblovnik
- Department of Ophthalmology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Miriam Kolko
- Department of Drug Design and Pharmacology, University of Copenhagen, 2100 Copenhagen, Denmark
- Department of Ophthalmology, Copenhagen University Hospital, Rigshospitalet, 2600 Glostrup, Denmark
| | - Burim Neziri
- Department of Pathophysiology, Medical Faculty, University of Prishtina, 10000 Prishtina, Kosovo
| | - Barbara Cvenkel
- Department of Ophthalmology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
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6
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Francisco Chacon-Camacho O, Arce-Gonzalez R, Sanchez-de la Rosa F, Urióstegui-Rojas A, Enriqueta Hofmann-Blancas M, Mata-Flores F, Carlos Zenteno J. Genetic Aspects of Glaucoma: An Updated Review. Curr Mol Med 2023:CMM-EPUB-132265. [PMID: 37272463 DOI: 10.2174/1566524023666230602143617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/17/2023] [Accepted: 04/20/2023] [Indexed: 06/06/2023]
Abstract
Glaucoma is a group of diverse diseases characterized by cupping of the optic nerve head due to the loss of retinal ganglion cells. It is the most common cause of irreversible blindness throughout the word; therefore, its timely diagnosis and early detection through an ophthalmological examination are very important. We, herein, present the information on the epidemiology, pathophysiology, clinical diagnosis, and treatment of glaucoma. We also emphasize the investigations of the last decades that have allowed identifying numerous genes and susceptible genetic factors. We have also described in detail the genes whose mutations cause or contribute to the development of the disease.
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Affiliation(s)
- Oscar Francisco Chacon-Camacho
- Instituto de Oftalmología Conde de Valenciana Genetic Ciudad de México Mexico
- Laboratorio 5 Edificio A-4, Carrera de Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México
| | | | | | | | | | | | - Juan Carlos Zenteno
- Instituto de Oftalmología Conde de Valenciana Genetics Ciudad de México Mexico
- Biochemistry Department, Faculty Medicine, National Autonomous University of Mexico, Mexico City, Mexico
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7
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Liu T, Bai F, Yang L, Liu L, Xiao J, Liu X. Primary Tumour Type, Clinical Features, Treatment and Outcome of Patients with Iris Metastasis. Ocul Immunol Inflamm 2022; 30:1726-1732. [PMID: 34228589 DOI: 10.1080/09273948.2021.1939392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To describe the primary tumour type, clinical features, treatment and outcome of patients with Iris metastasis. METHODS Retrospectively analyzed articles published from 1934 to 2019 in the PubMed database. RESULTS In total, 133 eyes of 125 patients with iris metastatic carcinoma were retrieved. The average age at metastasis diagnosis of the patients was 56 ± 15 years; 60 left eyes and 49 right eyes were involved. The most common primary tumors were lung carcinoma (42%) and breast carcinoma (15%). Approximately one-third of the patients were first diagnosed in the ophthalmology department before the primary tumor was detected. Twenty-two percent of iris metastases were discovered before and 33% were discovered after systemic metastasis. The most common complaints were blurred vision and pain. The clinical features included iris masses, neovascularization and keratic precipitates. 57 patients (64%, N = 90) had an elevated intraocular pressure. Local administration of radiation therapy or intraocular injections of anti-VEGF drugs relieved eye discomfort and controlled the high intraocular pressures. CONCLUSIONS Iris nodules with increased intraocular pressure and neovascularization may indicate iris metastasis. Lung cancer is the most common primary tumor.
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Affiliation(s)
- Tao Liu
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
| | - Feng Bai
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
| | - Li Yang
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
| | - Li Liu
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
| | - Jun Xiao
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
| | - Xiaoli Liu
- Ophthalmologic Center of the Second Hospital, Jilin University, Changchun, P.R. China
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8
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Esteban-Linares A, Wareham LK, Walmsley TS, Holden JM, Fitzgerald ML, Pan Z, Xu YQ, Li D. Dynamic Observation of Retinal Response to Pressure Elevation in a Microfluidic Chamber. Anal Chem 2022; 94:12297-12304. [PMID: 36018813 PMCID: PMC10519618 DOI: 10.1021/acs.analchem.1c05652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Dynamic observation of cell and tissue responses to elevated pressure could help our understanding of important physiological and pathological processes related to pressure-induced injury. Here, we report on a microfluidic platform capable of maintaining a wide range of stable operating pressures (30 to 200 mmHg) while using a low flowrate (2-14 μL/h) to limit shear stress. This is achieved by forcing flow through a porous resistance matrix composed of agarose gel downstream of a microfluidic chamber. The flow characteristics were investigated and the permeabilities of the agarose with four different concentrations were extracted, agreeing well with results found in the literature. To demonstrate the capability of the device, we measured the change in intracellular Ca2+ levels of retinal ganglion cells in whole mouse retina in response to pressure. The onset of enhanced pressure results in, on average, an immediate 119.16% increase in the intracellular Ca2+ levels of retinal ganglion cells. The demonstrated microfluidic platform could be widely used to probe cell and tissue responses to elevated pressure.
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Affiliation(s)
| | - Lauren K. Wareham
- Vanderbilt Eye Institute, Vanderbilt Medical Center, Nashville, TN, 37232, USA
| | - Thayer S. Walmsley
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN 37235, USA
| | - Joseph M. Holden
- Vanderbilt Eye Institute, Vanderbilt Medical Center, Nashville, TN, 37232, USA
| | - Matthew L. Fitzgerald
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, 37235, USA
| | - Zhiliang Pan
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, 37235, USA
| | - Ya-Qiong Xu
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, TN 37235, USA
- Department of Physics and Astronomy, Vanderbilt University, Nashville, TN, 37235, USA
| | - Deyu Li
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, 37235, USA
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9
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Barzilai-Birenboim S, Elitzur S, Nirel R, Ehrenberg M, Zahavi A, Avrahami G, Gabbay IE, Gilad G, Dotan G, Izraeli S, Daood RH, Geffen N. Elevated intraocular pressure in children with acute lymphoblastic leukaemia: A prospective study. Br J Haematol 2021; 196:1248-1256. [PMID: 34862597 DOI: 10.1111/bjh.17987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022]
Abstract
Most childhood acute lymphoblastic leukaemia (ALL) protocols include high-dose steroid therapy. However, the known potential of high-dose steroids to significantly elevate intraocular pressure (IOP) and lead to glaucomatous optic neuropathy has not been intensively investigated in children with ALL. Moreover, as children with ALL do not routinely undergo IOP measurements, the need for IOP monitoring and therapy is unknown. We prospectively measured IOP in 90 children with newly diagnosed ALL attending a tertiary paediatric haematology/oncology centre, at diagnosis and at the middle and end of induction therapy. Ocular hypertension (IOP > 21 mm Hg) at any time point was documented in 64 children (71%), and the prevalence increased during induction. Thirty-six children (40%) had elevated IOP at ALL diagnosis before therapy initiation, and stratification to non-standard ALL was a risk factor. IOP reduction therapy was administered to 13 children (14%); none required surgery. Values normalised in all cases. On multivariate logistic regression analysis, dexamethasone therapy was a significant risk factor for ocular hypertension. High body mass index was an additional risk factor in children with elevated IOP at ALL diagnosis. Routine evaluation of IOP during steroid therapy is very important in children with ALL to ensure early intervention which may prevent permanent ocular damage.
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Affiliation(s)
- Shlomit Barzilai-Birenboim
- Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sarah Elitzur
- Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronit Nirel
- Department of Statistics and Data Science, Hebrew University, Jerusalem, Israel
| | - Miriam Ehrenberg
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | - Alon Zahavi
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | - Galia Avrahami
- Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Itay E Gabbay
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | - Gil Gilad
- Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gad Dotan
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | - Shai Izraeli
- Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rabeea Haj Daood
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | - Noa Geffen
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
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10
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Mir T, Iftikhar M, Seidel N, Trang M, Goldberg MF, Woreta FA. Clinical Characteristics and Outcomes of Hyphema in Patients with Sickle Cell Trait: 10-Year Experience at the Wilmer Eye Institute. Clin Ophthalmol 2020; 14:4165-4172. [PMID: 33293789 PMCID: PMC7719005 DOI: 10.2147/opth.s281875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/17/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose To report the clinical characteristics, complications, and outcomes of hyphema in patients with sickle cell trait (SCT). Design Retrospective case series. Methods Medical records of SCT patients (confirmed by hemoglobin electrophoresis) presenting with hyphema at the Wilmer Eye Institute over 10 years (January 2008 through December 2017) were reviewed in detail. Data were collected regarding etiology, demographics, clinical course and management. Main outcome measures included intraocular pressure (IOP) and visual acuity (VA). Results A total of 14 black patients (males: 57%; median age: 20 years) were included in the study with a median follow-up of 4 months (range: 1 week to 6 years). Ten patients had traumatic hyphema with a mean presenting VA of approximately 1.10 logMAR (Snellen equivalent=20/250) and a mean presenting IOP of 40 mmHg. Nine of them required medical intervention to lower IOP, and six of them ultimately required surgical intervention, primarily in the form of anterior chamber paracentesis and/or washout. The mean time to achieve IOP control was 3 days, and the mean final VA was approximately 0.10 logMAR (Snellen Equivalent=20/25). Four patients had non-traumatic hyphema with a mean presenting VA of approximately 1.8 logMAR (Snellen equivalent=20/1260) and a mean presenting IOP of 31 mmHg. Three of them required medical intervention to lower IOP, and two of them ultimately required surgical intervention. Overall, seven patients underwent anterior chamber washout, six needed an anterior chamber paracentesis to lower the IOP, two required tube shunt placement procedures and one patient underwent a trabeculectomy. The mean time to achieve IOP control was 5 days, and the mean final VA was approximately 0.80 logMAR (Snellen equivalent=20/125). Conclusion Patients with SCT are likely to develop elevated IOP in the setting of hyphema, with a majority requiring one or more surgical interventions to achieve IOP control.
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Affiliation(s)
- Tahreem Mir
- Department of Ophthalmology & Visual Science, Yale School of Medicine, New Haven, CT, USA
| | - Mustafa Iftikhar
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Natalie Seidel
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michelle Trang
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Morton F Goldberg
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Fasika A Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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11
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Holló G, Aung T, Cantor LB, Aihara M. Cystoid macular edema related to cataract surgery and topical prostaglandin analogs: Mechanism, diagnosis, and management. Surv Ophthalmol 2020; 65:496-512. [PMID: 32092363 DOI: 10.1016/j.survophthal.2020.02.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 02/11/2020] [Accepted: 02/11/2020] [Indexed: 12/23/2022]
Abstract
Cystoid macular edema (CME) is a form of macular retina thickening that is characterized by the appearance of cystic fluid-filled intraretinal spaces. It has classically been diagnosed upon investigation after a decrease in visual acuity; however, improvements in imaging technology make it possible to noninvasively detect CME even before a clinically significant decrease in central vision. Risk factors for the development of CME include diabetic retinopathy, retinal vein occlusion, uveitis, and cataract surgery. It has been proposed that eyes with elevated intraocular pressure after cataract surgery, including those treated with prostaglandin analog eye drops, may be at higher risk for the development of CME. We summarize the current knowledge of the molecular mechanisms underlying CME, the potential role of ocular surgery and topical glaucoma medication in increasing the risk of CME, the newly developed imaging methods for diagnosing CME, and the clinical management of CME.
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Affiliation(s)
- Gábor Holló
- Glaucoma Unit, Department of Ophthalmology, Semmelweis University, Budapest, Hungary.
| | - Tin Aung
- Glaucoma Department, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Opthalmology, National University of Singapore, Singapore
| | - Louis B Cantor
- Department of Opthalmology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Makoto Aihara
- Department of Opthalmology, University of Tokyo, Tokyo, Japan
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Huang J, Zhou L, Wang H, Luo J, Xiong K, Zeng L, Chen D. Spatiotemporal alterations of presynaptic elements in the retina after high intraocular pressure. Neural Regen Res 2015; 7:1234-40. [PMID: 25709621 PMCID: PMC4336957 DOI: 10.3969/j.issn.1673-5374.2012.16.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Accepted: 05/03/2012] [Indexed: 12/25/2022] Open
Abstract
A rat model of acute high intraocular pressure was established by injecting saline into the anterior chamber of the left eye. Synaptophysin expression was increased in the inner plexiform layer at 2 hours following injury, and was widely distributed in the outer plexiform layer at 3–7 days, and then decreased to the normal level at 14 days. This suggests that expression of this presynaptic functional protein experienced spatiotemporal alterations after elevation of intraocular pressure. There was no significant change in the fluorescence intensity and distribution pattern for synapse-associated protein 102 following elevated intraocular pressure. Synapse-associated protein 102 immunoreactivity was confined to the outer plexiform layer, while synaptophysin immunoreactivity spread into the outer plexiform layer and the outer nuclear layer at 3 and 7 days following injury. These alterations in presynaptic elements were not accompanied by changes in postsynaptic components.
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Affiliation(s)
- Jufang Huang
- Department of Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha 410013, Hunan Province, China
| | - Lihong Zhou
- Department of Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha 410013, Hunan Province, China
| | - Hui Wang
- Department of Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha 410013, Hunan Province, China
| | - Jia Luo
- Department of Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha 410013, Hunan Province, China
| | - Kun Xiong
- Department of Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha 410013, Hunan Province, China
| | - Leping Zeng
- Department of Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha 410013, Hunan Province, China
| | - Dan Chen
- Department of Anatomy and Neurobiology, Xiangya School of Medicine, Central South University, Changsha 410013, Hunan Province, China
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Lee JY, Lee YK, Moon JI, Park MH. Spectral domain optical coherence tomography cross-sectional image of optic nerve head during intraocular pressure elevation. Int J Ophthalmol 2014; 7:1022-9. [PMID: 25540759 PMCID: PMC4270970 DOI: 10.3980/j.issn.2222-3959.2014.06.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Accepted: 12/12/2013] [Indexed: 01/23/2023] Open
Abstract
AIM To analyze changes of the optic nerve head (ONH) and peripapillary region during intraocular pressure (IOP) elevation in patients using spectral domain optical coherence tomography (SD-OCT). METHODS Both an optic disc 200×200 cube scan and a high-definition 5-line raster scan were obtained from open angle glaucoma patients presented with monocular elevation of IOP (≥30 mm Hg) using SD-OCT. Additional baseline characteristics included age, gender, diagnosis, best-corrected visual acuity, refractive error, findings of slit lamp biomicroscopy, findings of dilated stereoscopic examination of the ONH and fundus, IOP, pachymetry findings, and the results of visual field. RESULTS The 24 patients were selected and divided into two groups: group 1 patients had no history of IOP elevation or glaucoma (n=14), and group 2 patients did have history of IOP elevation or glaucoma (n=10). In each patient, the study eye with elevated IOP was classified into group H (high), and the fellow eye was classified into group L (low). The mean deviation (MD) differed significantly between groups H and L when all eyes were considered (P=0.047) and in group 2 (P=0.042), not in group 1 (P=0.893). Retinal nerve fiber layer (RNFL) average thickness (P=0.050), rim area (P=0.015), vertical cup/disc ratio (P=0.011), cup volume (P=0.028), inferior quadrant RNFL thickness (P=0.017), and clock-hour (1, 5, and 6) RNFL thicknesses (P=0.050, 0.012, and 0.018, respectively), cup depth (P=0.008), central prelaminar layer thickness (P=0.023), mid-inferior prelaminar layer thickness (P=0.023), and nasal retinal slope (P=0.034) were significantly different between the eyes with groups H and L. CONCLUSION RNFL average thickness, rim area, vertical cup/disc ratio, cup volume, inferior quadrant RNFL thickness, and clock-hour (1, 5, and 6) RNFL thicknesses significantly changed during acute IOP elevation.
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Affiliation(s)
- Ji Young Lee
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, the Catholic University of Korea, 62, Yeuido-dong, Youngdeungpo-gu, Seoul 150-713, Korea
| | - You Kyung Lee
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, the Catholic University of Korea, 62, Yeuido-dong, Youngdeungpo-gu, Seoul 150-713, Korea
| | - Jung Il Moon
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, the Catholic University of Korea, 62, Yeuido-dong, Youngdeungpo-gu, Seoul 150-713, Korea
| | - Myoung Hee Park
- Department of Ophthalmology, Yeouido St. Mary's Hospital, College of Medicine, the Catholic University of Korea, 62, Yeuido-dong, Youngdeungpo-gu, Seoul 150-713, Korea
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