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Stephenson M, Ohlsson H, Lannoy S, Sundquist J, Sundquist K, Edwards AC. Clarifying the relationship between physical injuries and risk for suicide attempt in a Swedish national sample. Acta Psychiatr Scand 2024; 149:389-403. [PMID: 38414134 PMCID: PMC10987261 DOI: 10.1111/acps.13675] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 01/09/2024] [Accepted: 02/14/2024] [Indexed: 02/29/2024]
Abstract
INTRODUCTION The Interpersonal-Psychological Theory of Suicide proposes that capability for suicide is acquired through exposure to painful and provocative events (PPEs). Although there is robust evidence for a positive association between aggregate measures of PPEs and risk for suicidal behavior, little is known about the contributions of physical injuries. The present study investigated the relationship between injuries and risk of subsequent suicide attempt (SA). METHODS Data were from Swedish population-based registers. All individuals born in Sweden between 1970 and 1990 were included (N = 1,011,725 females and 1,067,709 males). We used Cox regression models to test associations between 10 types of injuries (eye injury; fracture; dislocation/sprain/strain; injury to nerves and spinal cord; injury to blood vessels; intracranial injury; crushing injury; internal injury; traumatic amputation; and other or unspecified injuries) and risk for later SA. Analyses were stratified by sex and adjusted for year of birth and parental education. Additional models tested for differences in the pattern of associations based on age group and genetic liability for SA. In co-relative models, we tested the association between each injury type and risk for SA in relative pairs of varying genetic relatedness to control for unmeasured familial confounders. RESULTS All 10 injury types were associated with elevated risk for SA (hazard ratios [HRs] = 1.2-7.0). Associations were stronger in the first year following an injury (HRs = 1.8-7.0), but HRs remained above 1 more than 1 year after injury exposure (HRs = 1.2-2.6). The strength of associations varied across injury type, sex, age, and genetic liability for SA. For example, the magnitude of the association between crushing injury and risk for SA was larger in females than males, whereas other injuries showed a similar pattern of associations across sex. Moreover, there was evidence to support positive additive interaction effects between several injury types and aggregate genetic liability for SA (relative excess risk due to interaction [RERI] = 0.1-0.3), but the majority of these interactions became non-significant or changed direction after accounting for comorbid psychiatric and substance use disorders. In co-relative models, the pattern of associations differed by injury type, such that there was evidence to support a potential causal effect of eye injury, fracture, dislocation/sprain/strain, intracranial injury, and other and unspecified injuries on risk for SA. For the remaining injury types, HRs were not significantly different from 1 in monozygotic twins, which is consistent with confounding by familial factors. CONCLUSIONS Injuries are associated with increased risk for subsequent SA, particularly in the first year following an injury. While genetic and familial environmental factors may partly explain these associations, there is also evidence to support a potential causal effect of several injury types on future risk for SA.
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Affiliation(s)
- Mallory Stephenson
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Séverine Lannoy
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | | | - Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, United States of America
- Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, United States of America
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Tong X, Wang L, Chen F. Periorbital skin injury of elderly patients related to polyethylene covers during general anesthesia. J Clin Anesth 2024; 93:111350. [PMID: 38000221 DOI: 10.1016/j.jclinane.2023.111350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 11/16/2023] [Accepted: 11/20/2023] [Indexed: 11/26/2023]
Affiliation(s)
- Xiangyi Tong
- Department of Anesthesiology, the First Hospital of China Medical University, Shenyang, Liaoning province, China
| | - Limei Wang
- Department of Anesthesiology, the First Hospital of China Medical University, Shenyang, Liaoning province, China
| | - Fengshou Chen
- Department of Anesthesiology, the First Hospital of China Medical University, Shenyang, Liaoning province, China.
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Chuck RS, Jeng BH, Lum F. Consensus Guidelines versus Evidence-Based Medicine in the Treatment of Corneal Abrasions. Ophthalmology 2024; 131:524-525. [PMID: 38642953 DOI: 10.1016/j.ophtha.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 04/22/2024] Open
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Henry RK, Oydanich M, Khouri AS. Re: Patterson et al.: The use of preoperative prophylactic systemic antibiotics for the prevention of endophthalmitis in open globe injuries: a meta-analysis (Ophthalmol Retina. 2023;7:972-981). Ophthalmol Retina 2024; 8:e9-e10. [PMID: 38340119 DOI: 10.1016/j.oret.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/02/2024] [Indexed: 02/12/2024]
Affiliation(s)
- Roger K Henry
- Institute of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Marko Oydanich
- Institute of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Albert S Khouri
- Institute of Ophthalmology & Visual Science, Rutgers New Jersey Medical School, Newark, New Jersey.
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Zhang R, Jia H, Chang Q, Zhang Z, Jiao Y. Two cases of Duane retraction syndrome with abnormal orbital structures. J AAPOS 2024; 28:103855. [PMID: 38417542 DOI: 10.1016/j.jaapos.2024.103855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/10/2024] [Accepted: 01/12/2024] [Indexed: 03/01/2024]
Abstract
Duane retraction syndrome (DRS) is a rare congenital nonprogressive restrictive strabismus. The absence/hypoplasia of the abducens nerve and the aberrant innervation of the lateral rectus muscle by the oculomotor nerve have been hypothesized as causes of DRS, although the phenomenon of globe retraction can also occur in the setting of mechanical factors, such as congenital abnormal orbital structures or orbital trauma. We present the cases of 2 DRS patients with absent abducens nerve and abnormal muscular bands connecting the superior rectus and inferior rectus muscles on the temporal side of the optic nerve.
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Affiliation(s)
- Ranran Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Science Key Lab, Beijing, China
| | - Hongyan Jia
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Science Key Lab, Beijing, China
| | - Qinglin Chang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zongrui Zhang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yonghong Jiao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Ophthalmology and Visual Science Key Lab, Beijing, China.
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Azuma N, Yoshida T, Yokoi T, Nishina S, Uematsu S, Miyasaka M. Retinal hemorrhages and damages from tractional forces associated with infantile abusive head trauma evaluated by wide-field fundus photography. Sci Rep 2024; 14:5246. [PMID: 38438406 PMCID: PMC10912762 DOI: 10.1038/s41598-024-54664-y] [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: 09/30/2023] [Accepted: 02/15/2024] [Indexed: 03/06/2024] Open
Abstract
We evaluated the distribution and types of retinal hemorrhages (RHs) and other damages in eyes with abusive head trauma (AHT). This retrospective, consecutive case series of AHT and non-AHT conditions involved 54 children with AHT, 43 children with head bruises, and 49 children with blunt eye trauma, each of non-AHT supported by reliable witness accounts. RHs and other damage were evaluated using ophthalmoscopy and wide-field fundus photography. A variety of RH types and other damage were identified in the AHT group but not in the non-AHT group. RHs in AHT extended from the posterior pole to the far periphery in 77% of eyes and on/near the veins in 86% and arteries in 85%, most of which were in the far periphery. Retinoschisis, white-dot lesions, and retinal folds were seen even in the far periphery. RHs on/near the veins and arteries, retinoschisis, and retinal folds suggest a traumatic mechanism of the tractional force of the vitreous that is attached to the entire retinal surface. Identifying the distribution and arterio and venous origins of RHs is a key factor in determining the association with trauma. Thus, wide-field fundus photography is useful to record and evaluate the origin of the RHs and other retinal damage.
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Affiliation(s)
- Noriyuki Azuma
- Division of Ophthalmology, National Center for Child Health and Development, Tokyo, Japan.
| | - Tomoyo Yoshida
- Division of Ophthalmology, National Center for Child Health and Development, Tokyo, Japan
| | - Tadashi Yokoi
- Division of Ophthalmology, National Center for Child Health and Development, Tokyo, Japan
| | - Sachiko Nishina
- Division of Ophthalmology, National Center for Child Health and Development, Tokyo, Japan
| | - Satoko Uematsu
- Division of Emergency and Transport Services, National Center for Child Health and Development, Tokyo, Japan
| | - Mikiko Miyasaka
- Department of Radiology, National Center for Child Health and Development, Tokyo, Japan.
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Solaz-Ruiz MG, Sevilla-Redoreda N, Cauto-Picazo C, Azorín-Pérez L, Neira-Fonseca C, España-Gregori E. Purtscher-like retinopathy following carotid angioplasty and stenting in the treatment of severe carotid stenosis. Eur J Ophthalmol 2024; 34:NP73-NP77. [PMID: 37792548 DOI: 10.1177/11206721231204632] [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] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
We present a case of Purtscher-like retinopathy (PLR) following carotid angioplasty and stenting (CAS). A 56-year-old man with a history of severe stenosis of the left carotid artery and treated by CAS refers acute and painless visual loss on the left eye (OS) 48 h after the procedure. Funduscopic examination showed cotton wool spots and intraretinal hemorrhages confined to the peripapillary and posterior pole of the OS. The optical coherence tomography (OCT) showed retinal thickening and hyperintense lesions in the inner nuclear layer retina.
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Affiliation(s)
- M G Solaz-Ruiz
- La Fe University and Polytechnic Hospital, Valencia, Spain
| | | | - C Cauto-Picazo
- La Fe University and Polytechnic Hospital, Valencia, Spain
| | - L Azorín-Pérez
- La Fe University and Polytechnic Hospital, Valencia, Spain
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Gibbons AB, Niknahad A, Bacorn C, Halawa O, Li E. Subperiosteal and Orbital Abscesses: A Comparison of Clinical Features, Management, and Outcomes. Ophthalmic Plast Reconstr Surg 2024; 40:161-166. [PMID: 37581883 DOI: 10.1097/iop.0000000000002495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
PURPOSE To compare the clinical features, management, and outcomes between orbital cellulitis patients with subperiosteal abscess (SPA) and those with orbital abscess (OA). METHODS A retrospective study was conducted at a tertiary care center through medical record search to identify patients with orbital cellulitis from January 1, 2000 to December 31, 2022. Charts were screened for those with radiographic evidence of SPA or OA. Demographic data and presenting clinical features were compared between the 2 cohorts. Primary outcomes compared included rates of surgical intervention, reoperation, and readmission; and length of hospital stay and final vision. RESULTS A total of 189 patients, 162 with SPA and 27 with OA, met the criteria. The OA group (mean 46.5 ± 18.6 years) was older than the SPA group (mean 19.1 ± 21.4 years). Comorbid sinusitis was significantly more common in the SPA cohort (95.7% SPA; 70.4% OA; p < 0.001), while OA was more likely to occur with orbital trauma (29.6% vs. 8.0%; p = 0.003), implanted hardware (11.1% vs. 0.6%; p = 0.005), and comorbid diabetes (22.2% vs. 4.3%; p = 0.001). OA patients more often presented with a relative afferent pupillary defect (21.7% vs. 3.9%; p = 0.005), vision worse than 20 of 50 (42.3% vs. 16.2%; p = 0.005), and methicillin-resistant Staphylococcus aureus infection (20.8% vs. 5.8%; p = 0.036). OA was associated with a higher reoperation rate (47.8% vs. 21.3%; p = 0.019), readmission rate (18.5% vs. 5.6%, p = 0.047), and limited extraocular motility at follow-up (4.3% vs. 25%; p = 0.013); while mean length of hospital stay and final visual acuity were similar. CONCLUSION OA may affect an older population with a divergent risk factor profile compared with SPA. OA may cause more severe functional impairment on presentation, warranting more aggressive management to achieve visual outcomes similar to SPA.
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Affiliation(s)
- Alison B Gibbons
- The Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Ava Niknahad
- The Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
| | - Colin Bacorn
- The Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, U.S.A
| | - Omar Halawa
- The Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, U.S.A
| | - Emily Li
- The Johns Hopkins University School of Medicine, Baltimore, Maryland, U.S.A
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, U.S.A
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9
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Meng X, Wang Q, Chen S, Zhang S, Yu J, Li H, Chen X, Wang Z, Yu W, Zheng Z, Zhou H, Luo J, Wang Z, Chen H, Wu N, Hu D, Chen S, Wei Y, Cui H, Song H, Chen H, Wang Y, Zhong J, Chen Z, Zhang H, Yang T, Li M, Liu Y, Dong X, Du M, Wang X, Yao X, Lin H, Li MJ, Yan H. An interpretable model predicts visual outcomes of no light perception eyes after open globe injury. Br J Ophthalmol 2024; 108:285-293. [PMID: 36596662 DOI: 10.1136/bjo-2022-322753] [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] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/17/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The visual outcome of open globe injury (OGI)-no light perception (NLP) eyes is unpredictable traditionally. This study aimed to develop a model to predict the visual outcomes of vitrectomy surgery in OGI-NLP eyes using a machine learning algorithm and to provide an interpretable system for the prediction results. METHODS Clinical data of 459 OGI-NLP eyes were retrospectively collected from 19 medical centres across China to establish a training data set for developing a model, called 'VisionGo', which can predict the visual outcome of the patients involved and compare with the Ocular Trauma Score (OTS). Another 72 cases were retrospectively collected and used for human-machine comparison, and an additional 27 cases were prospectively collected for real-world validation of the model. The SHapley Additive exPlanations method was applied to analyse feature contribution to the model. An online platform was built for real-world application. RESULTS The area under the receiver operating characteristic curve (AUC) of VisionGo was 0.75 and 0.90 in previtrectomy and intravitrectomy application scenarios, which was much higher than the OTS (AUC=0.49). VisionGo showed better performance than ophthalmologists in both previtrectomy and intravitrectomy application scenarios (AUC=0.73 vs 0.57 and 0.87 vs 0.64). In real-world validation, VisionGo achieved an AUC of 0.60 and 0.91 in previtrectomy and intravitrectomy application scenarios. Feature contribution analysis indicated that wound length-related indicators, vitreous status and retina-related indicators contributed highly to visual outcomes. CONCLUSIONS VisionGo has achieved an accurate and reliable prediction in visual outcome after vitrectomy for OGI-NLP eyes.
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Affiliation(s)
- Xiangda Meng
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Qihua Wang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
- Department of Ophthalmology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Song Chen
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Shijie Zhang
- Department of Pharmacology, Tianjin Key Laboratory of Inflammation Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Jinguo Yu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Haibo Li
- Department of Ocular Trauma, Xiamen University Xiamen Eye Center, Xiamen, Fujian, China
| | - Xinkang Chen
- Department of Pharmacology, Tianjin Key Laboratory of Inflammation Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Zhaoyang Wang
- Department of Ophthalmology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Wenzhen Yu
- Department of Ophthalmology, Peking University People's Hospital, Beijing, China
| | - Zhi Zheng
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Heding Zhou
- Department of Ophthalmology, Ningbo Eye Hospital, Ningbo, Zhejiang, China
| | - Jing Luo
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhiliang Wang
- Department of Ophthalmology, Fudan University Huashan Hospital, Shanghai, China
| | - Haoyu Chen
- Department of Ocular Trauma, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China
| | - Nan Wu
- Department of Ophthalmology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Dan Hu
- Department of Ophthalmology, Eye Institute of Chinese PLA, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Suihua Chen
- Department of Ophthalmology, General Hospital of Eastern Theater Command, Nanjing, Jiangsu, China
| | - Yong Wei
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haibin Cui
- Department of Ocular Trauma, Heilongjiang Province Ophthalmology Hospital, Harbin, Heilongjiang, China
| | - Huping Song
- Department of Ophthalmology, Xi'an People's Hospital (Xi'an No.4 Hospital), Xi'an, Shaanxi, China
| | - Huijin Chen
- Department of Ophthalmology, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing, China
| | - Yun Wang
- Department of Ophthalmology, Xining First People's Hospital, Xining, Qinghai, China
| | - Jie Zhong
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
| | - Zhen Chen
- Eye Center, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Haokun Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Tiantian Yang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Mengxuan Li
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuanyuan Liu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xue Dong
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Molecular Ophthalmology and Tianjin Key Laboratory of Ocular Trauma, Tianjin Medical University, Tianjin, China
| | - Mei Du
- Department of Pharmacology, Tianjin Key Laboratory of Inflammation Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
- Laboratory of Molecular Ophthalmology and Tianjin Key Laboratory of Ocular Trauma, Tianjin Medical University, Tianjin, China
| | - Xiaohong Wang
- Department of Pharmacology, Tianjin Key Laboratory of Inflammation Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
- Laboratory of Molecular Ophthalmology and Tianjin Key Laboratory of Ocular Trauma, Tianjin Medical University, Tianjin, China
| | - Xuyang Yao
- Tianjin Medical University Eye Hospital, Eye Institute & School of Optometry and Ophthalmology, Tianjin, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong, China
- Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, Hainan, China
- Center for Precision Medicine and Department of Genetics and Biomedical Informatics, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Mulin Jun Li
- Department of Pharmacology, Tianjin Key Laboratory of Inflammation Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
- Department of Bioinformatics, The Province and Ministry Co-sponsored Collaborative Innovation Center for Medical Epigenetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, China
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Molecular Ophthalmology and Tianjin Key Laboratory of Ocular Trauma, Tianjin Medical University, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
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Jahnke L, Perrenoud V, Zandi S, Li Y, Conedera FM, Enzmann V. Modulation of Extracellular Matrix Composition and Chronic Inflammation with Pirfenidone Promotes Scar Reduction in Retinal Wound Repair. Cells 2024; 13:164. [PMID: 38247855 PMCID: PMC10814251 DOI: 10.3390/cells13020164] [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: 12/12/2023] [Revised: 01/11/2024] [Accepted: 01/13/2024] [Indexed: 01/23/2024] Open
Abstract
Wound repair in the retina is a complex mechanism, and a deeper understanding of it is necessary for the development of effective treatments to slow down or even prevent degenerative processes leading to photoreceptor loss. In this study, we harnessed a laser-induced retinal degeneration model (532-nm laser photocoagulation with 300 μm spot size, 60 ms duration and 60 mV pulse), enabling a profound molecular elucidation and a comprehensive, prolonged observation of the wound healing sequence in a murine laser-induced degeneration model (C57BL/6J mice, 6-12 weeks) until day 49 post-laser. Our observations included the expression of specific extracellular matrix proteins and myofibroblast activity, along with an analysis of gene expression related to extracellular matrix and adhesion molecules through RNA measurements. Furthermore, the administration of pirfenidone (10 mg/kg via drinking water), an anti-inflammatory and anti-fibrotic compound, was used to modulate scar formation after laser treatment. Our data revealed upregulated collagen expression in late regenerative phases and sustained inflammation in the damaged tissue. Notably, treatment with pirfenidone was found to mitigate scar tissue formation, effectively downregulating collagen production and diminishing the presence of inflammatory markers. However, it did not lead to the regeneration of the photoreceptor layer.
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Affiliation(s)
- Laura Jahnke
- Department of Ophthalmology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
- Department of BioMedical Research, University of Bern, 3008 Bern, Switzerland
| | - Virginie Perrenoud
- Department of Ophthalmology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
| | - Souska Zandi
- Department of Ophthalmology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
- Department of BioMedical Research, University of Bern, 3008 Bern, Switzerland
| | - Yuebing Li
- Department of Ophthalmology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
- Department of BioMedical Research, University of Bern, 3008 Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, 3012 Bern, Switzerland
| | - Federica Maria Conedera
- Department of Ophthalmology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
- Department of Oncology, Microbiology and Immunology, University of Fribourg, 1700 Fribourg, Switzerland
| | - Volker Enzmann
- Department of Ophthalmology, Bern University Hospital, University of Bern, 3010 Bern, Switzerland
- Department of BioMedical Research, University of Bern, 3008 Bern, Switzerland
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Chen H, Jin X, Zhou Z, Zhang X, Han J, Wang L. Characteristics and scoring method of computed tomography in open-globe injuries. BMC Ophthalmol 2024; 24:2. [PMID: 38166861 PMCID: PMC10759343 DOI: 10.1186/s12886-023-03269-6] [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] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Open-globe injuries (OGIs) remain the important cause of visual impairment and loss in all ages. Computed Tomography (CT) is a useful and common tool in the evaluation of the injuries of the eyeball. Prognostic value of CT scan in OGIs has been evaluated in many studies. However, there is no published consistent systematic scoring method for CT scan in OGIs. The purpose of this study was to evaluate the CT characteristics of OGIs and build a scoring method according to the CT scans which may aid the clinicians in management of OGIs. METHODS Retrospective chart review of inpatients with clinical diagnosis of OGIs between 2017 and 2021 at Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Henan provincial People's Hospital (Zhengzhou, China). RESULTS There were 1120 eyes from 1117 patients included in our study. The mean age was 35.7 ± 21.9 years with the range from 1 to 91 years. Significant male predominance was noted (889, 79.6%). CT scans of the OGIs were evaluated. Abnormality of anterior segment, posterior segment, and globe contour and volume were graded respectively. The most serious abnormality of anterior segment, posterior segment, and globe contour and volume were grade 3, 4 and 3 respectively and score 3, 4 and 3 respectively. Score of the CT scans of an open-injured globe ranged from 0 to 10. The correlation coefficient between the score and wound length was 0.798. The correlation coefficient between the score and final visual acuity was 0.799. In 78 eyes with 0 score, 70 eyes (89.7%) gained final visual acuity of 0.3 or better. In 31 eyes with 10 score, 20 eyes (64.5%) underwent evisceration of the eye globe and 10 eyes got visual acuity of no light perception and 1 eye lost to follow-up. CONCLUSIONS CT scans is a useful tool in evaluating the severity of an open-injured globe. Scoring of the CT scans of an open-injured globe is a meaningful attempt and it may provide useful prognostic information regarding the outcome of an open-injured globe.
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Affiliation(s)
- Hongling Chen
- Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
| | - Xuemin Jin
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhongqiang Zhou
- Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Xianliang Zhang
- Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Junjun Han
- Department of Ophthalmology, Henan Eye Institute, Henan Eye Hospital, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Ling Wang
- Department of Medical Imaging, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
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12
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Chitturi SP, Venkatesh R, Handa A, Mangla R, Chhablani J. A rare case of hyperpigmented torpedo maculopathy. Eur J Ophthalmol 2024; 34:NP108-NP110. [PMID: 37309137 DOI: 10.1177/11206721231182736] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE To describe a rare presentation of torpedo maculopathy (TM). CASE DESCRIPTION A 25-year-old male was examined in the retina clinic for a macular scar in the left eye. His visual acuity was 20/20, N6 in both eyes and no past history of ocular trauma or any medical or ocular history. The anterior segment was quiet and intraocular pressure was normal. RESULTS The patient's left eye on 78D slit lamp biomicroscopy revealed a flat, diffusely hyperpigmented fusiform torpedo-like lesion with sharp margins and surrounding hypopigmentation located predominantly temporal to the fovea, with its tip pointing towards it and just crossing the vertical foveal midline. Dilated fundus examination with binocular indirect ophthalmoscopy revealed no peripheral chorioretinal lesions or vitritis in both eyes. OCT scan through the lesion revealed gross damage to the outer retinal layers, as well as thickening of the retinal pigment epithelium and underlying shadowing, as well as a hyporeflective subretinal cleft involving the lesion. OCT also revealed outer retinal layer damage with an intact retinal pigment epithelium through the lesion's hypopigmented margins. Fundus autofluorescence image revealed a globally hypoautofluorescent lesion in the left eye, with surrounding patchy hyperautofluoroscent areas. Based on the patient history, clinical and imaging findings, other differential diagnoses such as atypical congenital hypertrophy of retinal pigment epithelium (RPE), choroidal nevus, RPE hamartoma, trauma and inflammatory conditions were ruled out. The diagnosis of TM was confirmed based on the typical lesion shape and location. CONCLUSION A torpedo lesion with diffuse hyperpigmentation is an unusually rare presentation.
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Affiliation(s)
| | - Ramesh Venkatesh
- Dept. of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Ashit Handa
- Dept. of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Rubble Mangla
- Dept. of Retina and Vitreous, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Jay Chhablani
- University of Pittsburgh School of Medicine, Medical Retina and Vitreoretinal Surgery, Pittsburg, PA, USA
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13
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Arseneault M, Mawko G, Abraham RJ. 90Y Contamination in the Interventional Radiology Suite: VARSKIN Estimation of Skin and Eye Injury and Review of Mitigation Strategies. J Nucl Med Technol 2023; 51:290-295. [PMID: 37586853 DOI: 10.2967/jnmt.122.265108] [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] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 05/10/2023] [Indexed: 08/18/2023] Open
Abstract
Our objective was to demonstrate, through computer simulations, radiation exposure levels from a 90Y contamination event during radioembolization procedures to calculate the radiation doses from various contamination scenarios. We also provide reasonable safety protocols to prevent contamination and minimize radiation exposure during decontamination. Methods: Simulations were performed using the computer code VARSKIN+, version 1.0, to determine the amount of radiation exposure resulting from different contamination scenarios. Results: The annual radiation dose limit to the skin and the lens of the eye was exceeded within 23 s of exposure to a 44-MBq droplet. Double layers of surgical gloves and level 3 gowns provided some attenuation of radiation from 90Y contamination by reducing the dose rate by 39% and 44%, respectively. Two layers of surgical gloves offered the best ratio of radiation protection without compromising dexterity. Conclusion: This study demonstrated that radiation exposures during 90Y spills or contamination events can be considerable. Interventional radiology and nuclear medicine personnel must be mindful of the risks, follow strategies to prevent spills, and be familiar with recommended decontamination procedures for spills in the interventional radiology suite.
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Affiliation(s)
- Michael Arseneault
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; and
| | - George Mawko
- Department of Diagnostic Radiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Robert J Abraham
- Department of Diagnostic Radiology, Dalhousie University, Halifax, Nova Scotia, Canada
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14
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Lotfy NM, Al Rashidi S, Hagras SM. Clinical outcomes of vacuum-dehydrated amniotic membrane (Omnigen) mounted on contact lens (Omnilenz) in eyes with acute chemical eye injuries. Graefes Arch Clin Exp Ophthalmol 2023; 261:3541-3547. [PMID: 37358651 PMCID: PMC10667437 DOI: 10.1007/s00417-023-06151-9] [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: 03/10/2023] [Revised: 05/09/2023] [Accepted: 06/07/2023] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Omnigen is a vacuum-dehydrated amniotic membrane transplant. It can be delivered to the eye pre-mounted on a special bandage contact lens (Omnilenz) that enables its application without the need for sutures or glue; the aim of this study is to evaluate the short-term clinical outcomes of Omnilenz-Omnigen complex in eyes with acute chemical injury (CEI). METHODS A prospective interventional study included patients with different grades of acute CEI attending the casualty between July 2021 and November 2022. All patients received first aid measures followed by the application of Omnilenz-Omnigen within the first 2 days. Patients were followed up for at least 1 month. Primary outcomes include epithelial defect and limbal ischemia. Secondary outcomes include best-corrected visual acuity (BCVA) and tolerability. RESULTS The study included 23 eyes of 21 patients with acute CEI mostly due to alcohol (34.8%). After the 1st application, the size of the epithelial defect showed a statistically significant reduction (p = 0.016) with improvement in BCVA (p < 0.001). Restoration of the limbal vascularity was obtained in 56.5% of the eyes. Repeated application of Omnilenz was required in 5 eyes (21.7%). The size of the epithelial defect was reduced after the second application (p = 0.504) with improved BCVA (p = 0.185). After 1st month, complete epithelial healing was achieved in all the eyes. Mild limbal ischemia persists in 3 (13%) of the eyes. Final BCVA showed statistically significant improvement (p < 0.001). None of the patients develops any serious complications. CONCLUSION Omnilenz proved to be easy to apply and well tolerated by patients, with promising clinical outcomes.
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Affiliation(s)
- Nancy M Lotfy
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Al-Saray Street, El Manial, Cairo, 11956, Egypt.
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15
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Rivera-Lara L, Videtta W, Calvillo E, Mejia-Mantilla J, March K, Ortega-Gutierrez S, Obrego GC, Paranhos JE, Suarez JI. Reducing the incidence and mortality of traumatic brain injury in Latin America. Eur J Trauma Emerg Surg 2023; 49:2381-2388. [PMID: 36637481 DOI: 10.1007/s00068-022-02214-4] [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] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 12/26/2022] [Indexed: 01/14/2023]
Abstract
Traumatic brain injury (TBI) represents a considerable portion of the global injury burden. The incidence of TBI will continue to increase in view of an increase in population density, an aging population, and the increased use of motor vehicles, motorcycles, and bicycles. The most common causes of TBI are falls and road traffic injuries. Deaths related to road traffic injury are three times higher in low-and middle-income countries (LMIC) than in high-income countries (HIC). The Latin American Caribbean region has the highest incidence of TBI worldwide, primarily caused by road traffic injuries. Data from HIC indicates that road traffic injuries can be successfully prevented through concerted efforts at the national level, with coordinated and multisector responses to the problem. Such actions require implementation of proven measures to address the safety of road users and the vehicles themselves, road infrastructure, and post-crash care. In this review, we focus on the epidemiology of TBI in Latin America and the implementation of solutions and preventive measures to decrease mortality and long-term disability.
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Affiliation(s)
- Lucia Rivera-Lara
- Department of Neurology, School of Medicine, Center for Academic Medicine, Stanford University, 453 Quarry Road, Palo Alto, CA, 94304, USA.
| | - Walter Videtta
- Department of National Hospital, Alejandro Posadas, Buenos Aires, Argentina
| | - Eusebia Calvillo
- Departments of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | | | - Karen March
- Clinical Development at Integra Life Sciences, Seattle, WA, USA
| | | | | | - Jorge E Paranhos
- Santa Casa da Misericordia de São João del Rey, Minas Gerais, Brazil
| | - Jose I Suarez
- Departments of Anesthesiology & Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
- Departments of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
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16
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Garrido-Hermosilla AM, Girón-Ortega M, Díaz-Ruiz MC. Evisceration of a globe with large scleromalacia and uveal prolapse after vegetal chemical burn. Orbit 2023; 42:659-660. [PMID: 34629035 DOI: 10.1080/01676830.2021.1982993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 09/08/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Antonio Manuel Garrido-Hermosilla
- Oculoplastics-Orbit & Ocular Oncology Units, Department of Ophthalmology, Virgen Macarena University Hospital, Seville, Spain
- RETICS OftaRed, Institute of Health Carlos III, Madrid, Spain
| | - Marina Girón-Ortega
- Department of Ophthalmology, Virgen Macarena University Hospital, Seville, Spain
| | - María Concepción Díaz-Ruiz
- Oculoplastics-Orbit & Ocular Oncology Units, Department of Ophthalmology, Virgen Macarena University Hospital, Seville, Spain
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17
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Yang J, Du Y, Zhen Z, Wang S, Zhao S, Zhao G, Shi B. Insights into orbital morphological features and fracture patterns in medial and inferior wall fracture: a retrospective cohort study. Sci Rep 2023; 13:20862. [PMID: 38012242 PMCID: PMC10681974 DOI: 10.1038/s41598-023-47941-9] [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] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 11/20/2023] [Indexed: 11/29/2023] Open
Abstract
This study investigated the orbital morphological features that lead to fractures at different sites by comparing patients with isolated inferior wall fracture (IWF) to patients with isolated medial wall fracture (MWF). This study analyzed the orbital morphologic characteristics of all orbital fracture patients who underwent orbital computed tomography (CT) scans between January 2017 and October 2022. On CT scans, the bony structures of the orbit were measured. We investigated the bilateral symmetry of orbital. In addition, orbital morphological differences were compared between patients with fractures of the medial wall and those with fractures of the inferior wall. A total of 135 patients with orbital fractures were included in the study. Of these, 91 were isolated MWFs and 44 were isolated IWF. We confirmed the symmetry of bilateral orbits and measured the orbit of the uninjured side. No differences were found between the MWF group and the IWF group in terms of ocular prominence, horizontal orbital diameter, orbital rim angle, sagittal orbital depth, sagittal orbital depth, and angle of inferior wall inclination. The distance between the infraorbital nerve (ION) entry point and the orbital rim was significantly smaller in the inferior lateral wall fracture group than in the MWF group (11.87 ± 2.54 vs 14.90 ± 4.64, P < 0.001), and the percentage of type 1 ION was significantly lower in the IWF group than in the MWF group (40.9% vs 65.9%, P = 0.012). We demonstrated the symmetry of bilateral orbits and found that when the point where the ION enters the infraorbital canal is near the orbital rim, patients are more prone to suffering a fracture of the inferior wall after orbital trauma. It is less likely for patients with type 1 ION to suffer an IWF following an orbital fracture.
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Affiliation(s)
- Junjie Yang
- Department of Ophthalmology, Union Hospital, Tong Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yali Du
- Department of Ophthalmology, Union Hospital, Tong Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhengyun Zhen
- Hubei Hospital of Integrated Traditional Chinese and Western Medicine, Wuhan, China
| | - Shuang Wang
- Department of Ophthalmology, Union Hospital, Tong Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sumei Zhao
- Hebei General Hospital for Veterans, Xingtai, China
| | - Guang Zhao
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Bingjie Shi
- Department of Ophthalmology, Union Hospital, Tong Medical College, Huazhong University of Science and Technology, Wuhan, China.
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18
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Hajira N, Sharma A, Dang K, Shashidhara HS, Khandelwal P. Custom-made ocular prosthesis: solitary method to improve facial aesthetics (a case report). Pan Afr Med J 2023; 46:86. [PMID: 38314228 PMCID: PMC10837282 DOI: 10.11604/pamj.2023.46.86.29680] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 03/05/2022] [Indexed: 02/06/2024] Open
Abstract
Loss of facial structures has a physical, social and psychological impact on affected individuals. Ocular trauma caused by assaults, falls, road traffic accidents, and household or work-related accidents may necessitate eye enucleation. Enucleation is also performed to treat severe infections of the eye, intraocular tumours and painful blind eyes. This procedure can result in post-enucleation socket syndrome with facial disfigurement and severely compromising facial aesthetics. Our patient complained of facial disfigurement because of a defect associated with the right eye. History and clinical features were suggestive of post-enucleation socket syndrome. The defect was rehabilitated with an ocular prosthesis. The rehabilitation procedure provided satisfactory results and a happy patient with good aesthetics. Maxillofacial prosthesis can restore and rehabilitate lost facial structures with artificial substitutes and helps in regaining patient´s natural appearance, the health of adjoining structures and subsequently, provide physical, social and psychological well-being.
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Affiliation(s)
- Neha Hajira
- Department of Prosthodontics, Rural Dental College, Pravara Institute of Medical Sciences University Deemed to be University (PIMS-DU), Loni, Ahmednagar, Maharashtra, India
| | - Atulya Sharma
- Department of Prosthodontics, College of Dental Sciences, Davangere, Karnataka, India
| | - Krutika Dang
- Department of Prosthodontics, College of Dental Sciences, Davangere, Karnataka, India
| | | | - Pulkit Khandelwal
- Department of Oral and Maxillofacial Surgery, Rural Dental College, Pravara Institute of Medical Sciences University (PIMS-DU), Loni, Ahmednagar, Maharashtra, India
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Abstract
We present a rare case of traumatic self-enucleation of the bilateral globes resulting in traumatic subarachnoid and intraventricular hemorrhages. This case highlights the critical importance of multidisciplinary trauma care, starting with recognition of the potential for less obvious injuries such as contralateral optic nerve injury in unilateral enucleation, intracranial hemorrhage, and cerebrovascular injuries. We highlight the role of a thorough trauma assessment and workup, especially in the context of highly distracting injuries in patients who may also have severe mental illness. The trauma and acute care surgeon, who also serves as the critical care specialist, should be well prepared to facilitate care between multiple subspecialists including neurosurgeons, interventional radiologists, vascular surgeons, and psychiatrists, with a high index of suspicion for occult trauma in seemingly isolated injuries.
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Affiliation(s)
- James Alford Flippin
- Department of Surgery, Division of Trauma, Critical Care, Burns and Emergency General Surgery, MetroHealth Medical Center, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Evelyn Truong
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Sami Kishawi
- Department of Surgery, Division of Trauma, Critical Care, Burns and Emergency General Surgery, MetroHealth Medical Center, Cleveland, OH, USA
| | - Annie Allan
- Department of Surgery, Division of Trauma, Critical Care, Burns and Emergency General Surgery, MetroHealth Medical Center, Cleveland, OH, USA
| | - Vanessa P. Ho
- Department of Surgery, Division of Trauma, Critical Care, Burns and Emergency General Surgery, MetroHealth Medical Center, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
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20
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Feng Y, Hu C, Cui K, Fan M, Xiang W, Ye D, Shi Y, Ye H, Bai X, Wei Y, Xu Y, Huang J. GSK840 Alleviates Retinal Neuronal Injury by Inhibiting RIPK3/MLKL-Mediated RGC Necroptosis After Ischemia/Reperfusion. Invest Ophthalmol Vis Sci 2023; 64:42. [PMID: 38015174 PMCID: PMC10691386 DOI: 10.1167/iovs.64.14.42] [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] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 11/06/2023] [Indexed: 11/29/2023] Open
Abstract
Purpose This study aimed to explore the impact of GSK840 on retinal neuronal injury after retinal ischemia/reperfusion (IR) and its associated mechanism. Methods We established an in vivo mouse model of IR and an in vitro model of oxygen and glucose deprivation/reoxygenation (OGDR) in primary mouse retinal ganglion cells (RGCs). GSK840, a small-molecule compound, was used to specifically inhibit RIPK3/MLKL-dependent necroptosis. Retinal structure and function evaluation was performed by using hematoxylin and eosin staining, optical coherence tomography, and electroretinography. Propidium Iodide (PI) staining was used for detection of necroptotic cell death, whereas Western blot analysis and immunofluorescence were used to assess necroptosis-related proteins and inner retinal neurons. Results RIPK3/MLKL-dependent necroptosis was rapidly activated in RGCs following retinal IR or OGDR. GSK840 helped maintain relatively normal inner retinal structure and thickness by preserving inner retinal neurons, particularly RGCs. Meanwhile, GSK840 ameliorated IR-induced visual dysfunction, as evidenced by the improved amplitudes of photopic negative response, a-wave, b-wave, and oscillatory potentials. And GSK840 treatment significantly reduced the population of PI+ RGCs after injury. Mechanistically, GSK840 ameliorated RGC necroptosis by inhibiting the RIPK3/MLKL pathway. Conclusions GSK840 exerts protective effects against retinal neuronal injury after IR by inhibiting RIPK3/MLKL-mediated RGC necroptosis. GSK840 may represent a protective strategy for RGC degeneration in ischemic retinopathy.
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Affiliation(s)
- Yanlin Feng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Chenyang Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Kaixuan Cui
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Matthew Fan
- Yale College, Yale University, New Haven, Connecticut, United States
| | - Wu Xiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Dan Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yuxun Shi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Huiwen Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Xue Bai
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yantao Wei
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yue Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Jingjing Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
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Motoyoshi A, Saitoh F, Iida T, Fujieda H. Nestin Regulates Müller Glia Proliferation After Retinal Injury. Invest Ophthalmol Vis Sci 2023; 64:8. [PMID: 37934159 PMCID: PMC10631512 DOI: 10.1167/iovs.64.14.8] [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] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/15/2023] [Indexed: 11/08/2023] Open
Abstract
Purpose The proliferative and neurogenic potential of retinal Müller glia after injury varies widely across species. To identify the endogenous mechanisms regulating the proliferative response of mammalian Müller glia, we comparatively analyzed the expression and function of nestin, an intermediate filament protein established as a neural stem cell marker, in the mouse and rat retinas after injury. Methods Nestin expression in the retinas of C57BL/6 mice and Wistar rats after methyl methanesulfonate (MMS)-induced photoreceptor injury was examined by immunofluorescence and Western blotting. Adeno-associated virus (AAV)-delivered control and nestin short hairpin RNA (shRNA) were intravitreally injected to rats and Müller glia proliferation after MMS-induced injury was analyzed by BrdU incorporation and immunofluorescence. Photoreceptor removal and microglia/macrophage infiltration were also analyzed by immunofluorescence. Results Rat Müller glia re-entered the cell cycle and robustly upregulated nestin after injury whereas Müller glia proliferation and nestin upregulation were not observed in mice. In vivo knockdown of nestin in the rat retinas inhibited Müller glia proliferation while transiently stimulating microglia/macrophage infiltration and phagocytic removal of dead photoreceptors. Conclusions Our findings suggest a critical role for nestin in the regulation of Müller glia proliferation after retinal injury and highlight the importance of cross species analysis to identify the molecular mechanisms regulating the injury responses of the mammalian retina.
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Affiliation(s)
- Aya Motoyoshi
- Department of Anatomy and Neurobiology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
- Department of Ophthalmology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Fuminori Saitoh
- Department of Anatomy and Neurobiology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Tomohiro Iida
- Department of Ophthalmology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Hiroki Fujieda
- Department of Anatomy and Neurobiology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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22
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Rogerson T, Shields M, Chan W. Re: Lin et al.: Clinical outcomes after ocular trauma with Orbeez gel pellet projectiles (Ophthalmology. 2023;130:553-555). Ophthalmology 2023; 130:e35. [PMID: 37429498 DOI: 10.1016/j.ophtha.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 06/29/2023] [Accepted: 07/06/2023] [Indexed: 07/12/2023] Open
Affiliation(s)
- Thomas Rogerson
- The Canberra Hospital, Department of Ophthalmology, Garran, Australian Capital Territory, Australia; The University of Adelaide, Adelaide, South Australia, Australia.
| | - Melissa Shields
- Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - WengOnn Chan
- The University of Adelaide, Adelaide, South Australia, Australia; The Royal Adelaide Hospital, Adelaide, South Australia, Australia
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23
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Yang C, Nguyen DD, Lai J. Poly(l-Histidine)-Mediated On-Demand Therapeutic Delivery of Roughened Ceria Nanocages for Treatment of Chemical Eye Injury. Adv Sci (Weinh) 2023; 10:e2302174. [PMID: 37430140 PMCID: PMC10502830 DOI: 10.1002/advs.202302174] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/10/2023] [Indexed: 07/12/2023]
Abstract
Development of topical bioactive formulations capable of overcoming the low bioavailability of conventional eye drops is critically important for efficient management of ocular chemical burns. Herein, a nanomedicine strategy is presented to harness the surface roughness-controlled ceria nanocages (SRCNs) and poly(l-histidine) surface coatings for triggering multiple bioactive roles of intrinsically therapeutic nanocarriers and promoting transport across corneal epithelial barriers as well as achieving on-demand release of dual drugs [acetylcholine chloride (ACh) and SB431542] at the lesion site. Specifically, the high surface roughness helps improve cellular uptake and therapeutic activity of SRCNs while exerting a negligible impact on good ocular biocompatibility of the nanomaterials. Moreover, the high poly(l-histidine) coating amount can endow the SRCNs with an ≈24-fold enhancement in corneal penetration and an effective smart release of ACh and SB431542 in response to endogenous pH changes caused by tissue injury/inflammation. In a rat model of alkali burn, topical single-dose nanoformulation can efficaciously reduce corneal wound areas (19-fold improvement as compared to a marketed eye drops), attenuate ≈93% abnormal blood vessels, and restore corneal transparency to almost normal at 4 days post-administration, suggesting great promise for designing multifunctional metallic nanotherapeutics for ocular pharmacology and tissue regenerative medicine.
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Affiliation(s)
- Chia‐Jung Yang
- Department of Biomedical EngineeringChang Gung UniversityTaoyuan33302Taiwan
| | - Duc Dung Nguyen
- Department of Biomedical EngineeringChang Gung UniversityTaoyuan33302Taiwan
| | - Jui‐Yang Lai
- Department of Biomedical EngineeringChang Gung UniversityTaoyuan33302Taiwan
- Department of OphthalmologyChang Gung Memorial Hospital, LinkouTaoyuan33305Taiwan
- Department of Materials EngineeringMing Chi University of TechnologyNew Taipei City24301Taiwan
- Research Center for Chinese Herbal MedicineCollege of Human EcologyChang Gung University of Science and TechnologyTaoyuan33303Taiwan
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24
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Tang J, Liu H, Mo S, Zhu Z, Huang H, Liu X. Cone Density Distribution and Related Factors in Patients Receiving Hydroxychloroquine Treatment. Invest Ophthalmol Vis Sci 2023; 64:29. [PMID: 37713205 PMCID: PMC10506682 DOI: 10.1167/iovs.64.12.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
Purpose Hydroxychloroquine is an effective treatment for rheumatic diseases; however, retinal damage is a possible side effect. We aimed to identify the retinal area and related risk factors associated with cone density reduction caused by hydroxychloroquine. Methods We recorded the retinal images of patients with rheumatic diseases taking hydroxychloroquine (n = 44) and compared them with images of healthy controls (n = 107). Cone density was obtained in vertical and horizontal axes. Regions of decreased cone density and associations between age, rheumatic disease type, dosage for ideal body weight, and cone density were evaluated. Results Cone densities were significantly lower in hydroxychloroquine-treated patients than in sex- and age-matched controls in the vertical axis (P < 0.001), with no significant difference in the horizontal axis (P = 0.120); in healthy elderly than in healthy young people in the horizontal axis (P < 0.001), with no significant difference in the vertical axis (P = 0.100); in hydroxychloroquine-treated elderly than in hydroxychloroquine-treated young patients in both axes (both P < 0.05); among patients with different rheumatic disease types, with no significant difference in the vertical axis (P = 0.294). The daily dose was negatively correlated with cone density in the vertical axis and inferior quadrant. Conclusions Hydroxychloroquine reduces retinal cone cell density in the vertical axis. Cone density loss in the horizontal axis increases with age; further, hydroxychloroquine dosage is negatively correlated with cone density in the vertical axis and inferior quadrant. Early screening of hydroxychloroquine-related retinal injury should consider changes in cone density in the vertical axis.
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Affiliation(s)
- Jun Tang
- Department of Rheumatology and Immunology, Hainan Hospital of Chinese PLA General Hospital, Hainan, China
- Institute of Life Science and Laboratory of Tissue and Cell Biology, Lab Teaching & Management Center, Chongqing Medical University, Chongqing, China
| | - Hua Liu
- Department of Ophthalmology, Hainan Hospital of Chinese PLA General Hospital, Hainan, China
| | - Shiyan Mo
- Department of Rheumatology and Immunology, Hainan Hospital of Chinese PLA General Hospital, Hainan, China
| | - Zhihong Zhu
- Department of Ophthalmology, Hainan Hospital of Chinese PLA General Hospital, Hainan, China
| | - Houbin Huang
- Department of Ophthalmology, Hainan Hospital of Chinese PLA General Hospital, Hainan, China
| | - Xiaofei Liu
- Department of Rheumatology and Immunology, Hainan Hospital of Chinese PLA General Hospital, Hainan, China
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Perez EA, Scott NL, Russell JF. Improved Visual Outcomes after Severe Open-Globe Injuries Associated with Perioperative Vitreoretinal Evaluation. Ophthalmol Retina 2023; 7:771-778. [PMID: 37148970 DOI: 10.1016/j.oret.2023.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 04/24/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 05/08/2023]
Abstract
PURPOSE To investigate the impact of perioperative evaluation by a vitreoretinal surgeon on outcomes after severe open-globe injury (OGI). DESIGN Retrospective, comparative study. SUBJECTS Open-globe injury cohorts from 2 academic United States ophthalmology departments with disparate OGI management protocols and vitreoretinal referral patterns. METHODS Patients with severe OGI (presenting visual acuity [VA] of counting fingers or worse) from the University of Iowa Hospitals and Clinics (UIHC) were compared with patients with severe OGI from the Bascom Palmer Eye Institute (BPEI). At UIHC, almost all cases of OGI were repaired by anterior segment surgeons, with postoperative vitreoretinal referral at the surgeon's discretion. In contrast, at BPEI, all OGIs were both repaired and managed postoperatively by a vitreoretinal surgeon. MAIN OUTCOME MEASURES Rate of vitreoretinal surgeon evaluation, rate of pars plana vitrectomy (PPV) (either primary or secondary), and VA at the last follow-up. RESULTS Overall, 74 subjects from UIHC and 72 subjects from BPEI met the inclusion criteria. There were no differences in preoperative VA or rates of vitreoretinal pathology. The rate of vitreoretinal surgeon evaluation was 100% at BPEI and 65% at UIHC (P < 0.001), and the rate of PPV was 71% at BPEI and 40% at UIHC (P < 0.001). Median VA at the last follow-up in the BPEI cohort was 1.35 logarithm of the minimum angle of resolution (logMAR) (interquartile range [IQR], 0.53-2.30, corresponding to a Snellen VA of ∼ 20/500) compared with a median VA of 2.70 logMAR (IQR, 0.93-2.92, corresponding to a Snellen VA of light perception) in the UIHC cohort (P = 0.031). Overall, 68% of patients in the BPEI cohort had an improvement in VA from presentation to last follow-up versus 43% in the UIHC cohort (P = 0.004). CONCLUSIONS Automatic perioperative evaluation by a vitreoretinal surgeon was associated with a higher rate of PPV and improved visual outcomes. Prompt evaluation by a vitreoretinal surgeon, either preoperatively or in the early postoperative period, should be considered, when logistically feasible, in severe OGIs because PPV is frequently indicated and may result in significant visual improvement. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Eli A Perez
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Nathan L Scott
- Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Jonathan F Russell
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa.
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Grall P, Schlund M, De Massary M, Nicot R. Post-traumatic enophthalmos: Is it only about bone? J Stomatol Oral Maxillofac Surg 2023; 124:101435. [PMID: 36907511 DOI: 10.1016/j.jormas.2023.101435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/12/2023]
Affiliation(s)
- Patrick Grall
- Univ. Lille, CHU Lille, Service de Chirurgie Maxillo-Faciale et Stomatologie, F-59000 Lille, France.
| | - Matthias Schlund
- Univ. Bordeaux, CHU Bordeaux, Inserm, Service de Chirurgie Maxillo-Faciale et Stomatologie, BioTis - Bioengineering of Tissues Inserm U1026, F-33000 Bordeaux, France
| | | | - Romain Nicot
- Univ. Lille, CHU Lille, INSERM, CNRS, Centrale Lille, Service de Chirurgie Maxillo-Faciale et Stomatologie, U1008 - Advanced Drug Delivery Systems, UMR9013 - LaMcube - Laboratoire de mécanique, multiphysique, multiéchelle, F-59000 Lille, France
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27
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Yang XD, Lyu Y. Rigid Gas-Permeable Contact Lens for Visual Rehabilitation in Children Younger Than 12 Years With Penetrative Ocular Trauma. Eye Contact Lens 2023; 49:e364-e369. [PMID: 37471251 PMCID: PMC10442111 DOI: 10.1097/icl.0000000000001015] [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] [Subscribe] [Scholar Register] [Accepted: 06/04/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVES To observe the clinical outcomes of visual rehabilitation using rigid gas-permeable contact lenses (RGPCLs) after penetrative ocular trauma in children younger than 12 years in China. METHODS Patients younger than 12 years with penetrative ocular trauma fitted with an RGPCL for visual rehabilitation from 2017 to 2021 were included. In the case cohort, the best-corrected visual acuity (BCVA) with spectacles was measured when the RGPCL was fitted, and the initial BCVA with RGPCL, and the BCVA at the last visit were compared. RESULTS Fifteen patients, aged 4 to 12 (mean 8.0±2.7) years, who wore an RGPCL for 7 to 53 (mean 20.3±15.7) months, were included. The BCVA was log of minimal angle of resolution 0.4 (0.2-0.7) with spectacles and 0.1 (0.1-0.2) for RGPCL at the initial visit, and 0.0 (0.0-0.1) for BCVA at the last visit, with a statistically significant difference between the three comparisons ( P <0.001). Six of the 15 (40%) children abandoned wearing RGPCL because of discomfort and lens rejection (n=3, 50%), lens loss and inability to replace broken lens because of travel distances and epidemics (n=2, 33%), and cost (n=1, 17%). CONCLUSIONS Although application is complicated and initial wearing comfort is poor, an RGPCL is still a beneficial, safe tool for postoperative visual rehabilitation in children with open ocular trauma.
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Affiliation(s)
- Xiao-Di Yang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yong Lyu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Chung RT, Legault GL, Stowe JS, Miller KE, Moccia MA, Cooper MR, Little JR, Gensheimer WG. Applying a Military Teleophthalmology Mobile App in a Noncombat Emergent Care Setting. Mil Med 2023; 188:e2909-e2915. [PMID: 36394286 DOI: 10.1093/milmed/usac345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/29/2022] [Accepted: 10/21/2022] [Indexed: 08/31/2023] Open
Abstract
INTRODUCTION Teleophthalmology has a natural role in the military due to the inherent organization of its medical system, which provides care to patients in remote locations around the world. Improving access to ophthalmic care enhances force readiness because ocular trauma and disease can cause vision impairment or blindness and can occur anywhere service members are located. Recently, a secure, Health Insurance Portability and Accountability Act-compliant mobile phone application (app) for teleophthalmology called Forward Operating Base Expert Telemedicine Resource Utilizing Mobile Application for Trauma (FOXTROT) was beta tested in Afghanistan and demonstrated that this solution can improve and extend ophthalmic care in a deployed environment. There are few civilian or military teleophthalmology solutions for ocular trauma and disease in an urgent or emergent ophthalmic care setting. Civilian teleophthalmology solutions have largely been developed for disease-specific models of care. In this work, we address this gap by testing the FOXTROT app in a non-deployed, emergent care setting. MATERIALS AND METHODS We evaluated the use of the teleophthalmology mobile phone app (FOXTROT) in a non-deployed military setting at the Malcolm Grow Medical Clinics and Surgery Center at Joint Base Andrews in Maryland. Consults from the emergent care center were placed by providers using the app, and the on-call ophthalmologist responded with treatment and management recommendations. The primary outcomes were response within the requested time, visual acuity tested in both eyes, agreement between the teleophthalmology and the final diagnosis, and the number of communication or technical errors that prevented the completion of consults. The secondary outcomes were average response time and the number of consults uploaded to the medical record. RESULTS From October 2020 to January 2022, 109 consults were received. Ten consults had communication or technical errors that prevented the completion of consults within the app and were excluded from the analysis of completed consults. Of the 99 completed consults, responses were given within the requested time in 95 (96.0%), with the average response time in 11 minutes 48 seconds (95% confidence interval, 8 minutes 57 seconds to 14 minutes 41 seconds). Visual acuity was tested in both eyes in 56 (56.6%). There was agreement between the teleophthalmology diagnosis and the final diagnosisin 40 of 50 (80.0%) consults with both a teleophthalmology and final diagnosis. Ninety-eight (99.0%) consults were uploaded to the patient's medical record. CONCLUSIONS Beta testing of a teleophthalmology mobile phone app (FOXTROT) in a noncombat emergent care setting demonstrated that this solution can extend ophthalmic care in this environment at a military treatment facility. However, improvements in the reliability of the platform are needed in future developments to reduce communication and technical errors.
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Affiliation(s)
- Robert T Chung
- Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
| | - Gary L Legault
- Department of Ophthalmology, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA
- Department of Surgery, Uniformed Services University, Bethesda, MD 20814, USA
| | - Jennifer S Stowe
- US Army Aeromedical Research Laboratory, Fort Rucker, AL 36362, USA
| | - Kyle E Miller
- Department of Surgery, Uniformed Services University, Bethesda, MD 20814, USA
- Department of Ophthalmology, Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA
| | - Michelle A Moccia
- Warfighter Eye Center, Joint Base Andrews, Joint Base Andrews, MD 20762, USA
| | - Mabel R Cooper
- Telemedicine & Advanced Technology Research Center (TATRC), Fort Detrick, MD 21702, USA
| | - Jeanette R Little
- Telemedicine & Advanced Technology Research Center (TATRC), Fort Detrick, MD 21702, USA
- Digital Health Innovation Center (DHIC), Fort Gordon, GA 30905, USA
- US Army Medical Research and Development Command (MRDC), Fort Detrick, MD 21702, USA
| | - William G Gensheimer
- Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
- Section of Ophthalmology, White River Junction VA Medical Center, White River Junction, VT 05001, USA
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Zhou C, Lei F, Mittermaier M, Ksander B, Dana R, Dohlman CH, Vavvas DG, Chodosh J, Paschalis EI. Opposing Roles of Blood-Borne Monocytes and Tissue-Resident Macrophages in Limbal Stem Cell Damage after Ocular Injury. Cells 2023; 12:2089. [PMID: 37626899 PMCID: PMC10453077 DOI: 10.3390/cells12162089] [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: 07/04/2023] [Revised: 08/14/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
Limbal stem cell (LSC) deficiency is a frequent and severe complication after chemical injury to the eye. Previous studies have assumed this is mediated directly by the caustic agent. Here we show that LSC damage occurs through immune cell mediators, even without direct injury to LSCs. In particular, pH elevation in the anterior chamber (AC) causes acute uveal stress, the release of inflammatory cytokines at the basal limbal tissue, and subsequent LSC damage and death. Peripheral C-C chemokine receptor type 2 positive/CX3C motif chemokine receptor 1 negative (CCR2+ CX3CR1-) monocytes are the key mediators of LSC damage through the upregulation of tumor necrosis factor-alpha (TNF-α) at the limbus. In contrast to peripherally derived monocytes, CX3CR1+ CCR2- tissue-resident macrophages have a protective role, and their depletion prior to injury exacerbates LSC loss and increases LSC vulnerability to TNF-α-mediated apoptosis independently of CCR2+ cell infiltration into the tissue. Consistently, repopulation of the tissue by new resident macrophages not only restores the protective M2-like phenotype of macrophages but also suppresses LSC loss after exposure to inflammatory signals. These findings may have clinical implications in patients with LSC loss after chemical burns or due to other inflammatory conditions.
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Affiliation(s)
- Chengxin Zhou
- Department of Ophthalmology, Massachusetts Eye and Ear and Schepens Eye Research Institute, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA; (C.Z.); (F.L.); (M.M.); (B.K.); (R.D.); (C.H.D.); (J.C.)
- Boston Keratoprosthesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA
- Disruptive Technology Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Fengyang Lei
- Department of Ophthalmology, Massachusetts Eye and Ear and Schepens Eye Research Institute, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA; (C.Z.); (F.L.); (M.M.); (B.K.); (R.D.); (C.H.D.); (J.C.)
- Boston Keratoprosthesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA
- Disruptive Technology Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Mirja Mittermaier
- Department of Ophthalmology, Massachusetts Eye and Ear and Schepens Eye Research Institute, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA; (C.Z.); (F.L.); (M.M.); (B.K.); (R.D.); (C.H.D.); (J.C.)
| | - Bruce Ksander
- Department of Ophthalmology, Massachusetts Eye and Ear and Schepens Eye Research Institute, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA; (C.Z.); (F.L.); (M.M.); (B.K.); (R.D.); (C.H.D.); (J.C.)
| | - Reza Dana
- Department of Ophthalmology, Massachusetts Eye and Ear and Schepens Eye Research Institute, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA; (C.Z.); (F.L.); (M.M.); (B.K.); (R.D.); (C.H.D.); (J.C.)
| | - Claes H. Dohlman
- Department of Ophthalmology, Massachusetts Eye and Ear and Schepens Eye Research Institute, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA; (C.Z.); (F.L.); (M.M.); (B.K.); (R.D.); (C.H.D.); (J.C.)
- Boston Keratoprosthesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA
| | - Demetrios G. Vavvas
- Retina Service, Department of Ophthalmology, Massachusetts Eye and Ear, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA;
| | - James Chodosh
- Department of Ophthalmology, Massachusetts Eye and Ear and Schepens Eye Research Institute, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA; (C.Z.); (F.L.); (M.M.); (B.K.); (R.D.); (C.H.D.); (J.C.)
- Boston Keratoprosthesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA
- Disruptive Technology Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
- Department of Ophthalmology and Visual Sciences, University of New Mexico School of Medicine, Albuquerque, NM 87108, USA
| | - Eleftherios I. Paschalis
- Department of Ophthalmology, Massachusetts Eye and Ear and Schepens Eye Research Institute, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA; (C.Z.); (F.L.); (M.M.); (B.K.); (R.D.); (C.H.D.); (J.C.)
- Boston Keratoprosthesis Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear, Mass General Brigham, Harvard Medical School, Boston, MA 02114, USA
- Disruptive Technology Laboratory, Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
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Speidel AJ, Wolf A, Peraud A, Schuler-Ortoli M, Parlak M. [Orbital impalement injury in childhood: the importance of imaging and interdisciplinary treatment]. Ophthalmologie 2023; 120:860-862. [PMID: 36074169 DOI: 10.1007/s00347-022-01724-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 08/01/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Affiliation(s)
- A J Speidel
- Klinik für Augenheilkunde, Universitätsklinik Ulm, Ulm, Deutschland.
- Universitätsaugenklinik Ulm, Prittwitzstr. 43, 89075, Ulm, Deutschland.
| | - A Wolf
- Klinik für Augenheilkunde, Universitätsklinik Ulm, Ulm, Deutschland
| | - A Peraud
- Klinik für Neurochirurgie, Sektion pädiatrische Neurochirurgie, Universitätsklinik Ulm, Ulm, Deutschland
| | - M Schuler-Ortoli
- Klinik für Neurochirurgie, Sektion pädiatrische Neurochirurgie, Universitätsklinik Ulm, Ulm, Deutschland
| | - M Parlak
- Klinik für Augenheilkunde, Universitätsklinik Ulm, Ulm, Deutschland
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31
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Mukit FA, Laplant JF, Wallace D, Troy C, Einhaus SL, Fowler BT. When the Cost of Vaping Is an Eye: A Case of an Open Globe and Superior Orbital Roof Fracture. Ophthalmic Plast Reconstr Surg 2023; 39:e128-e132. [PMID: 36972111 DOI: 10.1097/iop.0000000000002385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
The authors report a penetrating orbitocerebral vape pen injury necessitating a primary enucleation and craniotomy to remove the foreign body fragments. A 31-year-old male presented with acute right vision loss after a modifiable vape pen explosion launched multiple projectile fragments into his right eye. CT revealed a deformed globe with multiple radiodense curvilinear fragments in the superior orbital roof and intracranial space. A right frontal craniotomy and orbitotomy with removal of vape pen fragments, reconstruction of the orbital roof, primary enucleation, and eyelid repair were performed in conjunction with neurosurgery. To the best of the authors' knowledge, this is the first reported penetrating globe injury from a vape pen explosion.
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Affiliation(s)
- Fabliha A Mukit
- Ophthalmic Plastic and Reconstructive Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee
| | - Jacquelyn F Laplant
- Ophthalmic Plastic and Reconstructive Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee
| | - David Wallace
- Neurosurgery, The University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - Christopher Troy
- Neurosurgery, The University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - Stephanie L Einhaus
- Neurosurgery, The University of Tennessee Health Science Center, Memphis, Tennessee, U.S.A
| | - Brian T Fowler
- Ophthalmic Plastic and Reconstructive Surgery, The University of Tennessee Health Science Center, Memphis, Tennessee
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Soleimani M, Momenaei B, Baradaran-Rafii A, Cheraqpour K, An S, Ashraf MJ, Abedi F, Javadi MA, Djalilian AR. Mustard Gas-Induced Ocular Surface Disorders: An Update on the Pathogenesis, Clinical Manifestations, and Management. Cornea 2023; 42:776-786. [PMID: 36729713 PMCID: PMC10164045 DOI: 10.1097/ico.0000000000003182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 05/24/2022] [Accepted: 09/12/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE Mustard gas (MG) is a potent blistering and alkylating agent that has been used for military and terrorism purposes. Ocular surface injuries are common after exposure to MG. This review provides an update on the pathophysiology, ocular surface complications, and treatment options for MG-related ocular injuries. METHODS Required information was obtained by reviewing various databases such as Cochrane Library, Google Scholar, and PubMed until March 2022. Data were collected by using keywords: "mustard gas" OR "sulfur mustard" AND "eye" OR "cornea" OR "ocular complication" OR "keratitis" OR "keratopathy" OR "limbal stem cell deficiency" OR "dry eye." RESULTS Chronic intracellular toxicity, inflammation, and ischemia have been shown to play an essential role in the pathogenesis of MG injury. Ocular surface injuries can have acute, chronic, and most distinctly a delayed-onset presentation leading to various degrees of limbal stem cell deficiency. To date, no treatment has been agreed on as the standard treatment for chronic/delayed-onset MG keratopathy. Based on the authors' experience, we propose a management algorithm for MG-related ocular surface injuries involving optimization of ocular health, anti-inflammatory therapy, and if needed surgical interventions. The management of chronic and delayed-onset presentation remains challenging. CONCLUSIONS MG keratopathy is a unique form of chemical injury which can lead to a range of ocular surface pathologies. Long-term anti-inflammatory therapy even in patients with seemingly mild disease may potentially reduce the likelihood of the development of more severe delayed-onset disease.
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Affiliation(s)
- Mohammad Soleimani
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bita Momenaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Baradaran-Rafii
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of ophthalmology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Kasra Cheraqpour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seungwon An
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Mohammad Javad Ashraf
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Farshad Abedi
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Mohammad Ali Javadi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali R. Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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Lin BR, Al-Khersan H, Rowsey T, West M, Lin A, Qu P, Bitrian E, Hudson J, Venincasa M, Fan J, Gutkind N, Diaz JD, Parekh P, Sultan H, Yannuzzi NA. Clinical Outcomes after Ocular Trauma with Orbeez Gel Pellet Projectiles. Ophthalmology 2023; 130:553-555. [PMID: 36717000 DOI: 10.1016/j.ophtha.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 01/30/2023] Open
Affiliation(s)
- Benjamin R Lin
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | - Hasenin Al-Khersan
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | - Tyler Rowsey
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Matthew West
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, Alabama
| | - Albert Lin
- University of Mississippi Medical Center, Jackson, Mississippi
| | - Phillip Qu
- University of Mississippi Medical Center, Jackson, Mississippi
| | - Elena Bitrian
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | - Julia Hudson
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | - Michael Venincasa
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | - Jason Fan
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | - Naomi Gutkind
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
| | | | | | | | - Nicolas A Yannuzzi
- Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida.
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Nguyen L, Seeber N, Schneider SW, Herberger K. Thermal eye injuries from dermatologic laser treatments-an experimental study. Lasers Med Sci 2023; 38:110. [PMID: 37086295 PMCID: PMC10122618 DOI: 10.1007/s10103-023-03769-3] [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] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 04/04/2023] [Indexed: 04/23/2023]
Abstract
In recent years, severe ocular complications after dermatological laser therapies have been reported. One hypothesis is thermal damage due to heating of the metal eye shields. The aim of the present study is to evaluate the safety of ocular metal eye shields during laser therapy of the periocular region. For the experimental study, porcine eyelids were exposed to continuously increasing laser energy and multiple pulses using a number of dermatologic laser systems. Temperature differences of the convex and concave surface of metal eye shields were constantly measured using a thermocouple. Maximum increase of the convex surface of shields was + 8.9 °C (± 0.1 °C) provided by the long-pulsed alexandrite laser (20-25-J/cm2 energy, 15-mm spot size, 20-ms pulse duration, 1 Hz). Present data indicate that metal eye shields provide sufficient thermal protection when clinically used laser parameters are applied. Other safety precautions continue to be essential to protect both the patient and the laser operator. These include the use of nonreflective metal eye shields, precise knowledge of laser physics, and a clear understanding of how they interact with ocular and periocular anatomy.
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Affiliation(s)
- Lynhda Nguyen
- Laser Department, Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Nikolaus Seeber
- Joint Practice for Dermatology Dres. Peter/ Seeber/ Altheide, Wandsbeker Marktstrasse 48-50, 22041, Hamburg, Germany
| | - Stefan W Schneider
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Katharina Herberger
- Laser Department, Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
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Abstract
Infectious keratitis is a rare but potentially severe sight-threatening disease, associated with considerable societal burden, cost and morbidity. This review summarises the most recent evidence for the incidence, risk factors and impact of disease, all of which vary widely according to region, access to health care, socioeconomic and environmental factors, predisposing conditions and causative organisms. The frequency and societal impact of infectious keratitis are significantly higher in low-income countries. In non-viral infectious keratitis, bacterial causes predominate in most regions. Fungi, particularly linked with agricultural trauma, are more frequently associated with infectious keratitis in low-income regions, particularly in India and certain African countries. The disease impact is compounded by poverty and limited access to services and treatment. Early diagnosis, access to appropriate treatment, prophylaxis in ocular trauma, availability of eye protection, awareness of risk factors may be associated with reduced disease severity and vision loss. Evidence for the incidence and burden of disease is lacking in certain regions and well-designed epidemiological studies to identify independent risk factors for the disease and those associated with more severe outcomes may better identify causation and guide resource allocation and preventative strategies.
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Affiliation(s)
- Fiona Stapleton
- School of Optometry and Vision Science, UNSW, Level 3, North Wing, RMB, Gate 14, Barker St, Sydney, NSW, 2052, Australia.
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36
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AlBalawi AA, Arevalo JF, Abodarahim AM, Alyousif NA, Hazzazi MA. Endophthalmitis Following Inadvertent Intraocular Botulinum Toxin A Injection. J Pediatr Ophthalmol Strabismus 2023; 60:e8-e10. [PMID: 36975116 DOI: 10.3928/01913913-20221229-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Botulinum toxin A injection is a safe alternative procedure to surgery in the management of different types of strabismus. Serious complications such as globe perforation are rare in expert hands. The authors report a case of a child known to have a muscle-eye-brain disease with high myopia who developed endophthalmitis following inadvertent penetrating intraocular botulinum toxin A injection for strabismus correction. To their knowledge, this serious complication after penetrating botulinum toxin A injection has not been previously reported. [J Pediatr Ophthalmol Strabismus. 2023;60(2):e8-e10.].
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Alvarez-Falcón S, Glaser T, Go MS, Kelly MP, Chen X, Freedman SF, El-Dairi M. Retinal injury identified by overhead-mounted optical coherence tomography in two young children with infantile-onset glaucoma. J AAPOS 2023; 27:28.e1-28.e6. [PMID: 36567044 DOI: 10.1016/j.jaapos.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 11/04/2022] [Accepted: 11/08/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE To report and characterize unexpected retinal findings identified by imaging with overhead-mounted optical coherence tomography (OCT) in 2 young children with infantile-onset glaucoma. METHODS Children with glaucoma were imaged during clinically indicated examinations under anesthesia using overhead-mounted HRA+OCT Spectralis with Flex module (Flex-OCT, Heidelberg, Germany) from February 2017 through February 2022. Imagers prioritized scans of the peripapillary retinal nerve fiber layer (pRNFL), optic nerve head, and macula. Children imaged before age 2 years with images adequate for evaluation were included. Age at glaucoma diagnosis, glaucoma type, highest intraocular pressure (IOP), corneal diameter (CD), and axial length (AL) were recorded. RESULTS A total of 41 children (71 eyes with glaucoma) were imaged before age 2 years. Macular imaging identified both inner and outer retinal thinning in 3 eyes of 2 young children (both eyes of a child with newborn primary congenital glaucoma (PCG) and 1 eye of a child with glaucoma following cataract surgery), which remained stable over time. These findings were present in 2 of 41 children (4.9%) and 3 of 71 eyes (4.2%) imaged with Flex-OCT. Neither highest IOP, CD, nor AL at imaging differentiated the 3 eyes with retinal changes from the larger group. CONCLUSIONS Three eyes of 2 young children with refractory glaucoma of different etiologies and highly elevated IOP demonstrated areas of inner and outer retinal thinning, consistent with retinal injury from probable prior macular ischemia. Unexpected retinal pathology identified on Flex-OCT imaging in infantile-onset glaucomas highlights the need for continued study of the pathophysiology of this disease.
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Affiliation(s)
| | - Tanya Glaser
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
| | - Michelle S Go
- Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina
| | - Michael P Kelly
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
| | - Xi Chen
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
| | - Sharon F Freedman
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
| | - Mays El-Dairi
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina.
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38
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Hwang CJ, Maltry AC, Harrison AR, Mokhtarzadeh A. A Case of the Blues-Colored Pencil Orbitopathy in an 18-Month-Old Boy. Ophthalmic Plast Reconstr Surg 2023; 39:e4-e8. [PMID: 35829627 DOI: 10.1097/iop.0000000000002248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Orbital penetrating injuries from pencils are rare. This report describes a case of penetrating orbital injury in a young child with a retained blue-colored pencil core foreign body, which led to rapid onset of orbital abscess requiring surgical drainage. Intraoperatively, orbital tissues were stained a bright-blue color. Histopathological study of specimen also highlighted bright blue aggregates of foreign material infiltrating the orbital tissues. Cultures grew Streptococcus mitis and Exophiala jeanselmei , which are rare causes of orbital abscess. Unique properties of retained colored pencil core as compared to graphite pencil core are herein discussed. Due to differences in composition, colored pencil core foreign bodies may require more timely surgical intervention compared to noncolored graphite pencil core.
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Affiliation(s)
- Christopher J Hwang
- Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina, U.S.A
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Amanda C Maltry
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Andrew R Harrison
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, U.S.A
- Department of Otolaryngology and Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Ali Mokhtarzadeh
- Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, U.S.A
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AlAmry M, Alahareef E, Aljebreen A, AlJudaibi R. Preoperative and Intraoperative Spontaneous Scleral Rupture: A Case Report and Review of Literature. Middle East Afr J Ophthalmol 2023; 30:59-61. [PMID: 38435109 PMCID: PMC10903711 DOI: 10.4103/meajo.meajo_71_23] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 12/05/2023] [Accepted: 12/20/2023] [Indexed: 03/05/2024] Open
Abstract
Scleral rupture is a rare but significant complication that can occur due to multiple risk factors. In this report, we discuss two instances of scleral perforation that happened during a silicone oil injection and after a peribulbar injection. Our study suggests that prior ocular surgery is a further risk factor for intraoperative scleral rupture, and more investigation is required to identify additional relevant risk factors that weaken the sclera.
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Affiliation(s)
- Mohammed AlAmry
- Emergency Department Senior Consultant, Anterior Segment Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Esraa Alahareef
- General Practitioner, Ministry of Health, Medina, Saudi Arabia
| | | | - Ramzi AlJudaibi
- Ophthalmology Consultant, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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40
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Christian CW, Binenbaum G. The eye in child abuse. Childs Nerv Syst 2022; 38:2335-2344. [PMID: 35871261 DOI: 10.1007/s00381-022-05610-8] [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: 05/23/2022] [Accepted: 07/11/2022] [Indexed: 11/30/2022]
Abstract
Child physical abuse may result in a range of injuries to the globe and surrounding tissues. These injuries have varying degrees of specificity for abuse, and no pattern of injury is unique to abuse. Easily overlooked eye injuries in non-ambulatory infants often portend more severe abuse and require careful evaluation for occult injury when they are unexplained. Retinal hemorrhages are most often a sign of significant trauma and the severity of the hemorrhages generally parallels the severity of neurological trauma. Ophthalmologists contribute important data that more easily distinguish medical disease from trauma, but caution is needed in differentiating accidental from inflicted trauma. This distinction requires careful consideration of the complete clinical data and occasionally on additional law enforcement or child welfare investigation.
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Affiliation(s)
- Cindy W Christian
- The Children's Hospital of Philadelphia, 3500 Civic Center Blvd, Philadelphia, PA, 19104, USA.
- Department of Pediatrics, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, USA.
| | - Gil Binenbaum
- The Children's Hospital of Philadelphia, 3500 Civic Center Blvd, Philadelphia, PA, 19104, USA
- Department of Ophthalmology, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, USA
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41
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Pham AT, Whitescarver TD, Beatson B, Purt B, Yonekawa Y, Shah AS, Colyer MH, Woreta FA, Justin GA. Ophthalmic trauma: the top 100 cited articles in Ophthalmology journals. Eye (Lond) 2022; 36:2328-2333. [PMID: 34975150 PMCID: PMC9674607 DOI: 10.1038/s41433-021-01871-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 04/29/2021] [Revised: 10/26/2021] [Accepted: 11/19/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To analyze the top 100 cited papers on ophthalmic trauma. METHODS A literature search of Ophthalmology journals within the ISI Web of Science database for the most cited papers related to ophthalmic trauma. RESULTS The most cited articles were published between 1943 and 2013, the greatest number being published in 2000. Ophthalmology (45), Archives of Ophthalmology (17), and the American Journal of Ophthalmology (15) published most of the articles. The institutions with the highest number of publications were Wilmer Eye Institute (10) and Massachusetts Eye and Ear Infirmary (7). Sixty-seven percent of the articles originated from the USA. The most common type of trauma studied was non-open-globe injuries and the most frequent topic studied were pathological conditions secondary to trauma (34), particularly endophthalmitis (8), and optic neuropathy (6). Articles presenting a standardized classification system for eye injury received the highest average of citations per publication. Types of research most frequently cited were observational clinical studies (62) and epidemiological studies (30); the least frequent were clinical trials (2). CONCLUSION This bibliographic study provides a historical perspective of the literature and identifies trends within the most highly influential papers on ophthalmic trauma. Many of these articles emerged within the past three decades and came from Ophthalmology journals that remain high impact to this day. Clinical trials have been difficult to conduct and are lacking, reflecting a critical need in ophthalmic trauma research, as most of our understanding of ophthalmic trauma comes from observational and epidemiological studies.
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Affiliation(s)
- Alex T Pham
- Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD, 21287, USA.
| | - Todd D Whitescarver
- Department of Ophthalmology, Walter Reed National Military Medical Center, 4494 Palmer Rd N, Bethesda, MD, 20814, USA
| | - Bradley Beatson
- Johns Hopkins University School of Medicine, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Boonkit Purt
- Department of Ophthalmology, Walter Reed National Military Medical Center, 4494 Palmer Rd N, Bethesda, MD, 20814, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD, 20814, USA
| | - Yoshihiro Yonekawa
- Wills Eye Hospital Retina Service, Mid Atlantic Retina, Thomas Jefferson University, 840 Walnut St, Philadelphia, PA, 19107, USA
| | - Ankoor S Shah
- Departments of Ophthalmology, Boston Children's Hospital, Massachusetts Eye & Ear and Harvard Medical School, 300 Longwood Ave, Fegan 4, Boston, MA, 02115, USA
| | - Marcus H Colyer
- Department of Ophthalmology, Madigan Army Medical Center, Tacoma, WA, 98431, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD, 20814, USA
| | - Fasika A Woreta
- Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Grant A Justin
- Department of Ophthalmology, Walter Reed National Military Medical Center, 4494 Palmer Rd N, Bethesda, MD, 20814, USA
- Department of Surgery, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD, 20814, USA
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42
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Galet C, Slagel I, Froehlich A, Bobb M, Lilienthal M, Fuchsen E, Harland KK, Pelaez CA, Skeete DA, Takacs ME. Firework injuries remain high in years after legalisation: its impact on children. Inj Prev 2022; 28:553-559. [PMID: 35922137 PMCID: PMC9691548 DOI: 10.1136/ip-2022-044616] [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: 04/19/2022] [Accepted: 07/20/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE We evaluated the impact of Senate Bill 489 passed in May 2017, allowing the sale and use of fireworks in Iowa 1 June to 8 July and 10 December to 3 January, on hospital presentations for firework injuries in the state. To identify the public health implications of this law, we conducted a detailed subanalysis of hospital presentations to the two level I trauma centres. METHODS Hospital presentations for firework injuries from 1 June 2014 to 31 July 2019 were identified using the Iowa Hospital Admission database and registries and medical records of Iowa's two level 1 trauma centres. Trauma centres' data were reviewed to obtain demographics, injury information and hospital course. Prefirework and postfirework legalisation state data were compared using negative binomial regression analysis. Trauma centre data detailing injuries were compared using χ2 and Mann-Whitney U tests as appropriate. RESULTS Emergency department (ED) visits and hospital admissions for firework injuries increased in Iowa post-legalisation (B-estimate=0.598±0.073, p<0.001 and B-estimate=0.612±0.322, p=0.058, respectively). ED visits increased postlegalisation in July (73.6% vs 64.5%; p=0.008), reflecting an increase in paediatric admissions (81.8% vs 62.5%; p=0.006). Trauma centres' data showed similar trends. The most common injury site across both study periods was the hands (48.5%), followed by the eyes (34.3%) and face (28.3%). Amputations increased from 0 prelegalisation to 16.2% postlegalisation. CONCLUSION Firework legalisation led to an increase in the number of admissions and more severe injuries.
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Affiliation(s)
- Colette Galet
- Department of Surgery, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
| | - Isaac Slagel
- Department of Surgery, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
| | - Adam Froehlich
- Injury Prevention Research Center, The University of Iowa, Iowa City, Iowa, USA
| | - Morgan Bobb
- The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
| | - Michele Lilienthal
- Department of Surgery, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
| | | | - Karisa K Harland
- Injury Prevention Research Center, The University of Iowa, Iowa City, Iowa, USA
- Emergency Medicine, University of Iowa, Iowa City, Iowa, USA
| | - Carlos A Pelaez
- Department of Surgery, UnityPoint Health, Des Moines, Iowa, USA
| | - Dionne A Skeete
- Department of Surgery, The University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, Iowa, USA
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Habib MK, Oozeerkhan ZK, Ali M. Prompt Detection and Management of Globe Perforation due to Retrobulbar Anaesthesia. J Coll Physicians Surg Pak 2022; 32:958-959. [PMID: 35795957 DOI: 10.29271/jcpsp.2022.07.958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 02/09/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Muhammad Kashif Habib
- Department of Retina, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan
- Department of Glaucoma, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | - Zeeshan Khan Oozeerkhan
- Department of Retina, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan
- Department of Glaucoma, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan
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44
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Maleski ALA, Rosa JGS, Bernardo JTG, Astray RM, Walker CIB, Lopes-Ferreira M, Lima C. Recapitulation of Retinal Damage in Zebrafish Larvae Infected with Zika Virus. Cells 2022; 11:cells11091457. [PMID: 35563763 PMCID: PMC9100881 DOI: 10.3390/cells11091457] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/24/2022] [Accepted: 04/07/2022] [Indexed: 02/06/2023] Open
Abstract
Zebrafish are increasingly being utilized as a model to investigate infectious diseases and to advance the understanding of pathogen–host interactions. Here, we take advantage of the zebrafish to recapitulate congenital ZIKV infection and, for the first time, demonstrate that it can be used to model infection and reinfection and monitor anti-viral and inflammatory immune responses, as well as brain growth and eye abnormalities during embryonic development. By injecting a Brazilian strain of ZIKV into the yolk sac of one-cell stage embryos, we confirmed that, after 72 h, ZIKV successfully infected larvae, and the physical condition of the virus-infected hosts included gross morphological changes in surviving embryos (84%), with a reduction in larval head size and retinal damage characterized by increased thickness of the lens and inner nuclear layer. Changes in locomotor activity and the inability to perceive visual stimuli are a result of changes in retinal morphology caused by ZIKV. Furthermore, we demonstrated the ability of ZIKV to replicate in zebrafish larvae and infect new healthy larvae, impairing their visual and neurological functions. These data reinforce the deleterious activity of ZIKV in the brain and visual structures and establish the zebrafish as a model to study the molecular mechanisms involved in the pathology of the virus.
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Affiliation(s)
- Adolfo Luis Almeida Maleski
- Immunoregulation Unit of the Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, São Paulo 05503-900, Brazil; (A.L.A.M.); (J.G.S.R.); (J.T.G.B.); (M.L.-F.)
- Laboratory of Neuropharmacological Studies (LABEN), Post-Graduation Program of Pharmaceutical Science, Federal University of Sergipe, São Paulo 05503-009, Brazil;
| | - Joao Gabriel Santos Rosa
- Immunoregulation Unit of the Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, São Paulo 05503-900, Brazil; (A.L.A.M.); (J.G.S.R.); (J.T.G.B.); (M.L.-F.)
| | - Jefferson Thiago Gonçalves Bernardo
- Immunoregulation Unit of the Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, São Paulo 05503-900, Brazil; (A.L.A.M.); (J.G.S.R.); (J.T.G.B.); (M.L.-F.)
| | | | - Cristiani Isabel Banderó Walker
- Laboratory of Neuropharmacological Studies (LABEN), Post-Graduation Program of Pharmaceutical Science, Federal University of Sergipe, São Paulo 05503-009, Brazil;
| | - Monica Lopes-Ferreira
- Immunoregulation Unit of the Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, São Paulo 05503-900, Brazil; (A.L.A.M.); (J.G.S.R.); (J.T.G.B.); (M.L.-F.)
| | - Carla Lima
- Immunoregulation Unit of the Laboratory of Applied Toxinology (CeTICs/FAPESP), Butantan Institute, São Paulo 05503-900, Brazil; (A.L.A.M.); (J.G.S.R.); (J.T.G.B.); (M.L.-F.)
- Correspondence:
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45
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Weinert MC, Armstrong GW. Infectious Disease Prevention and Management in Traumatic Open Globe Injuries. Int Ophthalmol Clin 2022; 62:19-40. [PMID: 35325908 DOI: 10.1097/iio.0000000000000406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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46
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Stapleton F, Shrestha GS, Vijay AK, Carnt N. Epidemiology, Microbiology, and Genetics of Contact Lens-Related and Non-Contact Lens-Related Infectious Keratitis. Eye Contact Lens 2022; 48:127-133. [PMID: 35192567 DOI: 10.1097/icl.0000000000000884] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2021] [Indexed: 01/14/2023]
Abstract
ABSTRACT Infectious keratitis is a rare but severe condition associated with a range of ocular and systemic predisposing conditions, including ocular trauma, prior surgery, surface disease, and contact lens (CL) wear. This review explores the epidemiology of infectious keratitis, specifically the differences in disease incidence and risk factors, causative organism profile and virulence characteristics and host microbiome, genetics, gene expression, proteomics, and metabolomic characteristics in CL-related and non-CL-related diseases. Differences exist in the epidemiology, demographics, causative organisms, and their virulence characteristics in CL-related and non-CL-related diseases, and there is less evidence to support differences between these groups of individuals in the ocular surface microbiome, genetics, and pathways of disease. Genetic variations, however, in the host immune profile are implicated in both the onset and severity of infectious keratitis in CL and non-CL wearers. As technologies in metabolomics, proteomics, and genomics improved to be better able to process small-volume samples from the ocular surface, there will be improved understanding of the interplay between the CL, ocular surface, host immune profile, and the microbial environment. This may result in a more personalized approach in the management of disease to reduce disease severity.
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Affiliation(s)
- Fiona Stapleton
- School of Optometry and Vision Science, UNSW Sydney, Australia
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47
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Abstract
OBJECTIVES Open globe injuries (OGIs) in children can be visually devastating traumas and are a common cause of unilateral blindness in children. Three commonly used ocular trauma scores (Ocular Trauma Score [OTS], Pediatric Penetrating Ocular Trauma Score [POTS], and Toddler/Infant Ocular Trauma Score [TOTS]) can be used to help predict visual outcomes in ocular injuries. Each has strengths and weaknesses, but these scores have not been studied extensively in the pediatric population. METHODS The medical records of all pediatric patients presenting at a single institution with OGIs from 2011 to 2016 were retrospectively reviewed. Initial clinical presentation and subsequent examinations were reviewed. The 3 trauma scoring systems were applied to patient data to determine the effectiveness at predicting final visual acuity (VA). RESULTS A total of 15 patients met inclusion criteria. The mean age at presentation was 6.97 years. Seven of 15 (47%) of the patients had a final VA of 20/40 or better. The OTS was applied to 8 of 15 patients, as the OTS requires initial VA, which could not be obtained in 7 patients. The POTS and TOTS were applied to all 15 patients. The POTS, TOTS, and OTS were all significantly correlated to final VA. Incidence of relative afferent pupillary defect and more posterior zone of injury were correlated with poorer visual outcomes. CONCLUSIONS All 3 available ocular trauma scores were effective at predicting final VA in our cohort of pediatric patients with OGIs even outside of the age ranges for which they have been created. Of all the factors included in the scores, relative afferent pupillary defect and zone of injury were most closely correlated with poor final VA.
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Affiliation(s)
- Carleigh N Bruce
- From the University of Florida College of Medicine; Departments of
| | | | - Baiming Zou
- Biostatistics, University of Florida, Gainesville, FL
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48
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Saidzhamolov KM, Gromakina EV, Makhmadzoda SK, Karim-Zade KD. [Functional outcomes of penetrating eye injuries in children]. Vestn Oftalmol 2022; 138:15-18. [PMID: 36004586 DOI: 10.17116/oftalma202213804115] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
UNLABELLED Open wounds of the eye are the most common ocular injuries in children in Tajikistan. Assessment of visual functions in the outcome of such wounds is the most important task for developing a rehabilitation plan and predicting the prospects for the recovery of vision, especially in young patients. OBJECTIVE To assess visual acuity (VA) in the outcome of a penetrating wound of the eyeball in children. MATERIAL AND METHODS The study retrospectively analyzed VA in the outcome of type B open trauma of scleral (12.1%), corneal (59.1%), and scleral-corneal (28.8%) localization in 132 children (132 eyes) older than 4 years (mean age 8.3 years), who were admitted to the hospital on the first day after injury. The exclusion criteria from the main selection were: the presence of an intraocular foreign body, the age of patient higher than 4 years old, and the time of admission more than 24 hours post the moment of injury. RESULTS Visual acuity was checked at the time of discharge from the hospital (average stay was 19.02 days) and amounted to 0-light projection in 50 (37.9%) children; 0.01-0.1 in 43 (32.6%); 0.2-0.3 in 29 (22.0%); above 0.4 in 10 (7.6%). High rate of vascular reactions to trauma was noted on admission on the first day - intraocular hemorrhage (28.8%), hyphema (10.6%), endophthalmitis (5.3%) as a result of a penetrating injury to the eyeball - as well as their negative effect on vision at discharge. CONCLUSION Upon discharge from the hospital, in 92.4% of children the visual acuity in the outcome was 0.3 and below. Adverse visual outcomes significantly correlated with the depth of the injury (correlation coefficient 0.5931) and vascular reactions to trauma (correlation coefficient 0.503333).
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Affiliation(s)
- K M Saidzhamolov
- National Medical Center of the Republic of Tajikistan, Dushanbe, Tajikistan
| | | | - Sh K Makhmadzoda
- Avicenna Tajik State Medical University (ATSMU), Dushanbe, Tajikistan
| | - Kh D Karim-Zade
- Avicenna Tajik State Medical University (ATSMU), Dushanbe, Tajikistan
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Miyoshi LH, Hollaender MA, Giglio VB, Villela FF, Alves MR. Piggyback Photochromic Contact Lens for Visual Rehabilitation and Photophobia Management in Traumatic Aniridia. Eye Contact Lens 2021; 47:677-679. [PMID: 34653042 DOI: 10.1097/icl.0000000000000833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT We report herein a case of fitting with a photochromic silicone hydrogel contact lens under a rigid gas-permeable lens (piggyback system) for photophobia and low vision correction after traumatic aniridia and aphakia. A 40-year-old woman was referred to our practice for contact lens fitting in her right eye, which was left aphakic after an open globe injury. She also presented traumatic aniridia in the right eye, and her left eye had been previously eviscerated. A successful fitting was obtained with a photochromic silicone hydrogel (senofilcon A) contact lens, with a Dk/t of 121 × 10-9, under an aspheric design, +13.00 D rigid gas-permeable lens. The patient displayed visual acuity and contrast sensitivity improvement and reported decreased photophobia.
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刘 子豪, 赵 枢泉, 陈 建一, 邓 伟年, 石 青, 周 亦武. [Not Available]. Fa Yi Xue Za Zhi 2021; 37:718-720. [PMID: 35191243 DOI: 10.12116/j.issn.1004-5619.2020.400312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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