Survey of Ophthalmology

Neovascular age-related macular degeneration (nAMD) is the advanced and irreversible stage of AMD, the leading cause of severe vision loss in older adults. While anti-vascular endothelial growth factor (anti-VEGF) injections have been shown to preserve or improve vision quality in eyes with nAMD, the treatment regimen can be demanding of patients and caregivers, leading to lower rates of adherence. Therefore, it is crucial that disparities and obstacles in nAMD care are identified to improve access to treatment...

Although there have been numerous innovations in the management of retinal detachment (RD) over the past decades, there is still limited understanding of the pathophysiological processes that take place before and after repair. Summarizing key concepts using animal studies may allow a better assessment of common pre and postoperatively microstructural abnormalities in RD. We performed a systematic literature review on Ovid MEDLINE, EMBASE, and Cochrane Controlled Register of Trials from January, 1968, to January, 2022, searching animal or human studies reporting retinal histologic changes following primary or induced RD...

A growing number of patients with prior refractive surgery are now presenting for cataract surgery. Surgeons face a number of unique challenges in a patient population that tends to be highly motivated to retain or regain functional uncorrected acuity postoperatively. Primary challenges include recognition of the specific type of prior surgery, use of appropriate intraocular lens (IOL) power calculation formulas, matching IOL style with spherical aberration profile, the recognition of corneal imaging patterns that are and are not compatible with toric and/or presbyopia-correcting lens implantation, and surgical technique modifications, which are particularly relevant in eyes with prior radial keratotomy or phakic IOL implantation...

Systemic lupus erythematosus (SLE) is a chronic, systemic, autoimmune connective tissue disease that affects several vascular territories. We sought to assess the role of optical coherence tomography angiography in detecting subclinical microvascular alterations in SLE patients. PubMed, Scopus, and Web of Science databases were systematically searched until January 21, 2023. Studies using optical coherence tomography angiography as a primary diagnostic method to evaluate the macular microvasculature of SLE patients versus healthy controls were included...

Inherited retinal diseases (IRDs) are the most common cause of blindness in working-age adults. Macular neovascularisation (MNV) may be a presenting feature or occur as a late-stage complication in several IRDs. We performed an extensive literature review on MNV associated with IRDs. MNV is a well-known complication of Sorsby fundus dystrophy and pseudoxanthoma elasticum. Those with late-onset Stargardt disease may masquerade as exudative age-related macular degeneration (AMD) when MNV is the presenting feature...

Myopic choroidal neovascularization (CNV) is a vision-threatening complication of high myopia. Here we systematically review cohort, case-control, and cross-sectional studies in PubMed, Embase, and Web of Science; and summarize the associated factors of myopic CNV using meta-analysis where applicable. Among 1,333 records assessed, 50 were found eligible, all having a low to moderate risk of bias. Highly myopic eyes with CNV had a higher risk of lacquer cracks (OR=2.88) and of patchy chorioretinal atrophy (OR=3...

No abstract text is available yet for this article.

Tamoxifen is a selective estrogen receptor modulator used mainly for the treatment of breast cancer. Based on the case reports and studies performed to date on the retinal toxicity of tamoxifen, retinopathy appears to occur in as many as 12% of patients taking 20 mg tamoxifen a day for over 2 years. Of this 12%, as many as half develop symptomatic changes in visual acuity. Retinal changes consist primarily of crystalline deposits, cystoid macular edema, hyperreflective deposits in the inner retinal layers, and telangiectasia...

Retromode scanning laser ophthalmoscopy imaging captures a pseudo-3-dimensional image of the ocular fundus. Retromode scanning laser ophthalmoscopy imaging was introduced first in 2008 using the Nidek F-10 scanning laser ophthalmoscope (F-10; Nidek Co., Gamagori, Japan). At that time, no major role was described for this imaging modality. The interest in retromode scanning laser ophthalmoscopy imaging is reemerging with the recent advent of the Mirante that combines scanning laser ophthalmoscopy and optical coherence tomography (Nidek Co...

The toxicology of secondhand smoke (SHS), along with the harm of its exposure on human health, has been generally acknowledged; however, specific evidence is lacking on the association between SHS exposure and ocular health. In this systematic review (PROSPERO registration number: CRD42022247992), we included 55 original articles published by 12 May 2023 that dealt with SHS exposure and ocular disorders such as eye irritation, conjunctivitis, dry eye diseases, uveitis, myopia, astigmatism, contact lens discomfort, age-related macular degeneration, glaucoma, thyroid eye disease; that addressed the ocular neurovascular structures of the macular, retinal nerve fiber layer (RNFL), choroid, and corneal biomechanical parameters...

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are used to treat type 2 diabetes mellitus. Recent research suggests that GLP-1 RAs may influence diabetic retinopathy (DR). We searched ClinicalTrials.gov for trials comparing FDA-approved GLP-1 RAs to placebo, insulin, or oral antidiabetic medicine. Rates of DR, ocular adverse events, demographics, and clinical characteristics were compared amongst cohorts on 93 trials. GLP-1 RA use was significantly associated with increased risk of early-stage DR (risk ratio (RR) = 1...

The prevalence of retinopathy of prematurity (ROP) is rapidly increasing worldwide. Many researchers have explored the relationship between insulin-like growth factor-1 (IGF-1) and ROP; however, the results are controversial. This meta-analysis evaluates the correlation between IGF-1 and ROP systematically. We searched for PubMed, Web of Science, Embase, the Cochrane Central Register of Controlled Trials, Ovid MEDLINE, SinoMed, ClinicalTrials.gov, and 3 Chinese databases up to June 2022. Then, the meta-regression and subgroup analysis were carried out...

Uveal melanoma (UM) is uncommon in African Americans (AAs). Due to its rarity, UM may not be suspected in AAs leading to delayed diagnosis. In addition, socioeconomic factors may also play a role in delayed diagnosis. Clinical and ultrasonographic features may be atypical due to racial pigmentation necessitating diagnostic fine needle aspiration biopsy. Herein, we report illustrative case series of 12 AAs with UM highlighting clinical features and diagnostic challenges.

Retinotomy refers to "cutting" or "incising" the retina, whereas retinectomy denotes "excising" the retina. Retinotomies and retinectomies aid in tackling traction and retinal shortening that persist following membrane dissection and scleral buckling. We performed a literature search using Google Scholar and PubMed, followed by a review of the references procured. All relevant literature was studied in detail and summarized. We discuss the indications of retinotomies and retinectomies for relaxing retinal stiffness, accessing the subretinal space for choroidal neovascular membrane, hemorrhage and abscess clearance, drainage retinotomies to allow retinal flattening, radial retinotomies to release circumferential traction, harvesting free retinal grafts, and prophylactic chorioretinectomies in trauma...

Descemet membrane endothelial keratoplasty (DMEK) is a partial-thickness corneal transplantation procedure that involves selective transplantation of Descemet membrane and endothelium. DMEK offers significant advantages over other keratoplasty techniques such as faster visual rehabilitation, better final visual acuity due to minimal optical interface effects, lower risk of allograft rejection and less long-term dependence on topical steroids. Despite all its advantages, DMEK has been found to be challenging than other corneal transplantation techniques, and its steep learning curve appears to be an obstacle to its widespread use and adoption by corneal surgeons worldwide...

Subretinal autofluorescent deposits (SADs) may be found in the posterior pole, associated with very various conditions. These disorders usually present a typical pattern of autofluorescent lesions seen on short-wavelength fundus autofluorescence. We describe SADs according to their putative pathophysiological origin and also according to their clinical pattern, i.e., number, shape, and usual location. Five main putative pathophysiological origins of SADs were identified in disorders associated with an intrinsic impairment of phagocytosis and protein transportation, with excess of retinal pigment epithelium phagocytic capacity, with direct or indirect retinal pigment epithelium injury, and/or disorders associated with long-standing serous retinal detachment with mechanical separation between the retinal pigment epithelium and the photoreceptor outer segments...

During infectious keratitis, the production of collagenolytic and inflammatory substances, along with increased corneal metalloproteinase (MMP) activity, induce the degradation of corneal collagen and may cause post keratitis complications such as opacity, thinning, and corneal perforation. MMPs, especially MMP-2 and MMP-9, are over-expressed in infectious keratitis and sustained over time by inflammatory and non-microbial mechanisms. The high MMP levels are correlated with an excessive corneal destruction in bacterial, herpetic, fungal and acanthamoeba infections...

No abstract text is available yet for this article.

Multispectral Imaging (MSI) is a unique layer-by-layer imaging technique that allows the visualization of a wide array of retinal and choroidal pathologies including retinovascular disorders, retinal pigment epithelial changes, and choroidal lesions. Herein, we summarize the basic imaging principles and current applications of MSI together with recent technology advances in the field. MSI detects reflectance signal from both normal chorioretinal tissue and pathological lesions. Either hyperreflectance or hyporeflectance reveals the absorption activity of pigments such as haemoglobin and melanin and the reflection from interfaces such as the posterior hyaloid...

Choroidal osteoma (CO) is a benign ossifying tumor within the choroid. Complications associated with CO, including disruption of retinal pigment epithelium (RPE), atrophy of photoreceptor, subretinal fluid (SRF), and choroidal neovascularization (CNV), present challenges for clinicians, and management remain controversial. We performed a comprehensive search in the PubMed, EMBASE, and Ovid databases for published studies and case reports relating to the management of choroidal osteoma. Since it was first described in 1978, various case reports of ocular complications associated with CO have been documented, and various therapies have yielded different outcomes...