Survey of Ophthalmology

We set out to estimate the international incidence of rhegmatogenous retinal detachment (RRD) and to evaluate its temporal trend over time. There is a lack of robust estimates on the worldwide incidence and trend for RRD, a major cause of acute vision loss. We conducted a systematic review of RRD incidence. The electronic databases PubMed, Scopus, and Thomson Reuters' Web of Science were searched from inception through 2nd June 2022. Random-effects meta-analysis model with logit transformation was performed to obtain pooled annual incidence estimates of RRD...

Polyvinyl pyrrolidone or povidone-iodine (PVP-I) is a water-soluble complex formed by the combination of iodine and a water-soluble polymer, polyvinyl pyrrolidone. This complex exerts bactericidal, fungicidal, and virucidal action by gradually releasing free iodine at the site of application to react with pathogens. In ophthalmology, PVP-I is used as a disinfectant and antiseptic agent for preoperative preparation of the skin and mucous membranes and for treating contaminated wounds. PVP-I has been shown to reduce effectively the risk of endophthalmitis in various ocular procedures, including cataract surgery and intravitreal injections; however, it has also been used in the treatment of conjunctivitis, keratitis, and endophthalmitis, with promising results especially in low-resource situations...

Slowing down or stopping the natural process of cataractogenesis is certainly a challenge for those who today propose an option other than surgery. Addressing the same problem in different ways constitutes a new approach to solving what is today the number one cause of reversible blindness worldwide. The technological revolution, as well as the advances in the biological sciences, allows us to conceive mechanisms never thought of before to stop the process that, as a common pathway, constitutes opacification of the crystalline lens...

Microperimetry is an emerging technology that provides concurrent analysis of retinal structure and function by combining retinal sensitivity and fixation analysis with fundus imaging. We summarize the substantial evidence validating the evolving role of microperimetry as an adjunctive assessment of visual function in the perioperative setting. We show that microperimetry provides useful complementary information to other established imaging and functional modalities in the perioperative setting for a wide range of vitreoretinal surgical procedures, as well as in cataract and refractive surgeries...

There is a need to identify accurately prognostic factors that determine the progression of intermediate to late-stage age-related macular degeneration (AMD). Currently, clinicians cannot provide individualised prognoses of disease progression. Moreover, enriching clinical trials with rapid progressors may facilitate delivery of shorter intervention trials aimed at delaying or preventing progression to late AMD. Thus, we performed a systematic review to outline and assess the accuracy of reporting prognostic factors for the progression of intermediate to late AMD...

Vernal keratoconjunctivitis (VKC) is a chronic, progressive, and potentially sight-threatening form of ocular inflammatory disease that primarily affects children and young adults. Prevalence varies by region, ranging from <2 per 10,000 in the United States to as high as 1,100 per 10,000 in parts of Africa. The rarity of VKC in developed countries can make differential diagnosis challenging, and treatment is often delayed until the disease is advanced, and symptoms are significantly impacting patients' quality of life...

Indeterminate melanocytic proliferations of the conjunctiva have both benign and malignant features that previously made these lesions nearly impossible to categorize in existing classification schemes. With the evolution of immunohistochemistry and molecular genetics, however, subclassifications have emerged that allow for a more tailored diagnosis and management. These conjunctival melanocytic proliferations include deep penetrating nevus, granular cell nevus, and nevoid melanoma. There remains a small subset of conjunctival melanocytic proliferations that defy precise characterization as nevi, primary acquired melanosis, or melanomas despite currently available ancillary diagnostic modalities and remain indeterminate...

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No abstract text is available yet for this article.

I detail advances in fundoucopy diagnosis systems integrating smartphones. Smartphone funduscopy devices are comprised of lens devices connecting with smartphones and software applications to be used for mobile retinal image capturing and diagnosis of diabetic retinopathy. This is particularly beneficial to automate and mobilize retinopathy screening techniques and methods in remote and rural areas as those diabetes patients are often not meeting the required regular screening for diabetic retinopathy. Smartphone retinal image grading systems enable retinopathy to be screened for remotely as teleophthalmology or as a stand-alone point-of-care-testing system...

Cancer treatments have recently shifted from broad-spectrum cytotoxic therapies to more focused treatments, maximizing anti-cancerous activity while reducing toxicity to healthy cells. These modern anticancer therapies (MATs) encompass a wide range of innovative molecules that mainly include immune checkpoint inhibitors (ICIs) and targeted anticancer therapies (TATs), comprising antibody drug conjugates (ADCs) and inhibitors of signal transduction (IST). Some MATs are associated with ocular surface (OS) adverse events (AEs) that can cause severe discomfort and even lead to loss of vision...

Anti-vascular endothelial growth factor (anti-VEGF) injections have revolutionised the field of ophthalmology, and their use in a variety of retinal diseases is growing. One target disease is peripheral exudative haemorrhagic chorioretinopathy (PEHCR), a disease that is uncommon and poorly understood. Despite this, there are numerous studies and case reports outlining the potential role of intravitreal injection of anti-VEGF medicines to treat it. As such, an evidence-based understanding of its risk-benefit profile is vital...

Assessing anterior chamber (AC) inflammation is highly subjective and challenging. Although various grading systems attempt to offer objectivity and standardization, the clinical assessment has high interobserver variability. Traditional techniques, such as laser flare meter and fluorophotometry, are not widely used since they are time-consuming. With the development of optical coherence tomography with high sensitivity, direct imaging offers an excellent alternative to objectively assess inflammation with the potential for automated analysis...

It is now clear that retinal neuropathy precedes classical microvascular retinopathy in diabetes. Therefore, tests that underpin useful new endpoints must provide high diagnostic power well before the onset of moderate diabetic retinopathy (DR). Hence, we compare detection methods of early diabetic eye damage. We reviewed data from a range of functional and structural studies of early diabetic eye disease and computed Standardised Effect Size as a measure of diagnostic power, allowing the studies to be compared quantitatively...

Diseases leading to retinal cell loss can cause severe visual impairment and blindness. The lack of effective therapies to address retinal cell loss and the absence of intrinsic regeneration in the human retina leads to an irreversible pathological condition. Progress in recent years in the generation of human three-dimensional retinal organoids from pluripotent stem cells makes it possible to recreate the cytoarchitecture and associated cell-cell interactions of the human retina in remarkable detail. These human three-dimensional retinal organoid systems made of distinct retinal cell types and possessing contextual physiological responses allow the study of human retina development and retinal disease pathology in a way animal model and two-dimensional cell cultures were unable to achieve...

Adaptive optics (AO) imaging enables direct, objective assessments of retinal cells. Applications of AO show great promise in advancing our understanding of the etiology of inherited retinal disease (IRDs) and discovering new imaging biomarkers. This scoping review systematically identified and summarized clinical studies evaluating AO imaging in IRDs. Ovid MEDLINE and EMBASE were searched on 6 February 2023. Studies describing AO imaging in monogenic IRDs were included. Study screening and data extraction were performed by 2 reviewers independently...

Fibroblast growth factor receptor (FGFR) inhibitors are an emerging class of small molecule targeted cancer drugs with promising therapeutic possibilities for a wide variety of malignancies. While ocular adverse events from FGFR inhibitors are reported in clinical trials, subsequent case studies continue to reveal new toxicities. Disease pathology affecting multiple parts of the eye have been reported, but the ocular surface and the retina are the most commonly encountered areas affected by FGFR inhibitors, manifesting as dry eye and FGFR inhibitor-associated retinopathy, respectively...

Acute retinal necrosis (ARN) is a progressive intraocular inflammatory syndrome characterized by diffuse necrotizing retinitis that can lead to a poor visual outcome, mainly from retinal detachment. The antiviral treatment approach for ARN varies as there are no established guidelines. We summarize the outcomes of ARN with available antiviral treatments. Electronic searches were conducted in PubMed/MEDLINE, EMBASE, Scopus, and Google Scholar for interventional and observational studies. Meta-analysis was performed to evaluate the pooled proportion of the pre-defined selected outcomes...

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...