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eyeNEWS — Все новости офтальмологии. Версия 6.0
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Новости офтальмологии
The capsulotomy has a fascinating history – one tinged with jealousy, rivalry, fashion, evolution, revolution and even nationalistic pride – and it’s a story that’s got a great deal more to tell. It started with the Frenchman, Jaques Daviel, who ushered in the modern era of cataract surgery, abandoning couching (Box 1) for the first extracapsular cataract extraction (ECCE; Box 2). The British, for predominantly patriotic reasons, preferred couching (Box 3), but ECCE was always going to win out. Albrecht von Graefe improved it in 1850 with his eponymous knife (Box 4) and, extraordinarily, his technique lasted for over a century. That’s not to say that competing approaches weren’t developed along the way – Ignacio Barraquer devised the suction cup-based erisophake in 1917, which enabled rapid intracapsular extraction of the lens (Box 5), but its uptake was limited. So the von Graefe method persisted into the 1970s.
Abstract Determining target intraocular pressure (IOP) in glaucoma patients is multifaceted, requiring attention to many different factors such as glaucoma type, severity of disease, age, race, family history, corneal thickness and hysteresis, and initial IOP. Even with all these variables accounted for, there are still patients who have progression of the disease despite achieving target IOP. Intraocular pressure variability has been identified as a potential independent risk factor for glaucoma progression but is currently difficult to quantify in individual patients. New technologies enabling measurement of both diurnal and nocturnal IOP may necessitate modifying our concept of target pressure.
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In a bid to provide affordable technology to resource-poor countries, the humble ophthalmoscope has had a makeover – or rather a ‘makeunder.’ With a simplified design, a patented LED light source and a solar panel, the Arclight is a pocket instrument the size of a marker pen and lighter than an AA battery. The device is significantly lower in cost than the traditional ophthalmoscope – and its potential to serve those who need it most was quickly recognized by global health leaders. More than 8,000 devices have been distributed across the world – with the International Agency for the Prevention of Blindness (IAPB) based in London, UK, helping with marketing and sales to many countries including Malawi, Ethiopia, Fiji and Indonesia.
Purpose: The aim of this study was to estimate the efficacy of intense pulsed light (IPL), followed by meibomian gland expression (MGX), for reducing the number and severity of signs and symptoms of dry eye disease (DED) secondary to meibomian gland dysfunction (MGD)
Abstract Phacoemulsification as treatment for primary open-angle glaucoma (POAG) remains more controversial than for primary angle-closure glaucoma (PACG). If the objective of glaucoma surgery is an additional greater than or equal to 5 to 6 mm Hg reduction of intraocular pressure (IOP), the role of phacoemulsification should be based on the probability of achieving this. A Bayesian analysis of available data was performed to calculate the change in IOP after phacoemulsification in POAG and PACG. Standard meta-analysis formulation with prephacoemulsification and postphacoemulsification IOP—assumed to have normal distributions, with study-specific means and SDs—was used. Absolute and relative change in IOP was calculated using different priors, and sensitivity analyses were performed. The prior that just included a decrease of greater than or equal to 6 mm Hg in the 95% credible interval was identified. The probability of achieving greater than or equal to 5 to 6 mm Hg decrease in IOP (and other levels) was calculated. Depending on the prior, the probability of achieving a greater than or equal to 5 mm Hg reduction in IOP in POAG varied from 0.1% to 3%. Confidence in a greater than or equal to 6 mm Hg decrease required a prior belief that phacoemulsification produces a mean decrease of 7 mm Hg. The probability of a decrease in IOP was greater in PACG: approximately 50% probability of a greater than or equal to 5 mm Hg decrease in PACG uncontrolled on medications. Phacoemulsification in POAG has a high probability of producing a small decrease in IOP that may be useful in early, well-controlled disease. The probability of a clinically significant decrease of greater than or equal to 5 to 6 mm Hg—required for advanced/uncontrolled disease—is low. Results support the role of phacoemulsification in PACG.
These days, most eyecare practices have started to incorporate digital communication tools to interact with their patient base. Modern consumers are thrilled with the option to email, text or Facebook message as opposed to having to pick up a phone to call for information or to perform basic functions like scheduling appointments or ordering contact lenses.
Approximately 90% of uveal melanomas develop in the choroid, with the remainder arising in the ciliary body or the iris. The treatment of uveal melanoma is aimed at conserving the eye and useful vision, and, if possible, preventing metastatic disease. Enucleation is now reserved for tumors that are large and/or involve the optic disc, having largely been replaced by various forms of radiotherapy (plaque brachytherapy, proton beam or stereotactic radiotherapy) and laser therapy. Whereas iridectomy and iridocyclectomy are widely performed, transscleral exoresection of choroidal tumors is performed only in a few centers because it requires special skills and hypotensive anesthesia. Transretinal endoresection using vitrectomy equipment is easier but controversial because of concerns about tumor seeding. Long-term postoperative surveillance is necessary to identify and treat local tumor recurrence and any other complications, such as radiation-induced morbidity, and to provide counseling to the patient. Factors predicting metastasis include older age, large tumor size, ciliary body involvement, extraocular spread, epithelioid cytomorphology, chromosome 3 loss, chromosome 8q gain, class 2 gene expression profile, loss of BRCA1-associated protein-1 (BAP1), and the presence of inflammation. Prognostication is enhanced by multivariable analysis combining clinical, histologic, and genetic factors, also taking the patient’s age and sex into account. As there is a lack of options for treating metastases, much research is focused on identifying potential therapeutic targets.
Purpose: To determine adherence to face-down positioning (FDP) among patients who underwent vitrectomy and gas tamponade for macular hole (MH) repair. Method: A total of 69 patients (37 females and 32 males) who underwent primary vitrectomy for MH repair were studied. Nurses recorded whether the patient complied with FDP each time they examined the patient. FDP score was obtained from the nursing records; patients were given a score of 1 if they complied with the FDP and 0 if they did not. The score was recorded four times per day for the first 3 postoperative days. A perfect FDP score was 12. Results: The mean ± standard deviation of the FDP scores was 10.6±1.8 (range: 4–12). Overall, 32 (46.4%) patients scored a perfect 12, and 7 (10.1%) patients scored <8. Failure of the MH closure was observed in only one patient (1.4%), who showed the poorest adherence to FDP (score =4). Consequently, the closure rate in patients with FDP score <7 (2/3, 66.7%) was significantly lower than in patients with an FDP score ≥7 (66/66, 100%) (P<0.05, Fisher’s exact probability test). Conclusion: While adherence to FDP after MH surgery was better than that observed after vitrectomy for rhegmatogenous retinal detachments in our previous study, the percentage of patients with FDP scores <8 did not differ. Statistically, the poor adherence to FDP can negatively impact the effectiveness of the surgery for MH repair.
Abstract: Inflammatory bowel disease (IBD) is a chronic and heterogeneous disorder characterized by remitting and relapsing periods of activity. Pharmacogenetics refers to the study of the effect of inheritance on individual variation in drug responses. Several drug-related markers in IBD patients have been identified in order to predict the response to medical treatment including biological therapy as well as the reduction of adverse events. In the future, the treatment of IBD should be personalized in its specific profile to provide the most efficacious treatment with lack of adverse events.
Focused Ultrasound for Glaucoma: comparing clinical results and perspectives for patients in Western and Asian countries CHAIRMAN Keith Barton, MD, Moor elds Eye Hospital, London, United Kingdom Florent Aptel, MD, Grenoble University Hospital, France High-intensity Focused Ultrasound : mechanisms of action Ingeborg Stalmans, MD, Leuven University Hospital, Belgium Clinical experience on refractory and non-refractory open-angle glaucoma patients Ronnie George, MD, Sankara Nethralaya Hospital, Chennai, India Clinical experience of focused ultrasound in the Indian population Jian Ge, MD, Zhongshan Ophthalmic Center, Sun Yat-Sen University Hospital, Guangzhou, China Treatment outcomes on angle-closure glaucoma in Chinese patients
Выйдет в свет точно по расписанию! Номер посвящен перфузионному давлению при глаукоме. Публикация этого материла стала возможной благодаря достигнутому сотрудничеству с международным журналом Glaucoma Today (USA) и с личного согласия авторов
Trachoma affects approximately 150 million people worldwide, and the ICO is dedicated to its eradication. The ICO outlined this commitment in our 2009 Bahrain Declaration on Trachoma and Trichiasis Surgery. The declaration builds on the ICO’s long history of leadership in the prevention of trachomatous blindness: The organization that became the ICO grew out of actions in 1857 to address the problem of trachoma in Europe. In 1928, the ICO led international efforts to focus on trachoma around the world. The ICO is a founding member of the International Agency for Prevention of Blindness. The ICO is a partner in VISION 2020: The Right to Sight. ICO President Prof. Hugh Taylor literally wrote the book on trachoma.
Purpose: To evaluate the safety and ocular hypotensive efficacy of 4 trabodenoson doses administered twice daily over 14 or 28 days in subjects with ocular hypertension or primary open-angle glaucoma (POAG). Methods: In this multicenter, randomized, double-masked, placebo-controlled, dose-escalation Phase 2 study, patients received unilateral topical twice-daily trabodenoson (50, 100, or 200 mcg) or placebo for 14 days, or 500 mcg trabodenoson or placebo for 28 days. Ocular and systemic safety and tolerability were assessed by examinations, clinical and laboratory studies. Intraocular pressure (IOP) was assessed using Goldmann tonometry. Results: Trabodenoson was well tolerated; no clinically meaningful ocular or systemic side effects were identified. Trabodenoson produced a dose-dependent IOP reduction. IOP reductions in the 500 mcg group were significantly greater than placebo at all time points at Day 28. Mean IOP reductions from diurnal baseline ranged from −3.5 to −5.0 mmHg with a mean change of −4.1 mmHg in the 500 mcg group compared −1.0 to −2.5 mmHg with a mean change of −1.6 mmHg for the placebo group, and the Day 28 drop was significantly greater than at Day 14 (P = 0.0163) indicating improvement in IOP lowering with longer treatment time. IOP remained significantly reduced 24 h after the final 500 mcg dose (P = 0.048). Conclusion: Twice-daily ocular doses of trabodenoson, from 50 to 500 mcg, were well tolerated and showed a dose-related decrease in IOP that was statistically significant and clinically relevant at 500 mcg in patients with ocular hypertension or POAG.
Objective: The objective of this study was to assess the intraocular pressure (IOP)-lowering efficacy, tolerability, safety, and usage patterns of prostaglandin analog/prostamide (PGA/P)-containing topical ocular hypotensives in ocular hypertension (OHT) and primary open-angle glaucoma in the Turkish clinical setting.

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