OphthaTherapy. Therapies in Ophthalmology

Glaucoma – new possibilities, new research

Dorota Szumny, Małgorzata Mulak — Fri, 31 Mar 2023 00:00:00 +0200

Research efforts to develop effective and safe antiglaucoma drugs have been ongoing for many years. The cornerstone of treatment is still baroprotection, as this is virtually the only method available to protect the optic nerve and slow glaucoma progression, which can be easily controlled by an ophthalmologist. Research is also being conducted in the direction of neuroprotection, where new compounds are being evaluated, as well as those that have been used for years as adjunctive treatments. The greatest hope lies in gene therapy, which still has many problems to be solved, but it is the only one that offers hope for the patient’s complete recovery.

The association Between ALR2 -106C>T Gene Polymorphisms and Diabetic Retinopathy Susceptibility In Diabetes Mellitus Patient: A Systematic Review and Meta-Analysis

Indah Sagitaisna Putri, Bastomy Eka Rezkita, Steven Irving, Akhmad Azmiardi — Mon, 27 Mar 2023 00:00:00 +0200

Aldose reductase gene polymorphisms has been indicated to be associated with diabetic retinopathy (DR). The research data were from PubMed and EMBASE. We identified -106C > T single nucleotide polymorphism (SNP). Pool odds ratio (OR) with 95% CI were calculated. Nine studies were included. ALR2 106C > T gene polymorphisms was associated with the increased risk of DR in T1DM (C vs. T, OR = 2.07, p = 0.001; CC vs. CT + TT, OR = 2.56, p = 0.005). T allele and TT genotype were associated with decreased risk of DR in T1DM (OR = 0.48, p = 0.0001 and OR = 0.12, p = 0.0005). In conclusion, C allele and CC genotype may be a risk factor, while T allele and TT genotype may serve as protective factor for DR in T1DM patient.

When a large refractive defect is found in a child, should electroretinography be ordered immediately?

Mateusz Zabochnicki, Dorota Pojda-Wilczek — Fri, 31 Mar 2023 00:00:00 +0200

Electroretinography is a useful tool used in diagnosing retinal disorders. Refractive errors are a common and increasing group of abnormalities, which, if undiagnosed, may lead to complications. Physiologically, i.e., refraction of the child’s eye, evolves from myopic or hyperopic after birth, towards emmetropic. However, high refractive errors tend to present with retinal diseases. Early electroretinography is a great diagnostic test that allows its detection. Because of that, it can help avoid loss of eyesight and prevent future implications. Unfortunately, low accessibility and interpretational difficulties are main barriers in wider implementation of that method.

Risk factors for central serous chorioretinopathy

Maciej Gawęcki — Fri, 31 Mar 2023 00:00:00 +0200

Central serous chorioretinopathy is a well-described ocular disorder affecting primarily young individuals. As chronic forms of central serous chorioretinopathy are often leading to significant visual impairment, potential risk factors for its development are constantly analyzed in numerous studies. Review of available research shows that predominant risk factors for central serous chorioretinopathy include male gender, steroid intake, pregnancy, Cushing syndrome, chronic or acute stress, maladaptive personal traits, and increased choroidal thickness. Other factors, such as hypertension, gastric ulcer and reflux or genetic predispositions probably increase the risk of central serous chorioretinopathy onset, but its quantification remains the question of debate.

Diagnosis and treatment of corneal ulcers in the course of systemic autoimmune diseases

Fri, 31 Mar 2023 00:00:00 +0200

Peripheral ulcerative keratitis is an inflammatory condition, usually crescent shaped and occurring in the corneal stromal region, where it is always associated with corneal stromal thinning. Peripheral ulcerative keratitis often occurs in the course of rheumatic diseases but is most commonly associated with rheumatoid arthritis. Peripheral ulcerative keratitis is also seen in granulomatosis with polyangiitis, polyarteritis nodosa, relapsing chondritis, and systemic lupus erythematosus. These diseases are analyzed in the article in relation to peripheral ulcerative keratitis with a discussion of individual treatment methods in specific cases.

Efficacy of oral steroid therapy in the treatment of acute maculopathy in the course of hand, foot and mouth disease – 3 case reports

Adam Cywiński, Daniela Ferda-Lewińska, Marcin Gacek — Fri, 31 Mar 2023 00:00:00 +0200

Oral steroid therapy was administered in three patients with skin symptoms, diagnosed with hands, mouth and foot disease (HMFD, commonly known as “Boston’s disease”) and in the course of which there was a rapid deterioration of vision in one eye. Each of the patients had previous contact with a person with disease. Hospitalization of the first patient, during which general antibiotic therapy, antiviral drugs and short-term intravenous steroid therapy were used, brought only a slight improvement in visual acuity. Given the accompanying colour discrimination dysfunction, oral steroid therapy was introduced in this patient, already in the outpatient setting. The therapy brought a significant improvement in visual acuity in a short time and restored the ability to distinguish colours. This form of treatment was used in another two patients with similar, good result.

Macular hemorrhage – therapy

Fri, 31 Mar 2023 00:00:00 +0200

Submacular hemorrhage treatment is still an important issue in ophthalmology. At present we lack algorithms of treatment that could be used in clinical practice. Efficacy of every treatment method seems to differ by individual factors simultaneously existing in each patient. Therefore, anti-VEGF agents remain crucial in treating patients with coexisting vasculopathy, while in posttraumatic hemorrhage we should lean towards other approaches, like pneumatic displacement. Operative methods, despite being more invasive and burdened with higher potential risk, are indispensable in large hemorrhages, significantly speeding up clot removal. The primary aim of this work is to collect recent data regarding this issue and to determine usefulness of treatment methods in specific cases, regarding factors such as hemorrhage pathophysiology. The following article pertains to currently used treatment methods, such as: pneumatic displacement, anti-VEGF therapy, rtPA and operative methods.

Corneal biomechanical changes after myopic and hyperopic laser vision correction

Zofia Pniakowska, Piotr Jurowski, Joanna Wierzbowska — Fri, 31 Mar 2023 00:00:00 +0200

Laser vision correction became a popular method of refractive error treatment. The laser vision correction techniques influence the corneal biomechanical properties including corneal hysteresis and corneal resistance factor. The ocular response analyzer and Corvis ST devices are used in clinical practice to measure the corneal biomechanics. Reasonable laser treatment planning, taking into account the impact on corneal biomechanics, may potentially improve the safety of the refractive procedures. Thicker caps in refractive lenticule extraction and thinner flaps in flap-related procedures promote better corneal biomechanics preservation. The myopic refractive treatment appears to have a greater effect on corneal biomechanics weakening than hyperopic correction.