INTRODUCTION: This study was performed to compare the efficacy and safety of PreserFlo MicroShunt (PMS) implantation with mitomycin C (MMC) applied by sub-tenon injection versus conventional application by MMC-soaked sponges. METHODS: This retrospective, 1-year cohort study included 100 eyes of 100 patients with glaucoma who underwent PMS implantation with MMC (0.4 mg/ml) delivered either by sub-tenon injection (50 eyes) or via soaked sponges (50 eyes). The primary outcome measure at 1 year was intraocular pressure (IOP) reduction, with complete success defined as an IOP reduction of ≥ 20% and achieving a target IOP of ≤ 21 or 18 mmHg without the use of medication. Secondary outcomes, including corneal endothelial cell density (CECD) loss, the number of medications, and complications, were assessed and compared between the groups. RESULTS: Sustained reductions in mean IOP were observed in both groups over the 1-year follow-up, with no significant differences between the groups. The complete success rate, with a target IOP of ≤ 21 mmHg after 1 year, was 19.3% in the sponge group and 26.4% in the injection group. The qualified success rate was 59.0% and 87.4% in the sponge and injection groups, respectively. A longer survival rate was observed in the injection group than in the sponge group when IOP was below 21 mmHg. The mean CECD significantly decreased (P < 0.01) from baseline to each postoperative follow-up time point in both groups. At 1 year postoperatively, the percentage of total CECD loss was 8.1% in the sponge group and 8.0% in the injection group. However, no significant differences in mean CECD values, the number of medications, or adverse events were found between the groups. CONCLUSIONS: PMS implantation with sub-tenon injection of MMC was comparable in terms of efficacy and safety to traditional MMC delivery via soaked sponges. However, the injection group demonstrated a significantly higher success rate than the sponge group.
- Publication type
- Journal Article MeSH
This paper describes a compact video-ophthalmoscope (VO) designed for capturing retinal video sequences of the optic nerve head (ONH) under flicker light stimulation. The device uses an OLED display and a fiber optic-coupled LED light source, enabling high-frame-rate video at low illumination intensity (12 μW/cm2). Retinal responses were recorded in 10 healthy subjects during flicker light exposure with a pupil irradiance of 2 μW/cm2. Following 20 s of stimulation, all subjects displayed changes in retinal reflectance and pulsation attenuation, linked to blood flow and volume variations. These findings suggest that increased blood volume leads to decreased retinal reflectance. Temporal analysis confirmed the ability to capture flicker-induced retinal reflectance changes, indicating its potential for spatial and temporal analysis. Overall, this device offers a portable approach for investigating dynamic retinal responses to light stimuli, which can aid the diagnosis of retinal diseases like diabetic retinopathy, glaucoma, or neurodegenerative diseases affecting retinal blood circulation.
- MeSH
- Video Recording * instrumentation MeSH
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Ophthalmoscopes * MeSH
- Retina * radiation effects physiology MeSH
- Photic Stimulation * MeSH
- Light * MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- MeSH
- Adult MeSH
- Drug Combinations MeSH
- Glaucoma, Open-Angle * surgery diagnostic imaging drug therapy pathology MeSH
- Gonioscopy MeSH
- Carbonic Anhydrase Inhibitors adverse effects therapeutic use MeSH
- Drug Eruptions etiology MeSH
- Humans MeSH
- Intraocular Pressure * MeSH
- Ophthalmologic Surgical Procedures MeSH
- Tomography, Optical Coherence MeSH
- Trabeculectomy MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
This study investigates the interaction of two approved and one newly developed latanoprost formulation with in vitro and in silico models of the tear film and tear film lipid layer (TFLL). Latanoprost, a prostaglandin analogue used for intraocular elevated pressure treatment, is topically delivered by nanocarriers within aqueous solutions or emulsions. The study focuses on the impact of these carriers on drug interactions with the tear film and their effect on the TFLL. Three different types of latanoprost carriers, micellar, nanoemulsion, and polymer-based, were compared, and each revealed distinct interaction patterns with the TFLL. Surface pressure kinetics demonstrated a rapid increase for the benzalkonium chloride formulation and a slow rise for the preservative-free variants. Visualization of the acellular in vitro TFLL model revealed different patterns of incorporation for each formulation, indicating unique interaction mechanisms. Molecular dynamics simulations further revealed different mechanisms of drug release in the TFLL between micellar and nanoemulsion formulations. In-depth examination highlighted the role of triglyceride molecules in replenishing the nonpolar layer of the TFLL, which suggests potential improvements in ocular surface compatibility by adjusting the quality and concentration of the oily phase. These findings suggest the potential for optimizing latanoprost formulations by tuning the oily phase-to-surfactant ratio and selecting suitable surfactants.
- MeSH
- Antihypertensive Agents therapeutic use MeSH
- Glaucoma * drug therapy MeSH
- Latanoprost therapeutic use MeSH
- Drug Delivery Systems MeSH
- Humans MeSH
- Intraocular Pressure MeSH
- Eye * MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
[Scleral Grafts in Ophthalmic Surgery. A Review]
Cíle: Shrnout historii i současné trendy ve využití sklérálních štěpů v oftalmologii. Materiál a metody: Provedli jsme analýzu literatury prostřednictvím databází MEDLINE a Cochrane Library. Hledaná hesla byla “sclera”, “graft”, “surgery”. Výsledkem vyhledávání bylo 1596 článků, z nichž jsme 192 vyhodnotili jako relevantní. Relevantní články byly seřazeny chronologicky a dle způsobu využití sklerálních štěpu, což umožnilo vypracování přehledového článku. Výsledky: Skléra se v oftalmologii rutinně používá od padesátých let dvacátého století, a to v mnoha různých indikacích. Některé z nich se časem staly prakticky obsoletními (například využití při operačním řešení amoce sítnice), ale velká část nachází uplatnění dodnes (zejména využití v glaukomové či okuloplastické chirurgii, případně jako záplata při defektu skléry nebo rohovky). Závěr: I přesto, že je v současné době alogenní skléra oproti jiným produktům tkáňového bankovnictví v oftalmologii využívána spíše méně často a okruh jejích indikací se částečně zúžil, zůstává vzhledem ke své dostupnosti a vlastnostem užitečným a perspektivním materiálem.
Aim: To summarize the history and current trends in the use of scleral grafts in ophthalmology. Materials and methods: We conducted a review of the literature through the MEDLINE and Cochrane Library databases. The search terms were "sclera", "graft", and "surgery". The search resulted in 1596 articles, of which we evaluated 192 as relevant. The relevant articles were sorted chronologically and according to the method of using scleral grafts, which enabled the development of a review article. Results: The sclera has been routinely used in ophthalmology since the 1950s in many different indications. Some of these indications have become practically obsolete over time (for example, use in the surgical management of retinal detachment), but a large number still find application today (especially use in glaucoma or oculoplastic surgery, or as a patch for a defect in the sclera or cornea). Conclusion: Even though allogeneic sclera is currently used less frequently in ophthalmology compared to other tissue banking products and the range of its indications has partially narrowed, it remains a useful material due to its availability and properties.
- MeSH
- Allografts * classification MeSH
- History, 20th Century MeSH
- Humans MeSH
- Ophthalmologic Surgical Procedures history classification methods MeSH
- Review Literature as Topic MeSH
- Sclera * surgery MeSH
- Scleroplasty history classification methods MeSH
- Transplants history classification MeSH
- Vitreoretinal Surgery history classification methods MeSH
- Check Tag
- History, 20th Century MeSH
- Humans MeSH
- Publication type
- Review MeSH
BACKGROUND AND AIMS: Cardiovascular (CV) diseases are the most common risk factors (RFs) for retinal vein occlusion (RVO) development in general. The aim of this study was to identify the most frequent causes of RVO in patients under 50. METHODS: We retrospectively evaluated a group of patients with RVO under 50 years. The parameters of interest included age and sex, RVO type, presence of arterial hypertension (HT), hyperlipidaemia (HLD), diabetes mellitus (DM), congenital thrombophilic disorder (TD), obstructive sleep apnoea syndrome (OSAS), thyroid eye disease (TED), use of hormone contraception (HC) or hormone replacement therapy (HRT), glaucoma and other potential RFs. Patients with central RVO (CRVO), hemi-central RVO (HRVO), branch RVO (BRVO), impending CRVO and combined arterial-venous (AV) occlusion were included. RESULTS: The group consisted of 110 eyes of 103 patients. CV disease was the most common systemic abnormality. 55.3% patients had HT, 17.5% had HLD. TD was the third most frequent RF (12.6%). The cohort also included patients with DM (6.8%), glaucoma (6.8%) and women using HC/HRT (26.2% of female patients). There were isolated cases of RVO due to retinal vasculitis, intense exercise, antiphospholipid syndrome and COVID-19 pneumonia. None of the patients had OSAS, TED or a haemato-oncological disease. The etiology remained unexplained in 20.4% patients. No difference was observed in RF occurrence between patients with CRVO and HRVO and those with BRVO. CONCLUSION: The most common systemic abnormality in our cohort was CV disease, especially HT and HLD. The risk factors for central, hemi-central and branch RVOs were similar.
- MeSH
- Glaucoma * MeSH
- Hyperlipidemias * complications epidemiology MeSH
- Hypertension * complications epidemiology MeSH
- Cardiovascular Diseases * MeSH
- Humans MeSH
- Sleep Apnea, Obstructive * MeSH
- Retinal Vein Occlusion * epidemiology etiology MeSH
- Retrospective Studies MeSH
- Risk Factors MeSH
- Thrombophilia * complications MeSH
- Check Tag
- Humans MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
UNLABELLED: PURPOSE : To compare the efficacy and safety of the fixed-dose combination (FDC) of netarsudil 0.02%/latanoprost 0.005% ophthalmic solution (NET/LAT; Roclanda®) with bimatoprost 0.03%/timolol maleate 0.5% (BIM/TIM; Ganfort®) ophthalmic solution in the treatment of open-angle glaucoma (OAG) and ocular hypertension (OHT). METHODS: MERCURY-3 was a 6-month prospective, double-masked, randomized, multicenter, active-controlled, parallel-group, non-inferiority study. Patients (≥ 18 years) with a diagnosis of OAG or OHT in both eyes that was insufficiently controlled with topical medication (IOP ≥ 17 mmHg in ≥ 1 eye and < 28 mmHg in both eyes) were included. Following washout, patients were randomized to once-daily NET/LAT or BIM/TIM for up to 6 months; efficacy was assessed at Week 2, Week 4, and Month 3; safety was evaluated for 6 months. Comparison of NET/LAT relative to BIM/TIM for mean IOP at 08:00, 10:00, and 16:00 h was assessed at Week 2, Week 6, and Month 3. Non-inferiority of NET/LAT to BIM/TIM was defined as a difference of ≤ 1.5 mmHg at all nine time points through Month 3 and ≤ 1.0 mmHg at five or more of nine time points through Month 3. RESULTS: Overall, 430 patients were randomized (NET/LAT, n = 218; BIM/TIM, n = 212), and all received at least one dose of study medication. Efficacy analyses were performed at Month 3 on 388 patients (NET/LAT, n = 184; BIM/TIM, n = 204). NET/LAT demonstrated non-inferiority to BIM/TIM, with a between-treatment difference in IOP of ≤ 1.5 mmHg achieved at all time points and ≤ 1.0 mmHg at the majority of time points (six of nine) through Month 3. Mean diurnal IOP during the study ranged from 15.4 to 15.6 mmHg and 15.2 to 15.6 mmHg in the NET/LAT and BIM/TIM groups respectively, with no between-group statistically significant difference. No significant differences were observed in key secondary endpoints. No serious, treatment-related adverse events (AEs) were observed, and AEs were typically mild/moderate in severity. The most common treatment-related AEs were conjunctival hyperemia (NET/LAT, 30.7%; BIM/TIM, 9.0%) and cornea verticillata (NET/LAT, 11.0%; BIM/TIM, 0%). CONCLUSIONS: Once-daily NET/LAT was non-inferior to BIM/TIM in IOP reduction in OAG and OHT, with AEs consistent with previous findings. NET/LAT offers a compelling alternative FDC treatment option for OAG and OHT.
- MeSH
- Antihypertensive Agents adverse effects MeSH
- Benzoates * MeSH
- beta-Alanine analogs & derivatives MeSH
- Bimatoprost therapeutic use MeSH
- Double-Blind Method MeSH
- Glaucoma, Open-Angle * diagnosis drug therapy MeSH
- Latanoprost adverse effects MeSH
- Humans MeSH
- Intraocular Pressure MeSH
- Ocular Hypertension * diagnosis drug therapy MeSH
- Ophthalmic Solutions MeSH
- Prospective Studies MeSH
- Timolol adverse effects MeSH
- Tonometry, Ocular MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH
Úvod: Iridokorneální endotelový (ICE) syndrom je vzácné onemocnění charakterizované abnormální proliferací a strukturálními změnami endotelu, obliterací iridokorneálního úhlu a anomáliemi duhovky. Důsledkem těchto změn je sekundární glaukom a dekompenzace rohovky. Etiologie je nejasná a častěji postihuje ženy středního věku. Kazuistiky: Formou článku prezentujeme dvě odlišné kazuistiky mladých pacientů s diagnózou ICE syndromu s rozvinutými komplikacemi. V 1. kazuistice se jedná o mladou pacientku, u které se pomocí antiglaukomové a rohovkové chirurgie daří stabilizovat glaukomové onemocnění a rohovkový edém. Naproti tomu kazuistika 2. poukazuje na složitý a komplikovaný případ 29letého pacienta, u kterého ani přes opakované zákroky není léčba úspěšná. Závěr: Tento text poukazuje na komplikovanost ICE syndromu, obtížnost jeho terapie a důležitost včasné diagnostiky.
Aim: Iridocorneal endothelial (ICE) syndrome is a rare disease characterized by abnormal proliferation and structural changes of the endothelium, obliteration of the iridocorneal angle, and anomalies of the iris. The consequence of these changes is secondary glaucoma and corneal decompensation. The etiology is unclear, and the syndrome more commonly affects middle-aged women. Case reports: In this article we present two different case studies of young patients diagnosed with ICE syndrome with complications. The first case report is about a young woman in whom surgical treatment of glaucoma and corneal edema was successful. On the other hand, the second report presents a complicated case of a 29-year-old patient whose treatment was not successful despite repeated interventions. Conclusion: This text highlights the complexity of ICE syndrome, the difficulty of its therapy and the importance of early diagnosis.
- MeSH
- Diagnosis, Differential MeSH
- Adult MeSH
- Glaucoma etiology MeSH
- Iridocorneal Endothelial Syndrome * diagnostic imaging diagnosis complications pathology MeSH
- Humans MeSH
- Microscopy classification methods MeSH
- Corneal Diseases diagnostic imaging diagnosis classification MeSH
- Intraocular Pressure MeSH
- Endothelium, Corneal diagnostic imaging pathology MeSH
- Blindness etiology MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Case Reports MeSH