scholarly journals Comparison between the Express Implant and Transscleral Diode Laser in Neovascular Glaucoma

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Faried Mohammed Wagdy ◽  
Adel Galal Zaky
Keyword(s):  
Previous History ◽  
Visual Outcome ◽  
Glaucoma Surgery ◽  
Neovascular Glaucoma ◽  
Panretinal Photocoagulation ◽  
History Of ◽  
Therapeutic Tools ◽  
Endothelial Growth Factor ◽  
Glaucoma Filtration Device ◽  
Filtration Device

Purpose. To compare the outcomes of Ex-PRESS glaucoma filtration device and transscleral cyclophotocoagulation (TSCP) in the management of neovascular glaucoma (NVG). Patients and Methods. A total of 30 eyes (12 express shunts and 18 TSCP) of 28 patients were included. The eyes had NVG with intraocular pressure (IOP) more than 21 mmHg of the maximally tolerated medication treatment after previous panretinal photocoagulation and antivascular endothelial growth factor (anti-VEGF) injection, with no previous history of a cyclodestruction procedure or glaucoma surgery, were randomized either for Ex-PRESS glaucoma filtration device or TSCP. The patients were followed up weekly for the first month and then monthly for 12 months as regard to the IOP, number of topical antiglaucoma drugs required, visual outcome, and postoperative complications. Results. IOP was successfully controlled with both techniques in 83.3% of the eyes. Both techniques had fewer complications and required fewer subsequent procedures. Conclusion. Both the Ex-PRESS glaucoma filtration device and TSCP might constitute safe and alternative therapeutic tools for patients with NVG. However, TSCP is an easier procedure, less time consuming, and does not require a learning curve.

scholarly journals Use of Anti-VEGF Agents in Glaucoma Surgery

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Mark Slabaugh ◽  
Sarwat Salim
Keyword(s):  
Anterior Segment ◽  
Glaucoma Surgery ◽  
Neovascular Glaucoma ◽  
Delivery Methods ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Process Use ◽  
Anti Vegf ◽  
Repeated Use ◽  
Endothelial Growth Factor

A number of antivascular endothelial growth factor agents are currently available to treat various ocular conditions. These agents have similar, but distinct, biologic qualities and have been explored in the management of neovascular glaucoma and in glaucoma surgery. Several different delivery methods are described, and because these medications are routinely given as intraocular injections, some benefits over traditional antifibrotic medications when used in glaucoma surgery are noted. These agents effectively induce regression of anterior segment neovascularization and facilitate initial surgical management of neovascular glaucoma, but the long-term outcome of this condition remains dependent on definitive management of the underlying process. Use in trabeculectomy or tube shunt procedures for other types of glaucoma has shown promise in modulating bleb morphology but has not yet been found to be as effective as traditional antifibrotic agents. There are reports of persistently raised intraocular pressure after repeated use of the anti-VEGF agents, possibly related to frequency of injection. These medications have wide application in the field of surgical glaucoma, but a definitive role has yet to be defined.

scholarly journals Nontuberculous Mycobacterial Endophthalmitis: Case Series and Review of Literature

2020 ◽  
Author(s):  
Warinyupa Pinitpuwadol ◽  
Nattaporn Tesavibul ◽  
Sutasinee Boonsophon ◽  
Darin Sakiyalak ◽  
Sucheera Sarunket ◽  
...  
Keyword(s):  
Previous History ◽  
Case Series ◽  
Clinical Information ◽  
Visual Outcome ◽  
Treatment Modalities ◽  
Endogenous Endophthalmitis ◽  
Treatment Regimens ◽  
Department Of Ophthalmology ◽  
History Of ◽  
Exogenous Endophthalmitis

Abstract Background: To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the clinical profile, treatment modalities, and visual outcomes among patients with NTM endophthalmitis.Methods: Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE, EMBASE, and CENTRAL was performed. The clinical information and type of NTM from the previous studies and our cases were summarized.Results: We reported three cases of NTM endophthalmitis caused by M. haemophilum, M. fortuitum and M. abscessus and a summarized review of 112 additional cases previously published. Of 115 patients, there were 101 exogenous endophthalmitis (87.8%) and 14 endogenous endophthalmitis (12.2%). The patients’ age ranged from 13 to 89 years with mean of 60.5±17.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (67.3%). In contrast, almost all endogenous endophthalmitis patients were immunocompromised. Among all patients, previous history of tuberculosis infection was identified in 4 cases (3.5%). Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Treatment regimens consisted of macrolides, fluoroquinolones or aminoglycosides, which were continued for up to 12 months. Initial and final vision were generally worse than 6/60.Conclusions: NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner’s suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.

scholarly journals Nontuberculous Mycobacterial Endophthalmitis: Case Series and Review Literature

2020 ◽  
Author(s):  
Warinyupa Pinitpuwadol ◽  
Nattaporn Tesavibul ◽  
Sutasinee Boonsophon ◽  
Darin Sakiyalak ◽  
Sucheera Sarunket ◽  
...  
Keyword(s):  
Previous History ◽  
Case Series ◽  
Clinical Information ◽  
Visual Outcome ◽  
Review Literature ◽  
Treatment Modalities ◽  
Endogenous Endophthalmitis ◽  
Department Of Ophthalmology ◽  
History Of ◽  
Exogenous Endophthalmitis

Abstract Background: To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the clinical profile, treatment modalities, and visual outcomes among patients with NTM endophthalmitis.Methods: Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE, EMBASE, and CENTRAL was performed. The clinical information and type of NTM from the previous studies and our cases were summarized.Results: We reported three cases of NTM endophthalmitis caused by M. haemophilum, M. fortuitum and M. abscessus and a summarized review of 112 additional cases previously published. Of 115 patients, there were 101 exogenous endophthalmitis (87.8%) and 14 endogenous endophthalmitis (12.2%). The patients’ age ranged from 13 to 89 years with mean of 60.5±17.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (67.3%). In contrast, almost all endogenous endophthalmitis patients were immunocompromised. Among all patients, previous history of tuberculosis infection was identified in 4 cases (3.5%). Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Treatment regimens consisted of macrolides, fluoroquinolones or aminoglycosides, which were continued for up to 12 months. Initial and final vision were generally worse than 6/60.Conclusions: NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner’s suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.

scholarly journals Nontuberculous Mycobacterial Endophthalmitis: Case Series and Review Literature

2020 ◽  
Author(s):  
Warinyupa Pinitpuwadol ◽  
Nattaporn Tesavibul ◽  
Sutasinee Boonsophon ◽  
Darin Sakiyalak ◽  
Sucheera Sarunket ◽  
...  
Keyword(s):  
Previous History ◽  
Case Series ◽  
Clinical Information ◽  
Visual Outcome ◽  
Review Literature ◽  
Treatment Modalities ◽  
Endogenous Endophthalmitis ◽  
Department Of Ophthalmology ◽  
History Of ◽  
Exogenous Endophthalmitis

Abstract Background: To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the clinical profile, treatment modalities, and visual outcomes among patients with NTM endophthalmitis.Methods: Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE was performed. The clinical information and type of NTM from the previous studies and our cases were summarized.Results: We reported three cases of NTM endophthalmitis caused by M. haemophilum, M. fortuitum and M. abscessus and a summarized review of 95 additional cases previously published. Of 98 patients, there were 85 exogenous endophthalmitis (86.7%) and 13 endogenous endophthalmitis (13.3%). The patients’ age ranged from 13 to 89 years with mean of 61.1±18.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (62.4%). In contrast, almost all endogenous endophthalmitis patients were immunocompromised. Among all patients, previous history of tuberculosis infection was identified in 4 cases (4.1%). Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Treatment regimens consisted of macrolides, fluoroquinolones or aminoglycosides, which were continued for up to 12 months. Initial and final vision were generally worse than 6/60.Conclusions: NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner’s suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.

scholarly journals Nontuberculous Mycobacterial Endophthalmitis: Case Series and Review Literature

2020 ◽  
Author(s):  
Warinyupa Pinitpuwadol ◽  
Nattaporn Tesavibul ◽  
Sutasinee Boonsophon ◽  
Darin Sakiyalak ◽  
Sucheera Sarunket ◽  
...  
Keyword(s):  
Previous History ◽  
Case Series ◽  
Clinical Information ◽  
Visual Outcome ◽  
Review Literature ◽  
Treatment Modalities ◽  
Endogenous Endophthalmitis ◽  
Department Of Ophthalmology ◽  
History Of ◽  
Exogenous Endophthalmitis

Abstract Background: To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the clinical profile, treatment modalities, and visual outcomes among patients with NTM endophthalmitis.Methods: Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE was performed. The clinical information and type of NTM from the previous studies and our cases were summarized.Results: We reported three cases of NTM endophthalmitis caused by M. haemophilum, M. fortuitum and M. abscessus and a summarized review of 95 additional cases previously published. Of 98 patients, there were 85 exogenous endophthalmitis (86.7%) and 13 endogenous endophthalmitis (13.3%). The patients’ age ranged from 13 to 89 years with mean of 61.1±18.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (62.4%). In contrast, almost all endogenous endophthalmitis patients were either primary or secondary immunocompromised. Among all patients, previous history of tuberculosis infection was identified in 4 cases (4.1%). Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Treatment regimens consisted of macrolides, fluoroquinolones or aminoglycosides, which were continued for up to 12 months. Initial and final vision were generally worse than 6/60. There were no significant differences of initial and final vision between exogenous and endogenous causes (p=1.000, 0.446, respectively).Conclusions: NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner’s suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.

PRO score: predictive scoring system for visual outcomes after rhegmatogenous retinal detachment repair

2021 ◽  
pp. bjophthalmol-2021-320440
Author(s):  
Louis Z Cai ◽  
Jeffrey Lin ◽  
Matthew R Starr ◽  
Anthony Obeid ◽  
Edwin H Ryan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retinal Detachment ◽  
Scoring System ◽  
Rhegmatogenous Retinal Detachment ◽  
Vision Loss ◽  
Visual Outcome ◽  
Visual Outcomes ◽  
Poor Visual Outcome ◽  
History Of ◽  
Endothelial Growth Factor

Background/aimsTo compare risk factors for poor visual outcomes in patients undergoing primary rhegmatogenous retinal detachment (RRD) repair and to develop a scoring system.MethodsAnalysis of the Primary Retinal detachment Outcomes (PRO) study, a multicentre interventional cohort of consecutive primary RRD surgeries performed in 2015. The main outcome measure was a poor visual outcome (Snellen VA ≤20/200).ResultsA total of 1178 cases were included. The mean preoperative and postoperative logMARs were 1.1±1.1 (20/250) and 0.5±0.7 (20/63), respectively. Multivariable logistic regression identified preoperative risk factors predictive of poor visual outcomes (≤20/200), including proliferative vitreoretinopathy (PVR) (OR 1.26; 95% CI 1.13 to 1.40), history of antivascular endothelial growth factor (VEGF) injections (1.38; 1.11 to 1.71), >1-week vision loss (1.17; 1.08 to 1.27), ocular comorbidities (1.18; 1.00 to 1.38), poor presenting VA (1.06 per initial logMAR unit; 1.02 to 1.10) and age >70 (1.13; 1.04 to 1.23). The data were split into training (75%) and validation (25%) and a scoring system was developed and validated. The risk for poor visual outcomes was 8% with a total score of 0, 17% with 1, 29% with 2, 47% with 3, and 71% with 4 or higher.ConclusionsIndependent risk factors were compared for poor visual outcomes after RRD surgery, which included PVR, anti-VEGF injections, vision loss >1 week, ocular comorbidities, presenting VA and older age. The PRO score was developed to provide a scoring system that may be useful in clinical practice.

Reversing the Rubeotic Rampage – Current Approaches in the Management of Neovascular Glaucoma

2016 ◽  
Vol 10 (01) ◽  
pp. 19
Author(s):  
Ian A Rodrigues ◽  
K Sheng Lim ◽  
◽  
Keyword(s):  
Open Angle Glaucoma ◽  
Neovascular Glaucoma ◽  
Angle Closure ◽  
Panretinal Photocoagulation ◽  
Vascular Endothelial ◽  
Success Rates ◽  
Aggressive Management ◽  
Threatening Condition ◽  
Reduce Risk ◽  
Endothelial Growth Factor

Neovascular glaucoma is a sight-threatening condition, and can rapidly progress from rubeosis with normal intraocular pressure (IOP), to secondary open-angle glaucoma with raised IOP and finally secondary angle-closure glaucoma with uncontrolled IOP. Early detection and aggressive management with panretinal photocoagulation, intravitreal anti-vascular endothelial growth factor (VEGF), topical aqueous suppressants and valved glaucoma drainage surgery can reduce risk of significant visual loss secondary to neovascular glaucoma. This editorial explores some simple measures that can increase surgical success rates and minimise complications.

scholarly journals Nontuberculous Mycobacterial Endophthalmitis: Case Series and Review Literature

2020 ◽  
Author(s):  
Warinyupa Pinitpuwadol ◽  
Nattaporn Tesavibul ◽  
Sutasinee Boonsophon ◽  
Darin Sakiyalak ◽  
Sucheera Sarunket ◽  
...  
Keyword(s):  
Previous History ◽  
Case Series ◽  
Clinical Information ◽  
Visual Outcome ◽  
Review Literature ◽  
Endogenous Endophthalmitis ◽  
Department Of Ophthalmology ◽  
History Of ◽  
Exogenous Endophthalmitis ◽  
Almost All

Abstract Background : To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature of NTM endophthalmitis. Methods : Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE was performed. The clinical information and type of NTM from the previous studies and our cases were summarized. Results : We reported three cases of NTM endophthalmitis caused by M. haemophilum , M. fortuitum and M. abscessus and a summarized review of 95 additional cases previously published. Of 98 patients, there were 85 exogenous endophthalmitis (86.7%) and 13 endogenous endophthalmitis (13.3%). The patients’ age ranged from 13 to 89 years with mean of 61.1±18.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (62.4%). In contrast, almost all endogenous endophthalmitis patients were either primary or secondary immunocompromised, previous history of disseminated NTM infection was identified in 38.5% of cases. Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Initial and final vision were generally worse than 6/60. There were no significant differences of initial and final vision between exogenous and endogenous causes (p=1.000, 0.446, respectively). Conclusions : NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner’s suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.

scholarly journals Elevated vitreous Lipocalin-2 levels of patients with proliferative diabetic retinopathy

2020 ◽  
Author(s):  
Hui Wang ◽  
Hui Lou ◽  
Yongrong Li ◽  
Fengtao Ji ◽  
Wei Chen ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Panretinal Photocoagulation ◽  
Lipocalin 2 ◽  
History Of ◽  
The Mean ◽  
Endothelial Growth Factor ◽  
Vegf Level

Abstract Background Lipocalin-2 (LCN2) is a novel adipokine with potential roles in obesity, insulin resistance, and inflammation. This study aims to assess the concentrations of LCN2 and vascular endothelial growth factor (VEGF) expressed in the vitreous humors of patients with proliferative diabetic retinopathy (PDR). Methods The concentrations of LCN2 and VEGF were measured from the vitreous of 67 patients undergoing vitrectomy (20 controls and 47PDR) via enzyme-linked immunosorbent assay (ELISA). Results The vitreous concentration of LCN2 was statistically significantly higher in the PDR group compared to the control group (63,522 ± 30,009 pg/ml versus 1663 ± 1191 pg/ml, respectively; P<0.001). VEGF level was also significantly higher in the PDR group than in the control group (1038 ± 1326 pg/ml versus 9 pg/ml, respectively; P<0.001). The mean vitreous LCN2 and VEGF levels in active PDR patients were significantly higher than that of the inactive PDR patients. The mean LCN2 concentration in vitreous humor was significantly lower in the 28 PDR patients with a history of complete PRP (37,304 ± 16,651 pg/mL) in comparison with 19 PDR patients without preperformed panretinal photocoagulation or with preperformed incomplete panretinal photocoagulation (79,796 ± 24,391 pg/mL). A significant correlation between the vitreous LCN2 level and VEGF level was found in patients with PDR (R=0.34; P=0.019). Conclusions This report shows a significant increase of LCN2 in the vitreous fluid of patients with PDR and present a significant correlation between LCN2 and VEGF, suggesting LCN2 might be involved in the pathogenesis of PDR.

scholarly journals Ovarian Hyperstimulation Syndrome

2013 ◽  
Vol 4 (3) ◽  
pp. 71-78 ◽  
Author(s):  
Nalini Mahajan
Keyword(s):  
Growth Factor ◽  
Ovarian Hyperstimulation Syndrome ◽  
Transforming Growth Factor ◽  
Previous History ◽  
Ovarian Hyperstimulation ◽  
Vascular Endothelial ◽  
Patients At Risk ◽  
History Of ◽  
Endothelial Growth Factor ◽  
Severe Ohss

ABSTRACT ART is proven of great help to all the infertile couples anxious to get pregnant, but is not free of side effects and complications. OHSS one of the most important complication especially in cases of PCOS. Ovarian hyperstimulation syndrome (OHSS) is a potentially fatal complication of ovarian stimulation. The incidence has been estimated at 3 to 6% for moderate and 0.1 to 2% for severe OHSS. The trigger for initiation of OHSS appears to be human chorionic gonadotropin (hCG). In conception cycles symptoms may persist longer due to endogenous hCG stimulus. Vascular endothelial growth factor (VEGF), a member of the transforming growth factor superfamily, has emerged as one of the factors most likely involved in the pathophysiology of OHSS. There are various risk factors which increases the risk of developing OHSS during the stimulation like PCOS, low body weight, previous history of OHSS, etc. Primary and secondary preventive measures are been tried to reduce the risk of developing OHSS. GnRHa trigger in patients at risk revealed that incidence OHSS was reduced or totally eliminated. Use of antagonist cycle with an agonist trigger and elective vitrification of all embryos allows us to aim for an ‘OHSS Free’ clinic today. How to cite this article Mahajan N. Ovarian Hyperstimulation Syndrome. Int J Infertility Fetal Med 2013;4(3):71-78.

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