Clinical Manifestations, Outcomes, and Histopathology of Recurrent Uveitis in Patients Underwent Pupil Coroplasty Combined with Cataract Surgery

Purposes: This study was aimed to evaluate the clinical manifestations of recurrent uveitis in patients underwent pupil coroplasty combined with cataract surgery, and discovery the histopathological changes of iris tissues. Methods: There 28 patients with recurrent uveitis-induced cataract, who had underwent pupil coroplasty, phacoemulsification, and intraocular lens implantation were enrolled in this study. The clinical manifestations and outcomes of the enrolled patients were analyzed. The histopathological changes of iris tissues were observed by hematoxylin and eosin (HE) staining. Results: The uveitis were idiopathic in 89.29% cases (n = 25). Before the surgery, 20 cases had no topical medication for at least 3 months. The preoperative BCVA was > 0.5 in all cases. During the follow-up of 5-10 years, no recurrence of uveitis was found in 96.43% cases (n = 27). Uveitis only recurred in one case along with the onset of ankylosing spondylitis at the 6th week after the surgery. HE staining showed obvious atrophy of iris stroma in all samples. The hyperplasia of pigment cells was observed in the pigment epithelium (n = 9) and even invaded into stroma (n = 19). The infiltration of inflammatory cells in iris tissues was found in 7 cases, and neovascularization in the surface of the iris was found in 2 cases. Conclusion: Recurrent uveitis was characterized by the atrophy of iris stroma, and some cases also exhibited hyperplasia of pigment cells and infiltration of inflammatory cells. The surgery proposed in this study can effectively prevent the long-term recurrence of uveitis.

The Importance of Optical Coherence Tomography and Autofluorescence in the Documentation of Papillary Colobomatous Fossette

Aims: To describe the importance of optical coherence tomography and autofluorescence in the documentation of papillary colobomatous fossette. Presentation of Case: F.D.O. A 14-year-old male student is referred for evaluation of the fundus of the eye due to an alteration in the optic disc noticed by another professional who did not feel safe in the follow-up. The patient was completely asymptomatic at the time of the consultation and did not claim previous visual complaints. She denied systemic and ocular comorbidities and did not use any systemic and topical medication. Discussion: The congenital optic disc pit is a rare and typically unilateral congenital anomaly, consisting of a retinal herniation that extends into the subarachnoid space through a lamina cribrosa defect. 8,13,15,16 Although this condition, in most cases, does not present complications and remains asymptomatic, it can sometimes worsen with a significant decrease in visual acuity. This more serious condition can be characterized by important macular alterations, such as serous retinal detachment, cystic degenerations and degenerative pigmentary alterations. 14,16,17,18 The patient in the present report did not have any visual complaints and did not present severe structural and functional retinal damage, which highlights the importance of early diagnosis. Conclusions: The colobomatous papilla pit is characterized by the presence of isolated cavities in the optic disc head secondary to a developmental disorder of the primitive epithelial papilla. Its incidence is 1:10,000 people without sexual or racial predilection. It presents, in most cases, asymptomatic, unilateral in 85-95% of cases and rarely with more than one pit per disc.

Topical Medication Therapy for Glaucoma and Ocular Hypertension

Glaucoma is one of the most common causes of blindness, thus seriously affecting people’s health and quality of life. The topical medical therapy is as the first line treatment in the management of glaucoma since it is inexpensive, convenient, effective, and safe. This review summarizes and compares extensive clinical trials on the topical medications for the treatment of glaucoma, including topical monotherapy agents, topical fixed-combination agents, topical non-fixed combination agents, and their composition, mechanism of action, efficacy, and adverse effects, which will provide reference for optimal choice of clinical medication. Fixed-combination therapeutics offer greater efficacy, reliable security, clinical compliance, and tolerance than non-fixed combination agents and monotherapy agents, which will become a prefer option for the treatment of glaucoma. Meanwhile, we also discuss new trends in the field of new fixed combinations of medications, which may better control IOP and treat glaucoma.

Dermal Irritation Study of Pankajakasthuri Orthoherb Cream/Thermagel, a Potent Polyherbal Anti-inflammatory and Analgesic Formulation for Topical Application in Healthy New Zealand White Rabbits

Pankajakasthuri orthoherb cream/thermagel is a polyherbal topical medication formulated for managing inflammation and pain. The objective of the present study was to evaluate the skin irritation potential of Pankajakasthuri orthoherb cream/thermagel on a single and repeated application in New Zealand white rabbits. The rabbits were dermally exposed with Pankajakasthuri orthoherb cream/thermagel and the appearance of each application site at 1 h, 24 h, 48 h, 72 h, 7th day and 14th day was recorded. The dermal reactions (erythema and edema) were evaluated according to the skin reactions scoring system. Pankajakasthuri orthoherb

Hoornvliesbeschadiging na cataractchirurgie: belang van het droge-ogensyndroom en topische NSAID’s en oppuntstelling van de behandeling

Dry eye disease and cataract surgery: identification of risk factors for corneal damage and optimisation of treatment Various factors in the perioperative cataract surgery period can synergistically initiate a vicious inflammatory cycle of dry eye disease (DED) and tissue damage, with dire consequences. A careful anamnesis and preoperative assessment of the ocular surface can reveal some of the risk factors and facilitate an appropriate perioperative approach. Attention should be paid to DED and associated conditions, such as Meibomian gland dysfunction, as these conditions are very common. In the postoperative period, it is wise to avoid preserved topical medication, as well as to use topical medication that may be toxic to the ocular surface, such as non-steroidal anti-inflammatory drugs (NSAIDs), with care in specific cases. The treatment of DED and its complications consists primarily of the careful use of lubricating, antibiotic and anti-inflammatory agents. In serious DED cases, autologous serum promotes tissue regeneration by promoting epithelialisation and stromal recovery, and can be a useful adjunct to the first-line treatment. In extreme and rare cases, DED can, in combination with the use of topical NSAIDs and other risk factors, lead to sight-threatening complications, such as corneal melting. A surgical treatment consisting of conjunctival flap transplantation, amniotic membrane transplantation, gluing of the cornea or tectonic keratoplasty may be necessary when perforation is imminent.

Ranibizumab Inhibits Human Tenon’s Fibroblast Proliferation via p21 Dependent p53 Mechanisms

Trabeculectomy is the gold standard procedure performed in glaucoma when topical medication and laser intervention failed. In a trabeculectomy, number of clinical trials have shown the efficacy of ranibizumab in minimizing extracellular matrix accumulation at the filtering site. Ranibizumab (LucentisTM) is a drug that targets vascular endothelial growth factor (VEGF). However, to date the actual mechanisms of this anti-VEGF in trabeculectomy is still not well understood. Hence, in here we aimed to elucidate the effects of ranibizumab on human Tenon’s fibroblast (HTF) isolated from patients undergoing trabeculectomy. In our previous study, we had reported that ranibizumab reduces the level of spermidine metabolite whereby spermidine is an important polyamine for cell proliferation. For this current study, cultured HTFs were divided into untreated, control IgG, ranibizumab only, difluoromethylornithine (DFMO; inhibitor of spermidine) only and ranibizumab with DFMO. All cells were extracted for PCR array (expression of CDKN1A, CDK2, and CDK4) and protein expression of p53, p21, CDK2, and CDK4 by Western Blot. In here, our result demonstrated that cells treated with ranibizumab or DFMO and cells treated with ranibizumab-DFMO have similar effects as both show increased in p53 and p21. Meanwhile, no significant differences in expression of CDKN1A, CDK2 and CDK4 were observed in all groups. In essence, our findings suggest that ranibizumab action is mediated by p21 and p53.

Topical medication as an initial therapeutic option for protruding and non-protruding condylomata acuminata of the distal urethra

Genital warts (also known as condylomata acuminata) caused by the human papillomavirus (HPV) represent one of the most common sexually transmitted infections. Although they are usually found in the outer genital region, a small proportion of men can present with (often unrecognised) intraurethral warts, generally limited to the distal urethra and urethral meatus. This poses a treatment challenge not adequately addressed by the current guidelines. Here, we present two cases of low-risk HPV-positive patients with protruding and non-protruding condylomata acuminata of the distal urethra, which were treated successfully by using two different topical regimens (ie, a combination of policresulen and imiquimod for one patient and 5-fluorouracil monotherapy for the other). Although this type of management results in lower rates of tissue destruction and complications and may be given preference as an initial therapeutic option, additional prospective comparative clinical studies are needed to elucidate its potential in similar cases.