Treatment Of Ocular Conditions Research Articles

Impact of Telemedicine on Blood Glucose Control and Ophthalmic Screenings for Patients with Diabetes in Remote Areas During the COVID-19 Pandemic: A Real-World Study in Northern Taiwan.

Introduction: The purpose of this study was to assess the impact of telemedicine on ophthalmic screening and blood glucose control for patients with diabetes in remote areas of Northern Taiwan during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Telemedicine was implemented in Shiding and Wanli Districts using a 5G platform from April 2021 to December 2022. Patients with poorly controlled diabetes received real-time consultations from endocrinologists at Far Eastern Memorial Hospital, 50 km away, for medication adjustment, diet control, and lifestyle recommendations. The study also provided cloud-upload blood glucose meters for self-monitoring and regular medical advice from hospital nurses. Ophthalmic screenings included fundus imaging, external eye image, and intraocular pressure measurement, with instant communication and diagnosis by ophthalmologists through telemedicine. A satisfaction questionnaire survey was conducted. Results: The study enrolled 196 patients with diabetes. Blood glucose and glycosylated hemoglobin levels were significantly reduced after applying telemedicine (p = 0.01 and p = 0.005, respectively). Ophthalmic screenings led to hospital referrals for 16.0% with abnormal fundus images, 15.6% with severe cataract or anterior segment disorders, and 27.9% with ocular hypertension or glaucoma. Fundus screening rates remained high at 86.3% and 80.4% in 2022, mainly using telemedicine, comparable with the traditional screening rate in the past 5 years. The overall satisfaction rate was 98.5%. Conclusions: Telemedicine showed effectiveness and high satisfaction in managing diabetes and conducting ophthalmic screenings in remote areas during the COVID-19 pandemic. It facilitated early diagnosis and treatment of ocular conditions while maintaining good blood glucose control and fundus screening rates.

Mitophagy‐reporter Muller cell line (MQ‐MG2) as a novel platform for ocular drug discovery

Aims/Purpose: The controlled activation of mitophagy has emerged as an exciting therapeutic angle in the treatment of ocular conditions, including diabetic retinopathy and age‐related macular degeneration. Here, we report a novel Muller cell line (MQ‐MG2) for the rapid screening of mitophagy‐activating drugs.Methods: MQ‐MG2 were cloned from spontaneously immortalized primary Muller cells (PMCs) derived from mitophagy reporter (Mito‐QC) mice. Muller glia characteristics were assessed by immunocytochemistry, western blotting, and metabolic flux (Seahorse). The versatility of MQ‐MG2 to detect mitophagy‐activating drugs was tested via pharmacological activation (PINK1‐dependent and PINK1‐independent) and further validated in vivo using Mito‐QC mice.Results: MQ‐MG2 were expanded over 50 passages while retaining expression of Mito‐QC reporter. MQ‐MG2 showed key phenotypic markers of Muller glia, including glutamine synthetase, glial fibrillary acidic protein, Aquaporin 4, and Interleukin‐33. At the bioenergetic level, MQ‐MG2 showed lower basal‐ and ATP‐linked respiration than PMCs, while displaying superior reserve capacity (p < 0.001). Indicative of equivalent glycolytic profiles, extracellular acidification rates (baseline and stressed) remained comparable to PMCs. Importantly, MQ‐MG2 showed excellent sensitivity to screen for mitophagy‐activating drugs, including novel small‐molecules acting through (putative) PINK1‐independent pathways. The versatility of MQ‐MG2 as a drug discovery platform was validated in vivo, where oral administration of PINK1‐independent activator (PIA‐01) amplified mitophagy at the outer retina dose‐dependently.Conclusions: MQ‐MG2 enables rapid and reliable detection of mitophagy‐activating drugs for ocular application. This platform overcomes the limitations of primary cultures, including variability due to cellular senescence and heterogeneity, while minimizing the need for animals in drug discovery.

The identification and management of feline conjunctivitis

Feline conjunctivitis commonly presents in veterinary practice due to a variety of reasons; it can stem from a primary conjunctival disease or be secondary to an underlying extraocular, intraocular or systemic condition. Clinical signs of conjunctivitis are often non-specific and may be similar despite various aetiologies, therefore a methodical clinical examination should be followed. This article aims to explore the presentation, pathology and management options for feline conjunctivitis, whilst examining the role of registered veterinary nurses through the treatment of ocular conditions.

Ocular delivery of cyclosporine A using dissolvable microneedle contact lens

The penetration of large molecular weight and poorly aqueous soluble drugs within the cornea has been a limiting factor in the treatment of ocular conditions. The objective of the present study was to fabricate rapidly dissolving polymeric microneedle ocular patch (MOP) to effectively deliver cyclosporine A (CsA) within the cornea. Microneedles were prepared using polyvinyl pyrrolidone by micromolding technique with contact lens design features. The model macromolecule, CsA, was loaded in MOP in a bilayered approach, where CsA was entrapped in 25 microneedles. CsA loaded MOP were characterized for physical and mechanical properties, CsA loading, dissolution, corneal insertion, and CsA distribution in excised porcine eye globe. The average height and base diameter of the conical microneedles were 535 ± 15.7 and 287 ± 2.00 μm, respectively. The average amount of CsA loaded in one MOP was found to be 50.3 μg. Microneedles were found to completely dissolve in the cornea within 60 s of application. MOP showed a compression strength of 57.3 ± 13.7 N, and an insertional force of 10.8 ± 0.91 N in the excised porcine cornea. The application of MOP for 5 min significantly (p < 0.05) enhanced the flux (9.04 ± 0.88 μg/cm2/h) and retention (81 ± 5.1 μg/g) of CsA in excised porcine cornea when compared with commercially available Cyclomune® eye drops (flux 2.11 ± 0.56 μg/cm2/h and amount retained 53 ± 1.1 μg/g). The porcine eye globe distribution studies showed a disposition of 45.5, 29.1, 8.3, 5.2, 3.0 and 0.2% of CsA within the cornea, aqueous humor, lens, vitreous humor, sclera and choroid-retinal complex, respectively. Taken together, MOP can be developed for effective ocular delivery of CsA.

Hyperbaric oxygen therapy in ophthalmic practice: an expert opinion

ABSTRACTIntroduction: There has been a growing interest in hyperbaric oxygen therapy (HBOT) in recent years across multiple disciplines. In the field of ophthalmology, the implications of increased HBOT use may include expanded applications in treating ocular vascular pathologies as well as a greater incidence of HBOT-induced visual complications.Areas covered: The authors review recent studies on HBOT usage in the treatment of ocular conditions. In addition to providing updates on the ophthalmic indications of HBOT, adverse visual effects of HBOT are also investigated.Expert opinion: Further evidence substantiating HBOT as an effective treatment modality for ocular vascular pathologies, such as central retinal artery occlusion and diabetic retinopathy, have been published in recent years. With the identification of more prognostic factors, increased success in HBOT has been reported. However, studies also show that adverse ocular effects associated with hyperbaric oxygen exposure include myopia and cataracts. It is important to recognize the risks of iatrogenic changes in visual acuity when considering patients for HBOT.

Advances in Biodegradable Nano-Sized Polymer-Based Ocular Drug Delivery.

The effective delivery of drugs to the eye remains a challenge. The eye has a myriad of defense systems and physiological barriers that leaves ocular drug delivery systems with low bioavailability profiles. This is mainly due to poor permeability through the epithelia and rapid clearance from the eye following administration. However, recent advances in both polymeric drug delivery and biomedical nanotechnology have allowed for improvements to be made in the treatment of ocular conditions. The employment of biodegradable polymers in ocular formulations has led to improved retention time, greater bioavailability and controlled release through mucoadhesion to the epithelia in the eye, amongst other beneficial properties. Nanotechnology has been largely investigated for uses in the medical field, ranging from diagnosis of disease to treatment. The nanoscale of these developing drug delivery systems has helped to improve the penetration of drugs through the various ocular barriers, thus improving bioavailability. This review will highlight the physiological barriers encountered in the eye, current conventional treatment methods as well as how polymeric drug delivery and nanotechnology can be employed to optimize drug penetration to both the anterior and posterior segment of the eye.

Methazolamide improves neurological behavior by inhibition of neuron apoptosis in subarachnoid hemorrhage mice.

Subarachnoid hemorrhage (SAH) results in significant nerve dysfunction, such as hemiplegia, mood disorders, cognitive and memory impairment. Currently, no clear measures can reduce brain nerve damage. The study of brain nerve protection after SAH is of great significance. We aim to evaluate the protective effects and the possible mechanism of methazolamide in C57BL/6J SAH animal model in vivo and in blood-induced primary cortical neuron (PCNs) cellular model of SAH in vitro. We demonstrate that methazolamide accelerates the recovery of neurological damage, effectively relieves cerebral edema, and improves cognitive function in SAH mice as well as offers neuroprotection in blood- or hemoglobin-treated PCNs and partially restores normal neuronal morphology. In addition, western blot analyses show obviously decreased expression of active caspase-3 in methazolamide-treated SAH mice comparing with vehicle-treated SAH animals. Furthermore, methazolamide effectively inhibits ROS production in PCNs induced by blood exposure or hemoglobin insult. However, methazolamide has no protective effects in morality, fluctuation of cerebral blood flow, SAH grade, and cerebral vasospasm of SAH mice. Given methazolamide, a potent carbonic anhydrase inhibitor, can penetrate the blood–brain barrier and has been used in clinic in the treatment of ocular conditions, it provides potential as a novel therapy for SAH.

Ranibizumab treatment of retinal vein occlusion

The development and approval of anti-VEGF drugs for intravitreal injection has transformed the treatment and prognosis of several ocular conditions, including age-related macular degeneration and retinal vascular occlusion (the subject of this article). Their role in the treatment of ocular conditions is likely to continue to expand owing to the common pathway that VEGF plays in multiple retinal disorders. While important strides have been made, an important treatment challenge is the dosing frequency and the burden that this places on the patient and healthcare providers.

Self-medication in Ophthalmology: A Questionnaire-based Study in an Argentinean Population

Purpose: The aim of this study was to identify practices of self-medication in the treatment of ocular conditions and to identify a profile of patients who self-medicate.Methods: We conducted a cross-sectional descriptive survey of patients, over the age of 17 years seen in our ophthalmology practice in Cordoba, Argentina. Self-medication was defined as the use of ophthalmic medicines which had not been prescribed by a health care specialist in the previous year.Results: The sample included 379 subjects, 162 males (43%) and 217 females (57%); mean age 46.8 years. Prior to looking for medical attention in our institution, 97 patients (25.6%) reported self-medicating. The most frequently employed products included non-steroidal anti-inflammatory drops in combination with a vasoconstrictive agent (32%) followed by a combination of antibiotics and steroids (9%), however, 14% of patients did not remember the name or type of medication applied. A total of 31% of patients used drugs recommended by a pharmacist; 25% used drugs of their own choosing and 24% followed suggestions from a friend or family member. Only 12% of patients knew the drug’s components and only 3% were aware of any possible side effects. There was no difference in behavior patterns related to educational level or age, however, there was a significant difference related to gender, with males misusing ophthalmic drops more frequently than women (P = 0.004).Conclusions: Patients commonly attempt to treat conditions that require ophthalmologic care by self-medicating with over-the-counter eye drops. Educational efforts to inform patients of the consequences of self-medication are necessary.

Neurotoxic effects of topical cyclopentolate

Intraocular drugs are used in paediatric practice for diagnostic procedures as well as in the treatment of ocular conditions. Cyclopentolate is used in situations requiring mydriasis and cycloplegia. Systemic absorption of the drug can occur transconjunctivally or via nasolacrimal duct through highly vascular nasal mucosa [1]. Some amount of drug entering the nasolacrimal system may be swallowed and absorbed through stomach. Adverse effects are seen in upto 10% of cases. These include tachycardia, central nervous system (CNS) effects like restlessness, hallucination, psychosis, hyperactivity, seizures, incoherent speech and ataxia [2, 3]. We describe a case in which a child had acute CNS manifestation following instillation of cyclopentolate. Child completely recovered after eight hours.

Introduction: complementary medicine in ophthalmology

International Congress of Eye Research (ICER)’s September 2008 meeting in Beijing provided a unique conference of East meets West on healing approaches in ophthalmology, and for the first time, a section on complementary medicine (CM) was added to the program. CM includes all fields of healing including psychotherapy, hypnosis, meditation and visual imagery, prayer, acupuncture, herbal remedies and nutrients, massage therapy, exercise, reiki, and other measures which may facilitate healing other than traditional Western medicines and procedures. Before a therapy gains global acceptance and use, it must withstand the rigor of scientific investigation and pass through the narrow straits of peer review and possibly Food and Drug Administration approval to render it safe and effective. ICER’s goal was to encourage investigators of complementary methodology to cross that threshold. To that end, three CM sessions included 21 presentations which introduced novel complementary therapeutic approaches in the treatment of ocular conditions. This monograph has been designed to feature some of those presentations.

The Role of NSAIDs in the Management of Postoperative Ophthalmic Inflammation

Recent advances in cataract surgery, such as phacoemulsification, small-incision surgery and advances in foldable intraocular lenses, have resulted in the decrease of physical trauma associated with cataract surgery. The decrease in the physical surgical trauma decreases the release of prostaglandins, which are the main players in postoperative ocular inflammation. However, postoperative inflammation continues to be a cause of patient discomfort, delayed recovery and, in some cases, suboptimal visual results. Left untreated, this inflammation might interfere with patients' rehabilitation and/or contribute to the development of other complications, such as cystoid macular oedema.NSAIDs are commercially available, in topical or systemic formulations, for the prophylaxis and treatment of ocular conditions. Topically applied NSAIDs are commonly used in the management and prevention of non-infectious ocular inflammation and cystoid macular oedema following cataract surgery. They are also used in the management of pain following refractive surgery and in the treatment of allergic conjunctivitis. Despite their chemical heterogeneity, all NSAIDs share the similar therapeutic property of inhibiting the cyclo-oxygenase enzyme. The appeal of using NSAIDs in the treatment of ocular inflammation hinges on the complications associated with corticosteroids, the other commonly used therapy for ophthalmic inflammation.

Metipranolol

Metipranolol (Optipranololr`) is a new ophthalmic nonselective beta-blocker introduced by Bausch and Lomb Pharmaceuticals. Its chemical name is metipranolol hydrochloride or 1-(4-hydroxy-2,3,5-trimethylphenoxy)-3(isopropylaninol)-2-pro-panolol 4-acetate. 1 It is marketed as a 0.3% solution and has the advantage of a decreased cost compared to the other commercially available beta blockers. It is indicated in the treatment of ocular conditions in which lowering intraocular pressure (IOP) is likely to be of therapeutic benefit: in patients with ocular hypertension and patients with chronic open angle glaucoma.

Selection of controls for clinical research studies in ophthalmology.

Ophthalmologists are becoming increasingly aware of the need for well-designed, controlled studies to investigate etiology and treatment of ocular conditions. While patients with the conditions of interest, or with characteristics that place them at high risk of eventual development of such conditions, may be readily identified in the ophthalmology clinic, identification of appropriate controls to be used for comparison may be quite difficult. In this article, epidemiologic principles for selection of controls for retrospective (case-control) and prospective (cohort) studies are reviewed. Two related studies, a case-control study in which multiple control groups were employed and a 15-year cohort study of all cases and controls, provided an opportunity to compare controls selected at random from an ophthalmology practice with controls selected at random from the general population. Participation rates were higher among office patients selected for study, both in the case-control study and in the cohort study. In the cohort study, office controls were more likely to lose visual acuity and to develop new degenerative eye conditions. These differences between control groups selected from two different sources emphasize the need for careful evaluation of potential groups of controls with respect to biases that each may bring to interpretation of clinical research findings.

Year Book of Ophthalmology

Once again, 217 articles from 51 journals ending Jan 1,1983, have been selected by the editor for abstracts and his comments. In addition, introductions to the 14 chapters cover the following subjects: cosmetic oculoplastic surgery by Putterman, dissociated vertical deviations by Folk and Miller, automated refractors by Guyton, ocular toxicity of oral synthetic retinoids by Sugar, refractive surgery by Kramer, earlier surgery for glaucoma by Wilensky, intraocular lens implantation, corneal edema, and cystoid macular edema by Cotlier and Sharma, systemic and ocular findings in acquired immune deficiency syndrome by Jampol and Tessler, NdYAG laser treatment for pupillary membranes by Peyman, intraocular surgery by Goldberg, light toxicity from ophthalmic devices by Fishman, advances in neuro-ophthalmology by Frenkel, and nuclear magnetic resonance for diagnosis by Ernest. This book makes an ophthalmologist acutely aware of the rapid changes in diagnosis and treatment of ocular conditions. With the aid of the astute comments by

The role of pyrazole derivatives (irgapryin-geigy) in the treatment of ocular conditions.

The role of pyrazole derivatives (irgapryin-geigy) in the treatment of ocular conditions.