Clinicians have an array of techniques and devices available to them for assessing progression of glaucoma, and more are under development. Such tools rely on either subjective or objective measurements, with the latter generally providing more reliable results. Frequent, long-term follow-up with one or more of those approaches will increase the likelihood of detecting progression early.
Both quantitative and qualitative methods of detecting glaucomatous progression are useful, but optic disk photography remains the gold standard. New software for statistical analysis is helpful but should be an adjunct used with more established approaches.
The steps taken in the search for a cure for Leber's congenital amaurosis can serve as a model for other inherited eye disorders, according to an expert who delivered the Jackson Memorial Lecture at the 2007 American Academy of Ophthalmology annual meeting.
Early detection and treatment of incident choroidal neovascularization in eyes with age-related macular degeneration may offer patients the best opportunity to retain vision. Clinical trials have provided guidance on defining patient risk and the frequency of follow-up. An ongoing study is examining the role of noninvasive technologies as monitoring tools.
A prospective, randomized, open-label study compared bromfenac 0.09% (Xibrom, ISTA) and ketorolac tromethamine 0.4% (Acular LS, Allergan) as part of a postoperative medication regimen in patients undergoing PRK. Control of pain, burning, photophobia, and foreign body sensations were similar in the two treatment groups. Both agents were safe as there was no difference in re-epithelialization between the two agents.
Azithromycin 1% ophthalmic solution (AzaSite, Inspire Pharmaceuticals) has many properties that make it a rational choice for the treatment of blepharitis. Evaluations conducted by two ophthalmologists yielded favorable results in showing azithromycin was safe, well-tolerated, and resulted in rapid and dramatic improvement of both anterior and posterior lid margin disease.
Levofloxacin 1.5% (Iquix, Santen/Vistakon) is the only newer generation fluoroquinolone approved for the treatment of bacterial corneal ulcers. Extensive research indicates levofloxacin has maintained potent broad-spectrum activity against important ocular pathogens and that the 1.5% formulation offers excellent pharmacokinetics and safety profiles.
Analysis of the effect of nepafenac 0.1% (Nevanac, Alcon Laboratories) indicated that compared with diclofenac 0.1% (Voltaren, Novartis Pharmaceuticals) nepafenac might be more tolerable by patients after cataract surgery.
Moxifloxacin hydrochloride ophthalmic solution 0.5% (Vigamox, Alcon) seems to be a safe antimicrobial agent when injected intracamerally following cataract surgery. The eyes that received moxifloxacin had a significantly lower mean intraocular pressure value three months postoperatively compared with the control eyes that received balanced saline solution.
Findings of a recent study show that loteprednol 0.5%/tobramycin 0.3% and dexamethasone 0.1%/tobramycin 0.3% were equivalent in reducing the signs and symptoms of blepharokeratoconjunctivitis. Some safety concerns emerged, however, concerning elevated IOP in patients treated with the dexamethasone/tobramycin product.
Performing ECP at the time of cataract surgery has significant benefits for both patients and surgeons. After cataract removal and IOL implantation, there is plenty of room to get behind the iris with an endoscope and apply laser energy to the ciliary epithelium.
Long-term outcomes of a study of optic neuritis have shown that even one brain lesion ≥3 mm at the time of the first episode can be predictive of development of multiple sclerosis, making a brain MRI an essential part of patient management.
A basic understanding of corneal topography is paramount for effective screening and follow-up of refractive surgery patients in order to exclude those who are at risk for postoperative ectasia and to manage those who develop that complication.
The FDA's recent announcement that it is reviewing serious adverse effects, including death, that have occurred following the use of botulinum toxins for the management of juvenile cerebral palsy and other large-muscle, lower-limb spasticities applies primarily to the non-cosmetic formulation of botulinum toxin type A (Botox) rather than the cosmetic version (Botox Cosmetic), Allergan said in a statement.
The Centers for Medicare and Medicaid Services (CMS) has issued an emergency notice to correct a typographical error in the relative value unit of the new Current Procedural Terminology code for complex retina detachment, said the American Academy of Ophthalmology (AAO) in a notice to members.
The FDA has accepted Sirion Therapeutics' new drug application (NDA) for difluprednate ophthalmic emulsion 0.05% (Durezol) and has granted it priority review, the Tampa, FL-based company has announced.
NeoVista Inc. has announced that the American Medical Association Current Procedural Terminology Editorial Panel has released a new Category III code for the company's novel epiretinal beta radiation therapy to treat neovascular age-related macular degeneration.
A Cleveland Clinic research team has developed the first animal model of age-related macular degeneration (AMD), and it is expected to enable researchers to study the development and progression of AMD and conduct pre-clinical testing of new therapeutics.
IOLs that dislocate postoperatively may be repositioned rather than removed. A surgeon describes techniques for rescuing a dislocated sulcus-fixated IOL and a subluxated in-the-bag IOL.
Because microincisional cataract surgery permits the use of smaller incisions than those employed in conventional phacoemulsification, it is potentially a safer procedure, offering greater control to the surgeon; also, it may yield less astigmatism, less inflammation, and quicker healing for the patient, according to one surgeon.
Corneal cell responses after PRK performed with a 213-nm solid-state and a 193-nm excimer laser were compared in a rabbit model. The results showed that both lasers have similar cell death-inducing properties, but less keratocyte proliferation followed treatment with the 213-nm laser.
After studying a series of patients who developed ectasia following excimer laser corneal refractive surgery, investigators identified a set of risk factors and designed a highly sensitive and specific screening method to identify eyes at risk of developing ectasia after LASIK.
The informed consent for refractive lens exchange must apprise patients about the risks of endophthalmitis and rhegmatogenous retinal detachment. Data on these issues, which are mostly derived from the cataract surgery literature, are reviewed.
An initial analysis of data collected from LASIK patients pre- and postoperatively indicates personality influences visual quality of life after surgery.
According to the Barbados Eye Studies, black people treated for glaucoma are at increased risk of dying from heart and vascular disease, particularly those treated with timolol maleate eye drops.
Blood sugar levels below what is considered diabetic indicate a complication of the disease that leads to blindness, Australian researchers report.
Sutureless Descemet's stripping with endothelial keratoplasty may be a reliable method of endothelial keratoplasty with the use of sulfur hexafluoride in place of filtered air.
An aberration-free optic lens (SofPort AO, Bausch & Lomb) provides excellent visual acuity, low incidence of Nd:YAG capsulotomy, no patient complaints of visual disturbances, and improved nighttime vision, according to results of a 2-year postoperative study.
A study analyzing demographic, pretreatment, and outcomes variables in a large population of patients undergoing conventional LASIK for low-to-moderate myopia identified that postoperative UCVA and visual symptoms, such as monocular diplopia and glare, play a significant role in patient dissatisfaction. However, together they only explain a small portion of the variance.
Although tonometry remains a vital tool in glaucoma management, the significance of individual measurements should be regarded with a healthy degree of skepticism. Central corneal thickness (CCT) measurements should be incorporated into global assessment of glaucoma risk, but trying to correct tonometry readings by CCT is not appropriate.
