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Journal of Ophthalmic Inflammation and... Jun 2024Contamination in the contact lens training area could be due to bacteria, which can lead to the major consequence of ocular infections. We aimed to investigate the...
BACKGROUND
Contamination in the contact lens training area could be due to bacteria, which can lead to the major consequence of ocular infections. We aimed to investigate the contamination caused by bacteria in the contact lens training area in private optical clinics of the Udupi district, India.
METHODS
A cross-sectional study evaluated the swabs from the contact lens container, contact lens solution tip, washing area and lens fitting area for bacterial contamination. Twenty swabs collected from different areas of five optical clinics were inoculated in Brain heart infusion broth (BHIB). The broth was streaked in MacConkey and Blood agar and incubated at standard conditions for the growth of bacteria. All isolates were identified using conventional culture methods, and Gram staining was performed.
RESULTS
Twenty samples (contact lens case, n = 5; contact lens solution tip, n = 5; washing area, n = 5; cleaning towel, n = 5) from private optical clinics were recruited for the study. Bacterial growth was indicated in which lactose fermentation was seen at (15%), non-lactose fermentation at (35%), and no bacterial growth at (50%) in MacConkey agar. Partial or alpha-hemolytic (α hemolysis) was seen in (5%), complete or beta-hemolytic (β hemolysis) was seen in (40%), no hemolysis or gamma hemolysis (ϫ haemolysis), was seen in (30%), no growth was seen in (25%) on blood agar. Gram-positive cocci (45%), Gram-negative bacilli (20%), and no increase in (35%) were observed in MacConkey agar and Blood agar. Bacterial species were not identified in this study.
CONCLUSION
Contamination was found in lenses, solution tips, washing areas, and cleaning towels which might lead to ocular infections. Perception should be given to those responsible for fitting lenses.
PubMed: 38861099
DOI: 10.1186/s12348-024-00407-z -
Scientific Reports Jun 2024This study aimed to compare the clinical efficacy and investigate patients' preferences for two mucin secretagogues in the treatment of dry eye disease (DED). Thirty... (Randomized Controlled Trial)
Randomized Controlled Trial Comparative Study
This study aimed to compare the clinical efficacy and investigate patients' preferences for two mucin secretagogues in the treatment of dry eye disease (DED). Thirty patients with DED were randomly treated with either 3% diquafosol or 2% rebamipide ophthalmic solution for 4 weeks, followed by an additional 4-week treatment using the other eye drop after a 2-week washout period. Objective and subjective assessments, including the corneal and conjunctival staining score, tear breakup time (TBUT), Schirmer 1 test, tear osmolarity, tear matrix metalloproteinase-9 (MMP-9), lipid layer thickness (LLT) and ocular surface disease index (OSDI), were performed at baseline, 4 weeks, 6 weeks, and 10 weeks. Patient preferences were assessed based on four categories (comfort, efficacy, convenience, willingness to continue) using a questionnaire and the overall subjective satisfaction score for each drug was obtained at the end of the trial. In total, 28 eyes from 28 patients were included in the analysis. Both diquafosol and rebamipide significantly improved the OSDI (p = 0.033 and 0.034, respectively), TBUT (p < 0.001 and 0.026, respectively), and corneal (p < 0.001 and 0.001, respectively) and conjunctival (p = 0.017 and 0.042, respectively) staining after 4 weeks of treatment. An increase in Schirmer test scores was observed only after rebamipide treatment (p = 0.007). No significant changes were detected in tear osmolarity, MMP-9, and LLT following both treatments. The patients' preference was slightly greater for diquafosol (46.4%) than rebamipide (36.7%), presumably due to rebamipide's bitter taste. The self-efficacy of both drugs and overall satisfaction scores were comparable. These findings indicate that two mucin secretagogues showed comparable effects in ameliorating symptoms and improving signs (TBUT, corneal and conjunctival staining) in patients with DED.
Topics: Humans; Dry Eye Syndromes; Female; Male; Middle Aged; Quinolones; Prospective Studies; Mucins; Uracil Nucleotides; Alanine; Aged; Tears; Cross-Over Studies; Ophthalmic Solutions; Polyphosphates; Treatment Outcome; Adult; Matrix Metalloproteinase 9
PubMed: 38858411
DOI: 10.1038/s41598-024-63784-4 -
Ophthalmology Jun 2024To assess the effectiveness and safety of repeated low-level red light (RLRL), which is a newly available treatment for myopia control in children and adolescents with...
OBJECTIVE
To assess the effectiveness and safety of repeated low-level red light (RLRL), which is a newly available treatment for myopia control in children and adolescents with high myopia.
DESIGN
Multicenter, randomized, parallel-group, single-blind clinical trial (RCT; NCT05184621).
PARTICIPANTS
Between February 2021 and April 2022, 192 children aged 6 to 16 years were enrolled. Each child had at least one eye with myopia of cycloplegic spherical equivalent refraction (SER) at least -4.0 diopters, astigmatism of 2.0 diopters or less, anisometropia of 3.0 diopters or less, and best-corrected visual acuity of 0.2 logarithm of the minimum angle of resolution or better. Follow-up was completed by April 2023.
METHODS
Participants were randomly assigned at a 1:1 ratio to intervention (RLRL treatment plus single-vision spectacles) or control (single-vision spectacles) groups. The RLRL treatment was administered for 3 minutes per session, twice daily with a minimum interval of 4 hours, 7 days per week.
MEAN OUTCOMES AND MEASURES
The primary outcome and key secondary outcome were changes in axial length and cycloplegic SER measured at baseline and the 12-month follow-up visit. Participants who had at least 1 post randomization follow-up visit were analyzed for treatment efficacy.
RESULTS
Among 192 randomized participants, 188 (97.91%) were included in the analyses (97 in the RLRL group and 95 in the control group). After 12 months, the adjusted mean change in axial length was -0.06 mm (95% confidence interval [CI]: -0.10 to -0.02 mm) and 0.34 mm (95% CI: 0.30 to 0.39 mm) in the intervention and control groups, respectively. There were 48 participants (50.3%) of the intervention group were still experiencing axial shortening more than 0.05mm at 12-month follow-up. Furthermore, the mean spherical equivalent refraction change after 12 months was 0.11 D (95% CI: 0.02 to 0.19 D) and -0.75 D (95% CI: -0.88 to -0.62 D) in the intervention and control groups, respectively.
CONCLUSIONS
RLRL demonstrates much stronger treatment efficacy among high myopia, with 50.3% experience substantial axial shortening. RLRL provides an excellent solution for the management of high myopia progression, a significant challenge in ophthalmology practice.
PubMed: 38849054
DOI: 10.1016/j.ophtha.2024.05.023 -
Annals of Medicine and Surgery (2012) Jun 2024This article discusses the prevalence and impact of pharmacologically-induced mydriasis, a condition where the pupil becomes excessively dilated due to certain drugs. It... (Review)
Review
This article discusses the prevalence and impact of pharmacologically-induced mydriasis, a condition where the pupil becomes excessively dilated due to certain drugs. It highlights the challenges faced by medical professionals in dealing with this condition and the limitations of current treatments, like pilocarpine and dapiprazole, which come with systemic side effects and specific contraindications, limiting their regular use. The article introduces Ryzumvi, a novel ophthalmic solution approved by the US FDA, which effectively reverses mydriasis caused by adrenergic agonists and antimuscarinic drugs. The article provides insights into its mechanism of action, clinical efficacy, pharmacokinetics, safety, and tolerance based on extensive clinical trials. It emphasizes its rapid onset of action and effectiveness in restoring pupils to their initial size. It also underlines the potential for expanded applications, including in pediatric patients, solidifying its importance in the field of ophthalmology. Furthermore, Ryzumvi represents a promising advancement in managing pharmacologically-induced mydriasis, offering swift and effective relief while highlighting the importance of adhering to safety precautions and the continuous research and development efforts in ophthalmology to comprehensively address vision-related disorders and enhance patient outcomes.
PubMed: 38846833
DOI: 10.1097/MS9.0000000000002058 -
Israel Journal of Health Policy Research Jun 2024This study explores vision care priorities and coping mechanisms for Israeli evacuees and following the October 7th, 2023, attack by Hamas, which displaced 150,000...
BACKGROUND
This study explores vision care priorities and coping mechanisms for Israeli evacuees and following the October 7th, 2023, attack by Hamas, which displaced 150,000 individuals, with about 15,000 being evacuated to the Dead Sea area. Faced with minimal health care infrastructure in the Dead Sea area and often lacking personal belongings, including eyeglasses and ocular medicine, these evacuees confronted significant vision care challenges. This context sets the stage for investigating the emergency vision care needs and solutions for populations affected by conflict and displacement.
METHODS
In response to this crisis, a consortium led by Hadassah Academic College's Department of Optometry and the Dept. of Ophthalmology at Hadassah Medical Center established ophthalmic clinics in the Dead Sea region. These clinics offered comprehensive vision care services, including refractive and vision examinations, ophthalmological assessments, ocular imaging, and provision of free glasses. The setup included multiple stations for different vision tests, staffed by an interdisciplinary team of professionals. The study analyzes the effectiveness of these clinics, patient flow challenges, and the psychological impact of vision care in a crisis setting.
RESULTS
Approximately 800 evacuees received examinations, with around 700 pairs of glasses distributed. Notable cases included emergency referrals for serious conditions and instances where glasses served as psychological support. The operation highlighted the necessity of vision care during crises and its potential psychological and social implications. The clinics successfully provided immediate vision care, but challenges in patient flow and insufficient electronic medical record integration were noted. The experience underscores the importance of prepared eye care interventions in crises. Recommendations for health policy decision-makers include establishing a national emergency vision care network, developing standardized treatment protocols, training local health workers, and raising public awareness about eye health in emergencies.
CONCLUSIONS
The consortium's effort in providing urgent vision care to evacuees from the Hamas attack on Israel demonstrates the critical role of rapid, organized eye care in crisis situations. Vision care, along with hearing and mobility, is often overlooked during evacuations but is vital for the well-being and survival of evacuees, especially under trying circumstances. This project serves as a model for future humanitarian interventions, emphasizing the importance of addressing overlooked healthcare issues once the immediate crisis has passed, and the need for strategic planning in health care policy for similar emergency scenarios.
Topics: Humans; Israel; Male; Female; Adult; Middle Aged; Vision Disorders; Aged; Eyeglasses
PubMed: 38845038
DOI: 10.1186/s13584-024-00615-x -
Pharmaceutical Research Jun 2024Wet age-related macular degeneration (AMD) is a blinding retinal disease. Monthly intravitreal anti-VEGF antibody injections of bevacizumab (off-label) and ranibizumab...
PURPOSE
Wet age-related macular degeneration (AMD) is a blinding retinal disease. Monthly intravitreal anti-VEGF antibody injections of bevacizumab (off-label) and ranibizumab (FDA approved) are the standard of care. Antibody aggregation may interfere with ocular absorption/distribution. This study assessed topical delivery of dilute antibodies to the posterior segment of rabbit eyes using a novel anti-aggregation formula (AAF).
METHODS
Bevacizumab, or biosimilar ranibizumab was diluted to 5 mg/ml in AAF. All rabbits were dosed twice daily. Substudy 1 rabbits (bevacizumab, 100 µl eye drops): Group 1 (bevacizumab/AAF, n = 6); Group 2 (bevacizumab/PBS, n = 7) and Vehicle control (AAF, n = 1). Substudy 2 rabbits (ranibizumab biosimilar/AAF, 50 µl eye drops): (ranibizumab biosimilar/AAF, n = 8). At 14.5 days, serum was drawn from rabbits. Aqueous, vitreous and retina samples were recovered from eyes and placed into AAF aliquots. Tissue analyzed using AAF as diluent.
RESULTS
Bevacizumab in AAF permeated/accumulated in rabbit aqueous, vitreous and retina 10 times more, than when diluted in PBS. AAF/0.1% hyaluronic acid eye drops, dosed twice daily, provided mean tissue concentrations (ng/g) in retina (29.50), aqueous (12.34), vitreous (3.46), and serum (0.28 ng/ml). Additionally, the highest concentration (ng/g) of ranibizumab biosimilar was present in the retina (18.0), followed by aqueous (7.82) and vitreous (1.47). Serum concentration was negligible (< 0.04 ng/ml). No irritation was observed throughout the studies.
CONCLUSIONS
Bevacizumab and ranibizumab, in an AAF diluent eye drop, can be delivered to the retina, by the twice daily dosing of a low concentration mAb formulation. This may prove to be an adjunct to intravitreal injections.
Topics: Animals; Ranibizumab; Rabbits; Bevacizumab; Ophthalmic Solutions; Retina; Angiogenesis Inhibitors; Vitreous Body; Vascular Endothelial Growth Factor A; Intravitreal Injections; Biosimilar Pharmaceuticals; Wet Macular Degeneration
PubMed: 38839719
DOI: 10.1007/s11095-024-03721-2 -
BMJ Open Jun 2024In adult patients with high myopia (HM), progressive axial elongation poses a significant risk for the development of subsequent ocular complications that may lead to... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
In adult patients with high myopia (HM), progressive axial elongation poses a significant risk for the development of subsequent ocular complications that may lead to visual impairment. Effective strategies to reduce or prevent further axial elongation in highly myopic adult patients have not been available so far. Recent studies suggested that medically lowering intraocular pressure (IOP) may reduce axial elongation.
OBJECTIVE
This clinical randomised controlled trial (RCT) aims to evaluate the efficacy of medical IOP reduction in adult patients with progressive HM (PHM).
TRIAL DESIGN
Single-centre, open-label, prospective RCT.
METHODS
This RCT will recruit 152 participants with PHM at the Zhongshan Ophthalmic Center (ZOC). Randomised in a ratio of 1:1, participants will receive IOP-lowering eyedrops (intervention group) or will be followed without treatment (control group) for 12 months. Follow-up visits will be conducted at 1, 6 and 12 months after baseline. Only one eye per eligible participant will be included for analysis. The primary outcome is the change in axial length (AL) within the study period of 12 months. Secondary outcomes include the incidence and progression of visual field (VF) defects, changes in optic disc morphology and incidence and progression of myopic maculopathy. Difference in AL changes between the two groups will be analysed using linear regression analysis. For the secondary outcomes, a multifactor Poisson regression within a generalised linear model will be used to estimate the relative risk of progression in VF defects and myopic maculopathy, and the rate of thinning in retinal nerve fibre layer and ganglion cell-inner plexiform will be assessed through Kaplan-Meier curves and log-rank tests.
ETHICS AND DISSEMINATION
Full ethics approval for this trial has been obtained from the Ethics Committee of ZOC, Sun Yat-sen University, China (ID: 2023KYPJ110). Results of this trial will be disseminated through peer-reviewed journals and conference presentations.
TRIAL REGISTRATION NUMBER
NCT05850936.
Topics: Humans; Intraocular Pressure; Prospective Studies; Myopia, Degenerative; Adult; Disease Progression; Randomized Controlled Trials as Topic; Ophthalmic Solutions; Male; Female; Axial Length, Eye; Middle Aged; Visual Fields
PubMed: 38839388
DOI: 10.1136/bmjopen-2024-084068 -
BMJ Open Ophthalmology Jun 2024Unpreserved single-dose unit (SDU) eye drops are commonly used to avoid benzalkonium chloride-related toxicity. Although intended for single use, many patients report...
BACKGROUND
Unpreserved single-dose unit (SDU) eye drops are commonly used to avoid benzalkonium chloride-related toxicity. Although intended for single use, many patients report off-label repeated use of SDUs over a prolonged period. We investigated whether repeated use of dexamethasone 0.1% SDUs in the same patient increases the bacterial contamination rate.
METHODS
We prospectively enrolled patients scheduled for inpatient corneal and glaucoma surgery receiving dexamethasone 0.1% SDU four times per day from the same vial. To assess contamination rates, one drop from the vial was cultured immediately after opening the SDU (t0), 10 hours later after four drop applications (t10) and 24 hours after opening without further drop applications (t24). Conjunctival swabs were taken before and after drop application. Contamination rate was assessed with a standard clinical culturing protocol without introducing a positive control.
RESULTS
110 eyes of 109 patients were evaluated. Drops collected immediately after opening the SDU (t0) were contaminated in 9/110 cultures (8.1%). At t10, 13/110 cultures were contaminated (11.8%; p=0.267) and 11/110 at t24 (10.0%; t24 vs t0; p=1.00). In 5 of 21 cases of contaminated drops at t10 and/or t24, the same isolates were cultured from the initial conjunctival swab and the SDU. In three cases, the same bacterial species was found in consecutive samples.
CONCLUSION
The contamination rate of the SDU did not increase after multiple use within 24 hours. Contamination from fingertip flora was more likely than from ocular surface flora. Reuse of dexamethasone 0.1% SDU in the same patient within 24 hours appears to be safe.
Topics: Humans; Dexamethasone; Ophthalmic Solutions; Male; Female; Prospective Studies; Preservatives, Pharmaceutical; Aged; Middle Aged; Glucocorticoids; Aged, 80 and over; Adult; Drug Contamination; Glaucoma; Conjunctiva; Bacteria; Corneal Diseases
PubMed: 38830728
DOI: 10.1136/bmjophth-2024-001632 -
Veterinary Medicine and Science Jul 2024Recombinant intracameral tissue plasminogen activator (rTPA) administration can aid clearance of fibrin from the anterior chamber.
BACKGROUND
Recombinant intracameral tissue plasminogen activator (rTPA) administration can aid clearance of fibrin from the anterior chamber.
MATERIALS AND METHODS
In this retrospective multicentre case series, the effect of intracameral rTPA administration to treat fibrin in the anterior chamber resulting from trauma or inflammatory ocular disease was evaluated. Clinical data from 30 treatments in 29 horses were obtained from medical records from 2003 to 2022. Association between time from onset of clinical signs and time for rTPA treatment to effect was studied with regression analysis.
RESULTS
Twenty-seven horses (93.1%) had no previous history of ophthalmic disease; one had an iridic cyst, and another had equine recurrent uveitis. The majority of cases were related to trauma (79.3%). Median time from the onset of clinical signs to treatment was 12 h (IQR = 4-48 h). rTPA (72% 20 µg; 24% 25 µg; 3.3% 40 µg) was administered once in all but one eye, which was treated twice. Resolution of fibrin was seen in 96.9% (29/30) of treatments. Fibrin accumulation recurred in one case but resolved 14 days after the second treatment. Complications were seen in four treatments (13.3%): moderate pain for 24 h, intracameral debris and mild intracameral haemorrhage in a horse that received 40 µg of tissue plasminogen activator. Recurrence of fibrin accumulation was absent in 96.7% of cases. Median time to effect was 20 min (IQR = 10-45 min). Time for rTPA treatment to effect was not associated with time from fibrin formation (R = 0.09; p = 0.11).
CONCLUSION
Intracameral rTPA treatment can be considered at 20-25 µg in 0.1 mL solution to aid resolution of fibrin accumulation.
Topics: Animals; Horses; Tissue Plasminogen Activator; Horse Diseases; Retrospective Studies; Fibrin; Female; Male; Anterior Chamber; Fibrinolytic Agents; Recombinant Proteins; Eye Diseases
PubMed: 38818763
DOI: 10.1002/vms3.1448 -
Scientific Reports May 2024The aim was clinical evaluation of the efficacy of topical insulin eye drops in patients with refractory persistent epithelial defects (PEDs). This prospective...
The aim was clinical evaluation of the efficacy of topical insulin eye drops in patients with refractory persistent epithelial defects (PEDs). This prospective non-randomized investigation was conducted to examine the efficacy of insulin eye drops in treating patients with PEDs that did not respond to conventional therapy. A total of twenty-three patients were included in the study, and they were administered insulin eye drops formulated as 1 U/mL, four times a day. The rate of epithelial defect resolution and time to complete corneal re-epithelialization were considered primary outcome measures. The relative prognostic impact of initial wound size and other parameters, including age, sex, smoking, diabetes, and hypertension were also analyzed. The results showed that during follow-up (maximum 50 days), a total of 16 patients (69.6%) achieved improvement. Insulin eye drops significantly reduced the corneal wounding area in 75% of patients with small epithelial defects (5.5 mm or less) during 20 days. Only 61% of patients with moderate epithelial defects (5.51-16 mm) showed a significant recovery in 20-30 days. Also, 71% of patients with a defect size greater than 16 mm, demonstrated a significant improvement in the rate of corneal epithelial wound healing in about 50 days. In conclusion topical insulin reduces the PED area and accelerates the ocular surface epithelium wound healing.
Topics: Humans; Male; Female; Middle Aged; Epithelium, Corneal; Insulin; Aged; Ophthalmic Solutions; Prospective Studies; Adult; Wound Healing; Administration, Topical; Corneal Diseases; Treatment Outcome; Re-Epithelialization
PubMed: 38816428
DOI: 10.1038/s41598-024-63091-y