Current Opinion in Ophthalmology




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Editorial introductions

Editor(s): Busbee, Brandon G.; Kitchens, John W.; Hsu, Jason; Garg, Sunir J.

doi : 10.1097/ICU.0000000000000758

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p vi-vii

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Multimodal imaging in infectious and noninfectious intermediate, posterior and panuveitis

Thomas, Akshay S.a; Lin, Phoebeb

doi : 10.1097/ICU.0000000000000762

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 169-182

Given the heterogeneity of uveitis, markers of inflammation vary from patient to patient. Multimodal imaging has proven itself to be critical for accurate evaluation for disease activity and treatment response in uveitis.

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Radiation therapy for uveal melanoma: a review of treatment methods available in 2021

Reichstein, David A.; Brock, Anderson L.

doi : 10.1097/ICU.0000000000000761

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 183-190

Radiation therapy has become the standard of care for the treatment of uveal melanoma. We intend to outline the current radiation therapy methods that are employed to treat uveal melanoma. We will outline their relative benefits over one another. We will also provide some background about radiation therapy in general to accustom the ophthalmologists likely reading this review.

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Drug-related adverse effects of antivascular endothelial growth factor agents

Iyer, Prashanth G.; Albini, Thomas A.

doi : 10.1097/ICU.0000000000000757

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 191-197

Antivascular endothelial growth factor (VEGF) agents have provided historic therapeutic breakthroughs in the treatment of retinal disease. New anti-VEGF agents are emerging for the treatment of retinal vascular diseases. Both systemic and ocular adverse effect need to be understood in managing patients. This review aims to highlight the adverse effects seen with routine use of bevacizumab, ranibizumab and aflibercept, as well as with new medications such as brolucizumab and abicipar.

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Current treatment strategies for symptomatic vitreous opacities

Ryan, Edwin H.

doi : 10.1097/ICU.0000000000000752

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 198-202

Symptomatic vitreous opacities are increasingly recognized as a significant burden to patient well-being. There is growing interest in the use of vitrectomy or laser treatment to address these problems. This review is intended to update current assessment, management, and risks of treatment for persistent severely symptomatic vitreous opacities.

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Early pars plana vitrectomy for proliferative diabetic retinopathy: update and review of current literature

Berrocal, Mar?a H.a; Acaba-Berrocal, Luisb

doi : 10.1097/ICU.0000000000000760

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 203-208

Diabetic retinopathy (DR) is one of the leading causes of preventable vision loss in the world and its prevalence continues to increase worldwide. One of the ultimate and visually impairing complications of DR is proliferative diabetic retinopathy (PDR) and subsequent tractional retinal detachment. Treatment modalities, surgical techniques, and a better understanding of the pathophysiology of DR and PDR continue to change the way we approach the disease. The goal of this review is to provide an update on recent treatment modalities and outcomes of proliferative diabetic retinopathy and its complications including tractional retinal detachment.

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Opioids and ophthalmology: review of the current literature

Starr, Matthew R.; Patel, Luv G.; Ammar, Michael; Yonekawa, Yoshihiro

doi : 10.1097/ICU.0000000000000753

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 209-213

The number of opioid-related overdose deaths has rapidly increased since 2000, increasing more than five-fold from 1999 to 2016. Although surgeons only write 10% of opioid prescriptions annually, with ophthalmologists writing only a fraction of this amount, all physicians need to be cognizant of the current opioid epidemic and ways to decrease unnecessary opioid prescriptions.

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Stargardt disease masquerades

Ricca, Aaron M.; Han, Ian C.; Sohn, Elliott H.

doi : 10.1097/ICU.0000000000000750

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 214-224

Stargardt disease is the most common inherited macular dystrophy but has a wide clinical spectrum, and several inherited macular dystrophies have phenotypic similarities that can make clinical diagnosis challenging. This review seeks to highlight key clinical and multimodal imaging features to aid clinicians in accurate diagnosis.

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Photobiomodulation therapy in age-related macular degeneration

Muste, Justin C.a; Kalur, Aneeshaa; Iyer, Amogha; Valentim, Carolina C.S.a; Singh, Rishi P.a,b

doi : 10.1097/ICU.0000000000000742

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 225-232

To review the available data supporting the use of photobiomodulation therapy (PBT) in the treatment of age-related macular degeneration (AMD).

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Update on maculopathy secondary to pentosan polysulfate toxicity

Abou-Jaoude, Michelle; Fraser, Claire; Maldonado, Ramiro S.

doi : 10.1097/ICU.0000000000000754

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 233-239

The aim of the present review is to provide a comprehensive summary of available knowledge regarding toxic maculopathy secondary to pentosan polysulfate sodium (PPS).

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Current status of home monitoring technology for age-related macular degeneration

Busquets, Miguel A.a; Sabbagh, Osamaa,b

doi : 10.1097/ICU.0000000000000756

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 240-246

Evidence suggests that patients present with exudative age-related macular degeneration (AMD) in a delayed fashion. Increased lesion size associated with this delay directly impacts visual acuity. Upon treatment initiation, patients are monitored largely with optical coherence tomography (OCT) technology to determine the need for treatment. Home-monitoring systems using preferential hyperacuity perimetry (PHP) and OCT may optimize management.

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Geographic atrophy: where we are now and where we are going

Richard, Alyse J.; Duker, Jacob S.; Reichel, Elias

doi : 10.1097/ICU.0000000000000763

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 247-252

Age-related macular degeneration (AMD) affects a significant percentage of the elderly population and end-stage disease classified by either geographic atrophy (GA) or neovascular AMD (nvAMD) is one of the leading causes of vision loss worldwide. Despite the fact that there are currently treatments for nvAMD, there are no treatments in practice to prevent disease onset or progression of GA. This topic is at the forefront of ophthalmic research demonstrated by the recent advances in disease characterization, genetic and environmental risk factor classification, biomarker discovery and mechanism of pathogenesis categorization. There are also numerous clinical treatment trials underway, targeting proposed pathways and biomarkers associated with GA that are promising.

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Editorial: Current opinion in ophthalmology: translational ophthalmology 2021 editorial

Garg, Sunir J.; Hsu, Jason

doi : 10.1097/ICU.0000000000000755

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 253-254

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Orbital inflammatory disorders: new knowledge, future challenges

Kahana, Alona,b

doi : 10.1097/ICU.0000000000000743

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 255-261

This review aims to bring together recent advances in basic, translational and clinical research on the pathogenesis and treatment of orbital inflammatory conditions.

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Current and future therapies for persistent corneal epithelial defects and neurotrophic keratopathy

Ong, Erin S.; Jeng, Bennie H.

doi : 10.1097/ICU.0000000000000749

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 262-267

The corneal epithelium is a crucial barrier against pathogens, and when disrupted in the setting of certain underlying risk factors such as neurotrophic keratopathy (NK), may result in persistent epithelial defects (PEDs) of the cornea. Management is challenging and may require a variety of different approaches ranging from conservative medical therapy to surgical intervention. The purpose of this review is to provide an update on current and potential future therapeutic options for PEDs and NK.

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Rho kinase (ROCK) inhibitors in the management of corneal endothelial disease

Syed, Zeba A.; Rapuano, Christopher J.

doi : 10.1097/ICU.0000000000000748

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 268-274

Rho kinase (ROCK) inhibitors are growing increasingly relevant in ophthalmology, and the goal of this review is to summarize their mechanisms of action and potential applications in the subspecialties of glaucoma, retina, and cornea. We will focus specifically on corneal endothelial wound healing, for which ROCK inhibition demonstrates particular promise.

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In-vivo imaging of the conventional aqueous outflow system

Lee, Daniel; Kolomeyer, Natasha N.; Razeghinejad, Reza; Myers, Jonathan S.

doi : 10.1097/ICU.0000000000000751

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 275-279

The aim of this study was to provide a comprehensive summary of in-vivo imaging techniques of the aqueous outflow system and discuss its role in improving our understanding of glaucoma pathogenesis and management.

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Metabolic syndrome and the aging retina

Roddy, Gavin W.

doi : 10.1097/ICU.0000000000000747

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 280-287

This review explores metabolic syndrome (MetS) as a risk factor that accelerates aging in retinal neurons and may contribute to the neurodegeneration seen in glaucomatous optic neuropathy (GON) and age-related macular degeneration (AMD).

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Novel vitreous substitutes: the next frontier in vitreoretinal surgery

Schulz, Andréa,b; Januschowski, Kaia,b,c; Szurman, Petera,b

doi : 10.1097/ICU.0000000000000745

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 288-293

After removing the native vitreous during vitreoretinal surgery, an adequate substitute is required to ensure homeostasis of the eye. Current clinically used endotamponades (silicone oil, gases, semifluorinated alkanes) are effective in promoting retinal reattachment, but lead to complications such as emulsification, prolonged inflammation, blurred vision, raised intraocular pressure, cataract formation or the need for revision surgery. The aim of this review is to provide an update on novel vitreous substitutes with a focus on polymer-based systems.

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Emerging treatments for geographic atrophy in age-related macular degeneration

Mahmoudzadeh, Raziyeh; Hinkle, John W.; Hsu, Jason; Garg, Sunir J.

doi : 10.1097/ICU.0000000000000746

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 294-300

This review describes therapeutic research programs for geographic atrophy (GA) due to age-related macular degeneration (AMD). We highlight clinical trial data from phase I, II, and III studies.

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Uveal melanoma: laboratory advances and new frontiers in patient care

Xu, Timothy T.a; Moser, Justin C.b; Dalvin, Lauren A.c

doi : 10.1097/ICU.0000000000000744

Current Opinion in Ophthalmology: May 2021 - Volume 32 - Issue 3 - p 301-308

To review recent advancements in the genetic understanding, diagnosis, prognosis, and treatment of uveal melanoma (UM).

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