The British journal of ophthalmology
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Studies of patients with non-ocular pain suggest that it is therapeutically useful to identify those with features of neuropathic pain. No data is available, however, on whether this approach has similar utility in dry eye. The purpose of this study was to determine whether severity and persistence of dry eye symptoms associate with self-reported symptoms of neuropathic ocular pain (NOP). ⋯ NOP features are common in patients with symptomatic dry eye and these features correlate with symptom severity and persistence.
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Observational Study
The role of retrobulbar and retinal circulation on optic nerve head and retinal nerve fibre layer structure in patients with open-angle glaucoma over an 18-month period.
Evidence suggests that vascular abnormalities play a role in the pathogenesis of open-angle glaucoma (OAG) in some patients. This study aims to assess changes in retrobulbar and retinal blood flow over time in patients with glaucoma and examine their relationship to glaucomatous progression, as determined by retinal and optic nerve structure. ⋯ Reductions in retrobulbar and retinal blood flow over time were associated with structural glaucomatous progression, as indicated by retinal and optic nerve changes.
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To evaluate the anatomical outcome of patients after vitrectomy due to persisting symptomatic vitreomacular traction (VMT), including full-thickness macular holes (FTMHs) of less than 400 µm, after ocriplasmin treatment. ⋯ Data on ocriplasmin remain controversial. We report on four cases with resolution of VMT following PPV after unsuccessful ocriplasmin treatment. Newly developed subretinal fluid has been described after ocriplasmin treatment, predominantly in cases with resolution of VMT. We also detected this newly developed subretinal fluid after vitrectomy, which persisted for several weeks up to 7 months in two cases with FTMHs. This may be attributable to loosening of the photoreceptor complex due to enzyme activity of ocriplasmin. Long-term effects of ocriplasmin are still to be evaluated using SD-OCT.
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To introduce a modification to big-bubble deep anterior lamellar keratoplasty (DALK) which can decrease the risk of Descemet membrane (DM) perforation during air injection. ⋯ Air injection peripheral to the trephination site is a reproducible modification to the standard technique which can decrease the risk of DM perforation during air injection.
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Review
Managing antiplatelet and anticoagulant drugs in patients undergoing elective ophthalmic surgery.
The management of antiplatelet and anticoagulant treatment can be challenging for the ophthalmic surgeon with the risk of impaired surgical view or potentially sight-threatening haemorrhage. With the advent of newer medications and the expanding usage of these drugs, there is a need for up-to-date guidance on the subject. ⋯ A multidisciplinary approach has been used to develop a guideline for the management of antiplatelet and anticoagulation treatment in elective ophthalmic surgery. Specifically, guidance is provided on when and how to stop antiplatelet and anticoagulant treatment and, importantly, when to seek specialist medical advice.