Bimatoprost SR for Glaucoma Therapy Implanted at the Slit-Lamp in a Real-World Setting.

Purpose: To characterize clinical outcomes following a single administration of bimatoprost SR in eyes with glaucoma in a real-world setting implanted at the slit-lamp. Setting: Tertiary care Glaucoma practice, Glaucoma Associates of Texas, Dallas, Texas. Design: Retrospective interventional case series. Methods: Data were analyzed from consecutive patients receiving a single bimatoprost SR implant from the time of its approval to the time of data collection. All eyes were implanted at the slit-lamp. Eyes with less than 1 month of follow-up were excluded. The primary outcome was median time to next intraocular pressure (IOP)-lowering intervention. Mean IOP and medication use, and changes from baseline, were also assessed through 12 months of follow-up. Results: Overall 129 eyes of 81 patients were analyzed. Following bimatoprost SR administration (replacing a topical prostaglandin analogue [PGA] in most eyes), the median survival time without any further IOP-lowering interventions was between 6-9 months. Mean IOP remained unchanged from baseline at month 1 (consistent with switch from topical to intracameral PGA therapy) and began to rise at month 3. At month 12, 40.5% of eyes (52 eyes) remained intervention-free, mean medication reduction was 0.5 medications per eye, and 27.8% of eyes (36 eyes) were medication-free. Adverse events were uncommon and most were transient and resolved with or without intervention. Conclusion: This real-world analysis of bimatoprost SR use for glaucoma therapy complements Phase 3 study findings and demonstrates that the implant can safely provide medication reduction through 6 months in most eyes and through 12 months in almost 40% of eyes.

Forecasting Retirement in Pediatric Ophthalmology.

This cross-sectional study uses a forecasting model to assess the potential loss of pediatric ophthalmology care in the US due to potential ophthalmologist retirement.

Baastrup's Disease in Pediatric Gymnasts.

Baastrup's disease is a rare, often misdiagnosed, and causes back pain in children. It is characterized by degenerative changes of both spinous processes and interspinous soft tissues between two adjacent vertebrae. Repetitive spinal movements in the sagittal plane predispose injury to posterior elements of the spine. Chronic flexion and extension strain the interspinous ligament, causing the neighboring spinous processes to adjoin. Patients typically report midline back pain in the lumbar region, which radiates both cephalad and caudad but not laterally. Pain is aggravated by extension and palpation and is alleviated with flexion. Some children with Baastrup's do not experience pain but present with swelling along the spinous processes. Diagnosis is dependent on distinctive radiologic findings and exam features. Increased interspinous spaces and bone remodeling may be observed. While the current treatment for pain associated with Baastrup's is directed towards physical therapy, massage therapy, nonsteroidal anti-inflammatory medications, muscle relaxants, and rest from activity, this is the first report of children undergoing interventional modalities for the treatment of back pain associated with Baastrup's disease. We present two unique pediatric cases of female gymnasts with Baastrup's disease who were successfully treated by two different techniques: interspinous ligament injection and medial branch block.