ABSTRACT
Glucocorticoid (GC) therapy is indicated in many diseases, including ocular diseases. An important side-effect of GC therapy is GC-induced ocular hypertension (GIOHT), which may cause irreversible blindness known as GC-induced glaucoma (GIG). Here, we reviewed the pathological changes that contribute to GIOHT including in the trabecular meshwork and Schlemm's canal at cellular and molecular levels. We also discussed the clinical aspects of GIOHT/GIG including disease prevalence, risk factors, the type of GCs, the route of GC administration, and management strategies.
ABSTRACT
Given the various ocular manifestations of limbal stem cell insufficiency, an awareness of the genetic, acquired, and immunological causes and associated additional treatments of limbal stem cell deficiency (LSCD) is essential for providers. We performed a comprehensive review of the literature on the various etiologies and specific therapies for LSCD. The resources utilized in this review included Medline (PubMed), Embase, and Google Scholar. All English-language articles and case reports published from November 1986 through to October 2022 were reviewed in this study. There were collectively 99 articles on these topics. No other exclusion criteria were applied. Depending on the etiology, ocular manifestations of limbal stem cell deficiency range from dry eye syndrome and redness to more severe outcomes, including corneal ulceration, ocular surface failure, and vision loss. Identifying the source of damage for LSCD is critical in the treatment process, given that therapy may extend beyond the scope of the standard protocol, including artificial tears, refractive surgery, and allogeneic stem cell transplants. This comprehensive review of the literature demonstrates the various genetic, acquired, and immunological causes of LSCD and the spectrum of supplemental therapies available.
ABSTRACT
Purpose: To compare corneal power difference maps (∆maps) obtained from the Pentacam in patients with 1 year follow-up after LASIK, PRK, and SMILE with further stratification to low, moderate, and high myopia. Patients and methods: This retrospective study was comprised of patients who had preoperative and 1-year postoperative power maps that were obtained-front sagittal (SagF), refractive power (RP), true net power (TNP), and total corneal refractive power (TCRP)-for evaluation. Measurements were recorded and compared at the 4mm, 5mm and 6mm pupil and apex zones. Comparisons were made between each specific power ∆map and the surgically induced refractive change (SIRC). Further analysis of the ∆maps was performed based on degree of myopia (high, moderate, and low). Correlation and agreement were also assessed with regression and limits of agreement (LoA). Results: There were 172 eyes in the LASIK group, 187 eyes in the PRK group, and 46 eyes in the SMILE group. In the LASIK group, TNP ∆map at 5mm pupil zone had the least absolute mean difference with SIRC (0.007 ± 0.42D). In the PRK group, TNP ∆map at 5mm apex zone was most accurate compared to SIRC (0.066 ± 0.45D). In the SMILE group, TCRP ∆map at 4mm apex zone had the closest absolute value when compared to SIRC (0.011 ± 0.50D). There was good correlation and agreement for all three surgery groups, LASIK: r = 0.975, LoA -0.83D to +0.83D, PRK: r = 0.96, LoA -0.83D and +0.95D, and SMILE: r = 0.922, LoA -0.97 D to +0.99D. Conclusion: TNP ∆maps most accurately measured corneal power in the LASIK and PRK groups while TCRP ∆maps were most accurate in the SMILE group. The degree of myopia may change which ∆map is most accurate.
