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Called to ITU to Examine a Fundus
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
The most common referral probably remains a fundal review following positive blood or line cultures for candidaemia or suspected candidaemia. Endogenous endophthalmitis is always a concern following candida growth on blood cultures and a fundal review is recommended by the microbiologist. However, endogenous endophthalmitis only makes up around 2%–8% of the endophthalmitis cases we see. It is always worth checking the patient hasn't had recent ophthalmic surgery or intravitreal injection to exclude exogenous endophthalmitis. Studies have suggested an increase in incidence of systemic candidaemia in recent years, likely related to an increase in the number of ITU beds, complicated surgery and prolonged ITU stays. Patients at risk of systemic candidaemia include those following major abdominal surgery, patients who have prolonged central line placement with broad spectrum antibiotic usage and to a lesser degree transplant patients and those undergoing haemofiltration/haemodialysis. Diabetes mellitus and immunosuppression with corticosteroids and chemotherapy are also significant risk factors.
The retina, optic nerve and vitreous humour
Published in Mary E. Shaw, Agnes Lee, Ophthalmic Nursing, 2018
Complications of the intravitreal injection include HaemorrhageEndophthalmitisCataractRetinal detachmentRaised intraocular pressure
Eyedrops use perception during fasting
Published in Elida Zairina, Junaidi Khotib, Chrismawan Ardianto, Syed Azhar Syed Sulaiman, Charles D. Sands, Timothy E. Welty, Unity in Diversity and the Standardisation of Clinical Pharmacy Services, 2017
B.S. Zulkarnain, Sumarno, Y. Nita, R. Loebis
To date, there is lack of concensus about the use of eyedrops during fasting. Some recommendations are as follows: single dose, tasteless, one drop at a time eye medication; temporary lacrimal punctal occlusion with finger for two to three minutes; use of eye ointment or gel; other routes of administration such as subtenon injection, intravitreal injection or sustained-release implant; education to patients and mosque Imams; established common consensus from religious scholars (Ahmed et al. 2009). A concensus from Majelis Ulama Indonesia (MUI) or the Indonesian Ulema Council is important.
Hyaluronic acid-based nanoparticles to deliver drugs to the ocular posterior segment
Published in Drug Delivery, 2023
The nanodrug delivery system has great potential for controlled drug release, prolonged retention time and reduced administration frequency. Intravitreal injection is a vital treatment for posterior ocular diseases. We summarize the special pharmacokinetic characteristics of vitreous injection based on the anatomical structure of eyes. Previous studies have shown that the pharmacokinetics of nanoparticles after injection are related to their physicochemical properties and biological properties, such as their nanostructure, size, surface charge, hydrophilicity, and ligand receptor binding. Various nanoparticles have been successfully investigated in experimental studies for vitreous injection, with advantages and drawbacks (Table 1). In addition, some nanoparticles have shown intrinsic therapeutic effects or retinal cell targeting properties, which can be prioritized, such as PAMAM dendrimers and GNPs.
Effect of Penetration Angle and Velocity During Intravitreal Injection on Pain
Published in Seminars in Ophthalmology, 2021
Amir Sternfeld, Michal Schaap-Fogler, Assaf Dotan, Bashir Alaa, Elinor Megiddo, Rita Ehrlich, Eitan Livny
The development of intravitreal injection as a basic, widely used method for treating a growing amount of ocular diseases has led to an increasing number of patients receiving an increasing number of injections for long periods of time. Therefore, the ability to decrease the inconvenience and sometimes actual pain accompanying the procedure is of utmost importance. This study, to the best of our knowledge, is the first to investigate the possible association between the speed and angle of intravitreal injection with the patients’ subjective sensation of pain. On statistical analysis, we found that these factors had no effect on pain, either overall or by stratification of the data, taking into account previous experience with the same injector. Moreover, as this study is one of the largest conducted on the subject of pain during intravitreal injection, we also evaluated the potential association of additional, patient-, disease-, and procedure-related variables. No association was found between pain experienced after intravitreal injection and patient age and sex, underlying etiology, BCVA, eye injected, lens status, number of previous injections, previous injection by the same injector, type of anti-VEGF agent injected, and waiting time for the injection.
Retinal photoreceptors targeting SA-g-AA coated multilamellar liposomes carrier system for cytotoxicity and cellular uptake evaluation
Published in Journal of Liposome Research, 2021
E.R. Anishiya chella daisy, Naresh Kumar Rajendran, Murugaraj Jeyaraj, Andy Ramu, Mariappan Rajan
Drug delivery and pharmacokinetics play critical roles in contemporary retinal therapeutics with the new drug delivery system development (Agrahari et al2016). The retinal disease is increasing because of ageing, hereditary, and diabetes (Sayin et al.2015, Masuda et al. 2017). The distribution of drugs into retinal targets is demanding and complicated due to specific drug administration in the diseased sites (Edelhauser et al. 2010). Most of the available treatment and methods emerge in subtherapeutic drug levels in the retina. An intravitreal injection is a current-day approach in retinal drug delivery (Shikari and Samant 2016). The principal drawbacks of intravitreal injection cause pain because of increased intraocular pressure. This injection needs to be used frequently for the optimization of drug concentrations (Csaky 2018).