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Cataract and Cataract Surgical Coverage
Published in Ching-Yu Cheng, Tien Yin Wong, Ophthalmic Epidemiology, 2022
Olusola Olawoye, Priya Adhisesha Reddy, Ving Fai Chan, Prabhath Piyasena, Nathan Congdon
The slit lamp has been used both for examination and photographs for several years to grade cataracts, but other methods for cataract assessment have been proposed. These methods can be useful when time and resources are limited since they vary in their accuracy compared to standard slit-lamp photographs. Some authors have used retinal images.57,58 They quantified the optical degradation in retinal images using an automated method to detect cataract and this had good correlation with LOCS III. The disadvantage of this method is that the vitreous cavity could not be evaluated separately from the cataract and also there was no automated grading of the cataract. The anterior-segment optical coherence tomogram (ASOCT) has also been used to compare nucleus density measurement with LOCS III grading of color and opalescence of the nucleus with significant correlation. Opalescence has a higher association compared to nuclear color.59 The use of ASOCT to grade lens density can be objective, fast, and reliable and requires less training compared to the LOCS III grading system.
Ophthalmic Injuries
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Examination of the globe requires practice and, ideally, the use of a slit lamp. If the use of a slit lamp is not possible, as in the case of major multisystem trauma, a bright penlight and close inspection of the eye, or a magnifier such as the plus 10 lens in the ophthalmoscope, should be used. The fundus should always be examined using an ophthalmoscope.
Alternative Tumor-Targeting Strategies
Published in David E. Thurston, Ilona Pysz, Chemistry and Pharmacology of Anticancer Drugs, 2021
The mechanism of action of temoporfin is similar to that described for porfimer sodium, and involves the production of superoxide and hydroxyl radicals which exert a cytotoxic effect. Temoporfin is administered by slow intravenous infusion over at least six minutes, and injection site pain, extravasation, local hemorrhage, skin necrosis, and scarring near the injection site can occur. As with all PDT agents, photosensitivity is a major problem, and patients can remain photosensitive for several weeks after treatment. As with porfimer sodium, sunscreens offer no protection, and so exposure of eyes and skin to bright indoor light or direct sunlight should be avoided for at least 15 days after treatment. In addition, it is recommended that prolonged exposure of the injection site arm to direct sunlight should be avoided for six months after treatment and, if extravasation should occur, this area of skin must be completely protected from light for three months. It is also recommended that ophthalmic slit-lamp examination should not be carried out for 30 days after administration. Not surprisingly, temoporfin is contraindicated in patients with porphyria or other diseases exacerbated by light.
ATM and TP53 polymorphisms modified susceptibility to radiation-induced lens opacity in natural high background radiation area, China
Published in International Journal of Radiation Biology, 2022
Yu Gao, Yin-Ping Su, Xiao-Liang Li, Shu-Jie Lei, Hui-Feng Chen, Shi-Yue Cui, Su-Fen Zhang, Jian-Ming Zou, Qing-Jie Liu, Quan-Fu Sun
This study was approved by the ethics review committee of the National Institute for Radiological Protection, China CDC. Written informed consent was obtained from each participant. Slit-lamp examination was performed by a single registered ophthalmologist. Lens opacity was classified into three types based on anatomical location: nuclear, cortical, and PSC opacity. Opacity was graded in accordance with the Lens Opacity Classification System III (LOCS III) guideline and reference slides (Chylack et al. 1993). Cases were eligible if they met the following criteria: (1) aged 45 years or older in studied areas to obtain enough cumulative radiation dose for risk estimate; (2) diagnosed with cortical and PSC opacity (grade/stage ≥2); (3) no history of steroid intake, poisoning, and exposure to hazardous substances (such as benzene, metallic lead, and mercury); and (4) never received radiotherapy and never been exposed to occupational radiation. Ethnicity-matched healthy controls (grade/stage ≤1) were selected through counter-matching in terms of radiation status. All the cases and controls were farmers selected from two areas mentioned above, and they shared the same labor habits, so we considered that the level of ultraviolet radiation was the same.
Comparison of Digital Camera Real-Time Display with Conventional Teaching Tube for Slit Lamp Microscopy Teaching
Published in Current Eye Research, 2022
Zijing Huang, Jianling Yang, Hongxi Wang, Chi Pui Pang, Haoyu Chen
Adequate ophthalmic training is also needed in emergency services, which is a rapidly increasing concern.5 In emergency services in China, ocular trauma is a major burden. Consequently, adequate training in ophthalmology is vital for patient care and proper primary treatment affects the prognosis.6 In real-life clinical practice in the emergency department and outpatient clinics for eye patients, slit-lamp microscope is the most used equipment. It consists of a high-intensity slit beam light source providing an optical section and a microscope magnifying the morphology. Slit-lamp microscopy is an essential tool in ophthalmic investigations and for the diagnosis of eye diseases. Teaching slit-lamp microscopy should be included in medical school and junior residency education.
Recurrent Episodes with Serous Retinal Detachment and Anterior Uveitis in a Patient Using Nivolumab (Anti -PD-1 Antibody) Therapy: A case report and literature review
Published in Seminars in Ophthalmology, 2021
Busra Yilmaz Tugan, Berna Ozkan, Ozlem Sonmez
At the initial examination, his best-corrected visual acuity (BCVA) was counting fingers in both eyes, with an intraocular pressure of 13 mm Hg in the right eye and 12 mm Hg in the left eye. Slit-lamp examination revealed no abnormal findings or inflammation in the anterior segment of both eyes. Posterior segment evaluation showed serous retinal detachment, including the whole macula and inferior retina in both eyes. Optical coherence tomography (OCT, Heidelberg Engineering GmbH, Heidelberg, Germany) confirmed the presence of serous detachment with hyporeflective subretinal fluid in the macula (Figure 1). On Fluorescein Angiography (FA, Heidelberg Engineering GmbH, Heidelberg, Germany), no vascular abnormalities, filling defects, blockage, and leakage or staining were observed (Figure 1). The patient was treated with 48 mg oral methylprednisolone and subretinal fluid resolved one week after treatment in the right eye and two weeks after treatment in the left eye (Figure 2). BCVA was 20/20 in both eyes at the first month of treatment. Methylprednisolone was tapered after the first month and stopped at the end of the second month. The patient was followed monthly.