Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially me...Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially mesenchymal stem cells(MSCs),has surfaced as a viable approach for tissue regeneration and immunological regulation in DED.Preclinical and early clinical investigations indicate that MSCs can improve lacrimal gland functionality,diminish inflammation,and facilitate corneal regeneration.Nonetheless,obstacles persist in enhancing MSC viability,determining the optimal MSC source,and guaranteeing sustained therapeutic effectiveness.Additional extensive randomized clinical trials are required to confirm the efficacy of MSC-based therapies for severe DED.展开更多
BACKGROUND Cytomegalovirus(CMV)is a ubiquitous herpesvirus that can cause significant ocular morbidity,particularly in immunocompromised individuals.AIM To summarize the current understanding of the ophthalmic impact ...BACKGROUND Cytomegalovirus(CMV)is a ubiquitous herpesvirus that can cause significant ocular morbidity,particularly in immunocompromised individuals.AIM To summarize the current understanding of the ophthalmic impact of CMV,with a focus on its epidemiology,clinical manifestations,diagnosis,and management,ocular symptoms of CMV floaters,blurred vision,and loss of peripheral vision,eventually progressing to retinal necrosis and detachment.CMV retinitis(CMVR)is a sight-threatening condition that can lead to retinal detachment,blindness,and even death.METHODS We discuss the pathophysiology of CMVR,including the role of immune suppression and viral reactivation.We also examine the clinical features of CMVR,including its characteristic retinal lesions and associated ocular complications.Diagnostic approaches are reviewed,including polymerase chain reaction and fundus photography.RESULTS We discuss treatment options,including antiviral medications,intravitreal injections,and surgical interventions.Finally,we highlight areas of ongoing research and future directions in managing CMV-related ocular disease.CONCLUSION CMV poses a significant threat to ocular health,particularly in immunocompromised populations such as those with human immunodeficiency virus/acquired immune deficiency syndrome.展开更多
BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sen...BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sensitivity ranging from 85%to 90%for ocular surface squamous neoplasia(OSSN).The connections between HR-OCT features and histological findings have consistently shown robustness,hence increasing the reliability of clinical diagnosis.AIM To examine the existing HR-OCT indicators employed in the identification of common non-benign ocular surface tumors,namely,basal cell carcinoma,OSSN,and melanocytic conjunctival lesions,and to assess their diagnostic efficacy,benefits,and prospective developments.METHODS A thorough literature review was performed to assess the published research on HR-OCT in the diagnosis of ocular surface cancers.Significant attention was given to research that compares HR-OCT characteristics with histopath-ologic validation,as well as on publications addressing the integration of emerging technologies and artificial intelligence in ocular oncology imaging.RESULTS HR-OCT exhibits elevated diagnostic sensitivity(85%-90%)for identifying OSSN and presents distinct imaging patterns that align closely with histology results.This approach has substantial clinical advantages due to its non-invasive characteristics,improved axial resolution,and real-time imaging capabilities.HR-OCT has demonstrated potential in assessing various lesions,including basal cell carcinoma and melanocytic conjunctival malignancies.CONCLUSION HR-OCT assumes an increasingly vital role in the early identification and clinical management of ocular surface malignancies.With advancements in imaging technology and the integration of artificial intelligence,HR-OCT is anticipated to enhance individualized diagnosis and treatment planning in ocular oncology,hence improving patient outcomes.展开更多
BACKGROUND Eyelid reconstruction is an intricate process,addressing both aesthetic and functional aspects post-trauma or oncological surgery.Aesthetic concerns and oncological radicality guide personalized approaches....BACKGROUND Eyelid reconstruction is an intricate process,addressing both aesthetic and functional aspects post-trauma or oncological surgery.Aesthetic concerns and oncological radicality guide personalized approaches.The complex anatomy,involving anterior and posterior lamellae,requires tailored reconstruction for optimal functionality.AIM To formulate an eyelid reconstruction algorithm through an extensive literature review and to validate it by juxtaposing surgical outcomes from Cattinara Hos-in dry eye and tears,which may lead to long-term consequences such as chronic conjunctivitis,discomfort,or photo-phobia.To prevent this issue,scars should be oriented vertically or perpendicularly to the free eyelid margin when the size of the tumor allows.In employing a malar flap to repair a lower eyelid defect,the malar incision must ascend diagonally;this facilitates enhanced flap advancement and mitigates ectropion by restricting vertical traction.Conse-quently,it is imperative to maintain that the generated tension remains consistently horizontal and never vertical[9].Lagophthalmos is a disorder characterized by the inability to completely close the eyelids,leading to corneal exposure and an increased risk of keratitis or ulceration;it may arise following upper eyelid surgery.To avert this issue,it is essential to preserve a minimum of 1 cm of skin between the superior edge of the excision and the inferior boundary of the eyebrow.Epiphora may occur in cancers involving the lacrimal puncta,requiring their removal.As previously stated,when employing a glabellar flap to rectify medial canthal abnormalities,it is essential to prevent a trapdoor effect or thickening of the flap relative to the eyelid skin to which it is affixed.Constraints about our proposed algorithm enco-mpass limited sample sizes and possible publication biases in existing studies.Subsequent investigations ought to examine long-term results to further refine the algorithm.Future research should evaluate the algorithm across varied populations and examine the impact of novel graft materials on enhancing reconstructive outcomes.CONCLUSION Eyelid reconstruction remains one of the most intriguing challenges for a plastic surgeon today.The most fascinating aspect of this discipline is the need to restore the functionality of such an essential structure while maintaining its aesthetics.In our opinion,creating decision-making algorithms can facilitate reaching this goal by allowing for the individualization of the reconstructive path while minimizing the incidence of complications.The fact that we have decreased the incidence of severe complications is a sign that the work is moving in the right direction.The fact that there has been no need for reintervention,neither for reconstructive issues nor for inadequate oncological radicality,overall signifies greater patient satisfaction as they do not have to undergo the stress of new surgeries.Even the minor complic-ations recorded are in line with those reported in the literature,and,even more importantly for patients,they are of limited duration.In our experience,after a year of application,we can say that the objective has been achieved,but much more can still be done.Behind every work,a scientific basis must be continually renewed and refreshed to maintain high-quality standards.Therefore,searching for possible alternative solutions to be included in one’s surgical armamentarium is fundamental to providing the patient with a fully personalized option.展开更多
BACKGROUND Simultanagnosia is a neurological disorder that impairs an individual's ability to perceive more than one object at a time visually.While the individual may acknowledge the presence of multiple objects ...BACKGROUND Simultanagnosia is a neurological disorder that impairs an individual's ability to perceive more than one object at a time visually.While the individual may acknowledge the presence of multiple objects in his field of view,he cannot generally summarize the overall percept.CASE SUMMARY We describe a case of simultanagnosia in Posterior Cortical Atrophy,evidenced by the Ishihara color test.A 54-year-old woman complained of reading problems despite normal visual acuity and a structural eye exam.The patient failed to identify any of the Ishihara color plates in either eye despite adequate naming of colors.Automated visual field testing showed a homonymous hemianopia.Structural and functional neuroimaging and cerebrospinal fluid analysis were consistent with posterior cortical atrophy.CONCLUSION Simultanagnosia can be tested with the Ishihara pseudoisochromatic plates because the recognition of embedded number patterns in the test requires appreciation of a collection of individual stimuli.展开更多
BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to ...BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to corneal damage through mechanisms such as mechanical abrasion,secondary infection,or inflammatory responses.AIM To assess the surgical methodologies utilized in the treatment of corneal lesions resulting from eyelid disorders and evaluate their effects on patient outcomes,recurrence rates,and postoperative complications.The incorporation of advanced imaging techniques,including optical coherence tomography and ultrasound biomicroscopy,in conjunction with histopathological analysis,is addressed to improve surgical accuracy and patient outcomes.METHODS The authors searched online databases(PubMed and Cochrane)for publications on the surgical management of lid lesions.Records received from the two databases were checked for duplicates and relevance.Only records with full texts and in English language were included.RESULTS A total of 28 records were obtained following the screening for relevancy and duplication.The review underscores essential surgical approaches employed in the treatment of corneal lesions resulting from common eyelid diseases,focusing on operative efficacy,complication rates,and long-term results.CONCLUSION This systematic review emphasizes the significance of choosing suitable surgical techniques tailored to individual patient characteristics and stresses the need for interdisciplinary collaboration in ophthalmic care.The results indicate that sophisticated imaging techniques and careful preoperative preparation markedly improve surgical accuracy and long-term results.展开更多
BACKGROUND Dry eye disease(DED)represents a multifactorial condition characterized by ocular discomfort and visual disturbances.The management of DED relies heavily on accurate diagnosis to tailor effective treatments...BACKGROUND Dry eye disease(DED)represents a multifactorial condition characterized by ocular discomfort and visual disturbances.The management of DED relies heavily on accurate diagnosis to tailor effective treatments.Diagnostic approaches encompass both subjective and objective assessments.AIM To review the diagnostic methods used in the process of dry eye disease management.METHODS A comprehensive review of diagnostic approaches for dry eye was performed using scientific databases.Studies published within the last four years were considered.Studies were excluded if a full text was absent or the article was not written in English.Articles were assessed for relevancy,and a total of 107 studies were selected.The selection method used a systematic methodology,which guaranteed an exhaustive assessment of the diagnostic techniques reported in current literature.The study adheres to principles for systematic reviews ensuring dependability and accuracy.The studies were assessed for emphasize on both novel traditional and diagnostic methods for dry eye disease management.RESULTS Key objective tests include tear break-up time,which evaluates tear film stability;fluorescein and lissamine green staining,which assess ocular surface damage and inflammation;tear osmolarity measurement,indicative of tear film quality;and tear volume assessment via Schirmer's test,which evaluates tear production.Advanced imaging techniques such as optical coherence tomography and meibography offer detailed anatomical insights into the ocular surface and meibomian glands,aiding in the diagnosis of underlying structural abnormalities.Moreover,emerging technologies such as matrix metalloproteinase-9 testing and inflammatory biomarkers provide additional diagnostic precision,particularly in identifying inflammatory components of DED.CONCLUSION Integrating a combination of subjective and objective diagnostic tools allows clinicians to comprehensively assess the condition,tailor treatment plans,and monitor therapeutic efficacy.Continued advancements in diagnostic technologies promise to enhance our understanding and management of this prevalent ocular condition.展开更多
BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the tr...BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the treatment rates of eye emergencies in Africa.Ocular emergencies are particularly delicate due to the eye’s intricate structure and the necessity for its refractive components to remain transparent.METHODS This review examines the low treatment rates of eye emergencies in Africa,drawing on 96 records extracted from the PubMed database using predetermined search criteria.RESULTS The epidemiology of ocular injuries,as detailed in the studies,reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age,gender,and occupation.The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks.Management approaches reported in the review include both surgical and non-surgical interventions,from medication to evisceration or enucleation of the eye.Preventive measures emphasize eye health education and the use of protective eyewear and facial protection.However,inadequate healthcare infrastructure and personnel,cultural and geographical barriers,and socioeconomic and behavioral factors hinder the effective prevention,service uptake,and management of eye emergencies.CONCLUSION The authors recommend developing eye health policies,enhancing community engagement,improving healthcare personnel training and retention,and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.展开更多
Optic neuritis(ON)is a focal inflammatory demyelinating disorder of the optic nerve.Although classically regarded as a sentinel event for multiple sclerosis(MS),ON also occurs in antibody-mediated entities such as aqu...Optic neuritis(ON)is a focal inflammatory demyelinating disorder of the optic nerve.Although classically regarded as a sentinel event for multiple sclerosis(MS),ON also occurs in antibody-mediated entities such as aquaporin-4-IgGpositive neuromyelitis optica spectrum disorder(AQP4-NMOSD)and myelinoligodendrocyte-glycoprotein-antibody disease.In all these settings biological sex is a pivotal determinant of susceptibility,clinical expression,treatment response and long-term outcome.Data synthesized from an extensive literature analysis utilizing PubMed,Scopus,and Web of Science in this review shows that women experience ON far more frequently–with female-to-male ratios ranging from 3:1 in MS to almost 9:1 in AQP4-NMOSD–yet men,when affected,tend to accumulate irreversible neuro-axonal loss more rapidly.Sex-specific patterns arise at every biological stratum:X-linked gene dosage,epigenetic regulation,hormonal cycles from puberty through menopause,metabolic co-modifiers such as obesity and vitamin-D status,and psychosocial forces that influence healthcare utilization.By weaving these elements into an expanded narrative,the present review provides a detailed resource for clinicians and investigators aiming at gender-tailored management of ON.展开更多
Retinal pigment epithelium(RPE)dysfunction is involved in the advancement of numerous degenerative retinal illnesses,such as age-related macular degeneration and hereditary retinal abnormalities.Transplantation of RPE...Retinal pigment epithelium(RPE)dysfunction is involved in the advancement of numerous degenerative retinal illnesses,such as age-related macular degeneration and hereditary retinal abnormalities.Transplantation of RPE produced from stem cells has emerged as a promising therapeutic strategy to restore retinal function and prevent vision loss.However,other obstacles impede its clinical application,including immunological rejection,cell viability,functional integration,and the necessity for consistent differentiation techniques.This review offers a thorough examination of the molecular processes regulating RPE integrity,investigates recent progress in stem cell-derived RPE therapeutics,and addresses significant challenges to their broad implementation.Furthermore,we emphasize prospective avenues intended to enhance the safety,efficacy,and enduring success of RPE transplantation in clinical environments.展开更多
BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary appro...BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas,integrating neurosurgery,endocrinology,radiology,and pathology perspectives.AIM To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis,management,and rehabilitation of individuals with pituitary adenomas,to add to already preexisting knowledge,in managing these cases enhancing better ocular and systemic outcomes.METHODS A search was conducted on an online publication database(PubMed)using the term“pituitary adenoma”including all results published over twenty years(2004-2024).Results were sorted for relevance,language,and completeness.RESULTS A total of 176 records were returned.The guidelines of the PRISMA 2020 statement were followed in this study.A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates.Another 17 records were not available as full-length articles and were also excluded.The references of each included record was further searched for relevant publications.A total of 141 records were therefore used in this minireview.CONCLUSION Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact,modern therapeutic strategies offer effective management options.Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life.Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future.展开更多
BACKGROUND As one of the most common aesthetic surgical procedures carried out today,blepharoplasty should be in the repertoire of every plastic surgeon.The term blepharoplasty encompasses a wide range of techniques a...BACKGROUND As one of the most common aesthetic surgical procedures carried out today,blepharoplasty should be in the repertoire of every plastic surgeon.The term blepharoplasty encompasses a wide range of techniques and options that must be tailored to the specific defect and patient one has to treat.A sound knowledge of the upper and lower eyelids’anatomy is essential for proper surgical execution.Trends have shifted towards more conservative methods(especially of the fat compartment)and sometimes in combination with augmentation techniques,helping to reach a rejuvenated appearance.AIM To present an overview of the surgical techniques considered for upper lid blepharoplasty and fat pad management,in addition to information on how a surgeon may approach the best treatment for his patient based on current publications in literature.METHODS We searched the literature published between 2013,to 2023 using Medline and Reference Citation Analysis.The database was searched using the keywords“upper blepharoplasty”AND“fat”.Papers without full text/abstracts and reviews were excluded.The search strategy followed the PRISMA.The American Society of Plastic Surgeons guidelines for Therapeutic Studies checklist was used to assess all articles.Two authors individually reviewed each article and rated them for importance and relevance to the topic.A consensus was sought and the most relevant studies.RESULTS After the application of the selection criteria used in our review,13 publications were found to address upper lid blepharoplasty specifically.Three of these studies were reviews and three were retrospective studies.Five publications were comparative studies and a further two were clinical trials.CONCLUSION The tendency of modern surgery is to be conservative,by removing adipose tissue only if strictly necessary and restoring the volume of the upper eyelid in a concept of beauty that espouses a"full"sight.There is no gold standard technique to achieve younger and enhanced eyelids.Long-term prospective comparative studies are fundamental in understanding which path is the best to follow.展开更多
The aim of our minireview is to provide a brief overview of the diagnosis,clinical aspects,treatment options,management,and current literature available regarding herpes simplex keratitis(HSK).This type of corneal vir...The aim of our minireview is to provide a brief overview of the diagnosis,clinical aspects,treatment options,management,and current literature available regarding herpes simplex keratitis(HSK).This type of corneal viral infection is caused by the herpes simplex virus(HSV),which can affect several tissues,including the cornea.One significant aspect of HSK is its potential to cause recurrent episodes of inflammation and damage to the cornea.After the initial infection,the HSV can establish a latent infection in the trigeminal ganglion,a nerve cluster near the eye.The virus may remain dormant for extended periods.Periodic reactivation of the virus can occur,leading to recurrent episodes of HSK.Factors triggering reactivation include stress,illness,immunosuppression,or trauma.Recurrent episodes can manifest in different clinical patterns,ranging from mild epithelial involvement to more severe stromal or endothelial disease.The severity and frequency of recurrences vary among individuals.Severe cases of HSK,especially those involving the stroma and leading to scarring,can result in vision impairment or even blindness in extreme cases.The cornea's clarity is crucial for good vision,and scarring can compromise this,potentially leading to visual impairment.The management of HSK involves not only treating acute episodes but also implementing long-term strategies to prevent recurrences and attempt repairs of corneal nerve endings via neurotization.Antiviral medications,such as oral Acyclovir or topical Ganciclovir,may be prescribed for prophylaxis.The immune response to the virus can contribute to corneal damage.Inflammation,caused by the body's attempt to control the infection,may inadvertently harm the corneal tissues.Clinicians should be informed about triggers and advised on measures to minimize the risk of reactivation.In summary,the recurrent nature of HSK underscores the importance of both acute and long-term management strategies to preserve corneal health and maintain optimal visual function.展开更多
The aging of the periocular region has always aroused great interest.A fresh,young,and attractive sight determined an ever-greater attention to surgical and non-surgical techniques to obtain this result.In particular,...The aging of the periocular region has always aroused great interest.A fresh,young,and attractive sight determined an ever-greater attention to surgical and non-surgical techniques to obtain this result.In particular,the change in the concept of a young look,considered then“full”,led to the increasing use of surgical(fat grafting)or medical(hyaluronic acid)filling techniques.Eyelid rejuvenation became increasingly popular in the field of cosmetic treatments,with a focus on achieving a youthful and refreshed appearance.Among the various techniques available,the choice between using fat grafting or fillers presented a clinical dilemma.In particular,what surgery considered of fundamental importance was a long-lasting result over time.On the other hand,aesthetic medicine considered it fundamental not to have to resort to invasive treatments.But what was the reality?Was there one path better than the other,and above all,was there a better path for patients?The minireview aims to explore the physiopathology,diagnosis,treatment options,prognosis,and future studies regarding this dilemma.We analyzed the literature produced in the last 20 years comparing the two techniques.Current literature reveals advancements in biomaterials,stem cell research and tissue engineering held promise for further enhancing the field of eyelid rejuvenation.The choice between fat grafting and fillers in eyelid cosmetic treatments presented a clinical dilemma.Understanding physiopathology,accurately diagnosing eyelid aging,exploring treatment options,assessing prognosis,and conducting future studies were essential for providing optimal care to patients seeking eyelid rejuvenation.展开更多
BACKGROUND Retinoscopy is arguably the most important method in the eye clinic for diagnosing and managing refractive errors.Advantages of retinoscopy include its noninvasive nature,ability to assess patients of all a...BACKGROUND Retinoscopy is arguably the most important method in the eye clinic for diagnosing and managing refractive errors.Advantages of retinoscopy include its noninvasive nature,ability to assess patients of all ages,and usefulness in patients with limited cooperation or communication skills.AIM To discuss the history of retinoscopes and examine current literature on the subject.METHODS A search was conducted on the PubMed and with the reference citation analysis(https://www.referencecitationanalysis.com)database using the term"Retinoscopy,"with a range restricted to the last 10 years(2013-2023).The search string algorithm was:"Retinoscopy"(MeSH Terms)OR"Retinoscopy"(All Fields)OR"Retinoscopes"(All Fields)AND[(All Fields)AND 2013:2023(pdat)].RESULTS This systematic review included a total of 286 records.Publications reviewed iterations of the retinoscope into autorefractors,infrared photo retinoscope,television retinoscopy,and the Wifi enabled digital retinoscope.CONCLUSION The retinoscope has evolved significantly since its discovery,with a significant improvement in its diagnostic capabilities.While it has advantages such as non-invasiveness and broad applicability,limitations exist,and the need for skilled interpretation remains.With ongoing research,including the integration of artificial intelligence,retinoscopy is expected to continue advancing and playing a vital role in eye care.展开更多
Autologous blood therapy has emerged as a promising modality in managing ocular surface disorders.This review provides a comprehensive overview of the current literature regarding the use of autologous blood in ocular...Autologous blood therapy has emerged as a promising modality in managing ocular surface disorders.This review provides a comprehensive overview of the current literature regarding the use of autologous blood in ocular surface disorders,encompassing its physiological basis,clinical applications,techniques,challenges,and future perspectives.The ocular surface,comprising the cornea,conjunctiva,and tear film,plays a critical role in maintaining visual function,and its disruption can lead to various pathological conditions.With its rich composition of growth factors,cytokines,and other bioactive molecules,autologous blood offers therapeutic potential in promoting corneal wound healing,reducing inflammation,and improving tear film stability.Clinical studies have demonstrated the efficacy and safety of autologous blood therapy in diverse ocular surface disorders,including persistent epithelial defects,neurotrophic keratopathy,and dry eye disease.However,challenges such as variability in treatment response,adverse effects,and optimal patient selection remain areas of concern.Further research is needed to elucidate the underlying mechanisms of action,refine treatment protocols,and explore synergistic approaches with other therapeutic modalities.Despite these challenges,autologous blood therapy holds promise as a valuable adjunctive treatment option for ocular surface disorders,offering new avenues for improving patient outcomes and quality of life.This review examines the mechanisms underlying ocular surface disorders while discussing existing autologous blood-based therapies for managing these disorders.Current clinical trials are also summarized,and a comparison between autologous blood therapy and conventional eyedrops is attempted.Finally,safe techniques and protocols for autologous blood medicine are elucidated,and adverse effects and future perspectives of this novel therapy are reviewed.展开更多
BACKGROUND Blepharoconjunctivitis poses a diagnostic challenge due to its diverse etiology,including viral infections.Blepharoconjunctivits can be acute or chronic,selflimiting,or needing medical therapy.AIM To review...BACKGROUND Blepharoconjunctivitis poses a diagnostic challenge due to its diverse etiology,including viral infections.Blepharoconjunctivits can be acute or chronic,selflimiting,or needing medical therapy.AIM To review possible viral agents crucial for accurate differential diagnosis in cases of blepharoconjunctivitis.METHODS The PubMed database was searched for records relating to viral blepharoconjunctivitis.The search string generated was“("virally"[All Fields]OR"virals"[All Fields]OR"virology"[MeSH Terms]OR"virology"[All Fields]OR"viral"[All Fields])AND"Blepharoconjunctivitis"[All Fields]".RESULTS A total of 24 publications were generated from the search string.Reference lists from each relevant article were also searched for more information and included in this review.Viral etiologies such as adenovirus,herpes simplex virus(HSV),varicella-zoster virus(VZV),and Epstein-Barr virus(EBV)are frequently implicated.Adenoviral infections manifest with follicular conjunctivitis and preauricular lymphadenopathy,often presenting as epidemic keratoconjunctivitis.HSV and VZV infections can result in herpetic keratitis and may exhibit characteristic dendritic corneal ulcers.EBV,although less common,can cause unilateral or bilateral follicular conjunctivitis,particularly in immunocompromised individuals.Other potential viral agents,such as enteroviruses and molluscum contagiosum virus,should also be considered,especially in pediatric cases.CONCLUSION Prompt recognition of these viral etiologies is essential for appropriate management and prevention of complications.Thus,a thorough understanding of the clinical presentation,epidemiology,and diagnostic modalities is crucial for accurate identification and management of viral blepharoconjunctivitis.展开更多
New frontiers about retinal cell transplantation for retinal degenerative diseases start from the idea that acting on stem cells can help regenerate retinal layers and establish new synapses among retinal cells.Defici...New frontiers about retinal cell transplantation for retinal degenerative diseases start from the idea that acting on stem cells can help regenerate retinal layers and establish new synapses among retinal cells.Deficiency or alterations of synaptic input and neurotrophic factors result in trans-neuronal degeneration of the inner retinal cells.Thus,the disruption of photoreceptors takes place.However,even in advanced forms of retinal degeneration,a good percentage of the ganglion cells and the inner nuclear layer neurons remain intact.This phenomenon provides evidence for obtaining retinal circuitry through the transplantation of photoreceptors into the subretinal region.The eye is regarded as an optimal organ for cell transplantation because of its immunological privilege and the relatively small number of cells collaborating to carry out visual activities.The eyeball's immunological privilege,characterized by the suppression of delayed-type hypersensitivity responses in ocular tissues,is responsible for the low rate of graft rejection in transplant patients.The main discoveries highlight the capacity of embryonic stem cells(ESCs)and induced pluripotent stem cells to regenerate damaged retinal regions.Recent progress has shown significant enhancements in transplant procedures and results.The research also explores the ethical ramifications linked to the utilization of stem cells,emphasizing the ongoing issue surrounding ESCs.The analysis centers on recent breakthroughs,including the fabrication of three-dimensional retinal organoids and the innovation of scaffolding for cell transportation.Moreover,researchers are currently assessing the possibility of CRISPR and other advanced gene editing technologies to enhance the outcomes of retinal transplantation.The widespread use of universally recognized safe surgical and imaging methods enables retinal transplantation and monitoring of transplanted cell growth toward the correct location.Currently,most therapy approaches are in the first phases of development and necessitate further research,including both pre-clinical and clinical trials,to attain favorable visual results for individuals suffering from retinal degenerative illnesses.展开更多
文摘Dry eye disease(DED)is a multifactorial disorder that disturbs ocular surface equilibrium,considerably diminishing quality of life.Present therapies only offer symptomatic alleviation.Stem cell treatment,especially mesenchymal stem cells(MSCs),has surfaced as a viable approach for tissue regeneration and immunological regulation in DED.Preclinical and early clinical investigations indicate that MSCs can improve lacrimal gland functionality,diminish inflammation,and facilitate corneal regeneration.Nonetheless,obstacles persist in enhancing MSC viability,determining the optimal MSC source,and guaranteeing sustained therapeutic effectiveness.Additional extensive randomized clinical trials are required to confirm the efficacy of MSC-based therapies for severe DED.
文摘BACKGROUND Cytomegalovirus(CMV)is a ubiquitous herpesvirus that can cause significant ocular morbidity,particularly in immunocompromised individuals.AIM To summarize the current understanding of the ophthalmic impact of CMV,with a focus on its epidemiology,clinical manifestations,diagnosis,and management,ocular symptoms of CMV floaters,blurred vision,and loss of peripheral vision,eventually progressing to retinal necrosis and detachment.CMV retinitis(CMVR)is a sight-threatening condition that can lead to retinal detachment,blindness,and even death.METHODS We discuss the pathophysiology of CMVR,including the role of immune suppression and viral reactivation.We also examine the clinical features of CMVR,including its characteristic retinal lesions and associated ocular complications.Diagnostic approaches are reviewed,including polymerase chain reaction and fundus photography.RESULTS We discuss treatment options,including antiviral medications,intravitreal injections,and surgical interventions.Finally,we highlight areas of ongoing research and future directions in managing CMV-related ocular disease.CONCLUSION CMV poses a significant threat to ocular health,particularly in immunocompromised populations such as those with human immunodeficiency virus/acquired immune deficiency syndrome.
文摘BACKGROUND High-resolution optical coherence tomography(HR-OCT)has become an essential instrument in the screening and diagnosis of ocular surface neoplasms.Research demonstrates that HR-OCT possesses a diagnostic sensitivity ranging from 85%to 90%for ocular surface squamous neoplasia(OSSN).The connections between HR-OCT features and histological findings have consistently shown robustness,hence increasing the reliability of clinical diagnosis.AIM To examine the existing HR-OCT indicators employed in the identification of common non-benign ocular surface tumors,namely,basal cell carcinoma,OSSN,and melanocytic conjunctival lesions,and to assess their diagnostic efficacy,benefits,and prospective developments.METHODS A thorough literature review was performed to assess the published research on HR-OCT in the diagnosis of ocular surface cancers.Significant attention was given to research that compares HR-OCT characteristics with histopath-ologic validation,as well as on publications addressing the integration of emerging technologies and artificial intelligence in ocular oncology imaging.RESULTS HR-OCT exhibits elevated diagnostic sensitivity(85%-90%)for identifying OSSN and presents distinct imaging patterns that align closely with histology results.This approach has substantial clinical advantages due to its non-invasive characteristics,improved axial resolution,and real-time imaging capabilities.HR-OCT has demonstrated potential in assessing various lesions,including basal cell carcinoma and melanocytic conjunctival malignancies.CONCLUSION HR-OCT assumes an increasingly vital role in the early identification and clinical management of ocular surface malignancies.With advancements in imaging technology and the integration of artificial intelligence,HR-OCT is anticipated to enhance individualized diagnosis and treatment planning in ocular oncology,hence improving patient outcomes.
文摘BACKGROUND Eyelid reconstruction is an intricate process,addressing both aesthetic and functional aspects post-trauma or oncological surgery.Aesthetic concerns and oncological radicality guide personalized approaches.The complex anatomy,involving anterior and posterior lamellae,requires tailored reconstruction for optimal functionality.AIM To formulate an eyelid reconstruction algorithm through an extensive literature review and to validate it by juxtaposing surgical outcomes from Cattinara Hos-in dry eye and tears,which may lead to long-term consequences such as chronic conjunctivitis,discomfort,or photo-phobia.To prevent this issue,scars should be oriented vertically or perpendicularly to the free eyelid margin when the size of the tumor allows.In employing a malar flap to repair a lower eyelid defect,the malar incision must ascend diagonally;this facilitates enhanced flap advancement and mitigates ectropion by restricting vertical traction.Conse-quently,it is imperative to maintain that the generated tension remains consistently horizontal and never vertical[9].Lagophthalmos is a disorder characterized by the inability to completely close the eyelids,leading to corneal exposure and an increased risk of keratitis or ulceration;it may arise following upper eyelid surgery.To avert this issue,it is essential to preserve a minimum of 1 cm of skin between the superior edge of the excision and the inferior boundary of the eyebrow.Epiphora may occur in cancers involving the lacrimal puncta,requiring their removal.As previously stated,when employing a glabellar flap to rectify medial canthal abnormalities,it is essential to prevent a trapdoor effect or thickening of the flap relative to the eyelid skin to which it is affixed.Constraints about our proposed algorithm enco-mpass limited sample sizes and possible publication biases in existing studies.Subsequent investigations ought to examine long-term results to further refine the algorithm.Future research should evaluate the algorithm across varied populations and examine the impact of novel graft materials on enhancing reconstructive outcomes.CONCLUSION Eyelid reconstruction remains one of the most intriguing challenges for a plastic surgeon today.The most fascinating aspect of this discipline is the need to restore the functionality of such an essential structure while maintaining its aesthetics.In our opinion,creating decision-making algorithms can facilitate reaching this goal by allowing for the individualization of the reconstructive path while minimizing the incidence of complications.The fact that we have decreased the incidence of severe complications is a sign that the work is moving in the right direction.The fact that there has been no need for reintervention,neither for reconstructive issues nor for inadequate oncological radicality,overall signifies greater patient satisfaction as they do not have to undergo the stress of new surgeries.Even the minor complic-ations recorded are in line with those reported in the literature,and,even more importantly for patients,they are of limited duration.In our experience,after a year of application,we can say that the objective has been achieved,but much more can still be done.Behind every work,a scientific basis must be continually renewed and refreshed to maintain high-quality standards.Therefore,searching for possible alternative solutions to be included in one’s surgical armamentarium is fundamental to providing the patient with a fully personalized option.
文摘BACKGROUND Simultanagnosia is a neurological disorder that impairs an individual's ability to perceive more than one object at a time visually.While the individual may acknowledge the presence of multiple objects in his field of view,he cannot generally summarize the overall percept.CASE SUMMARY We describe a case of simultanagnosia in Posterior Cortical Atrophy,evidenced by the Ishihara color test.A 54-year-old woman complained of reading problems despite normal visual acuity and a structural eye exam.The patient failed to identify any of the Ishihara color plates in either eye despite adequate naming of colors.Automated visual field testing showed a homonymous hemianopia.Structural and functional neuroimaging and cerebrospinal fluid analysis were consistent with posterior cortical atrophy.CONCLUSION Simultanagnosia can be tested with the Ishihara pseudoisochromatic plates because the recognition of embedded number patterns in the test requires appreciation of a collection of individual stimuli.
文摘BACKGROUND The surgical management of corneal lesions resulting from eyelid pathologies requires a comprehensive approach to ensure optimal patient outcomes.Eyelid lesions,ranging from benign to malignant,can lead to corneal damage through mechanisms such as mechanical abrasion,secondary infection,or inflammatory responses.AIM To assess the surgical methodologies utilized in the treatment of corneal lesions resulting from eyelid disorders and evaluate their effects on patient outcomes,recurrence rates,and postoperative complications.The incorporation of advanced imaging techniques,including optical coherence tomography and ultrasound biomicroscopy,in conjunction with histopathological analysis,is addressed to improve surgical accuracy and patient outcomes.METHODS The authors searched online databases(PubMed and Cochrane)for publications on the surgical management of lid lesions.Records received from the two databases were checked for duplicates and relevance.Only records with full texts and in English language were included.RESULTS A total of 28 records were obtained following the screening for relevancy and duplication.The review underscores essential surgical approaches employed in the treatment of corneal lesions resulting from common eyelid diseases,focusing on operative efficacy,complication rates,and long-term results.CONCLUSION This systematic review emphasizes the significance of choosing suitable surgical techniques tailored to individual patient characteristics and stresses the need for interdisciplinary collaboration in ophthalmic care.The results indicate that sophisticated imaging techniques and careful preoperative preparation markedly improve surgical accuracy and long-term results.
文摘BACKGROUND Dry eye disease(DED)represents a multifactorial condition characterized by ocular discomfort and visual disturbances.The management of DED relies heavily on accurate diagnosis to tailor effective treatments.Diagnostic approaches encompass both subjective and objective assessments.AIM To review the diagnostic methods used in the process of dry eye disease management.METHODS A comprehensive review of diagnostic approaches for dry eye was performed using scientific databases.Studies published within the last four years were considered.Studies were excluded if a full text was absent or the article was not written in English.Articles were assessed for relevancy,and a total of 107 studies were selected.The selection method used a systematic methodology,which guaranteed an exhaustive assessment of the diagnostic techniques reported in current literature.The study adheres to principles for systematic reviews ensuring dependability and accuracy.The studies were assessed for emphasize on both novel traditional and diagnostic methods for dry eye disease management.RESULTS Key objective tests include tear break-up time,which evaluates tear film stability;fluorescein and lissamine green staining,which assess ocular surface damage and inflammation;tear osmolarity measurement,indicative of tear film quality;and tear volume assessment via Schirmer's test,which evaluates tear production.Advanced imaging techniques such as optical coherence tomography and meibography offer detailed anatomical insights into the ocular surface and meibomian glands,aiding in the diagnosis of underlying structural abnormalities.Moreover,emerging technologies such as matrix metalloproteinase-9 testing and inflammatory biomarkers provide additional diagnostic precision,particularly in identifying inflammatory components of DED.CONCLUSION Integrating a combination of subjective and objective diagnostic tools allows clinicians to comprehensively assess the condition,tailor treatment plans,and monitor therapeutic efficacy.Continued advancements in diagnostic technologies promise to enhance our understanding and management of this prevalent ocular condition.
文摘BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the treatment rates of eye emergencies in Africa.Ocular emergencies are particularly delicate due to the eye’s intricate structure and the necessity for its refractive components to remain transparent.METHODS This review examines the low treatment rates of eye emergencies in Africa,drawing on 96 records extracted from the PubMed database using predetermined search criteria.RESULTS The epidemiology of ocular injuries,as detailed in the studies,reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age,gender,and occupation.The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks.Management approaches reported in the review include both surgical and non-surgical interventions,from medication to evisceration or enucleation of the eye.Preventive measures emphasize eye health education and the use of protective eyewear and facial protection.However,inadequate healthcare infrastructure and personnel,cultural and geographical barriers,and socioeconomic and behavioral factors hinder the effective prevention,service uptake,and management of eye emergencies.CONCLUSION The authors recommend developing eye health policies,enhancing community engagement,improving healthcare personnel training and retention,and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.
文摘Optic neuritis(ON)is a focal inflammatory demyelinating disorder of the optic nerve.Although classically regarded as a sentinel event for multiple sclerosis(MS),ON also occurs in antibody-mediated entities such as aquaporin-4-IgGpositive neuromyelitis optica spectrum disorder(AQP4-NMOSD)and myelinoligodendrocyte-glycoprotein-antibody disease.In all these settings biological sex is a pivotal determinant of susceptibility,clinical expression,treatment response and long-term outcome.Data synthesized from an extensive literature analysis utilizing PubMed,Scopus,and Web of Science in this review shows that women experience ON far more frequently–with female-to-male ratios ranging from 3:1 in MS to almost 9:1 in AQP4-NMOSD–yet men,when affected,tend to accumulate irreversible neuro-axonal loss more rapidly.Sex-specific patterns arise at every biological stratum:X-linked gene dosage,epigenetic regulation,hormonal cycles from puberty through menopause,metabolic co-modifiers such as obesity and vitamin-D status,and psychosocial forces that influence healthcare utilization.By weaving these elements into an expanded narrative,the present review provides a detailed resource for clinicians and investigators aiming at gender-tailored management of ON.
文摘Retinal pigment epithelium(RPE)dysfunction is involved in the advancement of numerous degenerative retinal illnesses,such as age-related macular degeneration and hereditary retinal abnormalities.Transplantation of RPE produced from stem cells has emerged as a promising therapeutic strategy to restore retinal function and prevent vision loss.However,other obstacles impede its clinical application,including immunological rejection,cell viability,functional integration,and the necessity for consistent differentiation techniques.This review offers a thorough examination of the molecular processes regulating RPE integrity,investigates recent progress in stem cell-derived RPE therapeutics,and addresses significant challenges to their broad implementation.Furthermore,we emphasize prospective avenues intended to enhance the safety,efficacy,and enduring success of RPE transplantation in clinical environments.
文摘BACKGROUND Pituitary macroadenomas represent a significant challenge in clinical management due to their variable presentations and complex treatment considerations.This manuscript explores the multidisciplinary approach to understanding and managing pituitary macroadenomas,integrating neurosurgery,endocrinology,radiology,and pathology perspectives.AIM To summarize the literature on pituitary macroadenoma and outline the possible multidisciplinary approach in the diagnosis,management,and rehabilitation of individuals with pituitary adenomas,to add to already preexisting knowledge,in managing these cases enhancing better ocular and systemic outcomes.METHODS A search was conducted on an online publication database(PubMed)using the term“pituitary adenoma”including all results published over twenty years(2004-2024).Results were sorted for relevance,language,and completeness.RESULTS A total of 176 records were returned.The guidelines of the PRISMA 2020 statement were followed in this study.A total of 23 records were excluded due to being out of scope while a further 13 records were duplicates.Another 17 records were not available as full-length articles and were also excluded.The references of each included record was further searched for relevant publications.A total of 141 records were therefore used in this minireview.CONCLUSION Pituitary macroadenomas pose substantial clinical challenges due to their size and potential for significant hormonal and neurological impact,modern therapeutic strategies offer effective management options.Early detection and comprehensive treatment are essential for optimizing patient outcomes and maintaining quality of life.Continued research and advancements in medical technology are likely to further enhance the management and prognosis of this condition in the future.
文摘BACKGROUND As one of the most common aesthetic surgical procedures carried out today,blepharoplasty should be in the repertoire of every plastic surgeon.The term blepharoplasty encompasses a wide range of techniques and options that must be tailored to the specific defect and patient one has to treat.A sound knowledge of the upper and lower eyelids’anatomy is essential for proper surgical execution.Trends have shifted towards more conservative methods(especially of the fat compartment)and sometimes in combination with augmentation techniques,helping to reach a rejuvenated appearance.AIM To present an overview of the surgical techniques considered for upper lid blepharoplasty and fat pad management,in addition to information on how a surgeon may approach the best treatment for his patient based on current publications in literature.METHODS We searched the literature published between 2013,to 2023 using Medline and Reference Citation Analysis.The database was searched using the keywords“upper blepharoplasty”AND“fat”.Papers without full text/abstracts and reviews were excluded.The search strategy followed the PRISMA.The American Society of Plastic Surgeons guidelines for Therapeutic Studies checklist was used to assess all articles.Two authors individually reviewed each article and rated them for importance and relevance to the topic.A consensus was sought and the most relevant studies.RESULTS After the application of the selection criteria used in our review,13 publications were found to address upper lid blepharoplasty specifically.Three of these studies were reviews and three were retrospective studies.Five publications were comparative studies and a further two were clinical trials.CONCLUSION The tendency of modern surgery is to be conservative,by removing adipose tissue only if strictly necessary and restoring the volume of the upper eyelid in a concept of beauty that espouses a"full"sight.There is no gold standard technique to achieve younger and enhanced eyelids.Long-term prospective comparative studies are fundamental in understanding which path is the best to follow.
文摘The aim of our minireview is to provide a brief overview of the diagnosis,clinical aspects,treatment options,management,and current literature available regarding herpes simplex keratitis(HSK).This type of corneal viral infection is caused by the herpes simplex virus(HSV),which can affect several tissues,including the cornea.One significant aspect of HSK is its potential to cause recurrent episodes of inflammation and damage to the cornea.After the initial infection,the HSV can establish a latent infection in the trigeminal ganglion,a nerve cluster near the eye.The virus may remain dormant for extended periods.Periodic reactivation of the virus can occur,leading to recurrent episodes of HSK.Factors triggering reactivation include stress,illness,immunosuppression,or trauma.Recurrent episodes can manifest in different clinical patterns,ranging from mild epithelial involvement to more severe stromal or endothelial disease.The severity and frequency of recurrences vary among individuals.Severe cases of HSK,especially those involving the stroma and leading to scarring,can result in vision impairment or even blindness in extreme cases.The cornea's clarity is crucial for good vision,and scarring can compromise this,potentially leading to visual impairment.The management of HSK involves not only treating acute episodes but also implementing long-term strategies to prevent recurrences and attempt repairs of corneal nerve endings via neurotization.Antiviral medications,such as oral Acyclovir or topical Ganciclovir,may be prescribed for prophylaxis.The immune response to the virus can contribute to corneal damage.Inflammation,caused by the body's attempt to control the infection,may inadvertently harm the corneal tissues.Clinicians should be informed about triggers and advised on measures to minimize the risk of reactivation.In summary,the recurrent nature of HSK underscores the importance of both acute and long-term management strategies to preserve corneal health and maintain optimal visual function.
文摘The aging of the periocular region has always aroused great interest.A fresh,young,and attractive sight determined an ever-greater attention to surgical and non-surgical techniques to obtain this result.In particular,the change in the concept of a young look,considered then“full”,led to the increasing use of surgical(fat grafting)or medical(hyaluronic acid)filling techniques.Eyelid rejuvenation became increasingly popular in the field of cosmetic treatments,with a focus on achieving a youthful and refreshed appearance.Among the various techniques available,the choice between using fat grafting or fillers presented a clinical dilemma.In particular,what surgery considered of fundamental importance was a long-lasting result over time.On the other hand,aesthetic medicine considered it fundamental not to have to resort to invasive treatments.But what was the reality?Was there one path better than the other,and above all,was there a better path for patients?The minireview aims to explore the physiopathology,diagnosis,treatment options,prognosis,and future studies regarding this dilemma.We analyzed the literature produced in the last 20 years comparing the two techniques.Current literature reveals advancements in biomaterials,stem cell research and tissue engineering held promise for further enhancing the field of eyelid rejuvenation.The choice between fat grafting and fillers in eyelid cosmetic treatments presented a clinical dilemma.Understanding physiopathology,accurately diagnosing eyelid aging,exploring treatment options,assessing prognosis,and conducting future studies were essential for providing optimal care to patients seeking eyelid rejuvenation.
文摘BACKGROUND Retinoscopy is arguably the most important method in the eye clinic for diagnosing and managing refractive errors.Advantages of retinoscopy include its noninvasive nature,ability to assess patients of all ages,and usefulness in patients with limited cooperation or communication skills.AIM To discuss the history of retinoscopes and examine current literature on the subject.METHODS A search was conducted on the PubMed and with the reference citation analysis(https://www.referencecitationanalysis.com)database using the term"Retinoscopy,"with a range restricted to the last 10 years(2013-2023).The search string algorithm was:"Retinoscopy"(MeSH Terms)OR"Retinoscopy"(All Fields)OR"Retinoscopes"(All Fields)AND[(All Fields)AND 2013:2023(pdat)].RESULTS This systematic review included a total of 286 records.Publications reviewed iterations of the retinoscope into autorefractors,infrared photo retinoscope,television retinoscopy,and the Wifi enabled digital retinoscope.CONCLUSION The retinoscope has evolved significantly since its discovery,with a significant improvement in its diagnostic capabilities.While it has advantages such as non-invasiveness and broad applicability,limitations exist,and the need for skilled interpretation remains.With ongoing research,including the integration of artificial intelligence,retinoscopy is expected to continue advancing and playing a vital role in eye care.
文摘Autologous blood therapy has emerged as a promising modality in managing ocular surface disorders.This review provides a comprehensive overview of the current literature regarding the use of autologous blood in ocular surface disorders,encompassing its physiological basis,clinical applications,techniques,challenges,and future perspectives.The ocular surface,comprising the cornea,conjunctiva,and tear film,plays a critical role in maintaining visual function,and its disruption can lead to various pathological conditions.With its rich composition of growth factors,cytokines,and other bioactive molecules,autologous blood offers therapeutic potential in promoting corneal wound healing,reducing inflammation,and improving tear film stability.Clinical studies have demonstrated the efficacy and safety of autologous blood therapy in diverse ocular surface disorders,including persistent epithelial defects,neurotrophic keratopathy,and dry eye disease.However,challenges such as variability in treatment response,adverse effects,and optimal patient selection remain areas of concern.Further research is needed to elucidate the underlying mechanisms of action,refine treatment protocols,and explore synergistic approaches with other therapeutic modalities.Despite these challenges,autologous blood therapy holds promise as a valuable adjunctive treatment option for ocular surface disorders,offering new avenues for improving patient outcomes and quality of life.This review examines the mechanisms underlying ocular surface disorders while discussing existing autologous blood-based therapies for managing these disorders.Current clinical trials are also summarized,and a comparison between autologous blood therapy and conventional eyedrops is attempted.Finally,safe techniques and protocols for autologous blood medicine are elucidated,and adverse effects and future perspectives of this novel therapy are reviewed.
文摘BACKGROUND Blepharoconjunctivitis poses a diagnostic challenge due to its diverse etiology,including viral infections.Blepharoconjunctivits can be acute or chronic,selflimiting,or needing medical therapy.AIM To review possible viral agents crucial for accurate differential diagnosis in cases of blepharoconjunctivitis.METHODS The PubMed database was searched for records relating to viral blepharoconjunctivitis.The search string generated was“("virally"[All Fields]OR"virals"[All Fields]OR"virology"[MeSH Terms]OR"virology"[All Fields]OR"viral"[All Fields])AND"Blepharoconjunctivitis"[All Fields]".RESULTS A total of 24 publications were generated from the search string.Reference lists from each relevant article were also searched for more information and included in this review.Viral etiologies such as adenovirus,herpes simplex virus(HSV),varicella-zoster virus(VZV),and Epstein-Barr virus(EBV)are frequently implicated.Adenoviral infections manifest with follicular conjunctivitis and preauricular lymphadenopathy,often presenting as epidemic keratoconjunctivitis.HSV and VZV infections can result in herpetic keratitis and may exhibit characteristic dendritic corneal ulcers.EBV,although less common,can cause unilateral or bilateral follicular conjunctivitis,particularly in immunocompromised individuals.Other potential viral agents,such as enteroviruses and molluscum contagiosum virus,should also be considered,especially in pediatric cases.CONCLUSION Prompt recognition of these viral etiologies is essential for appropriate management and prevention of complications.Thus,a thorough understanding of the clinical presentation,epidemiology,and diagnostic modalities is crucial for accurate identification and management of viral blepharoconjunctivitis.
文摘New frontiers about retinal cell transplantation for retinal degenerative diseases start from the idea that acting on stem cells can help regenerate retinal layers and establish new synapses among retinal cells.Deficiency or alterations of synaptic input and neurotrophic factors result in trans-neuronal degeneration of the inner retinal cells.Thus,the disruption of photoreceptors takes place.However,even in advanced forms of retinal degeneration,a good percentage of the ganglion cells and the inner nuclear layer neurons remain intact.This phenomenon provides evidence for obtaining retinal circuitry through the transplantation of photoreceptors into the subretinal region.The eye is regarded as an optimal organ for cell transplantation because of its immunological privilege and the relatively small number of cells collaborating to carry out visual activities.The eyeball's immunological privilege,characterized by the suppression of delayed-type hypersensitivity responses in ocular tissues,is responsible for the low rate of graft rejection in transplant patients.The main discoveries highlight the capacity of embryonic stem cells(ESCs)and induced pluripotent stem cells to regenerate damaged retinal regions.Recent progress has shown significant enhancements in transplant procedures and results.The research also explores the ethical ramifications linked to the utilization of stem cells,emphasizing the ongoing issue surrounding ESCs.The analysis centers on recent breakthroughs,including the fabrication of three-dimensional retinal organoids and the innovation of scaffolding for cell transportation.Moreover,researchers are currently assessing the possibility of CRISPR and other advanced gene editing technologies to enhance the outcomes of retinal transplantation.The widespread use of universally recognized safe surgical and imaging methods enables retinal transplantation and monitoring of transplanted cell growth toward the correct location.Currently,most therapy approaches are in the first phases of development and necessitate further research,including both pre-clinical and clinical trials,to attain favorable visual results for individuals suffering from retinal degenerative illnesses.
