The Stem Cell Ophthalmology Treatment Study （SCOTS） is currently the largest-scale stem cell ophthal- mology trial registered at ClinicalTrials.gov （identifier： NCT01920867）. SCOTS utilizes autologous bone marrow...The Stem Cell Ophthalmology Treatment Study （SCOTS） is currently the largest-scale stem cell ophthal- mology trial registered at ClinicalTrials.gov （identifier： NCT01920867）. SCOTS utilizes autologous bone marrow-derived stem cells （BMSCs） to treat optic nerve and retinal diseases. Treatment approaches include a combination of retrobulbar, subtenon, intravitreal, intra-optic nerve, subretinal, and intravenous injection of autologous BMSCs according to the nature of the disease, the degree of visual loss, and any risk factors related to the treatments. Patients with Leber＇s hereditary optic neuropathy had visual acuity gains on the Early Treatment Diabetic Retinopathy Study （ETDRS） of up to 35 letters and Snellen acuity improvements from hand motion to 20/200 and from counting fingers to 20/100. Visual field improvements were noted. Macular and optic nerve head nerve fiber layer typically thickened. No serious complications were seen. The increases in visual acuity obtained in our study were encouraging and suggest that the use of autolo- gous BMSCs as provided in SCOTS for ophthalmologic mitochondrial diseases including Leber＇s hereditary optic neuropathy may be a viable treatment option.展开更多
We report results in a 77-year-old male patient with visual loss from long-standing serpiginous choroidop- athy treated with bone marrow derived stem cells （BMSC） within the Stem Cell Ophthalmology Treatment Study ...We report results in a 77-year-old male patient with visual loss from long-standing serpiginous choroidop- athy treated with bone marrow derived stem cells （BMSC） within the Stem Cell Ophthalmology Treatment Study （SCOTS）. SCOTS is an Institutional Review Board approved clinical trial and the largest ophthal- mology stem cell study registered at the National Institutes of Health to date （ClinicalTrials.gov Identifier： NCT01920867）. Eight months after treatment by a combination of retrobulbar, subtenon, intravitreal and intravenous injection of BMSC, the patient＇s best corrected Snellen acuity improved from 20/80- to 20/60.1 in the right eye and from 20/50- to 20/20 3 in the left eye. The Early Treatment of Diabetic Retinopathy Study （ETDRS） visual acuity continued to improve over the succeeding 8 months and the optical coherence tomography macular volume increased. The increases in visual acuity and macular volume are encouraging and suggest that the use of BMSC as provided in SCOTS may be a viable approach to treating serpiginous choroidopathy.展开更多
Macular edema is one of the most common visionthreatening complications of uveitis noted in one third of patients with uveitis. The release of a number of inflammatory mediators induces retinal vascular hyperpermeabil...Macular edema is one of the most common visionthreatening complications of uveitis noted in one third of patients with uveitis. The release of a number of inflammatory mediators induces retinal vascular hyperpermeability leading to uveitic macular edema(UME)which most commonly is of cystoid shape. Fluorescein angiography and non-invasive spectral-domain optical coherence tomography are standard procedures for diagnosis and follow-up of UME with some innovations such as scanning laser ophthalmoscope retro-mode imaging. Effective management of UME requires thorough understanding of the individual case. Proper control of intraocular inflammation is mandatory before targeting macular edema itself. Mainstay of treatment is immunosuppressive therapy with various drug delivery routes including topical, local subconjunctival, peribulbar and sub-Tenon's, intravitreal and systemic. Clinical trials with biologics are under way to study the efficacy of these agents in suppressing intraocular inflammation and resolution of UME. Visual prognosis in UME depends on numerous factors. Younger age and better visual acuity at baseline are associated with more favorable visual outcome in most展开更多
Dear Sir,We write to report on the clinical manifestations and outcomes of ocular sarcoidosis in patients presenting to uveitis referral centers in the Kingdom of Saudi Arabia.This is the first report focused solely o...Dear Sir,We write to report on the clinical manifestations and outcomes of ocular sarcoidosis in patients presenting to uveitis referral centers in the Kingdom of Saudi Arabia.This is the first report focused solely on ocular sarcoidosis from this country.展开更多
Immune mediated inflammatory anterior segment diseases are variable and their management requires intense immunosuppression.Treatment with topical steroids is associated with serious ocular side effects.In order to ov...Immune mediated inflammatory anterior segment diseases are variable and their management requires intense immunosuppression.Treatment with topical steroids is associated with serious ocular side effects.In order to overcome the potentially blinding complications of topical steroids,immunomodulatory drugs are being used more frequently.Tacrolimus is a calcineurin inhibitor that induces suppression of T lymphocytes activity and reduction of ocular inflammation.Tacrolimus was recently investigated for application in various anterior segment inflammatory disorders.In this review,we will discuss the therapeutic application of topical tacrolimus as a steroid-sparing agent in treating T cell mediated anterior segment inflammation.展开更多
The current field of posterior pole and retinal imaging of the human eye has expanded into detailed analyses of the macula,retinal periphery,individual retinal layers,vitreoretinal interface,imaging of the choroid and...The current field of posterior pole and retinal imaging of the human eye has expanded into detailed analyses of the macula,retinal periphery,individual retinal layers,vitreoretinal interface,imaging of the choroid and the optic nerve head.The challenge in retinal imaging is the enduring pursuit of deeper penetration into tissues,increased resolution to the cellular level,and interpretation of observations.How much deeper can we go and with what resolution and reproducibility?These are fundamental questions for experts in search of novel imaging modalities.New discoveries may resolve existing controversies,but inevitably stimulate new questions.Emerging technologies in retinal imaging include adaptive optics retinal imaging and optical coherence tomography-based retinal angiography.In this review,the focus of our discussion will be the discrepancy between the findings(interpretation)of one imaging technology that do not agree or are not even found with a complementary technology.If a clearly seen abnormality is present with one technology but absent in another,what are the possible explanations?Following is a summary of key concepts of retinal and optic nerve imaging modalities and current controversies regarding their interpretation and/or limitations.展开更多
文摘The Stem Cell Ophthalmology Treatment Study （SCOTS） is currently the largest-scale stem cell ophthal- mology trial registered at ClinicalTrials.gov （identifier： NCT01920867）. SCOTS utilizes autologous bone marrow-derived stem cells （BMSCs） to treat optic nerve and retinal diseases. Treatment approaches include a combination of retrobulbar, subtenon, intravitreal, intra-optic nerve, subretinal, and intravenous injection of autologous BMSCs according to the nature of the disease, the degree of visual loss, and any risk factors related to the treatments. Patients with Leber＇s hereditary optic neuropathy had visual acuity gains on the Early Treatment Diabetic Retinopathy Study （ETDRS） of up to 35 letters and Snellen acuity improvements from hand motion to 20/200 and from counting fingers to 20/100. Visual field improvements were noted. Macular and optic nerve head nerve fiber layer typically thickened. No serious complications were seen. The increases in visual acuity obtained in our study were encouraging and suggest that the use of autolo- gous BMSCs as provided in SCOTS for ophthalmologic mitochondrial diseases including Leber＇s hereditary optic neuropathy may be a viable treatment option.
文摘We report results in a 77-year-old male patient with visual loss from long-standing serpiginous choroidop- athy treated with bone marrow derived stem cells （BMSC） within the Stem Cell Ophthalmology Treatment Study （SCOTS）. SCOTS is an Institutional Review Board approved clinical trial and the largest ophthal- mology stem cell study registered at the National Institutes of Health to date （ClinicalTrials.gov Identifier： NCT01920867）. Eight months after treatment by a combination of retrobulbar, subtenon, intravitreal and intravenous injection of BMSC, the patient＇s best corrected Snellen acuity improved from 20/80- to 20/60.1 in the right eye and from 20/50- to 20/20 3 in the left eye. The Early Treatment of Diabetic Retinopathy Study （ETDRS） visual acuity continued to improve over the succeeding 8 months and the optical coherence tomography macular volume increased. The increases in visual acuity and macular volume are encouraging and suggest that the use of BMSC as provided in SCOTS may be a viable approach to treating serpiginous choroidopathy.
文摘Macular edema is one of the most common visionthreatening complications of uveitis noted in one third of patients with uveitis. The release of a number of inflammatory mediators induces retinal vascular hyperpermeability leading to uveitic macular edema(UME)which most commonly is of cystoid shape. Fluorescein angiography and non-invasive spectral-domain optical coherence tomography are standard procedures for diagnosis and follow-up of UME with some innovations such as scanning laser ophthalmoscope retro-mode imaging. Effective management of UME requires thorough understanding of the individual case. Proper control of intraocular inflammation is mandatory before targeting macular edema itself. Mainstay of treatment is immunosuppressive therapy with various drug delivery routes including topical, local subconjunctival, peribulbar and sub-Tenon's, intravitreal and systemic. Clinical trials with biologics are under way to study the efficacy of these agents in suppressing intraocular inflammation and resolution of UME. Visual prognosis in UME depends on numerous factors. Younger age and better visual acuity at baseline are associated with more favorable visual outcome in most
文摘Dear Sir,We write to report on the clinical manifestations and outcomes of ocular sarcoidosis in patients presenting to uveitis referral centers in the Kingdom of Saudi Arabia.This is the first report focused solely on ocular sarcoidosis from this country.
文摘Immune mediated inflammatory anterior segment diseases are variable and their management requires intense immunosuppression.Treatment with topical steroids is associated with serious ocular side effects.In order to overcome the potentially blinding complications of topical steroids,immunomodulatory drugs are being used more frequently.Tacrolimus is a calcineurin inhibitor that induces suppression of T lymphocytes activity and reduction of ocular inflammation.Tacrolimus was recently investigated for application in various anterior segment inflammatory disorders.In this review,we will discuss the therapeutic application of topical tacrolimus as a steroid-sparing agent in treating T cell mediated anterior segment inflammation.
文摘The current field of posterior pole and retinal imaging of the human eye has expanded into detailed analyses of the macula,retinal periphery,individual retinal layers,vitreoretinal interface,imaging of the choroid and the optic nerve head.The challenge in retinal imaging is the enduring pursuit of deeper penetration into tissues,increased resolution to the cellular level,and interpretation of observations.How much deeper can we go and with what resolution and reproducibility?These are fundamental questions for experts in search of novel imaging modalities.New discoveries may resolve existing controversies,but inevitably stimulate new questions.Emerging technologies in retinal imaging include adaptive optics retinal imaging and optical coherence tomography-based retinal angiography.In this review,the focus of our discussion will be the discrepancy between the findings(interpretation)of one imaging technology that do not agree or are not even found with a complementary technology.If a clearly seen abnormality is present with one technology but absent in another,what are the possible explanations?Following is a summary of key concepts of retinal and optic nerve imaging modalities and current controversies regarding their interpretation and/or limitations.
