Medical Hypothesis, Discovery and Innovation Ophthalmology Journal
Volume:9 Issue: 4, Winter 2021

To analyze the academic characteristics, career trajectory, scholarly publications,and demographic background of the 100 most-cited authors in ophthalmic literature.

In thisobservational cross-sectional study, a database containing every ophthalmology journal article from 1967 to 2018 was built using Scopus journal article information. The 100 authors with the most citations were identified,alongwith a control group of authors with at least five publications. Information about each author,such as gender, institution,and educational degrees were found from online web searches. Intra-and inter-group analyses were performed to identify correlations that may lead to having a high level of impact in ophthalmology literature.

Of the 100 most-cited ophthalmologists, 56 practice in the United States (US) and only 12 are female. In an odds ratio(OR)analysis, highly-cited researchers more often lived inthe US (OR, 2.97; P< 0.001), were male (OR, 2.4; P= 0.02), and graduated from an elite medical school (OR, 3.89; P= 0.02) and/or residency (OR, 3.67; P= 0.02), but were not from an undergraduate institution (P=0.75). There was no difference in citation numbers between different ophthalmology subspecialties (P= 0.22) or advanced degrees (PhD, MPH in addition to MD). Women among the top-100-cited authorswere more likely to author high impact journal articles (P< 0.05).

Among highly-cited ophthalmologists, practicing in the US and attending a top medical school or residency program may provide training for a successful research career in ophthalmology. Additionally, top female ophthalmologists participate in more influential research.

To determine if there is a difference in the quantity of microbial flora of the conjunctiva in individuals practicing head submersion (“dunk”) versus no head submersion(“no-dunk”) during hot tub use.

In this double-blind randomized clinical trial, healthy volunteers aged ≥ 18 years were recruited. Participants were randomized to head submersion versus no head submersion during a 15-minute hot tub soak. Study personnel,masked to the dunkor no-dunk group assignment,obtained conjunctival cultures before and immediately after hot tub use. De-identified specimens were submitted to the clinical microbiology laboratory for culture and analysis. The main outcome measure was the difference in the quantity of organisms cultured from the conjunctiva beforeand after hot tub exposure, as determined usinga defined ordinal scale.A two-tailed Student’s t-test was performed to compare the total microbial colony counts between the two arms. Simpson’s diversity was used to measure the changes in organism diversity between the arms.

Of 36 enrolled subjects, 19 were randomly assigned to thedunkand 17 were assigned to the no-dunk groups. Water samples obtained from all hot tubs wereculture negative. Eleven of 19 eyes (58%) from the dunkgroup and eight of 17 eyes (47%) from the no-dunkgroup had negative conjunctivalbacterial cultures before and after hot tub exposure. However, six of 19 eyes (32%) and four of 17 eyes (24%) of the dunkand no-dunkgroups, respectively, were culture-positiveafter,but not beforehot tub exposure. The quantity of organisms before and after hot tub exposure was notsignificantlydifferentbetween the two arms (P=0.12). However, the dunk grouponly showed a small increase in the quantity of organisms afterascompared to beforehot tub use(P=0.03). None of the samples from subjects or hot tubs were culture-positive for Acanthamoeba.

Head submersion in a public hot tubsduring a 15-minute soak does not appear to change conjunctival flora,as determinedby culture plate yield, this does not eliminate the association between hot tub use and devastating and painful corneal blindness. Therefore, our recommendation is to remove contact lenses prior to hot tub use, avoid head submersion in a hot tub, and urgently seek ophthalmological help if any eye pain and/or decrease in vision is experienced after hot tub use.

Retinitis pigmentosa (RP), an inherited degenerative ocular disease, is considered the most common type of retinal dystrophy. Abnormalities of the photoreceptors, particularlythe rods, and of the retinal pigment epithelium, characterizes this disease. The abnormalities progress from the midperiphery to the central retina. We herereviewedthe developments in RP geneticsin the last decade, along with its clinical features and natural course.

The present review focused on articles in English language published between January 2008 and February 2020, and deposited inPubMed/MEDLINEand Google Scholar databases.We searched for articles reporting on theclinical manifestations and genes related to both syndromic and non-syndromic RP. We screened and analyzed 139 articles,published in the last decade, referring to RP pathogenesis and identified, summarized,and highlightedthe most significant genes implicated in either syndromic or non-syndromic RP pathogenesis, causing different clinical manifestations.

Recent literature revealed that approximately 80 genes are implicated in non-syndromic RP,and 30 genes in syndromic forms, such as Usher syndrome and Bardet‒Biedl syndrome (BBS). Moreover, it is estimated that 27 genes are implicatedinautosomal dominant RP (adRP), 55 genes in autosomal recessive RP (arRP),and 6 genes in X-linked RP (xlRP), causing different RP phenotypes. Characteristically, RHOis the most prevalent adRP-and arRP-causinggene,and RPGRthe most common xlRP-causing gene.Other important genes are PRPH2, RP1, CRX, RPE65, ABCA4, CRB1,and USH2Α. However, different phenotypes canalsobe caused by mutations in the same gene.

The genetic heterogeneity of RP necessitates further study to map the exact mutations that cause more severe forms of RP,and to develop and use appropriate genetic or other effective therapies in future.

This study aimed to evaluate the non-inferiority and safety of a newly developed preservative-free (PF) multi-dose latanoprost/timolol ophthalmic solution, compared withthe benzalkonium chloride (BAK)-preserved fixed combination,in patients with open-angle glaucoma and ocular hypertension.

A Phase III randomized multi-center observer-blind parallel-group clinical trial was conducted. A total of 210 adult patients (aged over 18 years) were randomly treated withthe PF-or the BAK-preserved latanoprost/timolol solution once daily in the affected eye(s) for 12 weeks. Follow-up visits were scheduled at weeks 2, 6,and 12;intraocular pressure (IOP) was recorded at 8:00AM, 12:00 PM,and 4:00 PM. The primary efficacy endpoint to prove non-inferiority was the IOP changeat 8:00 AM(± 1 hour) from the baseline to the end of treatment (week 12) in the studiedeye. Safety parameters were also assessed.

In total,196 patients completed the study. The pressure-lowering effect of thePF eye drops was comparable to that of the preservedformulation at all-timepoints. Latanoprost/timolol PFformulation was non-inferior to the BAK-preserved solution as shown by the change in IOP from day 0 to week 12. The point estimate of the inter-treatment difference was 0.624 mmHg(95% CI: -0.094, 1.341). Both treatments were well-tolerated during the study, and they hadsimilar adverse event profiles.

PF-latanoprost/timolol combination was found to be non-inferior to the BAK-preserved formulationbased onthe efficacyat all times,with similar local tolerance.

Retinoblastoma is the most common primary intraocular malignancy in children, although it is a rare neural retinal tumor. Improving the quality of life isthe next goalafter the primary medical goal of life preservation. The genotype-phenotype correlationmay vary with the progression ofretinoblastoma. Expressivity is determinedby different RB1gene mutations among individuals. Herein, we share our experience on the evaluation of the long-term progressionof retinoblastoma,its treatment consequences, its impact on the quality of life,and howtheunderlyinggenotypesare related to the phenotypes. We providea review of the relevant literature and present a case of a sporadic heritable bilateral retinoblastoma.

We report the outcomes of a 28-year follow-up of a female diagnosed with an infantile disease. The patient’s best eye, according to the tumor classification and genetic results,was treatedconservativelywhereas the worst eye wasenucleated. Onre-examinations, she hadcomplications of the treatment she received. Therefore,anotherinterventionwas administeredfor several years. The patient’s pathogenic variant and RB1gene mutational inactivation were predispositionsto the recurrence of the tumor and non-ocular primary malignancy. Nevertheless, the disease had no progression. The patient is stable despite her type of retinoblastoma, which is the sporadic heritable bilateral form.

Each phenotype of bilateral retinoblastomavaries in progression. The nature of the genetic mutation may determine its expressivity. It is of great significance to individualize every decision. In each case, the sequelae of the disease and treatment-induced complications may have an impact on the quality of the patient’s life.

The aim of this study was to test the non-inferiority ofpreservative-free (PF) latanoprost 50μg/mL multi-dose ophthalmic solution versus the marketed benzalkonium chloride (BAK)-preserved latanoprost 50μg/mL ophthalmic solution in patients with open-angle glaucoma and patients with ocular hypertension.

This was a prospective, national, randomized, multi-center, observer-blind, parallel-group controlledclinical trial. Patients were randomized to receive either PF or BAK-preserved latanoprost once daily for 12 weeks. The primary endpoint was the change in intraocular pressure (IOP) at 8:00AMin the affected eye between the end of the treatment (week 12) and the baseline(week 0). Secondary measurements were takenat weeks 2 and 6, with IOP being recorded at 8:00AM, 12:00PM,and 4:00PM.

A total of 158 patients were included in the per protocol (PP) population (77 in the PF latanoprost treatment arm and81 patients in the BAK-preserved latanoprost treatment arm). PF latanoprost was non-inferior to BAK-preserved latanoprost in reducing IOP at 8:00 AMin the study eye from the baseline (week 0) to the end of the treatment (week 12). The point estimate of the between-treatment difference was 0.1 mmHg (95% confidence interval: -0.646, 0.847). Mean between-group differences in IOP reduction from the baseline to each of the secondary measurements were also similar between the two treatment arms. The two treatments were well tolerated and had comparable adverse event profiles.

PFlatanoprost was non-inferior to BAK-preserved latanoprost in reducing IOP in patients with open-angle glaucoma or ocular hypertension. Both treatments were well tolerated.