scholarly journals The Use of Topical Tacrolimus 0.1% Skin Ointment for Anterior Segment Conditions: A Case Series

2010 ◽  
Vol 2 ◽  
pp. 117917211000200 ◽  
Author(s):  
Poorna Abeysiri ◽  
Nicholas R. Johnston ◽  
Anthony C.B. Molteno
Keyword(s):  
Graft Rejection ◽  
Anterior Segment ◽  
Case Series ◽  
Operative Management ◽  
Vernal Keratoconjunctivitis ◽  
Fk 506 ◽  
Topical Tacrolimus ◽  
Inflammatory Conditions ◽  
License Application ◽  
Effective Use

Tacrolimus (FK 506) is a macrolactam derivative with immunomodulatory and anti-inflammatory activity. Topical tacrolimus 0.03% has been used for inflammatory conditions of the anterior segment. This article adds to the literature on the off-license application of tacrolimus ointment, by describing the safe and effective use of the higher strength of 0.1% topical tacrolimus skin ointment in four patients. To our knowledge this is the first report of topical tacrolimus 0.1% ointment applied to the conjunctival sac for the treatment of atopic keratoconjunctivitis, vernal keratoconjunctivitis and the post-operative management of trabeculectomy and graft rejection in steroid responders.

Topical tacrolimus 0.03% monotherapy for vernal keratoconjunctivitis--case series

2010 ◽  
Vol 94 (10) ◽  
pp. 1405-1406 ◽  
Author(s):  
P. M. K. Tam ◽  
A. L. Young ◽  
L. L. Cheng ◽  
P. T. H. Lam
Keyword(s):  
Case Series ◽  
Vernal Keratoconjunctivitis ◽  
Topical Tacrolimus

scholarly journals Etiologies and clinical characteristics of young patients with angle-closure glaucoma: a 15-year single-center retrospective study

2021 ◽  
Author(s):  
Feng Gao ◽  
Jiajian Wang ◽  
Junyi Chen ◽  
Xiaolei Wang ◽  
Yuhong Chen ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Anterior Segment ◽  
Young Patients ◽  
Case Series ◽  
Neovascular Glaucoma ◽  
Angle Closure Glaucoma ◽  
Angle Closure ◽  
Primary Angle Closure Glaucoma ◽  
Uncommon Presentation ◽  
Underlying Causes

Abstract Purpose To investigate the etiologies and the clinical characteristics of angle-closure glaucoma (ACG) patients younger than 40 years old in Chinese. Methods Inpatients with diagnosis of ACG and diagnosed age younger than or equal to 40 years old, who were admitted in Eye, Ear, Nose, and Throat Hospital Fudan University from 2002 to 2017, were included in this retrospective non-comparative case series. The underlying causes and clinical features for all the patients were analyzed by comprehensive review of medical charts. Results A total of 298 patients (463 eyes) met the criteria, including 153 females (51.3%) and 145 males (48.7%); the mean age was 25.6 ± 13.0 years. Primary angle-closure glaucoma (PACG), uveitis, and anterior segment dysgenesis (ASD) were the top three etiologies in our patients, which accounted for 32.6%, 20.3%, and 15.1% of the total patients respectively. PACG mainly occurs after 30 years of age and ASD is the top reason of ACG in patients younger than 20 years old. Other known etiologies include iridocorneal endothelial syndrome, neovascular glaucoma, nanophthalmos, retinitis pigmentosa, spherophakia, bestrophinopathy, persistent fetal vasculature, iridociliary cysts, congenital retinoschisis, Marfan’s syndrome, retinopathy of prematurity, familial exudative vitreoretinopathy, congenital retinal folds, Coat’s disease, and neurofibromatosis. Conclusions We described the uncommon presentation of ACG in Chinese young patients. Although unusual, most of the etiologies could be identified. Therefore, more careful and comprehensive examinations are needed for early detection and timely treatment for young ACG patients.

scholarly journals Safety and efficacy of posterior iris claw intraocular lens fixation in aphakic patients

2018 ◽  
Vol 16 (2) ◽  
pp. 124-133
Author(s):  
Rosemary Tomy ◽  
Rajkumar Maheshwari ◽  
Ansa Parveen Kunhu Muhammed ◽  
Venkataramana Kalikivayi ◽  
Sajeev Cherian Jacob
Keyword(s):  
Intraocular Lens ◽  
Anterior Segment ◽  
Case Series ◽  
Visual Outcome ◽  
Applanation Tonometry ◽  
Long Term Results ◽  
Retrospective Case ◽  
Case Series Study ◽  
Wide Range

Purpose: To assess the indications and visual outcome of eyes undergoing posterior iris fixated intraocular lens (IFIOL) implantation for aphakia, to identify reasons for poor visual outcome, and report occurrence of complications. Methods: In this retrospective case series study, all cases of posterior IFIOL fixation performed over a 30-month period were identified retrospectively. Preoperative and postoperative evaluations comprised objective and subjective refraction, best corrected visual acuity (BCVA), slit lamp biomicroscopy, applanation tonometry, and dilated fundus examination. Results: Fifty-six eyes of 56 patients were analyzed. Mean age was 60.55 ± 17.2 years. The most common indication for IFIOL implantation was surgical aphakia following complicated cataract surgery (n = 33; 58.9%) followed by trauma (n = 10; 17.9%), dropped nucleus/IOL during primary surgery (n = 6; 10.7%), and subluxated/dislocated lens-induced glaucomas (n = 5; 8.9%). BCVA better than or equal to their preoperative BCVA was achieved in 96.43% patients. The surgical aphakia and paediatric/adolescent groups had the best visual results while the dropped nucleus/IOL group and subluxated lens-induced glaucoma groups fared poorly. On the long-term follow-up visit, the most common complication noted was pigment dusting on the corneal endothelium (65.7%). Conclusion: The long-term results suggest that posterior IFIOL implantation is a safe and effective method for correction of aphakia and can be used for a wide range of indications in eyes without adequate capsule support. It may be considered an easier and faster alternative with minimal manipulation to anterior segment structures in paediatric and post-traumatic aphakic eyes.

scholarly journals Case Series : Operative vs Non-Operative Management in Grade III Pancreatic Injury

Medicinus ◽  
2020 ◽  
Vol 7 (6) ◽  
pp. 199
Author(s):  
Andry Irawan ◽  
Clinton Clinton ◽  
Sutanto D ◽  
Agustina F
Keyword(s):  
Case Series ◽  
Operative Management ◽  
Pancreatic Injury ◽  
Clinical Findings ◽  
First Case ◽  
Non Operative Management ◽  
Left Abdomen ◽  
Grade Iii ◽  
Selection Of

<p><strong>Introduction</strong><strong>:</strong> Pancreatic injury is a rare case, caused by blunt or sharp trauma. Difficulty in making diagnose on pancreatic trauma cases are associated with high mortality, and the treatment can be either operative or conservatively. However, It is still unclear which treatment is more favorable.</p><p><strong>Case:</strong> We present 2 cases of Grade III pancreatic injury with stable hemodynamic who suffered bicycle accident. First case, 12-year-old boy complaining severe pain on the upper left abdomen (VAS 9-10) and get worsening by time, with vomiting. The patient underwent distal Pancreatectomy-Splenectomy. Second case, 8-year-old boy complaining of pain on the upper left abdomen (VAS 6-7) without extension on whole abdominal region with vomiting and fever. The patient was treated conservatively. In both cases, patient was discharged with improvement. However, about 3 months later patients who were treated conservatively developed into a pseudocyst.</p><p><strong>Conclusion:</strong> The selection of management in grade III pancreatic injury can be operative or conservative depending on clinical findings such as hemodynamic condition and the quality of abdominal pain. But the occurrence of pseudocysts pancreas is another surgical challenge.</p>

scholarly journals Anatomical and Visual Effects of Implantable Phakic Contact Lens on Correction of Myopia

2022 ◽  
Author(s):  
Mahmoud Ekram ◽  
Ahmed Mohamed Kamal Elshafei ◽  
Asmaa Anwar Mohamed ◽  
Mohamed Farouk Sayed Othman Abdelkader
Keyword(s):  
Visual Acuity ◽  
Anterior Chamber ◽  
Contact Lens ◽  
Anterior Segment ◽  
Anterior Chamber Depth ◽  
Case Series ◽  
Care Group ◽  
Case Series Study ◽  
Significant Difference ◽  
The Mean

Abstract Purpose: To evaluate the anatomical effects of implantable phakic contact lens (IPCL) (Care Group, India) on anterior segment and its visual outcomes .Patients and methods: In a prospective interventional case series study, 60 highly myopic eyes of 32 patients were subjected to IPCL implantation in the Ophthalmology Department of Minia University Hospital, Egypt from January 2019 to June 2021. All patients had complete ophthalmic examination and were followed up for 1 year. Pentacam was used for preoperative and postoperative estimation of anterior chamber depth (ACD), anterior chamber angle (ACA), anterior chamber volume (ACV) and IPCL vault in the 1st, 3rd, and 12th months. Assessment of corneal endothelium was done using specular microscope preoperatively and after 12 months. Preoperative and postoperative refraction and visual acuity were measured. Results: There was a statistically significant decrease in ACD, ACA, and ACV. There was no significant difference between preoperative and postoperative mean intraocular pressure (IOP) by the 12th month (P=0.163). The mean preoperative endothelial cell count (ECD) was significantly reduced from 2929.3±248 cells/mm2 to 2737.9±303 cells/mm2 at the 12th month (P<0.001). with a statistically highly significant improvement of mean Log Mar uncorrected visual acuity (UCVA) from 1.48±0.19 preoperatively to 0.46±0.11 by the end of follow up (P<0.001) with insignificant difference between preoperative best corrected visual acuity (BCVA) and postoperative UCVA (P=0.209). In the 12th month, the mean vault was 240±540 μm. No sight threatening complications occurred.Conclusion: Although IPCL induced anatomical changes, it was safe and effective for correction of high myopia.

scholarly journals The Efficacy of 0.03% Dermatological Tacrolimus Ointment for Refractory Vernal Keratoconjunctivitis.

2020 ◽  
Vol 35 (4) ◽  
pp. 229-234
Author(s):  
Hafiza Sadia Imtiaz
Keyword(s):  
Clinical Symptoms ◽  
Clinical Signs ◽  
Vernal Keratoconjunctivitis ◽  
P Value ◽  
Baseline Score ◽  
Assessment Data ◽  
Tacrolimus Ointment ◽  
Topical Tacrolimus ◽  
Quasi Experimental ◽  
Written Informed Consent

  Purpose: To determine the efficacy of 0.03% dermatological tacrolimus ointment in patients with refractory vernal keratoconjunctivitis Study Design: Quasi-experimental study Study Place and Duration: Eye Department, DHQ-Teaching Hospital, Gujranwala, Pakistan from April 2018 to March 2019 Material and Methods: After approval from hospital ethical committee and obtaining written informed consent from each patient/guardian, patients of either gender between 4-16 years of age with VKC not responding to conventional treatment for more than 8 weeks or having steroid-induced complications were included in this study. Dermatological tacrolimus ointment 0.03% started to be placed in inferior fornix in BD frequency along with topical lubricants. Patients were followed up on a regular schedule. Individual symptoms score was assessed from the questionnaire and signs score from observer’s clinical assessment. Data were analyzed using SPSS v23.0. P-value <0.05 was considered as statistically significant. Results: 40 eyes of 20 patients were included in this study. Out of which 4(20%) were female and 16 were male (80%). Mean baseline score for clinical symptoms was 6.65±1.81 that reduced to 1.65±0.81 after 12 weeks treatment course of tacrolimus with a significant p-value of 0.006 (p<0.05). Mean baseline score for clinical signs was 5.9±1.59 that improved to 1.80±0.83 after 12 weeks treatment course with a statistically significant p-value of 0.003 (p<0.05). Conclusions: In conclusion, topical tacrolimus dermatological ointment 0.03% is highly effective in refractory VKC and can be safely used as an alternative in VKC patients who are steroid-responders.

Operative Outcomes of Grade 3 Turf Toe Injuries in Competitive Football Players

2018 ◽  
Vol 39 (9) ◽  
pp. 1076-1081 ◽  
Author(s):  
Kenneth Smith ◽  
Norman Waldrop
Keyword(s):  
Range Of Motion ◽  
Operative Procedure ◽  
Case Series ◽  
Operative Management ◽  
Return To Play ◽  
First Metatarsophalangeal Joint ◽  
Operative Outcomes ◽  
Turf Toe ◽  
Grade 3

Background: Turf toe is a term used to describe a hyperextension injury to the first metatarsophalangeal joint. Although the vast majority of turf toe injuries can be treated successfully without operative intervention, there are instances where surgery is required to allow the athlete to return to play. Although there is a plethora of literature on turf toe injuries and nonoperative management, there are currently few reports on operative outcomes in athletes. Methods: We obtained all cases of turf toe repair according to the ICD-10 procedural code. The inclusion criteria included: age greater than 16, turf toe injury requiring operative management and at least a varsity level high school football player. The charts were reviewed for age, BMI, level of competition, injury mechanism, football position, setting of injury and playing surface. In addition, we recorded the specifics of the operative procedure, a listing of all injured structures, the implants used and the great toe range of motion at final follow-up visit. The AOFAS Hallux score and VAS was used postoperatively as our outcome measures. Our patient population included 15 patients. The average follow-up time was 27.5 months. Results: The average patient was 19.3 years old with a body mass index of 32.3. The average playing time missed was 16.5 weeks. The average dorsiflexion range of motion at the final follow-up was 42.3 degrees. At final follow-up, the average AOFAS Hallux score was 91.3. The average VAS pain score was 0.7 at rest and 0.8 with physical activity. Conclusion: Complete turf toe injuries are often debilitating and may require operative management to restore a pain-free, stable, and functional forefoot. This study represents the largest cohort of operatively treated grade 3 turf toe injuries in the literature and demonstrates that good clinical outcomes were achieved with operative repair. Level of Evidence: Level IV, case series

Multi-center phase 1 safety and efficacy study of nivolumab in renal transplant patients with metastatic malignancy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 2567-2567
Author(s):  
John Raymond Zalcberg ◽  
Michael J. Boyer ◽  
Anne Elizabeth Taylor ◽  
Thean Hsiang Tan ◽  
Bronwyn Hockley ◽  
...  
Keyword(s):  
Graft Rejection ◽  
Checkpoint Inhibitors ◽  
Phase 1 ◽  
Graft Loss ◽  
Organ Transplant ◽  
Case Series ◽  
Incurable Cancer ◽  
No Donor ◽  
Organ Rejection ◽  
Rejection Rates

2567 Background: Organ Transplant Recipients (OTR) are generally excluded from trials of immune checkpoint inhibitors (ICI) due to the reported risk of allograft rejection. A recent systematic review of published case series includes only 65 cases. Transplant organ rejection rates of 41% are reported with cancer response rates of 39%. The majority of OTR treated with ICI have had reduction/cessation of immunosuppression (IS) prior to ICI. Isolated IS reduction is associated with organ rejection and therefore either IS manipulation alone and/or ICI could induce organ rejection episodes. Methods: Renal OTR with incurable cancer, for whom ICI would normally be used in the general population (without an organ transplant), were eligible if creatinine < 180 umol/l, no donor specific HLA antibodies and ECOG < 2. Treatment was with nivolumab (3mg/kg q 14 days for 5 doses, then 480 mg q 28 days), without manipulation of IS and pre-ICI-exposure alloimmune risk assessment. Treatment continued till progression, patient refusal, or graft rejection. Primary endpoint was rate of irretrievable renal graft rejection. Results: 15 patients (9 male:6 female; median age 66.6 years) were enrolled and treated with a median (range) 3(1-42) infusions and with median (range) follow-up of 128 (11-784) days. Tumour types included:1 melanoma; 2 renal tract; 1 hepatocellular carcinoma; 1 Merkel cell; 1 adenocarcinoma lung; 1 MSI high colorectal, 8 squamous cell carcinoma (SCC) head and neck. 2 patients experienced rejection; one at day 28 (2 infusions); one at day 36 (3 infusions). Both had SCC and have had a CR. One is on haemodialysis and alive at 2 years the other a creatinine 450 umol/l. Both rejections treated with steroid, plasma-exchange and anti-thymocyte-globulin (ATG). 1 patient (metastatic bladder cancer) experienced graft loss (at 300 days) due to ureteric-stent bleed and BK-nephritis indirectly related to nivolumab- this patient died of progressive disease at 65 days after nivolumab cessation. Median (range) progression free disease (PD) with ≥ 2 infusions was 300 (68-784+) days. There were 5 CR (1 MSI high colorectal, 4 SCC) median duration of response 13 months and 2 PR (1 SCC 1 bladder)- 1 without PD. Conclusions: In this interim analysis, rejection rates in OTR with incurable cancers treated with ICI was 2/15 (13%) when IS is maintained and there is pre exposure alloimmune assessment. The combined CR and PR rate was 7/15 (47%). Clinical trial information: 12617000741381.

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