UPDATE RISK OF PLAQUENIL RETINOTOXICITY

JAMA Ophthalmology

Importance  Hydroxychloroquine sulfate ...can cause irreversible toxic retinopathy. Prior estimations of risk were low but were based largely on short-term users or severe retinal toxicity (bull’s eye maculopathy). The risk may be much higher because retinopathy can be detected earlier when using more sensitive screening techniques.Objectives  To reassess the prevalence of and risk factors for hydroxychloroquine retinal toxicity and to determine dosage levels that facilitate safe use of the drug.Results  Real body weight predicted risk. The overall prevalence of hydroxychloroquine retinopathy was 7.5% but varied with daily consumption and with duration of use. For daily consumption of 4.0 to 5.0 mg/kg, the prevalence of retinal toxicity remained less than 2% within the first 10 years of use but rose to almost 20% after 20 years of use. Other major risk factors include kidney disease and concurrent tamoxifen citrate therapy.Conclusions and Relevance  These data suggest that hydroxychloroquine retinopathy is more common than previously recognized, especially at high dosages and long duration of use. While no completely safe dosage is identified from this study, daily consumption of 5.0 mg/kg of real body weight or less is associated with a low risk for up to 10 years.

ASSOCIATION BETWEEN GLAUCOMA AND DIABETES

Ophthalmology

Diabetes, diabetes duration, and fasting glucose levels were associated with a significantly increased risk of glaucoma, and diabetes and fasting glucose levels were associated with slightly higher IOP.

BLEPHASTEAM FOR MEIBOMIAN GLAND DISEASE

Clinical Ophthalmology

Blephasteam^® is an eyelid warming device designed to be an easy-to-use and standardized treatment for Meibomian Gland Disease (MGD). In the present study, 73 patients were treated for 21 days with twice daily Blephasteam^® sessions. There were... improvements in a number of efficacy variables including subjective ocular symptoms and clinical signs and symptoms of MGD and dry eye, though tear film breakup time and tear osmolarity were not improved. Global efficacy was assessed as satisfactory or very satisfactory in 83.8% of cases. Patient-reported subjective ocular symptoms declined during the study, and a majority of patients rated the efficacy of Blephasteam^® as satisfactory or very satisfactory. Most patients found the device comfortable and were able to continue with normal activities (reading, watching TV, using a computer) during the Blephasteam^® session. No safety or tolerability issues were identified.

Blephasteam appears to be available in Europe and can be ordered from it's website. 

TACROLIMUS FOR SUB EPITHELIAL INFILTRATES AFTER ADENOVIRAL KERATOCONJUNCTIVITIS

Journal of Cornea and External Disease: 

Purpose of this study is to describe the use of topical 0.03% tacrolimus in patients with symptomatic corneal subepithelial infiltrates (SEIs) secondary to adenoviral keratoconjunctivitis (AK) that were resistant to tapering of corticosteroid eye drops. Topical 0.03% tacrolimus seemed to be an effective corticosteroid–sparing agent for the treatment of SEIs after AK.

CoQ10 PROMOTES CORNEAL WOUND HEALING

This from the abstract in Investigative Ophthalmology and Visual Science

Conclusion We demonstrate that CoQ10 reduces corneal damages after UVB exposure both in vivo and in vitro by preserving mitochondrial function. Also, for the first time we showed that the administration of CoQ10 after corneal epithelium removal promotes corneal wound healing.

You can read more about CoQ10 at WebMD

SAFFRON ABSTRACT SIGNICANTLY LOWERS INTRAOCULAR PRESSURE

From the abstract in BMC, Complementary and Alternative Medicine

Eligible subjects were randomized to receive 30 mg/day aqueous saffron extract orally (17 subjects, 17 eyes) or placebo (17 subjects, 17 eyes) for one month as an adjunct to timolol and dorzolamide. Following treatment, both study groups entered a one-month wash-out period. The main outcome measure was IOP during treatment and after the wash-out period.

Results

Mean baseline IOP was 12.9 +/- 3.7 versus 14.0 +/- 2.5 mmHg in the saffron and control groups, respectively (p = 0.31). After three weeks of treatment, IOP was significantly decreased to 10.9 +/- 3.3 mmHg in the saffron group as compared to 13.5 +/- 2.3 mmHg in the control group (p = 0.013). At four weeks, IOP was still significantly lower in the saffron group (10.6 +/- 3.0 versus 13.8 +/- 2.2 mmHg, p = 0.001). At the end of the wash-out period, IOP was 12.9 +/- 3.0 in the saffron group versus 14.2 +/- 2.0 mmHg in the control group (p = 0.175). None of the patients experienced side effects during the study and wash-out period.

Conclusions

Oral aqueous saffron extract seems to exert an ocular hypotensive effect in primary open-angle glaucoma. This effect became evident after three weeks of therapy.

You can read more about Saffron on Wikipedia and WebMD

A NEW CANDIDATE DRUG FOR NEUROPROTECTIVE TREATMENT IN GLAUCOMA

Investigative Ophthalmology and Visual Science;

Purpose:To investigate the effect of K-115, a novel Rho kinase inhibitor, on retinal ganglion cell (RGC) death in an optic nerve crush (NC) model.  

Conclusions:The results delayed that oral K-115 administration inhibited RGC death...Our findings show that K-115 has a potential use in neuroprotective treatment for glaucoma and other neurodegenerative diseases.