ESR and CRP use in Eyecare

 From Review of Optometry:

"There are many ocular diseases in which inflammation is a key factor, potentially leading to abnormalities in these ancillary tests. The two most common and relevant clinical scenarios are temporal arteritis and uveitis. Elevations in ESR and CRP levels, for example, are often diagnostic for temporal arteritis or polymyalgia rheumatica in conjunction with the clinical picture.12

Uveitis, pictured here, is one ocular condition with marked inflammation, which would be indicated upon ESR or CRP testing. Photo: Kyle D. Dohm, OD. Click image to enlarge.

"Uveitis is a manifestation of numerous underlying systemic conditions, many of which would result in elevated ESR and/or CRP values. While uveitis in and of itself is inflammation, regardless of cause, studies have shown that first attacks of uveitis do not often lead to abnormal laboratory values. However, elevated levels of ESR and CRP suggest a systemic process causing uveitis. Further investigation has also attributed elevations in ESR to be due to autoimmune or collagen vascular disease etiologies, whereas abnormal CRP was more associated with trauma and infectious causes.3,13

"When taken together, both ESR and CRP laboratory tests can be helpful in the clinical setting. Understanding the nuances of each test and why they are measured will give the clinician the highest yield in the diagnosis and monitoring of diseases with inflammatory components."

Hypertension and Glaucoma Progression

 In this study:

Lower baseline 24-hour ambulatory blood pressure measurements, as well as low systolic blood pressure during follow-up, were associated significantly with faster rates of glaucomatous visual field loss progression and may be used as a predictor of risk of glaucomatous progression.

.05% Atropine and Myopia Progression

 In this study:

"Over 5 years, the continued 0.05% atropine treatment demonstrated good efficacy for myopia control. Most children needed to restart treatment after atropine cessation at year 3. Restarted treatment with 0.05% atropine achieved similar efficacy as continued treatment. Children should be considered for re-treatment if myopia progresses after treatment cessation."

.05% performed better than .025% and .01%. 

IPL AND DRY EYE

 This study concludes:

"Although IPL probably results in a clinically relevant reduction in symptoms of dry eyes when compared to placebo, in practice IPL would typically be used as an add-on to standard treatment. It is therefore essential with further studies investigating whether this use would give a clinically relevant reduction in symptoms, and what the potential harm of IPL is when treating MGD."

Vyzulta and Retinal Vessel Density

 According to this study: 

Treatment with Vyzulta reduced IOP by an average of 29.9% and 31.8% in patients with POAG and PXG, respectively, and improved retinal vessel density. Therefore, Vyzulta likely increases macular microcirculation, possibly via nitric oxide, independent of its IOP-reducing effect.