Purpose:Shelf-stable, cryopreserved amniotic membrane (AM) has anti-inflammatory and anti-scarring properties and clinically has been shown to promote corneal epithelialization with benefits reported up to 3 months. Herein, we assessed the long-term outcomes after treatment with AM in patients with recalcitrant keratopathy. Patients and Methods:A single-center, retrospective review was performed of consecutive recalcitrant keratopathy patients that received treatment with shelf-stable cryopreserved AM and had at least 6-month outcomes. Corneal staining, corneal sensitivity, tear osmolarity, symptoms, concomitant treatments, and complications were assessed before treatment and up to last follow-up visit. Results:A total of 33 eyes of 17 subjects that had recalcitrant keratopathy despite use of prior treatment were included in the analysis. After treatment with shelf-stable AM, corneal staining score significantly improved by a mean of 1.34 ± 0.9 at 1 week (p<0.001), 1.04 ± 0.8 at 1 month (p<0.001), 1.13 ± 0.7 at 6 months (p<0.001), 1.17 ± 0.7 at 12 months (p<0.001) and 1.10 ± 0.7 at 15 months (p<0.001). The proportion of subjects with improved corneal staining compared to baseline was 81.8% at 1 week, 72.0% at 1 month, 81.5% at 6 months, 86.2% at 12 months and 90.0% at 15 months. Improvements in corneal sensitivity were also observed, while tear osmolarity remained relatively unchanged. Despite initial improvement, symptoms gradually returned over time, coinciding with increased use of concomitant topical therapies. No complications related to the AM were observed. Conclusion:Recalcitrant keratopathy patients had significantly improved corneal epithelialization within 1 week of treatment with shelf-stable cryopreserved AM, which persisted in the majority of patients for up to 15 months with concomitant topical treatment.
AIM:To determine whether an association exists between health insurance and diabetic retinopathy (DR) prevalence in adults with diabetes. METHODS:An analytical cross-sectional study was conducted utilizing the National Health and Nutrition Examination Survey database. 4530 Patients aged ≥ 18 with diabetes from 2011 to 2020 with various insurance types (no insurance, private, Medicare, Medicaid, or other) were evaluated for prevalence of DR, including covariates. Unadjusted and adjusted logistic regression analysis were conducted to calculate odds ratios (OR) and 95 % confidence intervals (CI). RESULTS:There was no significant association between insurance status and DR prevalence when adjusting for confounders. OR for DR in patients without insurance, Medicare, Medicaid, or other insurance compared to those with private insurance were 1.13 (95 % CI 0.74-1.71), 0.78 (95 % CI 0.54-1.13), 1.20 (95 % CI 0.80-1.81), and 0.81 (95 % CI 0.47-1.37) respectively. However, factors like age ≥ 65 and use of diabetes medication were associated with reduced DR prevalence. CONCLUSION:Although insurance status alone does not have an association with the prevalence of DR, this study highlights several confounding variables that potentially influence previously reported associations between insurance status and DR.
Wet age-related macular degeneration (AMD) is an acquired degeneration of the retina that can lead to central vision impairment. It is primarily treated with intravitreal injections of vascular endothelial growth factor inhibitors. Although vascular endothelial growth factor inhibitors can effectively prevent progression of vision loss in many patients, they require ongoing regular administration and are therefore associated with considerable treatment burden. To gain insights into the impact of wet AMD and its treatment, AMCP convened an expert panel of managed care stakeholders in April 2024 through its Market Insights program. Key issues related to wet AMD identified by participants included cost and affordability, provider-related considerations, biosimilar adoption, measuring and improving quality, and incorporating the patient voice. Suggested payer best practices related to these issues in wet AMD also emerged from the discussion.
Ocular trauma is a leading cause of preventable vision loss worldwide. 1 Negrel A.D. Thylefors B. The global impact of eye injuries. Ophthalmic Epidemiol. 1998; 5: 143-169 Crossref PubMed Scopus (485) Google Scholar In studies examining sports-related ocular injury, paintball and air guns were shown to confer the greatest risk for visual impairment. 2 Haring R.S. Sheffield I.D. Canner J.K. Schneider E.B. Epidemiology of sports-related eye injuries in the United States. JAMA Ophthalmol. 2016; 134: 1382-1390 Crossref PubMed Scopus (44) Google Scholar More recently, gel blaster guns have been used to fire Orbeez (Spin Master) and similar gel pellets made of superabsorbent polymers that, when rehydrated with water, expand to around 6 to 8 mm in diameter while becoming soft and pliable. In 2022, the Orbeez challenge began trending on the popular social media platform TikTok (ByteDance). This consisted of shooting rehydrated gel pellets at people, oftentimes unsuspecting strangers. In contrast to paintballs or air gun pellets, shooting gel pellets was depicted as being relatively safe and harmless because of their soft texture. This is a case series describing ocular injuries observed after trauma resulting from gel pellet projectiles.
We read with interest the article by Lin et al.1 This case series detailed the concerning rise in incidence of ocular trauma from gel blaster guns, a relatively new category of toy guns that fire a rehydrated gel pellet at speeds up to 350 feet per second (fps). The increasing popularity of these guns, which are frequently marketed to children, has led to a proportionate increase in the incidence of blunt ocular trauma that carries the potential for significant short- and long-term morbidity.2 In general, there is a lack of awareness in the public regarding the risks posed from inadvertent eye injury with these toy guns.
