Journal of Clinical & Translational Ophthalmology

An in vitro study was conducted using a model of reconstituted human corneal epithelial (SkinEthic™ HCE/Human Corneal Epithelium) to test the modulation of cytokines secretion activity of Pomanox^® (PMX), a standardized commercial extract of pomegranate fruit characterized by high punicalagin α + β content. Cell viability and inhibition of the release of interleukin-8 (IL-8) was evaluated in four conditions: negative control, positive inflammatory control with lipopolysaccharide (LPS) from Escherichia coli, positive anti-inflammatory control (LPS plus dexamethasone), and LPS plus PMX after 24 h of culture. The mean (±standard error of mean (SEM)) IL-8 level was 48.7 ± 5.1 pg/mL in the PMX condition vs. 172.7 ± 19.3 and 26.6 ± 1.2 in the LPS from E. coli and negative control, respectively (p < 0.05) and 93.8 ± 8.7 pg/mL in LPS plus dexamethasone (p = 0.165). The percentages of inhibition of IL-8 release were 45.7% for LPS plus dexamethasone and 63.8% for LPS plus PMX. The percentage of cell viability (86%) was also higher for the LPS plus PMX condition. The present findings add evidence to the anti-inflammatory effect of a PMX in an in vitro model of reconstituted corneal epithelial cells. Full article

In 1931, Von Euler and Gaddum isolated substance P (SP), an undecapeptide from the tachykinin family, from equine brain and intestine tissue extracts. Numerous types of cells, including neurons, astrocytes, microglia, epithelial, and endothelial cells, as well as immune cells including T-cells, dendritic cells, and eosinophils, are responsible for its production. The corneal epithelium, immune cells, keratocytes, and neurons all express the two isoforms of NK1R, which has the highest affinity for SP. The most recent research supports SP’s contribution to corneal healing by encouraging epithelial cell migration and proliferation. Additionally, when applied to the eyes, SP has proinflammatory effects that result in miosis, intraocular inflammation, and conjunctival hyperemia. In this review article, we examine the role of substance P within the eye. We focus on the role of SP with regards to maintenance and healing of the corneal epithelium. Full article

Background: Traumatic brain injury (TBI) can cause visual dysfunction affecting binocularity, spatial orientation, posture, and balance. Currently, there are several options for treating manifested visual disturbances; vision therapy is one of the possible treatment options. Methods: A 14-year-old female fainted and sustained trauma to the upper-temporal part of her right eyebrow. The patient presented with eye pain, a decreased visual field, and blurred vision and she exhibited great difficulties when reading. Both neurological tests and exploration of the anterior and posterior ocular segments showed results within normal limits. The patient was diagnosed with fusional vergence dysfunction, associated with accommodative infacility and oculomotor dysfunction. To eliminate her symptoms, a visual rehabilitation program was implemented; it consisted of accommodative, anti-suppressive, vergential, motility, hand–eye coordination, and peripheral vision exercises. Results: The symptoms manifested by the patient gradually dissipated throughout the course of therapy. However, not all optometric parameters reached normal values after visual therapy, which could indicate a traumatic injury that limited the achievement of normal optometric ranges. Conclusions: After a mild traumatic brain injury (mTBI), it is necessary to carry out a complete examination of the patient’s visual function. This visual examination must include an analysis of vergences, ocular motility, and the accommodative system to obtain an accurate diagnosis. The outcomes of the present clinical case imply that visual therapy should be considered as a treatment in cases of mTBIs. Full article

(1) Background: After filtering surgery, bleb morphology is an indicator of the factors that may determine the final intraocular pressure (IOP). The present study aimed to evaluate and compare filtering bleb characteristics after combined cataract and glaucoma surgery. (2) Methods: We conducted a prospective multi-center randomized trial. Eyes with glaucoma and cataract were randomly assigned to either phacoemulsification and filtration surgery with an EX-PRESS implant (Alcon) or non-penetrating deep sclerectomy (NPDS) with an ESNOPER implant (AJL). The bleb characteristics were assessed with the Moorfields bleb grading system at months 1 and 12 of follow-up, and the relationship with IOP was analyzed. (3) Results: There were significant changes in bleb appearance between the assessments at month 1 and month 12. The changes in bleb appearance were more evident in the EX-PRESS group. The central area in the EX-PRESS group decreased from 2.9 at month 1 to 2.4 at month 12 (p = 0.014). Bleb height in the EX-PRESS group decreased from 2.3 at month 1 to 1.8 at month 12 (p = 0.034). The vascularity of the central area in the NPDS group decreased from 1.8 at month 1 to 1.3 at month 12 (p = 0.02). The maximal bleb area was inversely related (r = −0.39; p = 0.03) to the IOP in the NPDS group at month 1. Vascularity in the central area was directly related (r = 0.39; p = 0.01) to a higher IOP in the EX-PRESS group at month 1. Vascularity in the central area (r = 0.56; p < 0.001) and maximal area (r = 0.37; p = 0.012) at month 1 was directly related to a higher IOP in the EX-PRESS group at month 12. (4) Conclusions: More intense vascularity at month 1 was related to a higher final IOP in the EX-PRESS group. Larger blebs were associated with a lower IOP in the NPDS group. Full article

Here, we present a case of floppy iris leading to positional pupillary capture by a sutureless, scleral-fixated intraocular lens (IOL) causing recurrent uveitis-glaucoma-hyphema (UGH) syndrome. The patient developed recurrent episodes of UGH syndrome after dislocated IOL removal and the placement of sutureless, scleral-fixated IOL. Gravitationally dependent pupillary capture was noted with the superior iris moving in front of and behind the IOL, depending on head positioning. Ultrasonography showed a floppy iris that moved with shifting gaze. The lack of the capsular bag may have contributed to extreme iris movements. This finding may be secondary to a combination of a lack of zonular support and capsular bag support as well as the lack of vitreous support following vitrectomy. When possible, secondary IOL placement behind a peripherally preserved capsular bag may reduce the risk of UGH. Full article

Endophthalmitis is a serious ophthalmologic condition involving purulent inflammation of the intraocular spaces. Fungal endophthalmitis is a highly sight-threatening condition that can be complicated by difficulties in diagnosis and therapeutic delay. We report herein a rare case of bilateral endogenous Candida albicans endophthalmitis with favorable outcome. High suspicion of fungal origin is essential since the diagnosis for fungal endophthalmitis is usually based on the ophthalmological exhibition in combination with the presence of fungemia or predisposing factors. Only prompt initiation of systemic, intravitreal and surgical treatment may reduce ocular morbidity or even mortality. Full article