Rho Kinase (ROCK) Inhibitors for the Treatment of Glaucoma

Glaucoma is the most common cause of irreversible blindness worldwide. It is characterized by progressive optic nerve degeneration and loss of visual field. Pathological increased intraocular pressure is its main modifiable risk factor. Rho kinase inhibitors are developed as a new class of glaucoma medication that increases outflow facility from the conventional aqueous humor outflow pathway. Additionally, they also have neuroprotective and anti-scarring effects that can might increase the success rate of glaucoma filtration surgery. This review aims to summarize the current concept of Rho kinase inhibitors in the treatment of glaucoma from beach to bedside.

A Mini-review on New Developments in Nanocarriers and Polymers for Ophthalmic Drug Delivery Strategies

The eye is an important and vital organ of the human body consisting of two segments - anterior and posterior segments and these segments are associated with many diseases. This review elaborates upon the various eye-related diseases with their medications and carriers used to deliver them. Delivery strategies include drugs encapsulated into liposomes, polymeric micelles of drugs, solid lipid nanoparticles, nanostructured lipid carriers, nano emulsions, and Nanosuspension used to improve penetrating properties, bioavailability, and residence time of the drugs as examples available in the literature. With regard to this, different forms of ocular drug delivery are classified and elaborated. Additionally, the possibility of addressing the physical and chemical complexities of ocular diseases and how they could be overcome with environmentally stable nanoformulations are briefly discussed. Enhanced drug delivery efficiency with various novel pharmaceuticals along with enhanced uptake by different routes/modes of drug administration. Current advancements in drug carrier systems, i.e., nanocarriers, have shown promise for improving the retention time, drug permeation and prolonging the duration of release of the drug in the ocular site. Bio-degradable polymers investigated for the preparation of nanocarriers for the entrapment of drugs and to enhance the efficacy through improved adherence of tissue in the eye, sustained release measures, enhanced bioavailability, lower toxicity, and targeted delivery is applicable. This review covers the introduction of various nanocarriers and polymers for ocular drug delivery with the purpose of enhancing the absorption, retention and bioavailability of medications in the eye.

Prevalence of Pterygium and Associated Risk Factors in the High-Altitude Area of Ta'if City, Saudi Arabia

Background

Pterygium is an important public health problem. The prevalence rates of this disease varies widely from 1.2% to 23.4%.

Aim

To determine the prevalence rates and the associated risk factors of pterygium in the high-altitude area - Ta’if city, Saudi Arabia.

Material and method

A cross-sectional study was carried out from September 2018 till September 2019 at the ophthalmology outpatient clinics of King Abdul-Aziz Specialist Hospital, Ta’if area.

Results

Prevalence rate of pterygium in the high-altitude area, Ta’if city, Saudi Arabia was 2.4%. It is significantly higher in older patients belonging to the age group of more than 40 years. As for gender, it was significantly higher in male patients compared to females (2.6% vs. 1.9%). Pterygium prevalence was significantly higher among patients with outdoor occupations compared to indoor occupations (2.9% vs. 2.1%), and among patients with sunlight exposure during daily activities for more than 5 hours (2.6% vs. 2%) (p =< 0.05).

Conclusion

The overall incidence of pterygium in Al-Ta’if area, Saudi Arabia, was 2.4% but still lower than overall worldwide incidence (10.2%). There was an increased incidence of pterygium with age, high-altitude areas, rural areas, outdoor occupations, which is directly proportional to dose of sunlight exposure. Furthermore, smoking might be reported as a protective factor against pterygium.

The Association Between Keratoconus and Mitral Valve Prolapse: A Meta-Analysis

Objective

The debate pertaining to the association between Keratoconus (KC) and Mitral Valve Prolapse (MVP) continues to occur among physicians. The results of cross-sectional studies attempting to present the co-existing prevalence of these two diseases remain indeterminate. We compiled the first meta-analysis to determine the pattern of prevalence between the two diseases.

Methods

Two separate literature searches for cross-sectional studies were performed for this meta-analysis. The first search encompassed finding literature comparing the prevalence of KC between patients with MVP and a control group. The second search pertained to finding studies comparing the prevalence of MVP patients with KC and a control group.

Results

Six studies reported the prevalence of MVP in patients with KC and a control group. The prevalence was 41.6% in patients with KC and 11.5% in patients without KC (OR = 7.06 [95% CI = 2.41-20.64]). There was a significant heterogeneity among the studies (I² = 84%). Two studies showed the prevalence of KC in patients with MVP and a control group. The prevalence was 17.0% in patients with KC and 2.9% in the control group (OR = 5.07 [95% CI = 1.08-23.83]). There was no heterogeneity within the analysis (I² = 0%).

Conclusion

There is a statistically significant co-existing prevalence between MVP and KC. Patients with KC are more likely to present with MVP, and patients with MVP are more likely to present with KC.

Enduring influence of elizabethan ophthalmic texts of the 1580s: bailey, grassus, and guillemeau

Three English ophthalmic texts of the 1580s were frequently republished: 1) Walter Bailey's A Briefe Treatise Touching the Preseruation of the Eie Sight, 2) The Method of Phisicke, an adaptation of the medieval treatise of Benevenutus Grassus, and 3) A Worthy Treatise of the Eyes, a translation of Jacques Guillemeau's treatise. Their history is intertwined through composite publications, some of which lacked clear attribution. At least 21 editions incorporated these texts. Although not previously realized, major elements of all 3 works are found in Two Treatises Concerning the Preseruation of Eie-sight, first published in 1616. To preserve eyesight, Bailey recommended eyebright (Euphrasia officinalis), fennel (Fæniculum vulgare), and a moderate lifestyle incorporating wine. In the works of Grassus and Guillemeau, cataracts were believed to lie anterior to the 'crystalline humor,' and were treated by the 'art of the needle,' or couching. Links are found between Grassus, Guillemeau, and eighteenth century glaucoma concepts. Although one of his students has traditionally received credit, it was English oculist John Thomas Woolhouse who first combined the early concepts and used the term glaucoma to describe the palpably hard eye in the early eighteenth century. The three primary ophthalmic texts of 1580s England influenced ophthalmic thought for over a century.