Chemical Burns of the Eye: The Role of Retinal Injury and New Therapeutic Possibilities.
| Autor: | Dohlman CH; Cornea Service and Boston Keratoprosthesis Laboratory, Massachusetts Eye and Ear Infirmary and Schepens Eye Research Institute, Harvard Medical School, Boston, MA., Cade F, Regatieri CV, Zhou C, Lei F, Crnej A, Harissi-Dagher M, Robert MC, Papaliodis GN, Chen D, Aquavella JV, Akpek EK, Aldave AJ, Sippel KC, DʼAmico DJ, Dohlman JG, Fagerholm P, Wang L, Shen LQ, González-Andrades M, Chodosh J, Kenyon KR, Foster CS, Pineda R, Melki S, Colby KA, Ciolino JB, Vavvas DG, Kinoshita S, Dana R, Paschalis EI |
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| Jazyk: | angličtina |
| Zdroj: | Cornea [Cornea] 2018 Feb; Vol. 37 (2), pp. 248-251. |
| DOI: | 10.1097/ICO.0000000000001438 |
| Abstrakt: | Purpose: To propose a new treatment paradigm for chemical burns to the eye - in the acute and chronic phases. Methods: Recent laboratory and clinical data on the biology and treatment of chemical burns are analyzed. Results: Corneal blindness from chemical burns can now be successfully treated with a keratoprosthesis, on immediate and intermediate bases. Long term outcomes, however, are hampered by early retinal damage causing glaucoma. New data suggest that rapid diffusion of inflammatory cytokines posteriorly (TNF-α, etc) can severely damage the ganglion cells. Prompt anti-TNF-α treatment is markedly neuroprotective. Long term profound reduction of the intraocular pressure is also vital. Conclusion: A new regimen, in addition to standard treatment, for severe chemical burns is proposed. This involves tumor necrosis factor alpha (TNF-α) inhibition promptly after the accident (primarily for retinal neuroprotection), prophylactic maximal lowering of the intraocular pressure (starting immediately), and keratoprosthesis implantation in a later quiet state. |
| Databáze: | MEDLINE |
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