Comparison of Combined Bevacizumab plus Dexamethasone Vs. Ranibizumab Monotherapy as First-Line Therapy in Patients with Treatment Naive Neovascular Age-Related Macular Degeneration in Real-Life Clinical Practice: A Retrospective Case-Series Analysis

Age related macular degeneration (AMD) is a major cause of legal blindness in elderly individuals in the western world. It affects the macula, initially with characteristic retinal pigment epithelium (RPE) changes (mottling, hyper/hypopigmentation) and drusen deposition (dry AMD). Of note is the presence of a series of inflammatory factors between the RPE and Bruch's membrane. The progression of AMD leads either to late stage geographic atrophy of the macular RPE, or to neovascularization (neovascular AMD), due to vascular endothelial growth factor (VEGF) production.

Neovascular AMD is the most vision-threatening form of the disease. Visual impairment in neovascular AMD is caused by the formation of a choroidal neovascular membrane (CNV) beneath the macula with consequent subretinal leakage, hemorrhage and intraretinal fluid accumulation. Inflammatory factors and VEGF are the main contributing mediators involved in the progression of AMD, participating in a vicious cycle involving hypoxia, oxidative stress, inflammation, edema and neoangiogenesis.

Download PDF

Aberrometric Outcomes of Intrastromal Corneal Ring Segment (KeraRing 355) Implantation Using Pocket Maker Microkeratome in Patients with Keratoconus

Keratoconus, the most common primary corneal ectasia, is a bilateral asymmetric corneal degeneration which accompanies with local corneal thinning and occurs mostly in inferior and central part of the cornea. Initiating in puberty, Keratoconus (KCN) often progresses until fourth decade of life.

Affecting all ethnic groups equally, KCN usually causes high myopia and irregular astigmatism which results in poor quality of vision. Based on disease severity, many treatment modalities exist including glasses and contact lenses for mild to moderate disease while corneal graft preserved for more advanced disease. High costs, need to long follow-ups, long periods for visual rehabilitation, risks of graft rejection or infection, wound dehiscence and suture-related problems make corneal grafts preserved for the last therapeutic choice by many ophthalmologists.

Download PDF

Saints and Ophthalmology: A Pattern for Emulation, a Model of Healing, and Physicians in Action

From the earliest times, medical practitioners have sought divine help and support to aid them as they go about their busy rounds. In Christian Europe of the High Middle Ages, saints played a central role in the everyday life of the ailing. Alongside healing attempts which involved magic, folk or scientifically-based medicine, the invocation of specific patron saints for the curing of ailments was a widespread practice. 

The miracles of vision performed by saints over the past two millennia are listed and interpreted by various reviewers along faith healing, spontaneous recovery, or physicians acting as saints. The individuals honored as patron saints of medicine were practicing physicians who served their patients and their communities well. It is their role as saints to represent the spiritual element in the healing process as well as personifying the charitable idealism of the good physician, and therefore are models for humanitarian physicians, with the ultimate model of healing being Jesus Christ.