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Prostaglandin analogs in ophthalmology.

ABSTRACT: Glaucoma is a major cause of irreversible blindness worldwide. Reducing intraocular pressure (IOP) is currently the only approach to prevent further optic nerve head damage. Pharmacotherapy is the mainstay of treatment for glaucoma patients. In recent years, a significant milestone in glaucoma treatment has been a transition to prostaglandin analogs (PGAs) as the first line of drugs. The rapid shift from traditional β-blockers to PGAs is primarily due to their excellent efficacy, convenient once-a-day usage, better diurnal control of IOP, and systemic safety profiles. This review article aims to provide information regarding the various PGAs in practice and also the newer promising drugs.

SUBMITTER: Subbulakshmi S

PROVIDER: S-EPMC10391402 | biostudies-literature | 2023 May

REPOSITORIES: biostudies-literature

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Prostaglandin analogs in ophthalmology.

Subbulakshmi S S Kavitha Srinivasan S Venkatesh Rengaraj R

Indian journal of ophthalmology 20230501 5

Glaucoma is a major cause of irreversible blindness worldwide. Reducing intraocular pressure (IOP) is currently the only approach to prevent further optic nerve head damage. Pharmacotherapy is the mainstay of treatment for glaucoma patients. In recent years, a significant milestone in glaucoma treatment has been a transition to prostaglandin analogs (PGAs) as the first line of drugs. The rapid shift from traditional β-blockers to PGAs is primarily due to their excellent efficacy, convenient once ...[more]

PMID: 37203029

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Project description:For primary open angle glaucoma (POAG), laser treatment or surgery is used when the target intraocular pressure (IOP) cannot be achieved by pharmacological agents, such as prostaglandin (PG) analogs; these drugs also have varied effects. We retrospectively reviewed the medical records of 74 POAG patients (74 eyes) whose IOP was inadequately controlled by PG analogs (bimatoprost [13 eyes], latanoprost [34 eyes], tafluprost [11 eyes], and travoprost [16 eyes]) and underwent primary trabeculectomy. The proportion of patients with no recurrent IOP elevation within 24 months post-trabeculectomy was significantly (P < 0.001) lower in the bimatoprost group (31.3%) than in the latanoprost (83.2%), tafluprost (45.5%), or travoprost groups (65.6%). Deepening of the upper eyelid sulcus (DUES) was observed before trabeculectomy in 18 of 74 eyes (24.3%) treated with bimatoprost (9 eyes; 50.0%), latanoprost (3 eyes; 16.7%), tafluprost (1 eye; 5.5%) and travoprost (5 eyes; 27.8%). The proportion of patients with no recurrent IOP elevation up to 24 months post-trabeculectomy was significantly (P < 0.0001) lower in the DUES(+) group (34.7%) than in the DUES(-) group (74.3%). Multivariate stepwise logistic regression analysis, with no recurrent IOP elevation used as dependent variable, and bimatoprost, latanoprost, travoprost, tafluprost, β-blocker, carbonic anhydrase inhibitor, brimonidine, gender, age, preoperative IOP, mean deviation, duration of PG analog use before surgery, and the number of ophthalmic solutions used as independent variables, identified only bimatoprost as a significant independent factor (P = 0.0368). Thus, the outcome of trabeculectomy varied depending on the PG analog used preoperatively, and bimatoprost use was associated with a high risk of recurrent IOP elevation up to 2 years post-trabeculectomy. This may indicate that the incidence of DUES differed with the PG analog used. Patients with glaucoma who are treated with bimatoprost should be monitored for DUES, and when these patients undergo trabeculectomy, the postoperative course of IOP should be followed carefully.

Project description:PurposeTo review and evaluate the current literature on the application and impact of large language models (LLMs) in the field of ophthalmology, focusing on studies published in high-ranking ophthalmology journals.DesignThis is a retrospective review of published articles.ParticipantsThis study did not involve human participation.MethodsArticles published in the first quartile (Q1) of ophthalmology journals on Scimago Journal & Country Rank discussing different LLMs up to June 7, 2024, were reviewed, parsed, and analyzed.Main outcome measuresAll available articles were parsed and analyzed, which included the article and author characteristics and data regarding the LLM used and its applications, focusing on its use in medical education, clinical assistance, research, and patient education.ResultsThere were 35 Q1-ranked journals identified, 19 of which contained articles discussing LLMs, with 101 articles eligible for review. One-third were original investigations (32%; 32/101), with an average of 5.3 authors per article. The United States (50.4%; 51/101) was the most represented country, followed by the United Kingdom (25.7%; 26/101) and Canada (16.8%; 17/101). ChatGPT was the most used LLM among the studies, with different versions discussed and compared. Large language model applications were discussed relevant to their implications in medical education, clinical assistance, research, and patient education.ConclusionsThe numerous publications on the use of LLM in ophthalmology can provide valuable insights for stakeholders and consumers of these applications. Large language models present significant opportunities for advancement in ophthalmology, particularly in team science, education, clinical assistance, and research. Although LLMs show promise, they also show challenges such as performance inconsistencies, bias, and ethical concerns. The study emphasizes the need for ongoing artificial intelligence improvement, ethical guidelines, and multidisciplinary collaboration.Financial disclosuresThe author(s) have no proprietary or commercial interest in any materials discussed in this article.

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Prostaglandin analogs in ophthalmology.

Publications

Prostaglandin analogs in ophthalmology.

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