J. Clin. Transl. Ophthalmol., Volume 3, Issue 1 (March 2025) – 5 articles

In light of the potential effects of spaceflight on the anterior segment of the eye, there is a pressing need for anterior segment imaging to be available and accessible to monitor astronauts’ ocular health, including alterations to the cornea and lens. We aim to highlight the clinical basis and need for anterior segment imaging for astronauts. We explore the impacts of spaceflight-associated hazards, including microgravity and radiation, on astronauts’ risk of developing anterior segment pathology including risk of ocular trauma, infection, dry eye symptoms, cataracts, and possibly additional pathologies from increased radiation exposure. Such risks highlight the potential value that longitudinal assessment of anterior ocular structures would offer in future spaceflight missions. Specifically, anterior segment imaging would enable evaluations of corneal morphology, including longitudinal monitoring for microgravity-induced changes, and evaluation of interventions that aim to preserve anterior segment health during spaceflight. Lastly, non-invasive anterior segment imaging allows for unique insights into astronaut ocular health and can be performed routinely through modalities such as anterior segment optical coherence tomography (AS-OCT) and ultrasound biomicroscopy (UBM). We discuss these modalities and their implications for astronaut health during future spaceflight. Full article

Wound dehiscence is a rare complication after penetrating keratoplasty (PK) that may occur with or without prior trauma. Multiple factors may influence corneal wound healing, including patient factors, corneal wound characteristics, and other external factors. There is also the possibility that systemic medications could impact corneal wound healing. Possible factors that may predispose a cornea to experience wound dehiscence are discussed. We propose a hypothesis that oral angiotensin-inhibiting medications could play a role in reduced corneal wound healing. A literature review was conducted to investigate the effect of angiotensin inhibitors on corneal wound healing. Five patients on systemic oral angiotensin-inhibiting medications at the time of PK developed dehiscence of the graft–host wound junction following removal of sutures. The dehiscence required resuturing in all cases and resulted in an expulsive choroidal hemorrhage and complete loss of vision in one eye. Age, diabetes, lack of corneal neovascularization, early suture removal, underlying epithelial basement membrane dystrophy, corneal oedema, slower tapering of topical corticosteroid dosage, and glaucoma medication with preservatives were possible predisposing factors for some of these instances of wound dehiscence. However, oral angiotensin-inhibiting medications were taken by all patients in this series, and the literature suggests that ACE inhibitors and ARBs can reduce corneal fibrosis, resulting in inadequate healing. Oral angiotensin-inhibiting medications could have played an anti-fibrotic role in these corneae and predisposed them to wound dehiscence with minimal trauma. Despite limited evidence, these medications warrant further investigation as potential modulators of corneal wound healing. Full article

Orbital cavernous venous malformations (CVMs) are the most common primary lesions in the orbit, characterized by slow growth and benign nature. CVMs that become symptomatic require intervention. Surgical management is guided by the expertise of the operating surgeon. Common surgical techniques include anterior orbitotomy (transconjunctival and transcutaneous), lateral and transcranial orbitotomy, and endoscopic transnasal approaches. Liquid agent embolization aids in easier lesion resection with reduced blood loss and potential prevention of recurrence. Our case reports detail the advantages and disadvantages of this approach, showcasing collaboration between neuroradiologists and orbital surgeons. Full article

Glaucoma, the second leading cause of irreversible blindness globally, encompasses a heterogeneous group of ocular disorders characterized by the progressive degeneration of retinal ganglion cells. Pharmacotherapy remains the cornerstone of treatment, primarily aimed at reducing intraocular pressure (IOP) by decreasing aqueous humor production or enhancing its outflow. The therapeutic classes employed include carbonic anhydrase inhibitors, β-blockers, α-adrenergic agonists, prostaglandin analogs, parasympathomimetics, Rho kinase inhibitors, and hyperosmotic agents. Despite their efficacy, these medications are associated with a range of ocular and systemic side effects, influenced by their mechanisms of action, formulation, and dosage. Ocular adverse effects, such as irritation, dry eye, allergic reactions, and infections, are common, while systemic absorption may lead to more severe outcomes, including organ dysfunction, exacerbation of comorbid conditions, or life-threatening cardiovascular events. Given these potential risks, it is critical for clinicians to understand and monitor these adverse effects as they significantly affect patient adherence, quality of life, and treatment outcomes. Ongoing research is essential to develop novel therapeutic regimens, agents, or delivery methods that minimize side effects and improve compliance. Incorporating patient-reported outcomes in clinical practice may further enhance the assessment of treatment impact, facilitating more tailored and effective management of glaucoma. Full article

Background: Immunotherapy represents a revolutionary approach in cancer treatment, where it leverages the body’s immune system to target and destroy malignant cells. In ophthalmic oncology, immunotherapeutic agents offer potential for managing traditionally challenging ocular malignancies, such as melanoma and retinoblastoma. In this literature review, we aim to provide a comprehensive and up-to-date review of all current research and trends in this field. Methods: This literature reviews data from recent clinical trials, peer-reviewed articles, and meta-analyses focused on immunotherapeutic interventions for eye-related cancers. Emphasis is placed on the types of immunotherapies being tested, including checkpoint inhibitors, vaccine therapies, and adoptive cell transfer therapies. Results: Recent advancements indicate a growing and significant improvement in survival rates and tumor reduction with minimal adverse effects. Clinical trials focusing on melanoma show significant promise with targeted therapies, while early-stage investigations into retinoblastoma and conjunctival melanoma explore innovative approaches to harness the immune system without harming visual function. Conclusions: Immunotherapy in ophthalmic oncology is evolving rapidly and has demonstrated a remarkable potential as a primary treatment strategy. Although results from various clinical trials are promising, further research is needed to refine these therapies, minimize side effects, and improve overall patient outcomes. The future directions involve more comprehensive clinical trials that integrate immunotherapy with existing treatment modalities to establish more robust treatment protocols. Full article