Search

Purpose: An oxymetazoline 0.1% ophthalmic solution was recently approved for treatment of acquired blepharoptosis in adults. This study's objective was to evaluate the safety profile of oxymetazoline 0.1% when administered once daily for 14– 84 days. Patients and Methods: Pooled analysis examined safety outcomes from four randomized, double-masked, placebo-controlled clinical trials conducted at 6, 16, 27, and 35 sites, respectively, in the United States. In total, 568 participants with acquired blepharoptosis were evaluated. Median age was 66 years and 74.8% of participants were female. Overall, 375 participants self-administered oxymetazoline 0.1% to both eyes once/day and 193 self-administered placebo (vehicle) daily. Treatment-emergent adverse event (TEAE) rates, severity, and causality were evaluated in the overall population and within participant subgroups defined based on age, race, and ethnicity. Vital signs and ophthalmic findings were evaluated at predefined study visits. Patient-reported treatment tolerability was recorded at study end. Results: TEAE incidence was similar among participants using oxymetazoline 0.1% (31.2%) or vehicle (30.6%). Nearly all TEAEs were mild-to-moderate, and most were not suspected of being treatment related. Serious TEAEs occurred in four participants receiving oxymetazoline 0.1% and one participant receiving vehicle. Nine and two participants in the oxymetazoline 0.1% and vehicle groups, respectively, discontinued due to a TEAE. Ocular TEAEs occurring in ≥ 2% of participants receiving oxymetazoline 0.1% were punctate keratitis, conjunctival hyperemia, dry eye, blurred vision, instillation site pain, and corneal vital dye staining, with none occurring in > 3.5% of participants. TEAE rates were similar across subgroups based on age, race, and ethnicity. No clinically significant mean changes in vital signs or ophthalmologic findings occurred, and > 98% of participants rated oxymetazoline 0.1% as causing no/mild discomfort. Conclusion: Once-daily oxymetazoline 0.1% was safe and well tolerated in participants with acquired blepharoptosis when used for 14– 84 days. Safety did not appear to differ based on age, race, or ethnicity. [ABSTRACT FROM AUTHOR]

Purpose: Amblyopia is a leading cause of low vision and warrants timely management during childhood. We performed a literature review of the management of amblyopia and potential risk factors for amblyopia.Methods: Literature review of the management of amblyopia and risk factors for amblyopia.Results: Common amblyopia risk factors include anisometropic or high refractive error, strabismus, cataract, and ptosis. Often a conservative approach with spectacles is enough to prevent amblyopia. However, surgery may be necessary to clear the visual axis or align the eyes.Conclusion: Amblyopia risk factors should be managed early. Though amblyopia treatment is more likely to be successful at a younger age, those who are older but treatment-naïve may still respond to treatment. Promoting binocular or dichoptic experiences may be the future direction of amblyopia management. [ABSTRACT FROM AUTHOR]

Background: We conducted a bibliometric analysis of blepharoptosis, obtained the top 100 most-cited articles, and then researched the characteristics of every article., Materials and Methods: The Web of Science Citation Index was utilized to identify articles related to blepharoptosis written in English published from 1900 to 2021 using predefined search terms. Then, the returned results were screened, and the top 100 most-cited articles were individually classified based on publication year, country of publication, source journal, total citations, authors' specialty, level of evidence, main subject, and type of study., Results: The 100 most-cited articles were published between 1948 and 2014. The number of citations/articles ranged from 49 to 743. Ophthalmology journals made the greatest contributions to landmark literature (n=61). The primary focus of these 100 studies was the surgical technique (n=41). The majority of them (n=52) only achieved level 4 evidence, as a high proportion of these articles were case series (n=52). The most common country of publication was the United States (n=59)., Conclusions: Our bibliometric analysis provides insight into the citation frequency of the most-cited articles on blepharoptosis. The landmark, highly cited articles that have shaped the landscape of blepharoptosis were identified. The results from these top 100 cited articles are helpful for present current surgical decision-making., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 by Mutaz B. Habal, MD.)

Purpose: To report the association between 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase inhibitors (statins) and diplopia, blepharoptosis (ptosis), and ophthalmoplegia. Design: Database study. Participants: Two hundred fifty-six subjects studied. Methods: Spontaneous reports from the National Registry of Drug-Induced Ocular Side Effects, the World Health Organization (WHO), and the Food and Drug Administration were collected on statins and ptosis, diplopia, and ophthalmoplegia. Main Outcome Measures: Data garnered from the spontaneous reports include the type of statin, age, gender, adverse drug reaction (ADR), dosage, duration of therapy until onset of ADR, concomitant drugs, other systemic disease, and dechallenge and rechallenge data. Results: Two hundred fifty-six case reports of ptosis, diplopia, and ophthalmoplegia associated with statins were reported, including 143 males, 91 females, and 22 case reports where the gender was not specified. The average age was 64.5±10 years. Dosage varied between the different statin drugs, with the average dosage within the range recommended in the package insert for each different statin. Average time from beginning of therapy to appearance of the ADR was 8.3±1.5 months (range, 1 day–84 months). Seven patients were taking 2 statin drugs and 5 also were taking gemfibrozil. Nine patients had diabetes mellitus. A total of 23 case reports described total ophthalmoplegia. Ptosis was reported alone 8 times and in conjunction with diplopia 18 times. There were 62 positive dechallenge and 14 positive rechallenge case reports. Conclusions: According to WHO criteria, the relationship between statin therapy and diplopia, ptosis, or ophthalmoplegia is possible. This causality assessment is based on the time relationship of drug administration and ADR development, the multiple positive dechallenge and rechallenge reports, and the plausible mechanism by which diplopia, ptosis, or ophthalmoplegia may occur: myositis of the extraocular muscles, the levator palpebrae superioris muscles, or both. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. [Copyright &y& Elsevier]

The article discusses the impact of the changes in the reimbursement policy for blepharoplasty and blepharoptosis repair on the practice of ophthalmologists. It mentions the results of Mayo Clinic's survey about patients' and surgeons' attitudes and opinions toward the prohibition of separate payments for ptosis and blepharoplasty by the Centers for Medicare and Medicaid Services (CMS). Doctor Elizabeth A. Bradley expresses concern about the policy change.