Columbus Eye Surgery Center

ABSTRACT Introduction Dry eye disease (DED) is a prevalent and multifactorial ocular disorder characterized by tear film instability, ocular surface inflammation, and patient discomfort, negatively impacting the quality of life. Conventional therapies have limitations due to poor drug bioavailability and patient tolerability. Areas covered This review summarizes the application of semifluorinated alkanes (SFAs) as advanced ocular drug delivery systems, with a focus on perfluorobutylpentane (PFBP)-based cyclosporine A (CsA) eyedrops. Preclinical and clinical evidence highlighting the influence of SFAs on tear film dynamics, ocular bioavailability, and patient-reported outcomes has been discussed. The review compiles findings from preclinical and clinical studies reported in peer-reviewed journals and databases, including PubMed, USPTO, and conference abstracts up to 2024. Expert opinion SFAs represent a paradigm shift in ocular drug delivery. The unique physicochemical properties of PFBP-based eyedrops, such as their water-free nature, excellent spreadability, and ability to stabilize tear film lipid layer address several challenges associated with conventional DED therapies. Clinical evidence demonstrates that PFBP-based CsA eyedrops (VEVYE®) have an earlier onset of action than aqueous CsA eyedrops and show a significant improvement in the clinical signs and symptoms of DED with high patient tolerability. These properties of PFBP make it an excellent vehicle for ocular delivery and management of ocular surface disorders.

The BRCA1-associated protein-1 (BAP1) tumor predisposition syndrome (BAP1-TPDS) is a recently identified hereditary cancer syndrome. Germline mutations in this tumor suppressor gene predispose families to the development of various malignancies. The molecular functions of the gene as well as the clinical phenotype of the syndrome are still being clarified. We sought to conduct a comprehensive review of published research into BAP1-TPDS to more thoroughly delineate the clinical implications of germline BAP1 mutations. We also report two additional families with germline BAP1 mutations. Current evidence demonstrates that germline BAP1 mutations predispose families to uveal melanoma, renal cell carcinoma, malignant mesothelioma, cutaneous melanoma, and possibly to a range of other cancers as well. Some of these cancers tend to be more aggressive, have a propensity to metastasize, and onset earlier in life in patients with BAP1 mutations as compared to non-predisposed patients with equivalent cancers. Although further research is necessary, this information can aid in the management, diagnosis, and therapy of these patients and their families, and highlights the importance of genetic counseling.

Orbital tumors represent approximately 0.1 % of all body tumors and approximately one-fifth of all orbital diseases. Classification schemes vary and stratify orbital tumors based on demographics, site of origin, anatomic location within the orbit, histopathologic features, clinical course, and imaging findings. Defining orbital neoplasia presents difficulties, as choristomas, hamartomas, and inflammatory lesions can present as space-occupying lesions and behave as benign and even malignant, neoplasms. In general, neoplasms of the orbit may be classified as primary, secondary (infiltration from an adjacent structure), or metastatic (from distant structures). Orbital neoplasia can be divided into histological categories that include benign, benign but locally aggressive, and malignant. In some cases, especially lymphoproliferative lesions, a spectrum from benign to malignant exists.

Beta irradiation with strontium 90 has been associated with significant iatrogenic disease, causing such complications as ptosis, symblepharon, iridic and scleral atrophy, cataracts, and endophthalmitis. We studied 171 eyes in 140 patients treated and followed up during a 17-year period from 1973 to 1990. We sought to show that a single small dose of radiation administered immediately after surgical excision not only prevents decrease recurrence, but also avoids significant complication. Pterygia recurred in 14 (8%) of the 171 eyes treated. Six of these recurrences were corneal and eight were conjunctival. Complications were seen in five (3%) of the 171 eyes treated. All were minor except for one case of scleral thinning in a diabetic patient. Optimal radiation dosage to avoid significant recurrence in this adult population is a single dose of 2,000 rads using a bare sclera technique that vaults the limbus.