학술논문
Chemical Burns of the Eye: The Role of Retinal Injury and New Therapeutic Possibilities
Document Type
Academic Journal
Author
Dohlman, Claes H.; Cade, Fabiano; Regatieri, Caio V.; Zhou, Chengxin; Lei, Fengyang; Crnej, Alja; Harissi-Dagher, Mona; Robert, Marie-Claude; Papaliodis, George N.; Chen, Dongfeng; Aquavella, James V.; Akpek, Esen K.; Aldave, Anthony J.; Sippel, Kimberly C.; DʼAmico, Donald J.; Dohlman, Jan G.; Fagerholm, Per; Wang, Liqiang; Shen, Lucy Q.; González-Andrades, Miguel; Chodosh, James; Kenyon, Kenneth R.; Foster, C. Stephen; Pineda, Roberto; Melki, Samir; Colby, Kathryn A.; Ciolino, Joseph B.; Vavvas, Demetrios G.; Kinoshita, Shigeru; Dana, Reza; Paschalis, Eleftherios I.
Source
Cornea. Feb 01, 2018 37(2):248-251
Subject
Language
English
ISSN
0277-3740
Abstract
PURPOSE:: To propose a new treatment paradigm for chemical burns to the eye - in the acute and chronic phases. METHODS:: Recent laboratory and clinical data on the biology and treatment of chemical burns are analyzed. RESULTS:: Corneal blindness from chemical burns can now be successfully treated with a keratoprosthesis, on immediate and intermediate bases. Long term outcomes, however, are hampered by early retinal damage causing glaucoma. New data suggest that rapid diffusion of inflammatory cytokines posteriorly (TNF-α, etc) can severely damage the ganglion cells. Prompt anti-TNF-α treatment is markedly neuroprotective. Long term profound reduction of the intraocular pressure is also vital. CONCLUSION:: A new regimen, in addition to standard treatment, for severe chemical burns is proposed. This involves tumor necrosis factor alpha (TNF-α) inhibition promptly after the accident (primarily for retinal neuroprotection), prophylactic maximal lowering of the intraocular pressure (starting immediately), and keratoprosthesis implantation in a later quiet state.