PURPOSE. Photochemical cross-linking of corneal collagen is an evolving treatment for keratoconus and other ectatic disorders. We evaluated collagen cross-linking by rose bengal plus green light (RGX) in rabbit eyes and investigated factors important for clinical application.METHODS. Rose bengal (RB, 0.1%) was applied to deepithelialized corneas of enucleated rabbit eyes for 2 minutes. The diffusion distance of RB into the stroma was measured by fluorescence microscopy on frozen sections. RB-stained corneas were exposed to green (532-nm) light for 3.3 to 9.9 minutes (50-150 J/cm 2 ). Changes in the absorption spectrum during the irradiation were recorded. Corneal stiffness was measured by uniaxial tensiometry. The spatial distribution of the stromal elastic modulus was assessed by Brillouin microscopy. Viable keratocytes were counted on H&E-stained sections 24 hours posttreatment. RESULTS.RB penetrated approximately 100 lm into the corneal stroma and absorbed >90% of the incident green light. RGX (150 J/cm 2 ) increased stromal stiffness by 3.8-fold. The elastic modulus increased in the anterior approximately 120 lm of stroma. RB was partially photobleached during the 2-minute irradiation, but reapplication of RB blocked light transmission by >70%. Spectral measurements suggested that RGX initiated cross-linking by an oxygen-dependent mechanism. RGX did not decrease keratocyte viability.CONCLUSIONS. RGX significantly increases cornea stiffness in a rapid treatment (@12 minutes total time), does not cause toxicity to keratocytes and may be used to stiffen corneas thinner than 400 lm. Thus, RGX may provide an attractive approach to inhibit progression of keratoconus and other ectatic disorders.

A rapid, light-activated technique produces strong, immediate bonding between amnion and cornea and merits further evaluation for ocular surface surgeries.

Bonding LSC grafts with PTB produced improved outcomes compared to suture attachment. This light-activated method is a promising modality for treating patients with LSCD.

No abstract

Nerve Infiltration Responds to Radiation and Blinatumomab A 52-year-old man with a history of Philadelphia chromosome negative B-cell acute lymphoblastic leukemia in remission presented with decreased vision in the right eye (OD) and headache. His visual acuity was count fingers OD and 20/20 left eye (OS). Fundoscopic examination revealed bilateral optic disc edema (Fig 1A and B). He was diagnosed with leukemic infiltration of the optic nerves. Treatment consisted of urgent radiotherapy and Blinatumomab, an anti-CD19 antibody that redirects T cells to enhance lysis of tumor cells. Six weeks after treatment, the visual acuity improved to 20/50 OD and remained 20/20 OS (Fig 1C and D).

In head and neck squamous cell carcinoma, immune checkpoint inhibitors (ICI) lead to improved outcomes. There has been reports of accelerated disease progression, or hyperprogression, after ICI initiation. We present a case of hyperprogression after one dose of nivolumab in maxillary sinus squamous cell carcinoma. The patient had complete vision loss due to disease progression into the orbit, as well as intracranial invasion, lytic metastases, and new widespread distal metastases. Hyperprogression can occur after the first dose of immunotherapy. Absent biomarkers regarding individual risk of hyperprogression, caution should be exercised in using ICI in sinonasal cancers with orbital abutting disease. Laryngoscope, 130:907–910, 2020

No abstract

No abstract