Recent studies have implicated long-term pentosan polysulfate use with vision loss from a newly described macular condition. Affected patients report difficulty with reading and adjusting to dim lighting, and they occasionally develop severe visual disability. Macular changes resemble those seen in age-related macular degeneration, potentially leading to misdiagnosis. The objectives of this Current Commentary are to summarize studies evaluating the association between pentosan polysulfate use and macular disease, to educate pentosan polysulfate prescribers about the clinical manifestations of this condition, and to provide recommendations for screening at-risk patients.
Purpose:
To describe the ethical attitudes of corneal surgeons and eye bank leadership toward for-profit entities in corneal donation, processing, and distribution.
Methods:
Fifty postfellowship corneal surgeons practicing in the United States and 25 eye bank leaders (eg, eye bank directors, CEOs, or presidents) for the Eye Bank Association of America–accredited eye banks completed a 22-question interview, focusing on corneal donation industry changes, including the entry of for-profit institutions.
Results:
Most participants in both study groups agreed that they have concerns with the entry of for-profit businesses into eye banking (62% corneal surgeons, 68% eye bank leadership), although physicians partnered with a for-profit corneal processor were significantly more likely to have no concerns with the entry of for-profits into eye banking than corneal surgeons partnered with a nonprofit processor (P = 0.04). The most frequently identified concerns with the entry of for-profit businesses into corneal banking were the hypothetical loss of donor trust (56% corneal surgeons, 64% eye bank leadership, P = 0.04) and the potential exploitation of donor generosity (72% corneal surgeons, 60% eye bank leadership). Qualitative theme analysis suggests that both study groups may view increased research/innovation as a potential benefit (64% corneal surgeons, 66% eye bank leadership) of for-profits in eye banking.
Conclusions:
Key stakeholders in eye banking do hold relevant ethical beliefs toward recent industry changes, and these attitudes should be considered in the future creation of the ethical corneal donation policy. Further research is needed to assess the attitudes of potential donors and donor families.
Aim: To describe the clinicopathologic features of pyogenic granuloma (granulation tissue proliferation) extending from the retina. Methods: We describe 3 patients who underwent enucleation for endophthalmitis. The eyes were processed routinely for histopathologic examination. Results: All 3 enucleated eyes contained granulation tissue with reactive vascular channels and intervening stroma infiltrated with inflammatory cells. The vascular channels were arranged in a fan-like configuration and the tissue was classified as representing pyogenic granulomas. Conclusions: Pyogenic granulomas (granulation tissue) may emanate from the retina in cases of endophthalmitis. This is distinct from neovascularization that may occur in proliferative diabetic retinopathy, central retinal vein occlusion, or other etiologies.
(Abstracted from Obstet Gynecol 2020;135:1091–1094)
As the approved oral agent for interstitial cystitis, pentosan polysulfate sodium (PPS) has been widely used since its approval in 1996. Historically recognized adverse effects of PPS are not serious.
The authors describe a challenging case of unilateral retinoblastoma in a patient referred for xanthocoria. A 3-year-old boy was referred for unilateral xanthocoria and disordered retinal vasculature, suggestive of Coats disease. Further investigation revealed diffuse subretinal tumor seeding and areas of calcification, consistent with retinoblastoma. Enucleation was performed and histopathology confirmed exophytic retinoblastoma. This case highlights that xanthocoria, although often encountered in patients with Coats disease, can sometimes be associated with retinoblastoma. As such, retinoblastoma should be considered in the differential diagnosis for children with both leukocoria and xanthocoria.
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J Pediatr Ophthalmol Strabismus.
2022;59(X):e32–e34.]
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