Publications by authors named "Ciolino J"

Research studies involving human subjects require collection of and reporting on demographic data related to race and ethnicity. However, existing practices lack standardized guidelines, leading to misrepresentation and biased inferences and conclusions for underrepresented populations in research studies. For instance, sometimes there is a misconception that self-reported racial or ethnic identity may be treated as a biological variable with underlying genetic implications, overlooking its role as a social construct reflecting lived experiences of specific populations.

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Evaluation of benefits beyond quantitative academic outputs is essential in determining translational research value. We used the Translational Science Benefits Model (TSBM) to examine the impact of the QUARTET USA trial using 30 benefits across 4 domains: Clinical, Community, Economic, and Policy. We found that the QUARTET USA trial demonstrated impact in six areas within the Clinical, and Community domains and had potential impact in two additional areas within the Community and Economic domains.

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Communication between the different layers of the cornea (epithelium and stroma) is a complex, yet crucial element in the corneal healing process. Upon corneal injury, it has been reported that the bi-directional cross talk between the epithelium and stroma via the vesicular secretome, namely, extracellular vesicles (EVs), can lead to accelerated wound closure upon injury. However, the distinct protein markers of EVs derived from human corneal epithelial (HCE) cells, keratocytes (HCKs), fibroblasts (HCFs), and myofibroblasts (HCMs) remain poorly understood.

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Purpose: To collect tear fluid biomarkers from contact lenses (CLs) and determine the impact of CL wear duration.

Methods: Rabbits were fitted with commercial etafilcon A CLs, which were collected after 1 min, 4 and 8 h (n = 4/time point). Tear fluid proteins and cytokines were extracted from the CLs and quantified.

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Diabetes mellitus (DM) is a common metabolic disease associated with severe macrovascular and microvascular complications that influence nearly every tissue in the body, including the anterior and posterior segments of the eye. In the cornea, DM is associated with recurrent epithelial erosion and reduced wound-healing capacity, which increases the risk of corneal scarring. We previously developed a co-culture model of the cornea consisting of immortalized human corneal epithelial cells (hCE-TJ) overlaying a self-assembled stromal layer generated by human corneal fibroblasts (hCFs) over a 4-week period.

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Purpose: To develop an artificial intelligence (AI) model to diagnose Acanthamoeba keratitis (AK) based on in vivo confocal microscopy (IVCM) images extracted from the Heidelberg Retinal Tomograph 3 (HRT 3).

Methods: This retrospective cohort study utilized HRT 3 IVCM images from patients who had received a culture-confirmed diagnosis of AK between 2013 and 2021 at Massachusetts Eye and Ear. Two cornea specialists independently labeled the images as AK or nonspecific finding (NSF) in a blind manner.

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Purpose: Recombinant human nerve growth factor (rhNGF; cenegermin-bkbj, OXERVATE) is the first and only U.S. Food and Drug Administration-approved treatment for moderate to severe neurotrophic keratopathy.

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The tear fluid is a readily accessible, potential source for biomarkers of disease and could be used to monitor the ocular response to contact lens (CL) wear or ophthalmic pathologies treated by therapeutic CLs. However, the tear fluid remains largely unexplored as a biomarker source for RNA-based molecular analyses. Using a rabbit model, this study sought to determine whether RNA could be collected from commercial CLs and whether the duration of CL wear would impact RNA recovery.

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Introduction: 3 cases are used to illustrate the technique of Descemet membrane (DM) relaxing incisions followed by air descemetopexy for the management of patients with acute corneal hydrops.

Patients And Clinical Findings: In each case, anterior-segment optical coherence tomography (OCT) demonstrated taut DM detachments and hydrops was refractory to conservative medical management and intracameral air injection.

Diagnosis Intervention And Outcomes: To facilitate the reapproximation of DM and potentiate corneal deturgescence, intraoperative OCT-guided descemetotomy was performed with bent surgical scissors and a bent 30-gauge needle.

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Purpose: To assess the effectiveness of topical and subconjunctival bevacizumab in suppressing vascularization in graft and host bed after high-risk corneal transplantation.

Design: Secondary analysis of prospective, randomized, double-blind, placebo-controlled multicentric clinical trial.

Participants: The study includes patients aged > 18 years who underwent high-risk penetrating keratoplasty, which was defined as corneal vascularization in ≥ 1 quadrants of the corneal graft and host bed, excluding the limbus.

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Article Synopsis
  • New strategies are essential to improve blood pressure control rates, prompting the QUARTET USA trial to assess a four-drug combination therapy for hypertensive patients.
  • The study involved 62 participants, who were randomly assigned to receive either a quadpill with lower doses of four blood pressure medications or a single higher dose of one medication over 12 weeks.
  • Results showed no significant difference in systolic blood pressure between the two groups, though the quadpill led to greater reductions in diastolic blood pressure, indicating its potential effectiveness without increased adverse events.
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  • This study evaluated the long-term effects of lotilaner ophthalmic solution, 0.25%, for treating Demodex blepharitis, involving 239 patients who completed a prior study and returned for follow-ups at 180 and 365 days post-treatment.
  • Results showed a significantly higher number of patients in the lotilaner group with fewer collarettes (indicators of infestation) compared to the control group, with improvement continuing even after treatment ended, and only mild adverse events reported.
  • The conclusions suggest that the treatment remains effective over a year, with no significant long-term safety issues, indicating that the benefits of lotilaner may extend beyond the initial treatment period.
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Background: This convergent parallel-design mixed-methods process evaluation of the QUARTET USA (Quadruple Ultra-Low-Dose Treatment for Hypertension USA) clinical trial (NCT03640312) explores patient and health care professional perceptions about the use of low-dose quadruple therapy (LDQT) as a novel strategy for hypertension management.

Methods And Results: A survey of all 62 patients enrolled in the QUARTET USA trial was conducted. A subsample of 13 patients and 11 health care professionals, recruited via purposive sampling, took part in semistructured interviews.

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Article Synopsis
  • - Clinical trials, considered the "gold standard" for medical evidence, are evolving to include real-world data, which enhances their applicability and effectiveness in practical settings.
  • - Three case studies show how different data sources, like wearables and electronic health records, impact the role and responsibilities of Data and Safety Monitoring Boards (DSMBs).
  • - While real-world trials can improve findings' relevance and efficiency, they require strong data management systems and adapted monitoring practices to maintain the rigor of traditional clinical trials.
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Background And Objectives: Allergic conjunctivitis is the most common type of ocular allergy. The objective of this study was to evaluate the efficacy of a new once-daily, preservative-free, bilastine 0.6% eye drop formulation for the treatment of allergic conjunctivitis.

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Background: The burden of cardiovascular disease (CVD) is particularly high in several US states, which include the state of Michigan. Hypertension and smoking are two major risk factors for mortality due to CVD. Rural Michigan is disproportionally affected by CVD and by primary care shortages.

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Interim analyses in clinical trials can take on a multitude of forms. They are often used to guide Data and Safety Monitoring Board (DSMB) recommendations to study teams regarding recruitment targets for large, later-phase clinical trials. As collaborative biostatisticians working and teaching in multiple fields of research and across a broad array of trial phases, we note the large heterogeneity and confusion surrounding interim analyses in clinical trials.

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Article Synopsis
  • The study aims to assess the safety and effectiveness of lotilaner ophthalmic solution 0.25% in treating Demodex blepharitis compared to a placebo (vehicle).
  • In a randomized, double-masked clinical trial involving 412 participants, patients were split into two groups: one receiving lotilaner and the other receiving a vehicle without the active ingredient, over 6 weeks.
  • Results showed that the lotilaner group had significantly better outcomes in terms of collarette cure, mite eradication, and associated symptoms compared to the control group, indicating its efficacy in treating the condition.
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Objective: To study in a masked fashion whether an objective histological feature associated with keratoconus (KCN) occurs in donor corneas in eyes originally receiving a corneal graft for KCN.

Methods: Two ocular pathologists performed a retrospective masked histological analysis of slides from donor buttons recovered from 21 eyes with a history of KCN undergoing repeat penetrating keratoplasty (failed-PK-KCN), 11 eyes that underwent their first PK due to KCN (primary KCN), and 11 eyes without history of KCN which underwent PK for other conditions (failed-PK-non-KCN). Breaks/gaps in Bowman's layer served as the pathological feature indicative of recurrent KCN.

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Importance: Dry eye disease (DED) is a common public health problem with significant impact on vision-related quality of life and well-being of patients. Medications with rapid onset of action and a good tolerability profile remain an unmet need.

Objective: To assess efficacy, safety, and tolerability of a water-free cyclosporine ophthalmic solution, 0.

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Background And Objective: Bilastine is a second-generation antihistamine approved for the symptomatic treatment of allergic rhinoconjunctivitis and urticaria. The present trial evaluated the efficacy and safety of a new bilastine 0.6% preservative-free eye drop formulation for the symptomatic treatment of allergic conjunctivitis.

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