Postnatal glycaemic outcomes in women with high-risk gestational diabetes: Identifying key predictors for early intervention.

Aims: Women with gestational diabetes (GDM) have increased lifetime risk of developing diabetes. We aim to determine the factors contributing to poor adherence of the postpartum oral glucose tolerance test (OGTT) and identify key predictors to postpartum dysglycaemia in our Asian cohort.

Methods: We conducted a retrospective cohort study of women with high-risk GDM (n = 561).

Assessing the Utility, Impact, and Adoption Challenges of an Artificial Intelligence-Enabled Prescription Advisory Tool for Type 2 Diabetes Management: Qualitative Study.

Background: The clinical management of type 2 diabetes mellitus (T2DM) presents a significant challenge due to the constantly evolving clinical practice guidelines and growing array of drug classes available. Evidence suggests that artificial intelligence (AI)-enabled clinical decision support systems (CDSSs) have proven to be effective in assisting clinicians with informed decision-making. Despite the merits of AI-driven CDSSs, a significant research gap exists concerning the early-stage implementation and adoption of AI-enabled CDSSs in T2DM management.

Management of corneal neovascularization: Current and emerging therapeutic approaches.

Corneal neovascularization (CoNV) is a sight-threatening condition affecting an estimated 1.4 million people per year, and the incidence is expected to rise. It is a complication of corneal pathological diseases such as infective keratitis, chemical burn, corneal limbal stem cell deficiency, mechanical trauma, and immunological rejection after keratoplasties.

Three-Year Outcomes of the Paul Glaucoma Implant for Treatment of Glaucoma.

Prcis: In our case series, the 3-year failure for Paul Glaucoma Implant (PGI) implantation was 14.6%. At 3 years postoperatively, there was a significant reduction in mean intraocular pressure (IOP) and the number of glaucoma medications used.

Beware what lurks on the surface - persistent contamination of high-touch surfaces on slit lamps despite regular cleaning.

High-touch surfaces contributing to infection transmission are particularly concerning in the ophthalmology clinic where frequent contact exists between ophthalmologists and various ophthalmic instruments. Areas of surface contamination from an ophthalmologist's contact with the slit lamp environment were identified using ultraviolet fluorescence as a surrogate for pathogen contamination. Ultraviolet fluorescent product was applied on the ophthalmologist's hands after thorough hand washing to indicate the contamination that may be derived from multiple sources in the ophthalmology clinic, such as touching the patient or the patient's folder during eye examinations and transfers.

Mentorship in academic medicine: truth is in the eye of the beholder.

The path to becoming a clinical academic researcher is arduous and convoluted, with many hurdles. A good mentor is key to growth and development, not only as one embarks on the journey, but also as a ‘sounding board’ throughout one’s career.

Expanding the use of salivary cortisol as a non-invasive outpatient test in the dynamic evaluation of suspected adrenal insufficiency.

Background: Adrenal insufficiency (AI) is potentially life-threatening, and accurate diagnosis is crucial. The first-line diagnostic test, the adrenocorticotrophic hormone (ACTH) stimulation test, measures serum total cortisol. However, this is affected in states of altered albumin or cortisol-binding globulin levels, limiting reliability.

Uveitis and glaucoma: a look at present day surgical options.

Purpose Of Review: To review the various surgical options of management of medically refractory glaucoma in uveitic eyes.

Recent Findings: Uveitic glaucoma is particularly challenging to manage. We look at the evidence for various surgical options, or the lack of, in the surgical management of medically refractory glaucoma in uveitis.

The Management of Ocular Surface Squamous Neoplasia (OSSN).

The rise of primary topical monotherapy with chemotherapeutic drugs and immunomodulatory agents represents an increasing recognition of the medical management of ocular surface squamous neoplasia (OSSN), which may replace surgery as the standard of care in the future. Currently, there is no consensus regarding the best way to manage OSSN with no existing guidelines to date. This paper seeks to evaluate evidence surrounding available treatment modalities and proposes an approach to management.

Acromegaly: pathogenesis, diagnosis, and management.

Growth hormone-secreting pituitary adenomas that cause acromegaly arise as monoclonal expansions of differentiated somatotroph cells and are usually sporadic. They are almost invariably benign, yet they can be locally invasive and show progressive growth despite treatment. Persistent excess of both growth hormone and its target hormone insulin-like growth factor 1 (IGF-1) results in a wide array of cardiovascular, respiratory, metabolic, musculoskeletal, neurological, and neoplastic comorbidities that might not be reversible with disease control.

Glaucoma drainage implant exposure: A review of aetiology, risks and repair considerations.

In recent years, there has been a paradigm shift in glaucoma surgical procedures. Glaucoma drainage implant (GDI) surgeries are being performed much more commonly. Thus, it is important for surgeons to be cognisant of potential complications and their management.

Use of anterior segment imaging and direct cyclopexy repair of cyclodialysis cleft.

We aim to describe different imaging modalities to localize cyclodialysis clefts and direct cyclopexy repair of cyclodialysis clefts. We reviewed the record of a patient with traumatic cyclodialysis cleft who underwent direct cyclopexy retrospectively. Preoperative and postoperative visual acuity and intraocular pressure (IOP) were recorded.

Dupilumab-associated ocular manifestations: A review of clinical presentations and management.

Dupilumab is a first-in-class biologic approved by the European Medicines Agency and the US Food and Drug Administration for the treatment of multiple atopic diseases, including atopic dermatitis, asthma, and chronic rhinosinusitis with nasal polyposis. Since gaining traction as an effective treatment modality, multiple reports have highlighted the many ocular side effects associated with dupilumab usage. These range from mild diseases, such as conjunctivitis, dry eyes, and blepharitis, to more severe manifestations such as intraocular inflammation and cicatrizing conjunctivitis.

Two-Year Outcomes of the Paul Glaucoma Implant for Treatment of Glaucoma.

Purpose: To determine 2-year efficacy of the PAUL Glaucoma Implant (PGI), a novel glaucoma tube shunt in patients with advanced glaucoma.

Participants: Patients with glaucoma refractory to maximum medical therapy or previous failed glaucoma surgery.

Methods: Retrospective review of all patients who had underwent PGI implantation in a single tertiary institution between May 1, 2017 and March 30, 2021.

Personalized Medical Treatment of Patients With Acromegaly: A Review.

Acromegaly is associated with significant morbidity and mortality if it is not appropriately treated. In addition to insulin-like growth factor 1 and growth hormone normalization as well as tumor shrinkage, the treatment goals include relieving symptoms, managing complications, and improving patients' quality of life. Surgical resection is a first-line treatment option for most patients, with few being pretreated preoperatively with medications.

Tolerability and Efficacy of Long-Term Medical Therapy in Primary Aldosteronism.

Introduction: Patients with primary aldosteronism (PA) have increased cardiovascular risk, and there are concerns about the efficacy of medical therapy.

Objective: We aimed to assess long-term tolerability and efficacy of medical therapy in PA patients.

Methods: We conducted a retrospective study on 201 PA patients treated with medical therapy (spironolactone, eplerenone, or amiloride) from 2000 to 2020 at 2 tertiary centers.

One-Year Outcomes of Micropulse Cyclophototherapy for Primary Open-angle Glaucoma.

Precis: In primary open-angle glaucoma (POAG), micropulse trans-scleral cyclophototherapy (MPTCP) is effective in lowering intraocular pressure (IOP), but its effects are not permanent. Hence, it can serve as a temporizing measure before definitive glaucoma surgery.

Purpose: There is limited data on MPTCP in POAG.

Corneal Cross-Linking: The Evolution of Treatment for Corneal Diseases.

Corneal cross-linking (CXL) using riboflavin and ultraviolet A (UVA) light has become a useful treatment option for not only corneal ectasias, such as keratoconus, but also a number of other corneal diseases. Riboflavin is a photoactivated chromophore that plays an integral role in facilitating collagen crosslinking. Modifications to its formulation and administration have been proposed to overcome shortcomings of the original epithelium-off Dresden CXL protocol and increase its applicability across various clinical scenarios.

Re-evaluating absent clinical success after adrenalectomy in unilateral primary aldosteronism.

Background: Adrenalectomy cures unilateral primary aldosteronism, and it improves or cures hypertension. However, a significant proportion of patients are classified with absent clinical success postsurgery, suggesting that surgery was ineffective.

Methods: We assessed all patients 6 to 12 months post-surgery for clinical outcomes using Primary Aldosteronism Surgical Outcomes (PASO), AVIS-2, and CONNsortium criteria.