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Purpose: Mucous membrane pemphigoid (MMP) is a systemic autoimmune condition characterized by blistering and cicatrization, predominantly affecting mucous membranes, including those lining the esophagus, oropharynx, nasal cavity, trachea, conjunctiva, and genitalia. Ocular mucous membrane pemphigoid (OMMP) is observed in approximately 70% of MMP cases. This study aims to review the pathophysiology, clinical manifestations, diagnosis, treatment, and complications of OMMP., Methods: A literature search was conducted using MEDLINE and EMBASE databases., Results: OMMP is characterized by the deposition of autoantibodies along the basement membrane zone of mucous membranes, particularly affecting the conjunctival epithelium. OMMP manifests as chronic ocular discomfort, inflammation, conjunctival scarring, eyelid abnormalities, and visual impairment. Given the extensive range of similar conditions, including drug-induced pseudo-pemphigoid and paraneoplastic conjunctival cicatrization, challenges in differential diagnosis may arise. The clinical diagnosis of OMMP is supported by confirmatory biopsy with histopathology and immunofluorescence studies. The mainstay of management includes systemic immunomodulatory medications and anti-inflammatory agents, tailored to disease severity. Surgical interventions may be necessary, although caution is warranted due to the risk of exacerbating OMMP. Prompt diagnosis and treatment are essential to halt disease progression and prevent vision loss. Complications of OMMP include corneal disorders, lid disorders, and vision disturbances. A comprehensive understanding of OMMP aids in timely intervention and improved patient outcomes., Conclusion: OMMP is a bilateral, chronic, progressive, relapsing-remitting condition. Early diagnosis and treatment of OMMP are necessary to prevent disease progression. The management of OMMP varies according to the severity of the disease, but often involves both medical control of the underlying inflammatory process and subsequent surgical correction of residual anatomical changes., Competing Interests: Declarations. Human participants and animals: This is a review article and does not contain any study on human or animals. Informed consent: This is a review article and it is not applicable. Conflict of interest: No conflicts of interest to disclose by any of the authors., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Competing Interests: Financial disclosures/conflicts of interest: None reported.

Purpose: To explain the physical properties of ophthalmic viscoelastic devices (OVDs), covering their structural units, optimal features, existing viscoelastic materials, clinical applications, and potential side effects., Methods: This is a narrative review on the OVDs. A literature review was conducted in PubMed, Google Scholar, and Scopus databases. Studies that investigated physical characteristics, clinical applications, OVD commercial products, and their complications were included., Results: We included 42 articles from 2010 and discussed physical characteristics, properties of a desirable OVD, structural units of common OVDs, OVD commercial products, clinical applications, and also complications of OVDs., Conclusions: Today, viscoelastics hold a distinct and crucial role in intraocular surgery due to their remarkable properties. These materials safeguard the endothelium and epithelium, uphold anterior chamber depth, manage intraocular bleeding, ease tissue handling, and aid intraocular lens placement. Currently, the American market features 12 prevalent viscoelastic types, including 7 sodium hyaluronate derivatives (Healon, Healon-Greater Viscosity, Healon-5, Amvisc, Amvisc Plus, Advanced Medical Optics Vitrax, and Provisc), 2 hydroxypropyl methylcellulose 2% derivatives (OcuCoat and Cellugel), and 3 combinations of sodium hyaluronate and chondroitin sulfate (Viscoat, DisCoVisc, and DuoVisc). Despite the introduction of new viscoelastic materials annually, no single material encompasses all desired properties. Surgeons must select and employ suitable viscoelastics based on surgical conditions and patient requirements. Advancements in material development and understanding of physical properties and clinical applications continue to refine viscoelastic selection., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Current Ophthalmology.)

Purpose: To evaluate the effect of smoking on retinal thickness and macular and peripapillary vascular density in thyroid eye disease (TED)., Methods: In this cross-sectional study, subjects diagnosed with TED were analyzed in three groups: smokers, passive smokers, and non-smokers. Ganglion cell complex thickness, total retinal thickness, macular superficial vascular plexus densities, deep vascular plexus densities, optic nerve head, and radial peripapillary capillary density were measured in each group., Results: Twenty-two eyes (21.6%) of active smokers, 11 eyes (10.8%) of passive smokers, and 69 eyes (67.6%) of non-smokers constitute the study subjects. Twenty-one eyes (12.6%) had active status (clinical activity score ≥3), 77 eyes (46.1%) were neither active nor compressive, four eyes (2.4%) of two patients constituted the compressive group. Age and disease activity adjusted analysis was performed. Ganglion cell complex thickness of smokers was significantly higher than non-smokers in the inferior hemi-parafoveal sector (p = 0.04). Active smokers had significantly higher (p < 0.01) retinal thickness in all sectors compared to non-smokers, except the foveal sector. Smokers had lower superficial vessel density in the superior parafoveal sector compared to non-smokers (p = 0.04). Considering deep vessel densities between smokers and non-smokers, no significant difference was observed. Radial peripapillary capillary densities (significant difference was observed in the whole image and infranasal peripapillary sector), Macular vascular densities (significant difference was observed in parafoveal sectors), and optic nerve head (not reaching statistical significance level in any sectors) were highest in passive smokers., Conclusions: Smoking is associated with increased total retinal thickness. Macular vascular densities were not different between smokers and non-smokers in TED.

Purpose: To report causative organisms, visual outcomes, and associated medical conditions in endogenous endophthalmitis (EE)., Methods: Microbiological and medical reports of patients with culture-proven EE referred to Farabi Eye Hospital, Tehran, Iran, from January 2008 to January 2018 were reviewed., Results: A total of 144 cases (171 eyes) were included in the present study. Candida albicans (30.6%) and Staphylococcus aureus (27.1%) were the most prevalent microbial causes. Diabetes mellitus (43.8%) and IV drug abuse (10.4%) were the leading associated systemic conditions. Age of the patients (P = 0.002) and presenting corrected distance visual acuity (CDVA) (P < 0.001) were correlated with postoperative CDVA. Patients with bilateral involvement had significantly lower mean logMAR (P = 0.002), and patients with hypopyon had significantly higher mean logMAR (P = 0.006). Eyes with gram-negative bacillus cultures had a significantly worse logMAR than eyes with gram-positive cocci (P = 0.009)., Conclusion: Candida albicans and S. aureus were the most common causes of EE, and diabetes mellitus was the most common associated medical condition. EE is associated with poor visual outcome, especially in older patients, those with worse visual acuity at presentation, and those with positive cultures for gram-negative bacilli.

Background: Tracheal intubation is extremely distressing, painful, and may influence heart rate and blood pressure. Sedatives, analgesics, and muscle relaxants are not commonly used for intubation in neonates., Objectives: This study aimed to evaluate the effects of lidocaine spray as a non-intravenous drug before neonatal intubation on blood pressure, heart rate, oxygen saturation and time of intubation., Patients and Methods: In a randomized, controlled study each neonate was randomly assigned to one of the two study groups by staffs who were not involved in the infant's care. The allocation concealment was kept in an opaque sealed envelope, and the investigators, the patient care team, and the assessors were blinded to the treatment allocation. The selected setting was NICU unit of a teaching hospital in Ilam city, Iran and participants were 60 neonates with indication of tracheal intubation with gestational age > 30 weeks. Patients in the treatment group received lidocaine spray and the placebo group received spray of normal saline prior to intubation. Main outcome measurements were the mean rates of blood pressure, heart rate, oxygen saturation, intubation time and lidocaine side effects were measured before and after intubation., Results: Totally 60 newborns including 31 boys and 29 girls were entered into the study (drug group n = 30; placebo group n = 30). Boy/girl ratio in treatment and placebo groups were 1.3 and 0.88, respectively. Mean age ± SD of participants was 34.1 ± 24.8 hours (treatment: 35.3 ± 25.7; placebo: 32.9 ± 24.3; P < 0.0001). Mean weight ± SD of neonates was 2012.5 ± 969 g. Application of lidocaine spray caused a significant reduction of mean intubation time among treatment group compared with placebo group (treatment: 15.03 ± 2.2 seconds; placebo: 18.3 ± 2.3 seconds; P < 0.0001). Mean blood pressure, heart rate and oxygen saturation rate, among neonates in treatment group was reduced after intubation compared with their relevant figures before intubation; however, their differences were not statistically significant except for mean oxygen saturation rate that was reduced significantly in placebo group. No side effects were observed during study., Conclusions: Though the current study revealed some promising results in the application of lidocaine spray during neonatal intubation without any considerable side effects; however, the current investigation could only be considered as a pilot study for further attempts in different locations with higher sample sizes and in different situations.

Thalidomide is an old glutamic acid derivative which was initially used as a sedative medication but withdrawn from the market due to the high incidence of teratogenicity. Recently, it has reemerged because of its potential for counteracting number of diseases, including neurodegenerative disorders. Other than the antiemetic and hypnotic aspects, thalidomide exerts some anticonvulsant properties in experimental settings. However, the underlying mechanisms of thalidomide actions are not fully realized yet. Some investigations revealed that thalidomide could elicit immunomodulatory or neuromodulatory properties by affecting different targets, including cytokines (such as TNF α), neurotransmitters, and nitric oxide (NO). In this regard, we used a model of clonic seizure induced by pentylenetetrazole (PTZ) in male NMRI mice to investigate whether the anticonvulsant effect of thalidomide is affected through modulation of the l-arginine-nitric oxide pathway or not. Injection of a single effective dose of thalidomide (10 mg/kg, i.p. or higher) significantly increased the seizure threshold (P<0.05). On the one hand, pretreatment with low and per se noneffective dose of l-arginine [NO precursor] (10, 30 and 60 mg/kg) prevented the anticonvulsant effect of thalidomide. On the other hand, NOS inhibitors [l-NAME and 7-NI] augmented the anticonvulsant effect of a subeffective dose of thalidomide (1 and 5 mg/kg, i.p.) at relatively low doses. Meanwhile, several doses of aminoguanidine [an inducible NOS inhibitor] (20, 50 and 100 mg/kg) failed to alter the anticonvulsant effect of thalidomide significantly. In summary, our findings demonstrated that the l-arginine-nitric oxide pathway can be involved in the anticonvulsant properties of thalidomide, and the role of constitutive nNOS is prominent in the reported neuroprotective feature., (Copyright © 2014 Elsevier Inc. All rights reserved.)