The indications for topical ophthalmic antiinflammatory drugs (steroidal, nonsteroidal, and novel) are evolving rapidly, as new agents and new applications emerge. Many of these are novel—eg, the perioperative use of nonsteroidal antiinflammatory drugs (NSAIDs) to prevent cystoid macular edema—and/or fly in the face of older thinking—eg, the use of steroids to calm inflammation and reduce the risk of melting or scarring from infection. Neither of these important applications is on-label. In addition, new steroidal and nonsteroidal agents continue to come to market, expanding the utility of both classes.What has regrettably not followed this expansion of indications, formulations, and new molecular entities are protocols for drug selection and use. Topics in Ocular Antiinflammatories will provide clinicians up-to-date information about the indications and optimum uses for topical ophthalmic antiinflammatory drugs. In the context of recent clinical data, a clear mechanistic understanding of each drug class generally—and of newer formulations specifically—will equip clinicians to make effective, evidence-based prescribing decisions across the many clinical situations that call for ocular inflammation control.
Inflammation Control Following Refractive Surgery
Stephen Lane, MD
Immunity, Inflammation, and Hydration of the Ocular Surface
Stephen C. Pflugfelder, MD
Understand the variables that influence association between ocular surface inflammation associated with refractive surgery.
Reduce ocular surface inflammation in refractive surgery patients.
Describe the immunoinflammatory pathway underlying DED.
Improve management of DED by focusing treatment strategy on the prevention and treatment of ocular surface inflammation.
Ocular Surface Consequences of Systemic Inflammatory Diseases
Laura M. Periman, MD
Blepharitis and Meibomian Gland Dysfunction
Kenneth A. Beckman, MD
Make earlier diagnosis of dry eye associated with an underlying systemic inflammatory condition.
Engage in a multidisciplinary clinical approach to systemic inflammatory disease with ocular surface consequences.
Distinguish anatomic sites of blepharitis.
Better manage patients with anterior blepharitis or MGD.
Diagnosing Dry Eye
Eric D. Donnenfeld, MD
Ocular Surface Disease among Glaucoma Patients: A Review
Richard A. Lewis, MD
Approximate patient risk for dry eye disease.
Design a protocol for detecting and diagnosing MGD in the clinic.
Evaluate a glaucoma patient for ocular surface disease.
Manage ocular surface disease in glaucoma patients.
Advances in Antiinflammatory Therapy for Dry Eye
Shachar Tauber, MD
Inflammation Control Before and After Cataract Surgery
Sheri Rowen, MD
Examine the role of inflammation in the pathophysiology of dry eye.
Formulate diagnostic and therapeutic strategies for managing the ocular surface inflammation associated with dry eye.
Improve outcomes of cataract surgery by identifying and treating preexisting dry eye.
Minimize postoperative inflammation with appropriate anti-inflammatory therapies.
NSAIDs and the Ocular Surface: What are the Concerns Today?
Rajesh K. Rajpal, MD
Corticosteroids for Ocular Surface Inflammatory Disorders
Michael B. Raizman, MD
Identify patients at high risk for NSAID-associated adverse events.
Describe a strategy for long-term antiinflammatory treatment of ocular inflammation that minimizes the risks associated with long-term steroid exposures.
Devise topical NSAID regimens that ensure therapeutic efficacy while minimizing the risk of adverse events in the management of postsurgical complications.
MMP-9, Corticosteroids, and Ocular Surface Disease: A New Paradigm?
Christopher E. Starr, MD
Antiinflammatory Prophylaxis for Cataract Surgery: Corticosteroid, NSAID, or Both?
Derek W. DelMonte, MD
Incorporate MMP-9 testing in to their ocular surface diagnosis and treatment protocols
Incorporate topical NSAIDs into the perioperative and postoperative management of cataract surgery to optimize patient results.
State the limitations to MMP-9 testing for the diagnosis of dry eye disease.
Prophylaxis for Seasonal Allergic Conjunctivitis
S. Lance Forstot, MD
Ocular Graft-vs-Host Disease
Penny Asbell, MD, MBA, FACS; Ying Guo, MBBS, PhD
Timing the administration of medication to prevent mast cell degranulation makes sense for patients with severe seasonal allergic conjunctivitis.
Gain a better clinical management of patients with ocular graft-vs-host disease that may lead to new approaches to diagnosis, prevention, and treatment.
Cataract Surgery in Uveitis Patients
Lisa Brothers Arbisser, MD
Ocular Surface Consequences of Systemic Inflammatory Disease
Esen Akpek, MD; Ying Guo, MBBS, PhD
Outline a practical course of action for perioperative care of uveitis patients undergoing cataract removal surgery with IOL implantation.
Engage in a multidisciplinary clinical approach to ocular inflammatory disease associated with systemic disorders.
Corticosteroid Selection in Routine Cataract Surgery
Stephen S. Lane, MD
Managing Optic Neuritis
Neil R. Miller, MD
Select a corticosteroid for postoperative antiinflammatory prophylaxis based on a balance of patient need for potency and presence of risk factors.
Differentiate acute demyelinating optic neuritis from other optic neuropathies based on clinical features.
Are We Doing Enough? Comprehensive Management of Ocular Herpetic Disease Includes Preventing Recurrences
Elisabeth J. Cohen, MD
Strategies for Inflammation Control in Known Corticosteroid Responders
Nick Mamalis, MD
Integrate preventive tools into management of herpetic eye disease
Employ strategies that reduce the risks associated with use of corticosteroids in known corticosteroid responders
How Do Ocular Corticosteroids and NSAIDs Work?
Daniel R. Saban, PhD
Despite Risks, Intravitreal Corticosteroid Implants Remain Useful
Peter K. Kaiser, MD
Evaluate the mechanisms of action and pharmacokinetic properties of ophthalmic corticosteroids and NSAIDs in order to provide the most appropriate antiinflammatory therapy for patients.
Identify uveitis patients for whom the risks of intravitreal corticosteroid implant may outweigh the benefits.
Strategies for Corticosteroid Use in Common Ocular Surface Disorders
Sonia H. Yoo, MD
Current Thinking in the Antiinflammatory Treatment of Uveitis
Thomas Albini, MD
Reduce the risk of side effects in patients being treated with topical corticosteroid for common inflammatory conditions of the ocular surface.
Improve treatment of patients with uveitis through identification of agents and routes of delivery shown to reduce intraocular inflammation.
Serious Allergic Conditions of the Ocular Surface
Jodi I. Luchs, MD
Issues in Long-term Antiinflammatory Therapy
Michael B. Raizman, MD
Adopt strategies for effective treatment of serious ocular allergy that minimize risk of medication side effects.
Employ strategies for minimizing corticosteroid side effects in patients who require chronic management of severe ocular inflammation.
Topical Corticosteroids: Making Sense of the Options
Eric D. Donnenfeld, MD
Complications of Topical Antiinflammatory Agents
John R. Wittpenn, MD
Reevaluate corticosteroid regimens in light of potency and risk profile of newly available agents.
Devise strategies to minimize risk to patients associated with antiinflammatory drugs.
Inflammation and Pain Control in Cataract Surgery
Uday Devgan, MD, FACS, FRCS
What is the Role of Steroids in Treating Ocular Infection?
Thomas M. Lietman, MD; John D. Sheppard, MD
Adapt perioperative antiinflammatory regimens to specific patient factors in order to maximize both safety and efficacy.
Increase the safety of their ocular infection regimens by withholding steroid treatment from inappropriate patients.
Select an appropriate steroid for intravitreal use in endophthalmitis.
Prevention of Pseudophakic Cystoid Macular Edema
Keith A. Walter, MD
New Perspectives on Ocular Antiinflammatory Drugs
Pravin U. Dugel, MD; Terrence P. O’Brien, MD
Formulate effective, efficient prophylactic antiinflammatory regimens for cataract surgery patients.
Discern patients at increased of pseudophakic CME.
Explain how anterior segment surgery can produce inflammatory damage in the posterior segment and cite ways to prevent this from occurring.