Chemical burns of the eye: The role of retinal injury and new therapeutic possibilities

Claes H. Dohlman, Fabiano Cade, Caio V. Regatieri, Chengxin Zhou, Fengyang Lei, Alja Crnej, Mona Harissi-Dagher, Marie Claude Robert, George N. Papaliodis, Dongfeng Chen, James V. Aquavella, Esen K. Akpek, Anthony J. Aldave, Kimberly C. Sippel, Donald J. D'Amico, Jan G. Dohlman, Per Fagerholm, Liqiang Wang, Lucy Q. Shen, Miguel González-AndradesJames Chodosh, Kenneth R. Kenyon, C. Stephen Foster, Roberto Pineda, Samir Melki, Kathryn A. Colby, Joseph B. Ciolino, Demetrios G. Vavvas, Shigeru Kinoshita, Reza Dana, Eleftherios I. Paschalis

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To propose a new treatment paradigm for chemical burns to the eye - in the acute and chronic phases. Methods: Recent laboratory and clinical data on the biology and treatment of chemical burns are analyzed. Results: Corneal blindness from chemical burns can now be successfully treated with a keratoprosthesis, on immediate and intermediate bases. Long term outcomes, however, are hampered by early retinal damage causing glaucoma. New data suggest that rapid diffusion of inflammatory cytokines posteriorly (TNF-α, etc) can severely damage the ganglion cells. Prompt anti-TNF-α treatment is markedly neuroprotective. Long term profound reduction of the intraocular pressure is also vital. Conclusion: A new regimen, in addition to standard treatment, for severe chemical burns is proposed. This involves tumor necrosis factor alpha (TNF-α) inhibition promptly after the accident (primarily for retinal neuroprotection), prophylactic maximal lowering of the intraocular pressure (starting immediately), and keratoprosthesis implantation in a later quiet state.

Original languageEnglish (US)
Pages (from-to)248-251
Number of pages4
JournalCornea
Volume37
Issue number2
DOIs
StatePublished - 2018
Externally publishedYes

Keywords

  • Chemical burns
  • Glaucoma
  • Infliximab
  • Keratoprosthesis
  • Retinal protection
  • Tumor necrosis factor alpha

ASJC Scopus subject areas

  • Ophthalmology

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