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 journalArticle

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
Publication statusPublished - Jan 1 2018
Externally publishedYes

    Fingerprint

Keywords

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

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Dohlman, C. H., Cade, F., Regatieri, C. V., Zhou, C., Lei, F., Crnej, A., ... Paschalis, E. I. (2018). Chemical burns of the eye: The role of retinal injury and new therapeutic possibilities. Cornea, 37(2), 248-251. https://doi.org/10.1097/ICO.0000000000001438