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-Andrades; James 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

doi:10.1097/ICO.0000000000001438

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 journal › Article › peer-review

18 Scopus citations

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 language	English (US)
Pages (from-to)	248-251
Number of pages	4
Journal	Cornea
Volume	37
Issue number	2
DOIs	https://doi.org/10.1097/ICO.0000000000001438
State	Published - 2018
Externally published	Yes

Keywords

Chemical burns
Glaucoma
Infliximab
Keratoprosthesis
Retinal protection
Tumor necrosis factor alpha

ASJC Scopus subject areas

Ophthalmology

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10.1097/ICO.0000000000001438

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Dohlman, C. H., Cade, F., Regatieri, C. V., Zhou, C., Lei, F., Crnej, A., Harissi-Dagher, M., Robert, M. C., Papaliodis, G. N., Chen, D., Aquavella, J. V., Akpek, E. K., Aldave, A. J., Sippel, K. C., D'Amico, D. J., Dohlman, J. G., Fagerholm, P., Wang, L., Shen, L. Q., ... 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

Dohlman, CH, Cade, F, Regatieri, CV, Zhou, C, Lei, F, Crnej, A, Harissi-Dagher, M, Robert, MC, Papaliodis, GN, Chen, D, Aquavella, JV, Akpek, EK, Aldave, AJ, Sippel, KC, D'Amico, DJ, Dohlman, JG, Fagerholm, P, Wang, L, Shen, LQ, González-Andrades, M, Chodosh, J, Kenyon, KR, Foster, CS, Pineda, R, Melki, S, Colby, KA, Ciolino, JB, Vavvas, DG, Kinoshita, S, Dana, R & Paschalis, EI 2018, 'Chemical burns of the eye: The role of retinal injury and new therapeutic possibilities', Cornea, vol. 37, no. 2, pp. 248-251. https://doi.org/10.1097/ICO.0000000000001438

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title = "Chemical burns of the eye: The role of retinal injury and new therapeutic possibilities",

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.",

keywords = "Chemical burns, Glaucoma, Infliximab, Keratoprosthesis, Retinal protection, Tumor necrosis factor alpha",

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

note = "Funding Information: Supported by the Boston Keratoprosthesis Research Fund, Massachusetts Eye and Ear Infirmary, Boston, MA 02114. Publisher Copyright: Copyright {\textcopyright} 2018 Wolters Kluwer Health, Inc. All rights reserved.",

year = "2018",

doi = "10.1097/ICO.0000000000001438",

language = "English (US)",

volume = "37",

pages = "248--251",

journal = "Cornea",

issn = "0277-3740",

publisher = "Lippincott Williams and Wilkins",

number = "2",

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TY - JOUR

T1 - Chemical burns of the eye

T2 - The role of retinal injury and new therapeutic possibilities

AU - Dohlman, Claes H.

AU - Cade, Fabiano

AU - Regatieri, Caio V.

AU - Zhou, Chengxin

AU - Lei, Fengyang

AU - Crnej, Alja

AU - Harissi-Dagher, Mona

AU - Robert, Marie Claude

AU - Papaliodis, George N.

AU - Chen, Dongfeng

AU - Aquavella, James V.

AU - Akpek, Esen K.

AU - Aldave, Anthony J.

AU - Sippel, Kimberly C.

AU - D'Amico, Donald J.

AU - Dohlman, Jan G.

AU - Fagerholm, Per

AU - Wang, Liqiang

AU - Shen, Lucy Q.

AU - González-Andrades, Miguel

AU - Chodosh, James

AU - Kenyon, Kenneth R.

AU - Foster, C. Stephen

AU - Pineda, Roberto

AU - Melki, Samir

AU - Colby, Kathryn A.

AU - Ciolino, Joseph B.

AU - Vavvas, Demetrios G.

AU - Kinoshita, Shigeru

AU - Dana, Reza

AU - Paschalis, Eleftherios I.

N1 - Funding Information: Supported by the Boston Keratoprosthesis Research Fund, Massachusetts Eye and Ear Infirmary, Boston, MA 02114. Publisher Copyright: Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.

PY - 2018

Y1 - 2018

N2 - 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.

AB - 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.

KW - Chemical burns

KW - Glaucoma

KW - Infliximab

KW - Keratoprosthesis

KW - Retinal protection

KW - Tumor necrosis factor alpha

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U2 - 10.1097/ICO.0000000000001438

DO - 10.1097/ICO.0000000000001438

M3 - Article

C2 - 29135604

AN - SCOPUS:85043690286

SN - 0277-3740

VL - 37

SP - 248

EP - 251

JO - Cornea

JF - Cornea

IS - 2

ER -

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

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Keywords

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