Topical Losartan for Treating Corneal Haze After Ultraviolet-A/Riboflavin Collagen Cross-Linking.

PURPOSE: The purpose of this study was to report our first clinical experience using topical losartan for the treatment of severe corneal haze after epithelium-off corneal cross-linking (CXL). METHODS: A 20-year-old man presented with clinically significant corneal haze in the right eye 1 month following Ultraviolet-A/Riboflavin Epithelium-off Collagen CXL. Haze progressed to a deep stromal scar, and vision was 20/150 with no improvement on refraction, 60 days after CXL. After unsuccessful treatment with topical corticosteroids, the patient elected to start off-label treatment with topical losartan 0.8 mg/mL, administered 6 times per day. RESULTS: After 3 months of initiating topical losartan, the right eye vision improved to preoperative vision of 20/40-1. Corneal haze was significantly reduced as observed on slitlamp examination and on Scheimpflug corneal tomography (Pentacam; OCULUS, Inc. Arlington, WA). CONCLUSIONS: Topical losartan, a transforming growth factor-ß inhibitor, is a potential treatment in clinically significant corneal haze following epithelium-off corneal CXL. This clinical experience highlights the potential efficacy of topical losartan as a novel therapeutic option in such cases, but further clinical studies are needed.

Education and Misinformation: Exploring Ophthalmology Content on TikTok.

INTRODUCTION: With the continuous rise of social media usage, more patients are looking online for health-related information. TikTok is one of the fastest-growing video-based social media platforms, but the quality of its ophthalmologic content, at a comprehensive level, has not been previously analyzed. We aim to explore and characterize popular ophthalmology content on TikTok, including the presence of misinformation. METHODS: Between April 16 and May 22, 2023, 37 different ophthalmology-relevant hashtags were queried on TikTok, and the top 20 most-liked videos per hashtag were analyzed. The quality of educational videos was graded on understandability and actionability using the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V). Trends in creator identity, content type, engagement metrics, misinformation presence, and TikTok verification status were also assessed. RESULTS: The 37 ophthalmology-related hashtags yielded 723 videos comprising 3.806 billion views. A minority of videos were created by ophthalmologists (16.9%) and eyecare providers (35.1%), while the majority were created by non-healthcare providers (55.0%). The most common types of videos identified were primarily related to personal experiences (35.8%) and education (38.0%). Amongst educational videos, mean PEMAT-A/V understandability and actionability scores were 88.1% and 50.6%, respectively. Misinformation was found in 5.4% of all videos, comprising 4.8% of all likes, 4.7% of all comments, and 11.7% of all bookmarks. Its presence was significantly correlated with content created by non-healthcare providers (p < 0.001) and received a disproportionately higher percentage of bookmarks. CONCLUSIONS: This was the largest, most comprehensive evaluation of ophthalmologic content on TikTok. A significant portion of popular ophthalmologic content on TikTok is created by non-eyecare providers and contains misinformation. Our findings confirm the need for ophthalmologists to create more engaging, actionable, and factual educational content to combat misinformation adoption.

A classification of combined homicide-suicide: An update-Part I: Introduction and psychopathology.

A 1995 classification of combined homicide-suicide was based on the psychopathology of the perpetrator and the relationship between the perpetrator and the victim(s). A three-part model was proposed for the study and potential understanding of individual homicide-suicide acts. This triarchic model consisted of the concepts of ego weakness, stress, and vector, the vector representing the ideational component. Today, approaching a quarter of a century after this initial classification based on a review of the literature available then, a considerable volume of experience and investigative knowledge has been published advancing our knowledge of homicide-suicide. The present review updates and revises the original classification, retains the two-part, psychopathological and relational classification, and adds several categories. Because this updated classification is more expansive than the original, it is presented in three parts. Part I, the present article, provides the introduction to this classification and the classification of mental conditions that may attend homicide-suicide. Parts II and III will address intrafamilial and extrafamilial homicide-suicide, respectively, the two major divisions of the classification based on the relationship between the actor and the homicide victim(s). All three parts are integral to this classification and belong together.

A classification of combined homicide-suicide: An update-Part II: Intrafamilial homicide-suicide.

This Part II of the three-part presentation of the updated classification of combined-homicide published in the Journal of Forensic Sciences addresses intrafamilial homicide-suicides (H-Ss). Intrafamilial H-Ss in this classification includes all close relationships including dating and intimate partners, not just traditional family relationships, in contrast to extrafamilial H-Ss where the victim(s) of homicide are either strangers or in a more formal but nonintimate relationship with the actor. Intrafamilial H-Ss are further divided and classified as intimate partner, filicide, familicide, parricide, and siblicide H-Ss, respectively, and are typically so grouped in the literature.

A classification of combined homicide-suicide: An update-Part III: Extrafamilial homicide-suicide.

The subclassification of homicide-suicide into psychopathology and intrafamilial homicide-suicides having been presented in the foregoing Parts I and II, this Part III concerns extrafamilial homicide-suicides. Extrafamilial homicide-suicides are divided into adversarial, autogenic mass, cult, and terrorist homicide-suicides. Adversarial homicide-suicides involve a "formal" relationship between actor and homicide victims, further divided according to the role of the actor in their relationship as employee, current or former pupil/student as in school shootings, patient, and litigant. For comparison, school shootings were divided into those resulting in 10 or more homicide victims and those with fewer. The autogenic mass homicide-suicide, wherein victims are strangers to the actor, was heuristically bifurcated here depending on the number of homicide victims, 10 or more or fewer. As expected, the homicide-suicides with larger numbers of victims were more homogenous.