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Article: Does Prophylactic Oral Zinc Reduce the Risk of Contracting COVID-19?

Adrean, Sean D / Schmitt, Kenneth / Ng, Caleb / Pirouz, Ash / Ramkumar, Hema L / Grant, Scott

2022 Volume 14, Issue 10, Page(s) e30881

Abstract: Objective In this study, we aimed to investigate whether zinc provided in Age-Related Eye Disease Study 2 (AREDS2) vitamins is associated with a decreased risk of contracting coronavirus disease 2019 (COVID-19). Materials and methods We conducted a ... ...

Abstract	Objective In this study, we aimed to investigate whether zinc provided in Age-Related Eye Disease Study 2 (AREDS2) vitamins is associated with a decreased risk of contracting coronavirus disease 2019 (COVID-19). Materials and methods We conducted a retrospective observational cohort study involving patients at a retina-only practice who were provided a questionnaire at each visit to assess whether they were symptomatic of or had contracted COVID-19. Those who answered yes to testing positive for COVID-19 were retrospectively analyzed and categorized based on their AREDS2 vitamin use, and a Pearson's chi-squared test was performed. Demographic data and past ocular history were also analyzed. Results A total of 8,426 unique patients, including 2,111 with a diagnosis of age-related macular degeneration (AMD), were seen from April 1, 2020, to April 9, 2021. A total of 110 patients (1.3%) reported contracting COVID-19 and had positive COVID-19 tests. The average age of those who had contracted COVID-19 in this study was 68.3 years; 51.8% were male, 30.1% had AMD, 28.2% had diabetic retinopathy, 24.5% had surgical retinal disease, 11.8% had retinal vascular disease, and 4.5% had other disease states. Of the COVID-19-positive patients, 27.3% (30/110) took AREDS2 vitamins, while 72.7% (80/110) patients did not. A chi-squared analysis was performed, which was not statistically significant (p=0.667). Conclusions Oral zinc supplementation, in the form of AREDS2 vitamins, is not associated with a protective effect against contracting COVID-19.
Language	English
Publishing date	2022-10-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.30881
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Article: Long term results of patients with neovascular age-related macular degeneration switched from other anti-VEGF agents to intravitreal Aflibercept.

Adrean, Sean D / Knight, Darren / Chaili, Siyang / Ramkumar, Hema L / Pirouz, Ash / Grant, Scott

International journal of retina and vitreous

2022 Volume 8, Issue 1, Page(s) 11

Abstract: Background: This study explores the long term anatomic and functional results of patients who were switched to intravitreal aflibercept injections (IAI) after being initially managed with other anti-VEGF agents for neovascular age-related macular ... ...

Abstract	Background: This study explores the long term anatomic and functional results of patients who were switched to intravitreal aflibercept injections (IAI) after being initially managed with other anti-VEGF agents for neovascular age-related macular degeneration (nAMD). Methods: Patients with nAMD were included if they started with another anti-VEGF agent and were switched to IAI. Subjects had at least 3 years of consistent therapy with IAI and at least 1 injection quarterly. Results: Eighty-eight patients had at least 3 years of treatment while 58 of those patients, had at least 4 years of IAI. Average treatment time with other anti-VEGF agents was 32 months prior to switching. Baseline best corrected vision (VA) was 59.4 letters (20/70 + 2). At time of switch, VA increased significantly to 66.7 letters (20/50 + 2). At 3 months after switch, VA increased significantly to 69.0 (20/40-) letters. After 3 years of consistent IAI, vision was 67.5 letters (20/40-2), and for those patients that completed 4 years of therapy, the average VA was 66.0 letters (20/50 + 2), with a gain of 6.6 letters over baseline vision. 32.1% of patients gained 3 or more lines of vision. Initial central macular thickness (CMT) was 369 µm, which improved to 347 µm at time of switch, and further improved at 3 months to 301 µm and was maintained over time. Conclusion: Patients switched to IAI can maintain vision over the long term. Patients treated on average for 5.7 years, had a visual gain of 8.1 letters after 3 years and 6.6 letters after 4 years of IAI therapy. CMT significantly improved following the switch and was maintained.
Language	English
Publishing date	2022-02-10
Publishing country	England
Document type	Journal Article
ZDB-ID	2836254-8
ISSN	2056-9920
ISSN	2056-9920
DOI	10.1186/s40942-022-00361-9
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Article ; Online: Myelinated Retinal Nerve Fiber Layer (RNFL): A Comprehensive Review.

Ramkumar, Hema L / Verma, Rohan / Ferreyra, Henry A / Robbins, Shira L

International ophthalmology clinics

2018 Volume 58, Issue 4, Page(s) 147–156

MeSH term(s)	Eye Diseases/pathology ; Humans ; Myelin Sheath/physiology ; Nerve Fibers/pathology ; Nerve Fibers, Myelinated ; Retinal Ganglion Cells/pathology
Language	English
Publishing date	2018-10-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	207382-1
ISSN	1536-9617 ; 0020-8167
ISSN (online)	1536-9617
ISSN	0020-8167
DOI	10.1097/IIO.0000000000000239
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Article ; Online: A novel mutation in a case of dominant optic atrophy?

Ramkumar, Hema L / Savino, Peter J

Indian journal of ophthalmology

2014 Volume 62, Issue 10, Page(s) 1034–1036

MeSH term(s)	Adult ; DNA/genetics ; DNA Mutational Analysis ; Electroretinography ; Female ; GTP Phosphohydrolases/genetics ; GTP Phosphohydrolases/metabolism ; Humans ; Mutation ; Optic Atrophy, Autosomal Dominant/diagnosis ; Optic Atrophy, Autosomal Dominant/genetics ; Optic Atrophy, Autosomal Dominant/metabolism ; Optic Nerve/metabolism ; Optic Nerve/pathology ; Tomography, Optical Coherence
Chemical Substances	DNA (9007-49-2) ; GTP Phosphohydrolases (EC 3.6.1.-) ; OPA1 protein, human (EC 3.6.1.-)
Language	English
Publishing date	2014-10
Publishing country	India
Document type	Case Reports ; Journal Article
ZDB-ID	187392-1
ISSN	1998-3689 ; 0301-4738
ISSN (online)	1998-3689
ISSN	0301-4738
DOI	10.4103/0301-4738.146043
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Article ; Online: Toxic optic neuropathy: an unusual cause.

Ramkumar, Hema L / Savino, Peter J

Indian journal of ophthalmology

2014 Volume 62, Issue 10, Page(s) 1036–1039

Abstract: A 60-year-old woman with a history of chronic alcoholism and tobacco use presented with the complaint of a painless decrease in vision in both eyes. She lost vision first in the left eye then in the right eye. She admitted consuming at least one 16 ounce ...

Abstract	A 60-year-old woman with a history of chronic alcoholism and tobacco use presented with the complaint of a painless decrease in vision in both eyes. She lost vision first in the left eye then in the right eye. She admitted consuming at least one 16 ounce bottle of over the counter mouthwash daily and denied consumption of any other alcohols, methanol, or antifreeze. She stated that her vision had been continuing to deteriorate in both eyes. Her best-corrected visual acuity was 4/200 in each eye. Color vision was nil in each eye. Her pupils were sluggish bilaterally, and her optic discs were flat and hyperemic with peripapillary hemorrhages. Her visual fields revealed central scotomas bilaterally. The magnetic resonance imaging of the brain and lumbar puncture were within normal limits. Antinuclear antibody, human leukocyte antigen-B27 genotyping, and B12 were normal; serum thiamine was low. While continuing to ingest mouthwash, her vision decreased to count fingers at 2 feet, and maculopapillary bundle pallor developed. She was started on folate and thiamine supplementation. Once she discontinued mouthwash, her vision improved to 20/400 bilaterally, and her central scotomas improved. This case demonstrates an alcohol-induced toxic optic neuropathy from mouthwash ingestion with some visual recovery after discontinuation of the offending agent.
MeSH term(s)	Alcoholism/complications ; Chronic Disease ; Female ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Optic Nerve/pathology ; Optic Nerve Diseases/diagnosis ; Optic Nerve Diseases/etiology ; Tomography, Optical Coherence
Language	English
Publishing date	2014-10
Publishing country	India
Document type	Case Reports ; Journal Article
ZDB-ID	187392-1
ISSN	1998-3689 ; 0301-4738
ISSN (online)	1998-3689
ISSN	0301-4738
DOI	10.4103/0301-4738.146045
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Article ; Online: A novel mutation in a case of dominant optic atrophy?

Hema L Ramkumar / Peter J Savino

Indian Journal of Ophthalmology, Vol 62, Iss 10, Pp 1034-

2014 Volume 1036

Keywords	Ophthalmology ; RE1-994 ; Medicine ; R
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Medknow Publications
Document type	Article ; Online
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Article ; Online: Reply.

Muftuoglu, Ilkay K / Alam, Mostafa / You, Qi Sheng / Gaber, Raouf / Ramkumar, Hema L / Mendoza, Nadia / Meshi, Amit / Freeman, William R

Retina (Philadelphia, Pa.)

2017 Volume 37, Issue 9, Page(s) e110–e112

Language	English
Publishing date	2017-08-18
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	603192-4
ISSN	1539-2864 ; 0275-004X
ISSN (online)	1539-2864
ISSN	0275-004X
DOI	10.1097/IAE.0000000000001814
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Article ; Online: Optic nerve head problem.

Verma, Rohan / Chen, Kevin C / Ramkumar, Hema L / Goldbaum, Michael H / Shields, Carol L

Survey of ophthalmology

2017 Volume 64, Issue 4, Page(s) 579–583

Abstract: A 68-year-old woman with a recent history of blurring in the left eye had undergone mastectomy for breast cancer 20 years ago. A series of bone metastases started 5 years after her diagnosis. Examination of the optic nerve head of the left eye revealed ... ...

Abstract	A 68-year-old woman with a recent history of blurring in the left eye had undergone mastectomy for breast cancer 20 years ago. A series of bone metastases started 5 years after her diagnosis. Examination of the optic nerve head of the left eye revealed an isolated peripapillary mass. Indocyanine green angiography displayed vessels within the mass, and fluorescein angiography demonstrated hyperfluorescence of the mass from vascular leakage plus lobular spots of blocked fluorescence. B-scan ultrasound revealed a hyperechoic-elevated nodular mass on the optic disc. Spectral-domain optical coherence tomography displayed a mass of spherules. Magnetic resonance imaging of the brain demonstrated metastatic tumors. She was diagnosed with an optic disk metastasis from her breast carcinoma.
MeSH term(s)	Aged ; Breast Neoplasms/pathology ; Carcinoma/secondary ; Female ; Humans ; Optic Nerve Neoplasms/secondary
Language	English
Publishing date	2017-10-09
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	391346-6
ISSN	1879-3304 ; 0039-6257
ISSN (online)	1879-3304
ISSN	0039-6257
DOI	10.1016/j.survophthal.2017.10.003
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Article ; Online: QUANTITATIVE ANALYSIS OF THE INNER RETINAL LAYER THICKNESSES IN AGE-RELATED MACULAR DEGENERATION USING CORRECTED OPTICAL COHERENCE TOMOGRAPHY SEGMENTATION.

Muftuoglu, Ilkay Kilic / Ramkumar, Hema L / Bartsch, Dirk-Uwe / Meshi, Amit / Gaber, Raouf / Freeman, William R

Retina (Philadelphia, Pa.)

2017 Volume 38, Issue 8, Page(s) 1478–1484

Abstract: Purpose: To characterize inner retinal damage in patients with dry age-related macular degeneration (AMD) using high-resolution spectral domain optical coherence tomography images.: Methods: Sixty eyes of 60 patients with AMD were categorized using ... ...

Abstract	Purpose: To characterize inner retinal damage in patients with dry age-related macular degeneration (AMD) using high-resolution spectral domain optical coherence tomography images. Methods: Sixty eyes of 60 patients with AMD were categorized using the Age-Related Eye Disease Study (AREDS) severity scale. Spectral domain optical coherence tomography images of these patients were quantified by manually correcting the segmentation of each retinal layer, including the retinal nerve fiber layer, ganglion cell layer, and inner plexiform layer to ensure accurate delineation of layers. The mean ganglion cell complex thickness values (ganglion cell layer + inner plexiform layer + retinal nerve fiber layer) were compared with 30 eyes of 30 healthy subjects. Results: Ninety percent of eyes (81 eyes) required manual correction of segmentation. Compared with healthy subjects, mean ganglion cell complex thicknesses significantly decreased in more advanced dry AMD eyes, and this decrease was predominantly related to a change in inner plexiform layer thickness. There was no significant difference in thickness-related measurements between milder dry AMD (AREDS-2) eyes and healthy eyes (P > 0.05). Conclusion: In patients with dry AMD, automatic optical coherence tomography segmentation algorithms may be erroneous. As the severity of dry AMD increases, the inner plexiform layer layer becomes thinned, suggesting that transsynaptic degeneration may be occurring, as the photoreceptor layer is affected by AMD.
MeSH term(s)	Aged ; Aged, 80 and over ; Female ; Humans ; Macular Degeneration/diagnostic imaging ; Macular Degeneration/pathology ; Male ; Middle Aged ; Nerve Fibers/pathology ; Retina/diagnostic imaging ; Retina/pathology ; Retinal Ganglion Cells/pathology ; Tomography, Optical Coherence/methods ; Visual Acuity
Language	English
Publishing date	2017-09-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	603192-4
ISSN	1539-2864 ; 0275-004X
ISSN (online)	1539-2864
ISSN	0275-004X
DOI	10.1097/IAE.0000000000001759
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Article ; Online: Toxic optic neuropathy

Hema L Ramkumar / Peter J Savino

Indian Journal of Ophthalmology, Vol 62, Iss 10, Pp 1036-

An unusual cause

2014 Volume 1039

Abstract	A 60-year-old woman with a history of chronic alcoholism and tobacco use presented with the complaint of a painless decrease in vision in both eyes. She lost vision first in the left eye then in the right eye. She admitted consuming at least one 16 ounce bottle of over the counter mouthwash daily and denied consumption of any other alcohols, methanol, or antifreeze. She stated that her vision had been continuing to deteriorate in both eyes. Her best-corrected visual acuity was 4/200 in each eye. Color vision was nil in each eye. Her pupils were sluggish bilaterally, and her optic discs were flat and hyperemic with peripapillary hemorrhages. Her visual fields revealed central scotomas bilaterally. The magnetic resonance imaging of the brain and lumbar puncture were within normal limits. Antinuclear antibody, human leukocyte antigen-B27 genotyping, and B12 were normal; serum thiamine was low. While continuing to ingest mouthwash, her vision decreased to count fingers at 2 feet, and maculopapillary bundle pallor developed. She was started on folate and thiamine supplementation. Once she discontinued mouthwash, her vision improved to 20/400 bilaterally, and her central scotomas improved. This case demonstrates an alcohol-induced toxic optic neuropathy from mouthwash ingestion with some visual recovery after discontinuation of the offending agent.
Keywords	Atypical optic neuritis ; autoimmunity ; multiple sclerosis ; neuromyelitis optica ; neuroretinitis ; optic neuritis ; optic neuropathy ; Acetylcholine ; autoimmune ; neuro-muscular junction ; ocular myasthenia gravis ; Cortical visual impairment ; hypoxia ; hypoglycemia ; optic atrophy ; prematurity ; periventricular leukomalacia ; Idiopathic intracranial hypertension ; pseudotumor cerebri ; treatment ; Chemosis ; strabismus ; thyroid eye disease ; Childhood optic atrophy ; clinical profile ; etiology ; India ; Abducens palsy ; computed tomography ; cranial nerve palsy ; magnetic resonance imaging ; mononeuropathy ; neuroimaging ; sixth nerve palsy ; Fellowship ; neuro-ophthalmology ; ophthalmology ; sub-specialty ; lumbo-peritoneal shunt ; optic nerve sheath fenestration ; ventriculo-peritoneal shunt ; Megadose ; methylprednisolone ; steroids ; traumatic optic neuropathy ; Alcohol ; mouthwash ; toxic optic neuropathy ; Ophthalmology ; RE1-994 ; Medicine ; R
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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