Use of repository corticotropin injection for the prophylaxis of corneal graft rejection in high-risk patients: A case series
Bibliographic record
Abstract
Introduction: Graft rejection is the leading cause of corneal allograft failure. Prompt recognition followed by aggressive steroid therapy are key elements in the treatment of graft rejection; however, prolonged corticosteroid use carries an unfavorable safety profile. Repository corticotropin injection (RCI) is United States Food and Drug Administration (FDA)-approved for the treatment of several inflammatory disease states and is indicated for use in severe ophthalmic acute and chronic allergic and inflammatory processes. In this consecutive, observational case report we provide descriptive results of the use of RCI as prophylaxis for corneal graft rejection in high-risk patients. Presentation of cases: Eligible high-risk patients were administered 80 units of RCI subcutaneously twice weekly beginning one-month pretransplant. Preoperative visual acuity (VA) and postoperative intraocular pressure, graft integrity, and VA values were collected for all patients. Discussion: The majority of patients (87.5 %) receiving RCI demonstrated maintenance or improvement of VA post-keratoplasty as well as post-operative intraocular pressures that fell within the normal range. Upon postoperative examination, the majority of patients (6/8; 75 %) treated with RCI maintained a clear graft quality with no signs of rejection. No treatment-emergent adverse effects were reported by the patients during treatment with RCI. Conclusion: The use of RCI prophylactically in high-risk, post-keratoplasty patients demonstrated maintenance or improvement in VA in the majority of patients. The results of this study also showed that RCI was safe and well tolerated, which is consistent with the known safety profile of RCI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".