Can Uveitis Be Treated At Home

Here’s how to Treat Uveitis at Home and how to think about the Risk Factors linked to Steroid Eye Drops and how this can affect your Vision down the line.

1. Uveitis Symptoms
2. Is Uveitis Serious
3. Steroid Eye Drops and IOP
4. Uveitis and High Eye Pressure
5. Best Anti-inflammatory Eye Drops
6. How to Reduce Eye Pressure

1. UVEITIS SYMPTOMS

What are the Symptoms of Uveitis

What are Uveitis Symptoms

Uveitis Symptoms can affect one or both eyes and may develop rapidly.

Uveitis Symptoms Include:

  • Blurred vision
  • Floaters, which are dark floating spots in your vision
  • Eye Pain
  • Red Eyes
  • Sensitivity to Light (Photophobia)
  • A Halo Effect around lights is a very good indicator!!

  • There is a direct link between Uveitis and Glaucoma considered by many as a preventable blindness.

Uveitis Image

What is Anterior Uveitis?

Anterior Uveitis is an eye condition that causes inflammation in the Uvea, the middle layer of the eye. It can lead to serious problems if not treated properly. Knowing the types and symptoms can help you recognise and manage flare-ups.

You may be more prone to anterior Uveitis if you have:

What is the link between Uveitis and the Herpes Virus

  • Prior infections with the Herpes Virus (cold sore or genital herpes) or the chicken pox virus can increase your chance of developing Uveitis when your immune system is low.

What is Intermediate Uveitis

Intermediate Uveitis  causes inflammation in the vitreous- the fluid-filled space inside the eye. It is the least common type of Uveitis (15%). Seen among young adults.

About one in three people with Intermediate Uveitis also have:

What is Posterior Uveitis

Posterior Uveitis is the least common form of Uveitis, but it is the most serious type of Uveitis, since it affects the back of the eye – including the retina, choroid, and optic nerve.

This type can cause recurrent symptoms that last months or years. Potential causes include:

  • Birdshot chorioretinopathy.
  • Viral etiologies such as herpes virus or chicken pox virus.
  • Lupus.
  • Sarcoidosis.
  • Syphilis.
  • Tuberculosis

What is Panuveitis

Panuveitis or Diffuse Uveitis affects all the layers or parts of the eye. Rarely seen. This can cause severe damage to the Retina and therefore raises the chances of permanent vision loss. Treatment options need to chosen carefully.

Potential causes include:

  • Bacterial or fungal retinitis.
  • Viral retinitis.
  • Toxoplasmosis.
  • Lupus.
  • Sarcoidosis.
  • Syphilis.
  • Tuberculosis (TB).
What Is Uveitis

2. Is Uveitis Serious

Uveitis Can Be Serious for At Risk Population Groups and if you are a Steroid Responder.

Steroid Responders
Steroid Eye Drop Side Effects

3. Steroid Eye Drops Side Effects

Steroid Eye Drops side effects are serious for people who are Steroid Responders

What Causes High Eye Pressure and How to Reduce It

High Eye Pressure can be caused by Inflammation in the eye or because you are a Steroid Responder.

INTRAOCULAR PRESSURE

Steroid Eye Drops-Complications and Comorbidities

Uveitis and Glaucoma

There is a direct link between Uveitis and Glaucoma. With a time lag of sustained inflammation and long-term steroid use in between.

Uveitic Glaucoma

Glaucoma in patients with Uveitis is usually caused by sustained inflammation, and prolonged use of steroid eye drops.

The Strength of Steroid Eye Drops and the Length of Use of Steroid Eye drops factors as a high risk factor for developing Uveitic Glaucoma.

Being a Steroid Responder means the eye drops cause high high pressure and/ or being in the Special At Risk Population Groups means that your chance of developing Glaucoma and permanent vision loss are high, which makes Steroid-free remission an important goal.

OcuSolve eye drops can be used to maintain remission and avoid Uveitis flare-ups altogether.

Impact on Vision

Uveitis can significantly affect your vision. It may cause blurred vision, floaters, or even severe vision loss if not treated promptly. One common complication is increased eye pressure, which can lead to glaucoma.

Managing inflammation in the eye reduces eye pressure.

Consider using a safe non-toxic anti-inflammatory eye drops like OcuSolve in order to achieve this goal.

Elevated pressure can damage the optic nerve over time. Glaucoma is often called the “sneak thief of vision” , because mild eye pressure increases can damage the eye without your knowledge, until it’s too late.

Uveitic Cataract

Uveitic Cataracts are formed in patients with uveitis usually caused by sustained inflammation, or prolonged use steroid eye drops.

Long-term steroid use may lead to:

STEROID EYE DROP SIDE-EFFECTS

What Are Steroid Eye Drop Side-effects

1. GLAUCOMA

Figure 1: A fundus photo of the optic nerve showing increased cupping, a risk factor for glaucoma.

Glaucoma is a condition related to elevated eye pressure or intraocular eye pressure.

The result of this damage is a progressive, permanent vision loss.

The risk of steroid-induced glaucoma depends on the duration of use and potency of the steroids themselves as well as the individual’s baseline risk for glaucoma.6-8 

At Risk Groups are also likely to have increased eye pressure due to Steroid Eye drops or Oral Steroids themselves.

It is impossible to evaluate IOP changes constantly, and therefore avoid the moment at which this will occur and therefore the subsequent damage to the eye.

AT RISK POPULATION GROUPS AND STEROID EYE DROPS

Read more here

What Causes High Eye Pressure

Figure 2. Example of a posterior subcapsular cataract, the type of cataract that often forms from chronic steroid use. Photographer: James Gilman, CRA, FOPS, Moran Eye Center11

Cataracts

Long-term steroid Chronic Uveitis eye drop use is associated with an accelerated development of Cataracts, andreduced vision. While the mechanism of cataract development in this setting is not well understood, it is thought to involve steroid-induced changes in gene transcription within lens epithelial cells.10

Classically, the type of cataract associated with steroid use is called a posterior subcapsular cataract, which forms in the back of the lens (Figure 1).11

3. DELAYED WOUND HEALING AND RISK OF INFECTION

Fluorescein staining of a dendritic ulcer

Figure 3: Fluorescein staining of a dendritic ulcer, pathognomonic for herpetic keratitis.  This is a type of corneal ulcer where steroids are absolutely contraindicated due to the risk of worsening the infection.

Steroids are often used in conjunction with topical antibiotics in ocular infections such as corneal ulcers. However research has identified that steroids inhibit growth factors critical in wound healing.12 Therefore local ocular infections treated with steroids may become worse, especially viral infections such as herpetic keratitis.12

While local steroid therapy is valuable in infections of the eye, owing to their ability to reduce inflammation and scarring, these benefits must be weighed against the risk of recurrent infection and poor wound healing and require the close monitoring of an eye specialist.

4. UVEITIS and High Eye Pressure

Dr Douglas Rhee is a Molecular Biologist, Glaucoma Specialist and Ophthalmologist. In his opinion solid control of Inflammation in the eye will resolve Eye Pressure. He also says that up to 40% of Normal Adults are Steroid Responders and will react to Steroid Eye Drops with elevated eye pressure.

SEE DIRECT COMPARISON between Ocusolve Eye Drops and Steroid Eye Drops here.

Better education of Eye Care Providers, including Uveitis and Glaucoma Specialists, about this blinding disease and the ramifications of improper therapy, is vital to bridging the gaps in treatment that exist for many patients.

According to Dr Stephen Anesi who is a Glaucoma Specialist the number of providers who understand this premise is thankfully growing.

He goes on to say that ” Providers do their patients a disservice when they are overly concerned about the dangers of systemic steroid therapy and then continue to pour steroid drops on Uveitis, keep symptoms “quiet” only to let resulting glaucoma ravage the eye”.- Dr Stephen Anesi.

Ocusolves Healing anti-inflammatory Eye Drops are an imperative for these patients in order to avoid Glaucoma- “the sneak thief” of vision.

“Solid control of Ocular Inflammation can lessen the risk of perpetual vision loss from secondary glaucoma, cataract or optic nerve damage- directly caused by or related to this inflammation. And this absolutely must be achieved off of all steroids, achieving “steroid free remission” of inflammation. “ – Dr Stephen Anesi

Glaucoma is the ‘sneak thief’ of vision, a blinding disease of the optic nerve, or the structure that connects your eye and brain and allows you to see.

  • It causes irreversible vision loss which,
  • at first, is usually completely unnoticed by the patient,
  • asymptomatic, because it affects the ‘peripheral’ vision,
  • but slowly progresses until significant central vision loss occurs

Some forms of uveitis are more prone to developing glaucoma, including both infectious causes, such as some types of virus-associated uveitis, and non-infectious causes, like juvenile idiopathic arthritis-associated uveitis.

The most common reason why glaucoma causes vision loss is because of high pressure in the eye. It is primarily a problem with fluid balance in the eye which creates the pressure – “too much fluid in” or “not enough fluid out”. In uveitic glaucoma, several other factors may be in play, including scarring and poor blood flow due to chronic inflammation. Scarring may cause abnormalities in the “outflow” pathway of fluid from the eye, leading to higher pressure.

Abnormal blood flow and blood vessel inflammation can also damage outflow pathways, but may also pose a threat to oxygen delivery to the retina and optic nerve (ischemia), which can also cause irreversible damage. At times, active inflammation is felt to be the cause of high eye pressure, as may happen in herpes simplex iritis – simply treating the inflammation causes the eye pressure to return to normal.

5. Best Anti-inflammatory Eye Drop

Ocusolve is the best anti-inflammatory eye drop that is safe and well tolerated.

Ocusolve is the best alternative treatment for Uveitis
  • You can use OcuSolve™ for all forms of inflammation and infection control. OcuSolve™ Eye Wash has several mechanisms of action:
    • Ocusolve is non-toxic and well tolerated by sensitive individuals
    • Ocusolve is safe for Long-term use
    • Ocusolve is safe for Children and other Steroid Responders.
    • Ocusolve can be used during pregnancy
    • Ocusolve is safe for At Risk Groups who are likely to respond to Steroids with elevated eye pressure.
    • Ocusolve can be used by Glaucoma patients and need to achieve lower eye pressure without steroid eye drops.
    • Ocusolve speeds up healing after Cataract or Lens implants and reduces pain levels considerably in 85% of patients.

Being a Steroid Responder and/ or being in the Special At Risk Population Groups means that your chance of developing Glaucoma and permanent vision loss are high, which makes Steroid-free remission an important goal.

Uveitis can significantly affect your vision. It may cause blurred vision, floaters, or even severe vision loss if not treated promptly. One common complication is increased eye pressure, which can lead to glaucoma.

Managing inflammation in the eye reduces eye pressure. Consider using a safe non-toxic anti-inflammatory eye drops like OcuSolve in order to achieve this goal.

There is a direct link between Uveitis and Glaucoma. With a time lag of sustained inflammation and long-term steroid use in between.

Elevated pressure can damage the optic nerve over time. Glaucoma is often called the “sneak thief of vision” , because mild eye pressure increases can damage the eye without your knowledge, until it’s too late.

  • OcuSolve™ combats biofilms. A biofilm is a colony of microbes that exude sticky material which forms a matrix or grid.
  • It’s estimated that almost 70% of all infections that require treatment are due to biofilm formation. This film forms in order to protect the microbes colony
  • Ocusolve’s REGEN BIO-HOCI molecule penetrates and disrupts the biofilm and microbial cell membranes.
  • OcuSolve™ is thus able to create a challenging environment for invasive pathogenic Conjunctivitis.
  • Ocusolve’s REGEN BIO-HOCI is an Oxygen rich solution. Each Oxygen species has a distinct mode of action and capability:
  • which is a potent antimicrobial capable of eradicating antibiotic-resistant strains of bacteria, viruses and fungus.
  • without promoting the emergence of newly resistant strains of infection
  • Several studies have shown that BIO-HOCl (in OcuSolve) has a high kill rate without affecting healing.

Bettamed OcuSolve Eye Drops are a life-altering advance in Uveitis Care.

Bettamed Ocusolve (with Hypochlorous Acid) is naturally produced by our white blood cells and is an essential part of our immune system. This process is called phagocytosis and is one of nature’s symbiotic actions- with no evidence of induced microbe resistance.5

Bettamed OcuSolve™ with (HOCl) exhibits potent broad-spectrum antimicrobial activity, including antibiotic-resistant strains of bacteria (including MRSA and VRE), viruses, fungi and spores- as demonstrated in numerous studies1,2,5,6,8,12,13, while reducing inflammation and increasing Oxygen (O2) in treated tissue.

There are no concerns about ocular toxicity with HOCL, in fact it has been found to be non-irritating and non-sensitising in various animal safety models.5

Bettamed OcuSolve™ is bio-compatible, non-toxic and non-sensitizing, making it safe for regular use.

A significant portion of HOCl’s potency is derived from its anti-inflammatory effects, as a result of its modulating effect controlling mast cell response.

A study by Medina-Tamayo et al43 suggests a neutral PF Superoxidised Solution (SOS), acts like a mast cell membrane stabilizing inhibitor, inhibiting the cell machinery for granule secretion, without altering the signal transduction pathways. Additionally, many studies, including Sakarya et al44 demonstrate that HOCl induces significant healing, as well as a substantial reduction in signs of inflammation.

In 2013, Pelgrift et al45 proposed that HOCL is both antimicrobial and anti-inflammatory, which accounts for the reduction in pruritis in dermatology.

A study by Bongiovanni46 investigated the micro-circulatory integrity (oxygenation) of patients with venous leg ulcers and its effect on time to wound healing. Exposure of the Venous leg ulcers to HOCl elevated TcPO2 levels for up to 72 hours after exposure, which increased time to wound healing between 2-180 days.

The added advantage is that the dissolved Oxygen (O2) in Bettamed Ocusolve eye drops, improves Oxygen balance for infection control, creating a reversal of the tissue damage and possible vision loss caused by uncontrolled inflammatory processes.47,48,49

7. How to Lower Eye Pressure at Home

According to Dr Stephen Anesi who is a Glaucoma Specialist and an Ocular Immunology Chair, proper and solid resolution of inflammation resolves eye pressure.

  1. Unresolved underlying inflammation in the eye causes Increased Eye Pressure or increased Intraocular Pressure.
  2. Steroid Therapy (both Systemic and topical drops) increase eye pressure in 40% of Normal Adults Intraocular Pressure.

Use Ocusolve as a Step-down or Replacement Therapy without Risk.

Regular eye exams will NOT save your eyesight!!

the risks of long term uveitis

8. REFERENCES

  1. Chen J, Xie H, Wang Z, Yang B, Liu Z, Chen L, Gong X, Lin Y. Mooren’s ulcer in China: a study of clinical characteristics and treatment. Br. J. Ophthalmol. 2000;84:1244–1249. [PMC free article][PubMed] [Google Scholar]
  2. Srinivasan M, Zegans ME, Zelefsky JR, Kundu A, Lietman T, Whitcher JP, Cunningham ET., Jr Clinical characteristics of Mooren’s ulcer in South India. Br. J. Ophthalmol. 2007;91:570–575. [PMC free article][PubMed] [Google Scholar]
  3. 3. Zegans ME, Srinivasan M. Mooren’s Ulcer.  Clin. Ophthalmol. 1996;36:81–88. [Google Scholar]
  4. Markomichelakis NN, Canakis C, Zafirakis P, Marakis T, Mallias I, Theodossiadis G. Cytomegalovirus as a cause of anterior uveitis with sectoral iris atrophy. Ophthalmology. 2002;109:879–882. [PubMed] [Google Scholar]
  5. Yoser SL, Forster DJ, Rao NA. Systemic Viral Infections and their retinal and choroidal manifestations. Surv. Ophthalmol. 1993;37:313–352. [PubMed] [Google Scholar]
  6. Craig EL, Suie T. Histoplasma Capsulatum in Human Ocular Tissue. Arch. Ophthalmol. 1971;91:285–289. [PubMed] [Google Scholar]
  7. Gonzales CA, Scott IU, Chaudhry NA, Luu KM, Miller D, Murray TG, Davis JL. Endogenous endophthalmitis caused by Histoplasma capsulatum var. capsulatum: a case report and literature review. Ophthalmology. 2000;107:725–729. [PubMed] [Google Scholar]
  8. Hawkins BS, Alexander J, Schachat AP. In: Ocular histoplasmosis.Ryan SJ, editor. St. Louis: Retina Mosby; 1994. pp. 1661–1675. [Google Scholar]
  9. Scholz R, Green WR, Kutys R, Sutherland J, Richards RD. Histoplasma capsulatum in the eye. Ophthalmology. 1984;91:1100–1104. [PubMed] [Google Scholar]
  10. Bakunowicz-Lazarczyk A, Maciorkowska E, Antosiuk R, Kaczmarski M. Helicobacter pylori as supposed factor of uveitis in children: a case report. Klin. Oczna. 1999;101:463–465. [PubMed] [Google Scholar]
  11. Otasevic L, Walduck A, Meyer TF, Aebischer T, Hartmann C, Orlic N, Pleyer U. Helicobacter pylori infection in anterior uveitis. Infection. 2005;33:82–85. [PubMed] [Google Scholar]
  12. Otasevic L, Zlatanovic G, Stanojevic-Paovic A, Miljkovic-Selimovic B, Dinic M, Djordjevic-Jocic J, Stankovic A. Helicobacter pylori: an underestimated factor in acute anterior uveitis and spondyloarthropathies? Ophthalmologica. 2007;221:6–13. [PubMed] [Google Scholar]
  13. Cancino-Diaz JC, Vargas-Rodríguez L, Grinberg-Zylberbaum N, Reyes-López MA, Domínguez-López ML, Pablo-Velazquez A, Cancino-Diaz ME. High levels of IgG class antibodies to recombinant HSP60 kDa of Yersinia enterocolitica in sera of patients with uveitis. Br. J. Ophthalmol. 2004;88:247–250. [PMC free article][PubMed] [Google Scholar]
  14. Careless DJ, Chiu B, Rabinovitch T, Wade J, Inman RD. Immunogenetic and microbial factors in acute anterior uveitis. J. Rheumatol. 1997;24:102–108. [PubMed] [Google Scholar]
  15. Huhtinen M, Laasila K, Granfors K, Puolakkainen M, Seppälä I, Laasonen L, Repo H, Karma A, Leirisalo-Repo M. Infectious background of patients with a history of acute anterior uveitis. Ann. Rheum. Dis. 2002;61:1012–1016. [PMC free article][PubMed] [Google Scholar]
  16. Larkin F. Yersinia infection in acute anterior uveitis. Arch. Ophthalmol. 1990;108:1515–1516. [PubMed] [Google Scholar]
  17. Osusky R, Kain HL. Uveitis after Yersinia enterocolitica infection. Klin. Monbl. Augenheilkd. 1991;198:451–452. [PubMed] [Google Scholar]
  18. Arora R, Das S, Chauhan D, Daraius S, Narula R, Sachdev R. Bilateral endogenous panophthalmitis caused by Salmonella typhi: first case report. Orbit. 2008;27:115–117. [PubMed] [Google Scholar]
  19. Yodprom R, Pathanapitoon K, Kunavisarut P, Ausayakhun S, Wattananikorn S, Rothova A. Endogenous endophthalmitis due to Salmonella choleraesuis in an HIV-positive patient. Ocul. Immunol. Inflamm. 2007;15:135–138. [PubMed] [Google Scholar]
  20. Sprenkels SH, Van Kregten E, Feltkamp TE. IgA antibodies against Klebsiella and other Gram-negative bacteria in ankylosing spondylitis and acute anterior uveitis. Clin. Rheumatol. 1996;S1:48–51. [PubMed] [Google Scholar]
  21. Altiparmak UE, Ozer PA, Ozkuyumcu C, Us AD, Aslan BS, Duman S. Postoperative endophthalmitis caused by Bacillus cereus and Chlamydia trachomatis. J. Cataract Refract. Surg. 2007;33:1284–1287. [PubMed] [Google Scholar]
  22. Garg SP, Bajaj MS, Jaffery NF, Mahajan VM. Chlamydial serology in uveitis. Rev. Int. Trach. Pathol. Ocul. Trop. Subtrop. 1989;66:7–20. [PubMed] [Google Scholar]
  23. Haller-Schober EM, El-Shabrawi Y. Chlamydial conjunctivitis (in adults), uveitis, and reactive arthritis, including SARA. Sexually acquired reactive arthritis. Best Pract. Res. Clin. Obstet. Gynaecol. 2002;16:815–828. [PubMed] [Google Scholar]
  24. Huhtinen M, Puolakkainen M, Laasila K, Sarvas M, Karma A, Leirisalo-Repo M. Chlamydial antibodies in patients with previous acute anterior uveitis. Invest. Ophthalmol.Vis. Sci. 2001;42:1816–1819. [PubMed] [Google Scholar]
  25. Krichevskaia GI, Vakhova ES, Maĭchuk F, Davydova GA. Implication of Chlamydia trachomatis in the etiopathogenesis of anterior uveitis. Vestn Oftalmol. 2008;124:48–51. [PubMed] [Google Scholar]
  26. Numazaki K, Chiba S, Aoki K, Suzuki K, Ohno S. Detection of serum antibodies to Chlamydia pneumoniae in patients with endogenous uveitis and acute conjunctivitis. Clin. Infect. Dis. 1997;25:928–929. [PubMed] [Google Scholar]
  27. Khairallah M, Chee SP, Rathinam SR, Attia S, Nadella V. Novel infectious agents causing uveitis. Int. Ophthalmol. 2010;32:465–483. [PubMed] [Google Scholar]
  28. Klaeger AJ, Herbort CP. Acute acquired toxoplasmic retinochoroiditis in a patient with anterior uveitis, amplified by immunosuppressive therapy. Int. Ophthalmol. 2009;29:191–193. [PubMed] [Google Scholar]
  29. Melamed J, Eckert GU, Spadoni VS, Lago EG, Uberti F. Ocular manifestations of congenital toxoplasmosis. Eye. 2010;24:528–534. [PubMed] [Google Scholar]
  30. Curi A, Matos K, Pavesio C. Acute anterior uveitis. Clin. Evid. 2005;14:739–743. [PubMed] [Google Scholar]
  31. Read RW. Uveitis: advances in understanding of pathogenesis. Curr. Rheumatol. Rep. 2006;8:260–266. [PubMed] [Google Scholar]
  32. Rathinam SR, Cunningham ET., Jr Infectious causes of uveitis in the developing world. Int. Ophthalmol. Clin. 2000;40:137–152. [PubMed] [Google Scholar]
  33. Wallis S, Macierewicz J, Shrestha BM. Behcet’s Disease: report of a case and review of the literature. J. Nepal Med. Assoc. 2006;45:362–365. [PubMed] [Google Scholar]
  34. Alebiosu CO, Raimi TH, Badru AI, Amore OO, Ogunkoya JO, Odusan O. Reiter’s syndrome–a case report and review of literature. Afr. Health Sci. 2004;4:136–138. [PMC free article][PubMed] [Google Scholar]
  35. Amor B. Reiter’s syndrome. Diagnosis and clinical features. Rheum. Dis. Clin. North Am. 1998;24:677–695. [PubMed] [Google Scholar]
  36. Cuttica RJ, Scheines EJ, Garay SM, Romanelli MC, Maldonado CJA. Juvenile onset Reiter’s syndrome. A retrospective study of 26 patients. Clin. Exp. Rheumatol. 1992;10:285–288. [PubMed] [Google Scholar]
  37. Francois J. Cortisone et tension oculaire. Ann D’Oculist 1954; 187: 805.
  38. Cantrill HL, Palmberg, Zink HA, Waltman SR, Podos SM, Becker B. Comparison of in vitro potency of corticosteroids with ability to raise intraocular pressure. Am J Ophthalmol 1975; 79: 1012–1017.
  39. Francois J. Corticosteroid glaucoma. Ann Ophthalmol 1977; 9: 1075–1080.
  40. James ER. The etiology of steroid cataract. J Ocul Pharmacol Ther 2007;23:403–20.

41.Moran CORE | Cataracts. http://morancore.utah.edu/medical-student-education-outline/cataracts/ (accessed 28 Jul 2018)

42.Srinivasan M, Mascarenhas J, Rajaraman R, et al. The Steroids for Corneal Ulcers Trial. Arch Ophthalmol 2012;130.

  1. Medina-Tamayo J, Sanchez-Miranda E, Balleza-Tapia H, et al. Super-oxidized solution inhibits IgE-antigen-induced degranulation and cytokine release in mast cells. Int Immunopharmacol. 2007;7(8):1013-1024.
  2. Sakarya S, Gunay N, Karakulak M, Ozturk B, Ertugrul B. Hypochlorous acid: an ideal wound care agent with powerful microbicidal, antibiofilm, and wound healing potency. Wounds. 2014;26(12): 342-350.
  3. Pelgrift R, Friedman AJ. Topical hypochlorous acid (HOCl) as a potential treatment of pruritus. Curr Derm Rep. 2013;2:181-190.
  4. Bongiovanni CM. Effects of hypochlorous acid solutions on venous leg ulcers (VLU): experience With 1249 VLUs in 897 patients. J Am Coll Clin Wound Spec. 2014;6(3):32-37
  5. Gottrup F. Oxygen in wound healing and infection. World J Surg 2004; 28(3):312–315. https://doi.org/10.1007/s00268-003-7398-5
  6. Sen CK. Wound healing essentials: let there be oxygen. Wound Repair Regen 2009; 17(1):1–18. https://doi.org/10.1111/j.1524-475X.2008.00436.x