1
|
Yilmaz YC, Hayat SC, Ipek SC. Corneal Clarity and Tomographic Patterns in Pseudoexfoliation Syndrome: A Severity-Based Investigation. Eye Contact Lens 2024:00140068-990000000-00223. [PMID: 39231628 DOI: 10.1097/icl.0000000000001126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2024] [Indexed: 09/06/2024]
Abstract
PURPOSE The aim of the study was to investigate the corneal and anterior segment characteristics in pseudoexfoliation syndrome (PXS), depending on the severity of the disease. MATERIALS AND METHODS This cross-sectional study was conducted at a tertiary care hospital, in the ophthalmology department, in Turkey. Pseudoexfoliation syndrome group was classified into three groups. Pseudoexfoliative material on the part of the pupillary border was classified as group 1, on the entire pupillary border was classified as group 2, and pseudoexfoliative material on the entire pupillary border and iris surface was classified as group 3. The control group was composed of age and gender-matched individuals who had undergone a completely normal ophthalmologic examination. Scheimpflug tomography was performed to record tomographical data. RESULTS The PXS groups 1, 2, and 3, along with the control group, consist of 29, 32, 33, and 42 participants, respectively. There was no significant difference in age-gender distribution between patients and the control group (P>0.05). Group 3 showed significant differences in central corneal thickness compared with the control group (P=0.001). In addition, anterior chamber angle was found to be significantly lower in group 3 than the control group (P<0.001). In corneal densitometry (CD) values, significant increases compared with the control group were observed in groups 2 and 3 across all anterior annuli (P<0.001). In group 1, significant increases observed in the anterior 6-10 mm and 10-12 mm annuli (P<0.001). In the middle 6-10 mm annuluses, only group 3 showed a significant increase compared with the control group (P<0.001). In the posterior 0-2, 2-6, and 6-10 mm annuli, significant increases compared with the control were observed only in groups 2 and 3 (P=0.001, P=0.001, P<0.001, respectively). CONCLUSIONS Corneal densitometry values, even without an increase in intraocular pressure, have a tendency to increase in PXS depending on the severity of the disease. While minimal changes were observed in the middle layer, it was particularly noted that the effects of the disease were more prominent in the peripheral cornea.
Collapse
Affiliation(s)
- Yusuf Cem Yilmaz
- Department of Ophthalmology (Y.C.Y., S.C.H.), Basaksehir Cam Sakura State Hospital, Istanbul, Turkey; Department of Ophthalmology (Y.C.Y., S.C.I.), Agri Ibrahim Cecen University Faculty of Medicine, Agri, Turkey; and Bodrum Gozakademi Private Eye Hospital (S.C.I.), Bodrum, Mugla, Turkey
| | | | | |
Collapse
|
2
|
Jaichander RC, Thomas RK, Shobha V. A study to determine the effect of hydroxychloroquine (HCQ) on central corneal thickness (CCT) in patients with rheumatoid arthritis (RA). Indian J Ophthalmol 2024; 72:270-274. [PMID: 38099363 PMCID: PMC10941934 DOI: 10.4103/ijo.ijo_3052_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 09/14/2023] [Accepted: 09/21/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE Corneal thinning is common in rheumatoid arthritis (RA), thereby affecting the central corneal thickness (CCT). Effect of hydroxychloroquine (HCQ) in RA has abounding literature on retinal toxicity, but there is lack of data on its corneal effects. METHODS A cross-sectional study was carried out to compare CCT in RA patients before treatment initiation (Group 1) with CCT in those on HCQ for ≥3 months (Group 2). RESULTS Fifty patients were enrolled in each group. The mean age was 44.36 years with similar age, gender distribution and visual acuity in both groups. The mean CCT of patients in the cohort was 521.80 µm ± 32.57 µm and 523.94 µm ± 33.40 µm in the right eye (RE) and left eye (LE), respectively. Mean CCT in Group 1 was (RE) 522.80 µm/(LE) 524.26 µm and in Group 2 was (RE) 520.80 µm/(LE) 523.62 µm, and there was no significant difference in CCT between both the groups. Median duration of HCQ usage in Group 2 was 24 months, with the median cumulative dosage being 171 g and a majority having a dosage of 200 mg/day. There was no significant correlation between the duration/cumulative dosage of HCQ intake and CCT. No corneal deposits were identified in any patient. CONCLUSION CCT of RA patients was similar to those reported in the Indian literature. However, there was no significant change in CCT or corneal deposits identified with an HCQ dosage of 200-400 mg/day. Longer follow-up would provide clarity on the impact of duration and cumulative dosage of HCQ on corneal changes and CCT.
Collapse
Affiliation(s)
| | - Reji Koshy Thomas
- Department of Ophthalmology, St. John’s Medical College Hospital, Bengaluru, Karnataka, India
| | - Vineeta Shobha
- Department of Immunology, St. John’s Medical College Hospital, Bengaluru, Karnataka, India
| |
Collapse
|
3
|
Özkaya D, Doğru A, Baykal T. Assessment of corneal parameters in patients with rheumatoid arthritis. Indian J Ophthalmol 2024; 72:206-210. [PMID: 38273684 PMCID: PMC10941932 DOI: 10.4103/ijo.ijo_2024_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 12/27/2022] [Accepted: 01/21/2023] [Indexed: 01/27/2024] Open
Abstract
PURPOSE To assess the corneal parameters in rheumatoid arthritis (RA) patients. METHODS We enrolled 64 patients with RA (32 receiving biologic and 32 receiving conventional drugs) and 32 healthy subjects. Keratometric values (anterior flat [K1], steep [K2], and mean keratometry [Km]), corneal thickness from the pupil center (CCT), apex (ACT), and the thinnest point (TCT), and corneal volume (CV) were measured and compared between the groups. RESULTS K1, K2, and Km values were significantly higher in the RA group (P = 0.013, P = 0.048, P = 0.027, respectively). The means of CCT, ACT, TCT, and CV were significantly lower in RA patients (P < 0.001, P < 0.001, P < 0.001, P = 0.011, respectively). When we divided RA patients into two groups according to the treatment and compared them to controls, the differences in K1, CCT, ACT, TCT and CV were significant (P = 0.030, P = 0.005, P = 0.001, P = 0.001, P = 0.034, respectively). K1 and CV values of RA-biologic group were similar to the control group (P = 0.205 and P = 0.127, respectively). CONCLUSION Biologic agents contribute to the improvement of K1 and CV values in patients with RA.
Collapse
Affiliation(s)
- Dilek Özkaya
- Department of Ophthalmology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Atalay Doğru
- Department of Rheumatology, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| | - Tuba Baykal
- Department of Physical Medicine and Rehabilitation, Süleyman Demirel University Faculty of Medicine, Isparta, Turkey
| |
Collapse
|
4
|
Gurlevik U, Karakoyun A, Yasar E. When rheumatoid arthritis is mentioned, should only dryness come to mind? Clin Rheumatol 2020; 39:3317-3321. [PMID: 32388745 DOI: 10.1007/s10067-020-05124-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/09/2020] [Accepted: 04/21/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate corneal parameters of rheumatoid arthritis (RA) patients by corneal topography. METHODS One hundred two RA patients and 60 control subjects were enrolled. Corneal topography measurements and ophthalmologic findings were examined from all participants' files. RESULTS Corneal thickness measurements were significantly lower in the RA group (p = 0.025). All values of corneal curvatures (K1, K2, Kmean) in 3 mm, 5 mm, and 7 mm zones were found statistically significantly higher in the RA group compared with the control group. Forty-five RA patients had a dry eye. Disease duration was correlated with dry eye in the RA group. There was a significant correlation between the duration of disease in RA patients and mean corneal curvatures (p 0.012/0.010/0.007, 3/5/7 mm respectively) and central corneal thickness (p 0.025). There is no statistical difference between other topographic measurements. CONCLUSIONS The results suggest that RA patients have thinner and steeper corneas compared with control subjects. These parameters change in negative correlation as the duration of the disease increases. Key Points • Rheumatoid arthritis is an autoimmune disease with systemic involvement. • In rheumatoid arthritis, systemic involvement is affected in the eyes. • When it comes to eye involvement, it comes to mind that it makes the eyes more dryness. • In addition to dryness in the eyes, rheumatoid arthritis makes morphological changes in the cornea.
Collapse
Affiliation(s)
- Ugur Gurlevik
- Ophthalmology Department, Faculte of Medicine, Aksaray Education and Research Hospital, Aksaray University, Aksaray, Turkey. .,Physical Therapy and Rehabilitation Department, Faculte of Medicine, Aksaray Education and Research Hospital, Aksaray University, Aksaray, Turkey.
| | - Ahmet Karakoyun
- Ophthalmology Department, Faculte of Medicine, Aksaray Education and Research Hospital, Aksaray University, Aksaray, Turkey.,Physical Therapy and Rehabilitation Department, Faculte of Medicine, Aksaray Education and Research Hospital, Aksaray University, Aksaray, Turkey
| | - Erdogan Yasar
- Ophthalmology Department, Faculte of Medicine, Aksaray Education and Research Hospital, Aksaray University, Aksaray, Turkey.,Physical Therapy and Rehabilitation Department, Faculte of Medicine, Aksaray Education and Research Hospital, Aksaray University, Aksaray, Turkey
| |
Collapse
|
5
|
Nagy A, Rentka A, Nemeth G, Ziad H, Szücs G, Szekanecz Z, Gesztelyi R, Zsuga J, Aszalos Z, Szodoray P, Kemeny-Beke A. Corneal Manifestations of Systemic Sclerosis. Ocul Immunol Inflamm 2018; 27:968-977. [PMID: 30015530 DOI: 10.1080/09273948.2018.1489556] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Purpose: Corneal involvement in systemic sclerosis (SSc) is rare, but due to rich collagen composition cornea is especially vulnerable to connective tissue diseases. Therefore, our aim was to evaluate corneal parameters of SSc patients. Methods: The study included 32 SSc patients and 39 control subjects with no ocular symptoms or ocular surface disorders. All study participants underwent Pentacam evaluation and objective signs of dry eye disease (DED), and clinical parameters were evaluated. Results: All pachymetric values, most of the corneal front surface, corneal volume, as well as anterior chamber depth measurements were significantly lower in the SSc group than in the control group (p < 0.05). Significant negative correlation was found between corneal parameters and age on the one hand, and disease duration on the other. Conclusions: Early recognition of corneal impairment, a possible extraintestinal manifestation of SSc, should be included in the check-up of the disease in order to reduce sight-threatening complications.
Collapse
Affiliation(s)
- Annamaria Nagy
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen , Debrecen , Hungary
| | - Aniko Rentka
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen , Debrecen , Hungary
| | - Gabor Nemeth
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen , Debrecen , Hungary.,Department of Ophthalmology, Borsod-Abauj-Zemplen County Hospital and University Teaching Hospital , Miskolc , Hungary
| | - Hassan Ziad
- Orbi-Dent Refractive Surgery and Medical Centre , Debrecen , Hungary
| | - Gabriella Szücs
- Department of Rheumatology, Institute of Medicine, Faculty of Medicine, University of Debrecen , Debrecen , Hungary
| | - Zoltán Szekanecz
- Department of Rheumatology, Institute of Medicine, Faculty of Medicine, University of Debrecen , Debrecen , Hungary
| | - Rudolf Gesztelyi
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen , Debrecen , Hungary
| | - Judit Zsuga
- Department of Health Systems Management and Quality Management in Health Care, Faculty of Public Health, University of Debrecen , Debrecen , Hungary
| | - Zsuzsa Aszalos
- Department of Immunology, Institute of Medicine, Faculty of Medicine, University of Debrecen , Debrecen , Hungary
| | - Peter Szodoray
- Institute of Immunology, Rikshospitalet, Oslo University Hospital , Oslo , Norway
| | - Adam Kemeny-Beke
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen , Debrecen , Hungary
| |
Collapse
|
6
|
Can Appropriate Systemic Treatment Help Protect the Cornea in Patients With Rheumatoid Arthritis? A Multidisciplinary Approach to Autoimmune Ocular Involvement. Cornea 2018; 37:235-241. [PMID: 29176449 PMCID: PMC5768223 DOI: 10.1097/ico.0000000000001467] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Purpose: To correlate rheumatologic with ophthalmic and laboratory findings in patients with rheumatoid arthritis (RA) to identify what effect these have on development of ocular disease. Methods: This is a cross-sectional study of 172 eyes of 86 patients with RA. Patients were examined by a group of rheumatologists. Sociodemographic, clinical, and laboratory data were collected. All patients underwent complete ophthalmologic examination including corneal topography and endothelial cell count. Results: There was no significant correlation between RA-negative prognostic indicators (NPIs) and pathologic corneal findings. Patients using disease-modifying antirheumatic drugs (DMARDs) and antimalarial drugs had greater corneal volumes (mean difference 8.51 mm3, 90% confidence interval [CI], 3.98–13.04, P = 0.004; and 2.24, 90% CI, 0.32–4.54, P = 0.048, respectively). Patients using azathioprine had lower endothelial cell counts compared with those using other drugs (mean difference 180 cells/mm2, 90% CI, 69–291, P = 0.008). Patients using biologic DMARDs had better tear osmolarity values (between 280 and 300 mOsm/L) than patients not using them (mean difference 14.3 mOsm/L, P = 0.022). There was no correlation between NPIs of RA and positive keratoconus screening indices (Spearman correlation OD −0.013, P = 0.91; OS −0.033, P = 0.76). Conclusions: There was no clear correlation between RA-NPIs and pathologic corneal findings in our study. DMARDs treatment may help maintain corneal integrity in our patients and prevented collagenolytic manifestations of RA. Other medications such as azathioprine should be used carefully, as endothelial damage may potentially occur.
Collapse
|
7
|
Biomechanical evaluation of cornea in patients with ankylosing spondylitis. Int Ophthalmol 2016; 37:1017-1024. [DOI: 10.1007/s10792-016-0368-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 09/30/2016] [Indexed: 10/20/2022]
|