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Bruttini C, Esposti R, Pece A, Maione G, Cavallari P. Comparison of central corneal thickness measured by automatic and manual analysis of optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2024; 262:1857-1863. [PMID: 38206413 DOI: 10.1007/s00417-023-06354-0] [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: 09/20/2023] [Revised: 12/14/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
PURPOSE To compare central corneal thickness (CCT) measured with optical coherence tomography (OCT) using an automatic algorithm (A-OCT) vs. manual measurements (M-OCT) with respect to the gold standard ultrasound pachymetry (USP). METHODS CCT measurements were performed on both eyes of 28 healthy subjects at four times of the day. A-OCT used an automatic software analysis of the corneal image, M-OCT was performed by two operators by setting a digital calliper on the corneal borders, and USP was performed after corneal anesthesia. Measurements were compared using a three-way repeated measures ANOVA. Bland-Altman plots were used to evaluate the agreement between OCT measurements and USP. RESULTS Both A-OCT and M-OCT significantly underestimated the USP measures, with the mean difference, i.e., the systematic error, being larger for A-OCT (- 19.0 µm) than for M-OCT (- 6.5 µm). Good reproducibility between the two operators was observed. Bland-Altman plots showed that both OCT methods suffered from proportional errors, which were not affected by time and eye. CONCLUSIONS Measuring CCT with OCT yielded lower values than USP. Therefore, clinicians should be aware that corneal thickness values may be influenced by the measurement method and that the various devices should not be used interchangeably in following up a given patient. Intriguingly, M-OCT had less systematic error than A-OCT, an important outcome that clinicians should consider when deciding to use an OCT device.
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Affiliation(s)
- Carlo Bruttini
- University Eye Clinic, IRCCS, Policlinico San Matteo, Pavia, Italy.
- Eye Clinic, Melegnano Hospital, Via Pandina, 1, 20077, Vizzolo Predabissi, Italy.
| | - Roberto Esposti
- Human Physiology Section of the DePT, Università Degli Studi Di Milano, Milan, Italy
| | - Alfredo Pece
- Eye Clinic, Melegnano Hospital, Via Pandina, 1, 20077, Vizzolo Predabissi, Italy
| | - Giulio Maione
- Eye Clinic, Melegnano Hospital, Via Pandina, 1, 20077, Vizzolo Predabissi, Italy
| | - Paolo Cavallari
- Human Physiology Section of the DePT, Università Degli Studi Di Milano, Milan, Italy
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Ghimire R, Kaiti R, Dahal M, Marasini S. Central corneal thickness in new cases of dry eyes: A case-control study. Optom Vis Sci 2024; 101:272-275. [PMID: 38857039 DOI: 10.1097/opx.0000000000002128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024] Open
Abstract
SIGNIFICANCE Loss of homeostasis and chronic inflammation result in ocular surface damage in dry eyes, which is also associated with corneal thinning in established cases. Yet, the correlation between corneal thickness and new cases of dry eyes remains inadequately supported by evidence. PURPOSE This study aimed to compare the central corneal thickness of new cases of dry eyes to that of age- and gender-matched controls. METHODS A total of 45 dry eye patients were compared with 61 age- and gender-matched non-dry eye individuals. The Ocular Surface Disease Index (OSDI) questionnaire was used to evaluate symptoms, and the central corneal thickness was measured with a Nidek CEM-530 specular microscope. Patients were grouped based on disease severity (OSDI scores), and the clinical findings were compared between groups for slit-lamp examinations, Schirmer's I test, and tear film breakup time. RESULTS The median age of patients was 25.0 (interquartile range [IQR], 20.0 to 32.0) and 27.0 (IQR, 20.0 to 32.0) years in the control and dry eye groups, respectively (p=0.63). The median (IQR) values of the OSDI scores, tear film breakup time scores, and Schirmer's test measurements in the control groups were 10.4 (8.3 to 10.4), 12.0 (11.0 to 14.0) seconds, and 16.0 (13.5 to 19.5) mm, respectively, which differed from the dry eye groups (p<0.0001). These values in the dry eye group were 29.1 (25.0 to 39.5), 4.0 (3.0 to 8.0) seconds, and 8.0 (3.5 to 11.0) mm, respectively. Patients with dry eyes had lower central corneal thickness than controls (p<0.01). The mean ± standard deviation central corneal thicknesses in patients with dry eyes and the control group were 520.3 ± 26.8 and 545.3 ± 18.8 μm, respectively. CONCLUSIONS The central corneal thickness in dry eyes was significantly reduced compared with the control group. These findings may be useful in monitoring and managing dry eyes and should be considered in intraocular pressure measurements and refractive surgical procedures.
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Affiliation(s)
- Rekha Ghimire
- Nepal Eye Hospital, Ophthalmology, National Academy of Medical Sciences, Nepal
| | - Raju Kaiti
- Nepal Eye Hospital, Ophthalmology, National Academy of Medical Sciences, Nepal
| | - Manish Dahal
- Nepal Eye Hospital, Ophthalmology, National Academy of Medical Sciences, Nepal
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Haidar H, Çelik EB, Eraslan M. Clinical Characteristics and Surgical Outcomes of Turkish Patients With Pediatric Glaucoma Who Underwent Glaucoma Surgery in a University Hospital. J Pediatr Ophthalmol Strabismus 2024; 61:188-197. [PMID: 38112386 DOI: 10.3928/01913913-20231026-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
PURPOSE To describe the clinical characteristics and outcomes of a pediatric cohort surgically treated for primary or secondary pediatric glaucoma (PPG/SPG). METHODS A retrospective chart review was conducted of all patients with pediatric glaucoma who had surgery between 2013 and 2021. Relevant demographic and clinical data were cumulated and analyzed. RESULTS Forty-two eyes of 29 patients (18 girls and 11 boys) were included: 22 (52.4%) primary congenital glaucoma (PCG), 7 (16.7%) juvenile open-angle glaucoma, and 13 (30.9%) SPG. Mean ages at presentation were 2.57 ± 2.87, 131.96 ± 27.71, and 62.09 ± 65.12 months, respectively. In this study, eyes with PCG presented the earliest, with the highest intraocular pressure (IOP) and thickest central corneal thickness (CCT). The mean number of glaucoma surgeries was 1.48 ± 0.71, with 38.1% of the eyes needing two or more glaucoma surgeries; trabeculectomy was the most frequent glaucoma surgery in this cohort. After surgical intervention, the overall mean IOP dropped from 32.25 ± 12.97 to 18.10 ± 9.23 mm Hg (P < .001). Moreover, the percentage using antiglaucoma medications decreased from 100% to 35.7% at the final visit, as did the number of medications prescribed per eye (2.69 ± 0.92 vs 1.05 ± 1.46, P ≤ .001). Mean best corrected visual acuity (BCVA), in patients who could have their BCVA measured, improved from 0.61 ± 0.61 to 0.53 ± 0.51 logMAR at final follow-up. CONCLUSIONS Surgical intervention was shown to provide a well-controlled IOP, decrease dependance on glaucoma medications, and improve BCVA in both PPG and SPG. Multiple surgical interventions may be necessary in the treatment of some pediatric patients with glaucoma. Prognostically, thicker CCT was significantly associated with worse IOP control, more glaucoma surgeries, and more antiglaucoma medications at the final visit. Initial BCVA correlated significantly with BCVA at the final visit. [J Pediatr Ophthalmol Strabismus. 2024;61(3):188-197.].
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Komninou MA, Seiler TG, Enzmann V. Corneal biomechanics and diagnostics: a review. Int Ophthalmol 2024; 44:132. [PMID: 38478103 PMCID: PMC10937779 DOI: 10.1007/s10792-024-03057-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 02/16/2024] [Indexed: 03/17/2024]
Abstract
PURPOSE Corneal biomechanics is an emerging field and the interest into physical and biological interrelations in the anterior part of the eye has significantly increased during the past years. There are many factors that determine corneal biomechanics such as hormonal fluctuations, hydration and environmental factors. Other factors that can affect the corneas are the age, the intraocular pressure and the central corneal thickness. The purpose of this review is to evaluate the factors affecting corneal biomechanics and the recent advancements in non-destructive, in vivo measurement techniques for early detection and improved management of corneal diseases. METHODS Until recently, corneal biomechanics could not be directly assessed in humans and were instead inferred from geometrical cornea analysis and ex vivo biomechanical testing. The current research has made strides in studying and creating non-destructive and contactless techniques to measure the biomechanical properties of the cornea in vivo. RESULTS Research has indicated that altered corneal biomechanics contribute to diseases such as keratoconus and glaucoma. The identification of pathological corneas through the new measurement techniques is imperative for preventing postoperative complications. CONCLUSIONS Identification of pathological corneas is crucial for the prevention of postoperative complications. Therefore, a better understanding of corneal biomechanics will lead to earlier diagnosis of ectatic disorders, improve current refractive surgeries and allow for a better postoperative treatment.
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Affiliation(s)
- Maria Angeliki Komninou
- Department of Ophthalmology, Bern University Hospital Inselspital, University of Bern, Bern, Switzerland
- Institute of Intensive Care Medicine, University Hospital Zurich & University of Zurich, Zurich, Switzerland
| | - Theo G Seiler
- Department of Ophthalmology, Bern University Hospital Inselspital, University of Bern, Bern, Switzerland
- Klinik Für Augenheilkunde, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
- Institut Für Refraktive Und Opthalmo-Chirurgie (IROC), Zurich, Switzerland
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Volker Enzmann
- Department of Ophthalmology, Bern University Hospital Inselspital, University of Bern, Bern, Switzerland.
- Department of BioMedical Research, University of Bern, Bern, Switzerland.
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Zhou X, Xu J, Zhang X, Zhao Y, Duan X. Causal relationships between Gut microbiota and primary open-angle Glaucoma: A Mendelian randomization and mediation analysis of Glaucoma endophenotypes. Exp Eye Res 2024; 240:109788. [PMID: 38218362 DOI: 10.1016/j.exer.2024.109788] [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: 10/31/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/15/2024]
Abstract
Primary open-angle glaucoma (POAG) is a widespread condition responsible for irreversible blindness, and its prevalence is expected to increase substantially in the coming decades. Despite its significance, the exact cause of POAG remains elusive, necessitating a comprehensive exploration of its pathogenesis. Emerging research suggests a potential link between alterations in gut microbiota composition and POAG. However, establishing causality in these associations remains a challenge. In this study, we employed Mendelian randomization (MR) analysis to investigate the potential causal relationships between gut microbiota (GM) and POAG. Significant bacteria taxa were further analyzed with POAG endophenotypes. We utilized data from genome-wide association studies (GWAS) for GM and POAG, as well as for glaucoma endophenotypes, including intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness, vertical cup-to-disc ratio (VCDR), and central corneal thickness (CCT). Univariable, multivariable MR and mediation effect analysis were conducted. Our analysis revealed that certain taxa, including phylum Euryarchaeota, genus Odoribacter, Rumnicoccaceae UCG009, Ruminiclostridium9, unknown genus id.2071, and Eubacterium rectale group, were associated with an increased risk of POAG. On the other hand, family Victivallaceae, Lacchnospiraceae, genus Lachnoclostridium, Oscillospira, Ruminococcaceae UCG011, Alloprevotella, and Faecalibacterium were found to be associated with a decreased risk of POAG. Furthermore, some of these taxa were found to be connected to glaucoma endophenotypes. Through further multivariable MR analysis, it was determined that IOP, VCDR, and CCT might played mediating roles between GM and POAG. In conclusion, this study utilizes MR analysis to elucidate potential causal associations between GM and POAG, providing insights into specific GM taxa that influence POAG risk and related endophenotypes. These findings emphasize the potential role of the gut microbiota in the pathogenesis of POAG and pave the way for future research and therapeutic interventions.
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Affiliation(s)
- Xiaoyu Zhou
- Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, Changsha, Hunan, China; The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Jiahao Xu
- Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, Changsha, Hunan, China; The Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Xinyue Zhang
- Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, Changsha, Hunan, China; The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Yang Zhao
- Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, Changsha, Hunan, China; The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China
| | - Xuanchu Duan
- Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, Changsha, Hunan, China.
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Patton GN, Lee HJ. Chemical Insights into Topical Agents in Intraocular Pressure Management: From Glaucoma Etiopathology to Therapeutic Approaches. Pharmaceutics 2024; 16:274. [PMID: 38399328 PMCID: PMC10891530 DOI: 10.3390/pharmaceutics16020274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
Glaucoma encompasses a group of optic neuropathies characterized by complex and often elusive etiopathology, involvihttng neurodegeneration of the optic nerve in conjunction with abnormal intraocular pressure (IOP). Currently, there is no cure for glaucoma, and treatment strategies primarily aim to halt disease progression by managing IOP. This review delves into the etiopathology, diagnostic methods, and treatment approaches for glaucoma, with a special focus on IOP management. We discuss a range of active pharmaceutical ingredients used in glaucoma therapy, emphasizing their chemical structure, pharmacological action, therapeutic effectiveness, and safety/tolerability profiles. Notably, most of these therapeutic agents are administered as topical formulations, a critical aspect considering patient compliance and drug delivery efficiency. The classes of glaucoma therapeutics covered in this review include prostaglandin analogs, beta blockers, alpha agonists, carbonic anhydrase inhibitors, Rho kinase inhibitors, and miotic (cholinergic) agents. This comprehensive overview highlights the importance of topical administration in glaucoma treatment, offering insights into the current state and future directions of pharmacological management in glaucoma.
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Affiliation(s)
| | - Hyuck Jin Lee
- Department of Chemistry Education, Kongju National University, Gongju 32588, Chungcheongnam-do, Republic of Korea;
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Yoo L, Kadambi N, Bohnsack BL. Corneal characteristics and OCT-angiography findings in pediatric glaucoma and glaucoma suspects. J AAPOS 2023; 27:327.e1-327.e6. [PMID: 37913864 DOI: 10.1016/j.jaapos.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/20/2023] [Accepted: 09/23/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE To analyze corneal biomechanics, specular microscopy, and optical coherence tomography-angiography findings in children with glaucoma. METHODS Pediatric patients (<18 years of age) with glaucoma (n = 38), increased cup:disk ratio and normal intraocular pressure (IOP) glaucoma suspects (n = 36), and controls (n = 67) were prospectively enrolled. Patients underwent testing with Ocular Response Analyzer, CellChek Specular Microscope, and Heidelberg OCT-A. RESULTS Average age of participants was 12.4 ± 3.5 years, with no difference between groups (P = 0.71). Glaucoma patients had undergone more intraocular surgeries (P < 0.0001) and showed worse logMAR visual acuity (P < 0.0001) than suspects or controls. Central corneal thickness (CCT) was greater in glaucoma patients (642.8 ± 85.9 μm [P < 0.0001]) and suspects (588 ± 43.7 μm [P = 0.003]) compared with controls (561 ± 39.9 μm). Corneal hysteresis (CH) was decreased in eyes with glaucoma (10.4 ± 3.0) compared with controls (11.7 ± 1.5 [P = 0.006]), but not suspects (11.3 ± 2.0 [P = 0.1]). Glaucoma patients had lower endothelial cell density (2028.4 ± 862.7 [P < 0.0001]) and greater average cell area (547.2 ± 332.4 [P < 0.0005]) compared with suspects (2919.3 ± 319.1, 347.5 ± 46.2) and controls (2913.7 ± 399.2, 350.8 ± 57.7), but there was no difference in polymegathism (P = 0.12) or pleomorphism (P = 0.85). No differences in vessel density or vessel skeletal density in the retinal vascular complex (P = 0.3077, P = 0.6471) or choroidal vascular complex (P = 0.3816, P = 0.7306) were detected. CONCLUSIONS Children with glaucoma showed thicker corneas with lower endothelial cell density and greater cell area, but no difference in retinal/choroidal vascular densities compared with suspects and controls.
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Affiliation(s)
- Lauren Yoo
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Namrata Kadambi
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Brenda L Bohnsack
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Division of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago, Illinois.
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Jiménez-Santos M, Sáenz-Francés F, Rodríguez-Quet O, Cerván-Lopez I, Santos-Bueso E, Martinez-de-la-Casa JM, Jañez-Escalada L. Dependence of corneal hysteresis on non-central corneal thickness in healthy subjects. J Fr Ophtalmol 2023; 46:866-872. [PMID: 37085371 DOI: 10.1016/j.jfo.2022.12.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 04/23/2023]
Abstract
OBJECTIVE To evaluate the dependence of corneal hysteresis (CH) on non-central corneal thickness. METHODS Cross-sectional study of 1561 eyes of 1561 healthy volunteers with IOP less than 21mmHg, open angles on gonioscopy and no prior eye surgeries or local or systemic diseases. Pentacam-Scheimpflug technology was employed to segment the cornea into 6 circular zones centered on the apex (zones 1-6) and to determine the mean corneal thickness of these areas. CH was measured with ORA. Univariate and multivariate linear regression models adjusted for age and sex were created to model the dependence of CH on corneal thickness in zones 1 to 6. RESULTS In the univariate linear regression models, we found that CH was dependent on mean corneal thickness of zone 1 (B=0,004; R2=0.95%; P<0.001), zone 2 (B=0,004; R2=0.57%; P=0.002), zone 4 (B=0,005; R2=1.50%; P<0.001) and zone 6 (B=0,003; R2=0.92%; P<0.001). Similar results were obtained in the multivariate model (R2=3.46%; P<0.001). CONCLUSION This study suggests a significant dependence of CH on non-central corneal thickness. The model of corneal thickness segmentation into circular zones centered on the corneal apex is able to explain 3.47% of the variation in CH measurements.
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Affiliation(s)
- M Jiménez-Santos
- Ophthalmology Department, Hospital Clinico San Carlos, Madrid, Spain
| | - F Sáenz-Francés
- Ophthalmology Department, Hospital Clinico San Carlos, Madrid, Spain
| | - O Rodríguez-Quet
- Ophthalmology Department, Hospital Clinico San Carlos, Madrid, Spain.
| | - I Cerván-Lopez
- Centre d'ophthalmologie, Jardin des Buis, Carpentras, France
| | - E Santos-Bueso
- Ophthalmology Department, Hospital Clinico San Carlos, Madrid, Spain
| | | | - L Jañez-Escalada
- Instituto de Tecnología del Conocimiento, Universidad Complutense de Madrid, Madrid, Spain
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McLoughlin ST, McKenna AR, Fisher JP. 4D Bioprinting via Molecular Network Contraction for Membranous Tissue Fabrication. Adv Healthc Mater 2023; 12:e2300642. [PMID: 37463127 DOI: 10.1002/adhm.202300642] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/29/2023] [Accepted: 07/08/2023] [Indexed: 07/20/2023]
Abstract
Generation of thin membranous tissues (TMT), such as the cornea, epidermis, and periosteum, presents a difficult fabrication challenge in tissue engineering (TE). TMTs consist of several cell layers that are less than 100 µm in thickness per layer. While traditional methods provide the necessary resolution for TMT fabrication, they require significant handling and incorporation of several layers is limited. Extrusion bioprinting offers precise control over deposition of different biomaterials and cell populations within the same construct but lacks the resolution to generate biomimetic TMTs. For the first time, a 4D bioprinting strategy that allows for the generation of cell-laden TMTs is developed. Anionic gelatin methacrylate (GelMA) hydrogels are treated with cationic poly-l-lysine (PLL), which induces charge attraction, microscale network collapse, and macroscale hydrogel shrinking. The impact of shrinking on hydrogel properties, print resolution, and cell viability is presented. Additionally, this work suggests that a novel mechanism is occurring, where PLL exhibits a contractile force on GelMA and PLL molecular weight drives GelMA shrinking capabilities. Finally, it is shown that this phenomenon can occur while maintaining an encapsulated cell population. These findings address a critical barrier by generating macroscale tissue structures with their microscale TMT counterparts in the same print.
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Affiliation(s)
- Shannon T McLoughlin
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, 20742, USA
- Center for Engineering Complex Tissues, University of Maryland, College Park, MD, 20742, USA
| | - Abigail R McKenna
- Center for Engineering Complex Tissues, University of Maryland, College Park, MD, 20742, USA
- Department of Biology, University of Maryland, College Park, MD, 20742, USA
| | - John P Fisher
- Fischell Department of Bioengineering, University of Maryland, College Park, MD, 20742, USA
- Center for Engineering Complex Tissues, University of Maryland, College Park, MD, 20742, USA
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Rodrigues C, Carvalho F, Marques M. Upper Eyelid Blepharoplasty: Surgical Techniques and Results-Systematic Review and Meta-analysis. Aesthetic Plast Surg 2023; 47:1870-1883. [PMID: 37430010 PMCID: PMC10581926 DOI: 10.1007/s00266-023-03436-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/28/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Upper eyelid blepharoplasty is a surgical procedure that aims to correct the typical changes that occur with aging to the periorbital area. The outcomes of this surgery are aesthetic, as well as functional. Many studies have described an impact on the cornea, intraocular pressure, dry eye syndrome, and visual quality. The aim of this systematic review is to compare the different surgical techniques and their outcomes. METHODS The authors performed a literature review through online databases PubMed, Web of Science, Clinicaltrials.gov, and CENTRAL libraries. Information was collected about the surgery techniques and the functional and aesthetic outcomes as well as complications of the interventions. Six types of upper blepharoplasty surgery were studied. Data were analyzed using Cochrane RevMan. RESULTS Twenty studies were included in our systematic review and nine in our meta-analysis. We presented results about intraocular pressure, central corneal thickness, flattest keratometry, steepest keratometry, corneal astigmatism, visual acuity, Schirmer test 1 and 2, tear film break-up time and the ocular surface disease index questionnaire, according to type of surgery. Our meta-analysis showed no significant results. CONCLUSIONS No significant results were found; however, many studies reported an impact of upper blepharoplasty surgery in the outcomes studied. Only a small number of complications were reported, and patients were satisfied with the aesthetic outcomes. LEVEL OF EVIDENCE III This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors https://www.springer.com/00266 .
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Affiliation(s)
- Catarina Rodrigues
- Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - Francisco Carvalho
- Department of Plastic and Reconstructive Surgery, Centro Hospitalar de São João, Porto, Portugal
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Marisa Marques
- Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, Portugal
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Sekimitsu S, Xiang D, Smith SL, Curran K, Elze T, Friedman DS, Foster PJ, Luo Y, Pasquale LR, Peto T, Segrè AV, Shweikh Y, Warwick A, Zhao Y, Wiggs JL, Zebardast N. Deep Ocular Phenotyping Across Primary Open-Angle Glaucoma Genetic Burden. JAMA Ophthalmol 2023; 141:891-899. [PMID: 37589995 PMCID: PMC10436188 DOI: 10.1001/jamaophthalmol.2023.3645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/25/2023] [Indexed: 08/18/2023]
Abstract
Importance Better understanding of primary open-angle glaucoma (POAG) genetics could enable timely screening and promote individualized disease risk prognostication. Objective To evaluate phenotypic features across genetic burden for POAG. Design, Setting, and Participants This was a cross-sectional, population-based study conducted from 2006 to 2010. Included participants were individuals from the UK Biobank aged 40 to 69 years. Individuals with non-POAG forms of glaucoma were excluded from the analysis. Data were statistically analyzed from October 2022 to January 2023. Main Outcomes and Measures POAG prevalence based on structural coding, self-reports, and glaucoma-related traits. Results Among 407 667 participants (mean [SD] age, 56.3 [8.1] years; 219 183 majority sex [53.8%]) were 14 171 POAG cases. Area under receiver operating characteristic curve for POAG detection was 0.748 in a model including polygenic risk score (PRS), age, sex, and ancestry. POAG prevalence in the highest decile of PRS was 7.4% (3005 of 40 644) vs 1.3% (544 of 40 795) in lowest decile (P < .001). A 1-SD increase in PRS was associated with 1.74 times higher odds of POAG (95% CI, 1.71-1.77), a 0.61-mm Hg increase in corneal-compensated intraocular pressure (IOP; 95% CI, 0.59-0.64), a -0.09-mm Hg decrease in corneal hysteresis (95% CI, -0.10 to -0.08), a 0.08-mm Hg increase in corneal resistance factor (95% CI, 0.06-0.09), and a -0.08-diopter decrease in spherical equivalent (95% CI, -0.11 to -0.07; P < .001 for all). A 1-SD increase in PRS was associated with a thinning of the macula-region retinal nerve fiber layer (mRNFL) of 0.14 μm and macular ganglion cell complex (GCC) of 0.26 μm (P < .001 for both). In the subset of individuals with fundus photographs, a 1-SD increase in PRS was associated with 1.42 times higher odds of suspicious optic disc features (95% CI, 1.19-1.69) and a 0.013 increase in cup-disc ratio (CDR; 95% CI, 0.012-0.014; P < .001 for both). A total of 22 of 5193 fundus photographs (0.4%) in decile 10 had disc hemorrhages, and 27 of 5257 (0.5%) had suspicious optic disc features compared with 9 of 5158 (0.2%) and 10 of 5219 (0.2%), respectively, in decile 1 (P < .001 for both). CDR in decile 10 was 0.46 compared with 0.41 in decile 1 (P < .001). Conclusion and Relevance Results suggest that PRS identified a group of individuals at substantially higher risk for POAG. Higher genetic risk was associated with more advanced disease, namely higher CDR and corneal-compensated IOP, thinner mRNFL, and thinner GCC. Associations with POAG PRS and corneal hysteresis and greater prevalence of disc hemorrhages were identified. These results suggest that genetic risk is an increasingly important parameter for risk stratification to consider in clinical practice.
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Affiliation(s)
| | - David Xiang
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
- Harvard Medical School, Boston, Massachusetts
| | | | - Katie Curran
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Tobias Elze
- Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts
| | - David S. Friedman
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
| | - Paul J. Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital & UCL Institute of Ophthalmology, London, United Kingdom
| | - Yuyang Luo
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
- Ocular Genomics Institute, Harvard Medical School, Boston, Massachusetts
| | - Louis R. Pasquale
- Icahn School of Medicine at Mount Sinai, Department of Ophthalmology, New York, New York
| | - Tunde Peto
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Ayellet V. Segrè
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
- Ocular Genomics Institute, Harvard Medical School, Boston, Massachusetts
| | - Yusrah Shweikh
- Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Sussex, United Kingdom
| | - Alasdair Warwick
- University College London, Institute of Cardiovascular Science, London, United Kingdom
- Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | - Yan Zhao
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
- Ocular Genomics Institute, Harvard Medical School, Boston, Massachusetts
| | - Janey L. Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
- Ocular Genomics Institute, Harvard Medical School, Boston, Massachusetts
| | - Nazlee Zebardast
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston
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12
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Gundreddy P, Thool AR, Rao SL, Vaishnav LM. Ocular Dominance and Its Association With Central Corneal Thickness: An Observational Study in Central India. Cureus 2023; 15:e41033. [PMID: 37519501 PMCID: PMC10373619 DOI: 10.7759/cureus.41033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Abstract
Background The aim of this study is to determine ocular dominance and its association with central corneal thickness (CCT). These two parameters are of great significance in clinical practice; identifying the dominant eye helps in planning cataract surgeries, treatment of presbyopia, monovision correction, etc., and assessing the CCT helps in early diagnosis and management of keratoconus, glaucoma, contact lens-related complications, and dry eye. Methods A cross-sectional study that involves patients and volunteers who have come for a checkup to the ophthalmology department of the college hospital. Ninety patients were examined for this study within two months. The hole-in-card test is performed to determine the ocular dominance in people with normal and healthy eyes without any pathologies except refractive errors. Specular microscopy through a non-contact modality will be done to assess the thickness of the central cornea in both eyes. Statistical analysis was done using the paired t-test to compare the patient's eyes and the chi-square test, which helps us associate ocular dominance and CCT. Results Right eye dominance was seen in the majority of the participants (72.91%), whereas left eye dominance was seen in comparatively fewer participants (27.08%). The CCT of the dominant eye is found to be 520.40 ± 29.83 μm and that of the non-dominant eye is 524.40 ± 29.37 μm. A lower CCT in the dominant eye was seen in 83.33% of the subjects; 14.58% of them had a higher CCT in the dominant eye and 2.08% had the same CCT in both eyes. Conclusion From the observational study that has been made, the majority of the population shows right eye dominance. The CCT is relatively thinner in the dominant eye. About 80-85% of the examined people showed a thinner cornea in the dominant eye. But we cannot generalize that the eye with a lesser corneal thickness will be the dominant eye in all the cases, as a few cases have shown dominance in the eye with a thicker cornea.
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Affiliation(s)
- Ppavani Gundreddy
- Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Archana R Thool
- Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Sri Lekha Rao
- Ophthalmology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Lokesh M Vaishnav
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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13
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Baxter J, Atwan N. A Comparison Between Ultrasound Pachymetry and CASIA2 (Anterior-Segment Optical Coherence Tomography) in the Measurement of Central Corneal Thickness. Cureus 2023; 15:e39921. [PMID: 37409208 PMCID: PMC10317844 DOI: 10.7759/cureus.39921] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2023] [Indexed: 07/07/2023] Open
Abstract
Background and objective Due in part to its effect on intraocular pressure (IOP) measurements, the assessment of central corneal thickness (CCT) is recognized as an essential part of the initial glaucoma assessment. The most widely utilized clinical technique to measure CCT is ultrasound pachymetry (USP). In recent years, many dedicated anterior-segment optical coherence tomography scanners (AS-OCTs) have been developed. Previous studies have compared CCT measurements between USP and various AS-OCTs. This study aimed to assess the degree of agreement between USP and CASIA2 (Tomey Corporation, Nagoya, Japan), a second-generation swept-source AS-OCT developed in Japan. Methodology The data on CCT screening measurements of 156 eyes (88 patients) performed over a period of three months, from January to March 2020, on glaucoma patients attending the Royal Hallamshire Hospital (RHH) in Sheffield, UK were collected retrospectively and statistically analyzed. Results The average age of the 88 patients included in the study was 66 years (range: 20-86 years). Our findings show that when compared to CASIA2 measurements, USP measurement of the CCT resulted in significantly thicker values (paired t-test: t=23.15,p<2.2 x 10-16). The average difference between the two methods was 19.98 ± 10.78 μm. It is hypothesized that this difference may be due in part to inaccurate probe placement during ultrasound probe measurement, resulting in thicker CCT values. Conclusion The observed difference may be clinically significant as it could induce clinical discrepancy in terms of perceived glaucoma risk in patients. Therefore, USP and CASIA2 should not be used interchangeably, and clinicians should take into account the significant difference between these methods.
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Affiliation(s)
- Joe Baxter
- Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, GBR
| | - Nadeem Atwan
- Ophthalmology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, GBR
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14
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Keller WJ. International comparisons of intraocular pressures, as measured by Tono-Pen and Goldmann applanation tonometry, in healthy adults: A meta-analysis. Medicine (Baltimore) 2023; 102:e33078. [PMID: 36897721 PMCID: PMC9997780 DOI: 10.1097/md.0000000000033078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 02/02/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Investigate intraocular pressure (IOP), as measured by Tono-Pen (TP) and Goldmann applanation tonometry (GAT), in healthy adults. Provide an updated synthesis of multinational, primary studies, reported during the 10-year period 2011 to 2021 and offer an evidence-based benchmark, against which IOP can be evaluated across subject variables and pathologies. Three primary research questions are investigated: Is there a statistically significant difference between IOP measured by TP and GAT? If yes, is the difference clinically significant? Is measurement of IOP affected by the country or setting location, in which the measurements are made? METHODS An aggregate meta-analysis was conducted on 22 primary studies, from 15 different countries. IOP measurements were made from each healthy adult subject, with both the TP and GAT. Primary studies were identified and data extracted according to recommended preferred reporting items for systematic reviews and meta-analysis protocol guidelines. Meta-analysis summary results are reported as the point estimate of the raw mean difference of IOP. RESULTS Meta-analysis reveals a statistically significant difference in raw mean differences in IOP, when measured by TP and GAT, in the healthy adult population. Tono-Pen IOP measurements are higher than GAT IOP measurements. The point estimate for the summary effect size = -0.73 mm Hg, P = .03. The prediction interval for the true effect size, in 95% of all comparable populations, is -4.03 to 2.58 mm Hg. There is no clinically significance difference in IOP when measured by TP and GAT. Meta-regression analysis reveals statistically significant differences in measurement of IOP by countries, R2 analog = 0.75, P = .001. There is no statistically significant difference in measurement of IOP as a function of measurement location setting, R2 analog = -0.17, P = .65. CONCLUSIONS IOP measured by TP are marginally higher compared to GAT, in the healthy adult population. However, from a clinical practice perspective, TP and GAT produce similar IOP measurements. There is evidence of significant variabilities in IOP measurements as a function of country. IOP measurements collected in a research laboratory setting are similar to IOP collected in a clinical setting. Results have implications for the primary care physician requiring a portable, inexpensive, reliable, and easily administered instrument to assess IOP.
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Affiliation(s)
- William J. Keller
- Medical Education, Nova Southeastern University, Kiran C. Patel College of Allopathic Medicine (NSU-MD), Fort Lauderdale, Florida, USA
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15
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Yuhas PT, Roberts CJ. Clinical Ocular Biomechanics: Where Are We after 20 Years of Progress? Curr Eye Res 2023; 48:89-104. [PMID: 36239188 DOI: 10.1080/02713683.2022.2125530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Purpose: Ocular biomechanics is an assessment of the response of the structures of the eye to forces that may lead to disease development and progression, or influence the response to surgical intervention. The goals of this review are (1) to introduce basic biomechanical principles and terminology, (2) to provide perspective on the progress made in the clinical study and assessment of ocular biomechanics, and (3) to highlight critical studies conducted in keratoconus, laser refractive surgery, and glaucoma in order to aid interpretation of biomechanical parameters in the laboratory and in the clinic.Methods: A literature review was first conducted of basic biomechanical studies related to ocular tissue. The subsequent review of ocular biomechanical studies was limited to those focusing on keratoconus, laser refractive surgery, or glaucoma using the only two commercially available devices that allow rapid assessment of biomechanical response in the clinic.Results: Foundational studies on ocular biomechanics used a combination of computer modeling and destructive forces on ex-vivo tissues. The knowledge gained from these studies could not be directly translated to clinical research and practice until the introduction of non-contact tonometers that quantified the deformation response of the cornea to an air puff, which represents a non-destructive, clinically appropriate load. The corneal response includes a contribution from the sclera which may limit corneal deformation. Two commercial devices are available, the Ocular Response Analyzer which produces viscoelastic parameters with a customized load for each eye, and the Corvis ST which produces elastic parameters with a consistent load for every eye. Neither device produces the classic biomechanical properties reported in basic studies, but rather biomechanical deformation response parameters which require careful interpretation.Conclusions: Research using clinical tools has enriched our understanding of how ocular disease alters ocular biomechanics, as well as how ocular biomechanics may influence the pathophysiology of ocular disease and response to surgical intervention.
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Affiliation(s)
- Phillip T Yuhas
- College of Optometry, The Ohio State University, Columbus, OH, USA
| | - Cynthia J Roberts
- Department of Ophthalmology and Visual Sciences, College of Medicine, The Ohio State University, Columbus, OH, USA.,Department of Biomedical Engineering, College of Engineering, The Ohio State University, Columbus, OH, USA
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16
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Lotfy A, Mattout HK, Fouda SM, Hemeda S. Correlation between radial peripapillary vascular density and reduced central corneal thickness in glaucoma suspect patients. BMC Ophthalmol 2022; 22:414. [PMID: 36316681 PMCID: PMC9620628 DOI: 10.1186/s12886-022-02628-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 09/29/2022] [Accepted: 10/04/2022] [Indexed: 11/27/2022] Open
Abstract
Background Optical coherence tomography (OCT) angiography (OCTA) provides a quantitative assessment of the microcirculation of the retina and choroid. It may precede the retinal nerve layer (RNFL) and optic disc head defects. Retinal nerve fiber layer defects and reduced central corneal thickness (CCT) are important parameters in the assessment of a glaucoma suspect patients. The aim of this study is to investigate any possible relationship between the reduced central corneal thickness and the radial peripapillary capillary (RPC) density defect in glaucoma suspect. Methods In this cross sectional study, 92 eyes were incorporated. Peripapillary OCT angiography (4.5 mm) and Anterior segment OCT for corneal pachymetry were done. C/D Ratio, thickness of nerve fiber layer, the blood flow indices and central corneal thickness also were evaluated. Results In eyes of glaucoma suspect patients; a significant positive correlation between CCT and total RPC density was detected (r = 0.38, P < 0.001). A strong positive correlation was also found between total RPC and peripapillary RNFL thickness (r = 0.55, P < 0.001). Conclusion Reduced central corneal thickness and peripapillary capillary density are two screening parameters for glaucoma suspect patients. The radial peripapillary capillary density is a valid diagnostic tool for glaucoma. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-022-02628-z.
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Affiliation(s)
- Ayman Lotfy
- grid.31451.320000 0001 2158 2757Zagazig University, Zagazig, Egypt
| | | | | | - Sahar Hemeda
- grid.31451.320000 0001 2158 2757Zagazig University, Zagazig, Egypt
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17
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Elhusseiny AM, Gouda J, Farag C, Chauhan MZ, Arfeen SA, Elhilali HM. Central corneal thickness profile in relation to pediatric cataract morphology. J AAPOS 2022; 26:260-262. [PMID: 36113702 DOI: 10.1016/j.jaapos.2022.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/15/2022] [Accepted: 07/17/2022] [Indexed: 11/24/2022]
Abstract
Several studies have demonstrated that central corneal thickness (CCT) increases in pediatric eyes after cataract extraction with or without intraocular lens (IOL) implantation. This thickening has been hypothesized to be the result of endothelial dysfunction caused by direct trauma during surgery, toxic effects of irrigating fluids, or postoperative inflammation. Limited literature is available regarding the preoperative profile of CCT in pediatric cataract eyes. The purpose of the current study was to evaluate the differences in the mean preoperative CCT in eyes with pediatric cataract related to the presence or absence of persistent fetal vasculature.
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Affiliation(s)
- Abdelrahman M Elhusseiny
- Department of Ophthalmology, Kasr Al-Ainy Hospitals, Cairo University, Egypt; Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
| | - Jylan Gouda
- Department of Ophthalmology, Kasr Al-Ainy Hospitals, Cairo University, Egypt
| | - Christina Farag
- Department of Ophthalmology, Kasr Al-Ainy Hospitals, Cairo University, Egypt
| | - Muhammad Z Chauhan
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Shaimaa A Arfeen
- Department of Ophthalmology, Kasr Al-Ainy Hospitals, Cairo University, Egypt
| | - Hala M Elhilali
- Department of Ophthalmology, Kasr Al-Ainy Hospitals, Cairo University, Egypt
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18
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Hypertension secondary to nitric oxide depletion produces oxidative imbalance and inflammatory/fibrotic outcomes in the cornea of C57BL/6 mice. J Physiol Biochem 2022; 78:915-932. [PMID: 35943663 PMCID: PMC9684300 DOI: 10.1007/s13105-022-00916-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/28/2022] [Indexed: 10/15/2022]
Abstract
Arterial hypertension (AH) leads to oxidative and inflammatory imbalance that contribute to fibrosis development in many target organs. Here, we aimed to highlight the harmful effects of severe AH in the cornea. Our experimental model was established by administration of NG-nitro-L-arginine-methyl-ester (L-NAME) to C57BL/6 mice, which were monitored weekly for arterial blood pressure and intraocular pressure (IOP). Morphological studies of ocular tissues were accompanied by analyses of reactive oxygen species generation, and localization/expression of NAPDH oxidase isoforms (NOX1, NOX2, NOX4) and inflammatory biomarkers (PPARα, PPARγ, IL-1β, IL-6, IL-10, TNF-α, and COX-2). Masson's trichrome and Sirius Red staining were used to explore the fibrotic status of the cornea. The expression of collagen isoforms (COL1α1, COL1α2, COL3α1, COL4α1, COL4α2) and relevant metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) were also quantified to evaluate the participation of collagen metabolism in AH-related corneal damage. Hypertensive animals showed an increase in IOP values, and a thinner cornea compared with normotensive controls. Moreover, AH increased NADPH oxidase activity and reactive oxygen species generation in the cornea, which was accompanied by transcriptional upregulation of NOX isoforms and inflammatory biomarkers, while reducing PPAR expression. L-NAME-treated animals also developed corneal fibrosis with overexpression of collagen isoforms and reduction of factors responsible for collagen degradation. This is the first study reporting structural changes in the cornea and elevated IOP in L-NAME-treated mice. Overexpression of the NADPH oxidase system and collagen deposition might play a substantial role in the pathogenic mechanisms contributing to ocular disturbances in a context of severe hypertension.
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19
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Kang JH, Wang M, Frueh L, Rosner B, Wiggs JL, Elze T, Pasquale LR. Cohort Study of Race/Ethnicity and Incident Primary Open-Angle Glaucoma Characterized by Autonomously Determined Visual Field Loss Patterns. Transl Vis Sci Technol 2022; 11:21. [PMID: 35877093 PMCID: PMC9339699 DOI: 10.1167/tvst.11.7.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Purpose We evaluated racial/ethnic differences in primary open-angle glaucoma (POAG) defined by machine-learning–derived regional visual field (VF) loss patterns. Methods Participants (N = 209,036) from the Nurses’ Health Study (NHS; 1980–2018), Nurses’ Health Study II (NHS2; 1989–2019), and Health Professionals Follow-Up Study (HPFS; 1986–2018) who were ≥40 years of age and free of glaucoma were followed biennially. Incident POAG cases (n = 1946) with reproducible VF loss were confirmed with medical records. Total deviation information from the earliest reliable glaucomatous VF for each POAG eye (n = 2564) was extracted, and machine learning analyses were used to identify optimal solutions (“archetypes”) for regional VF loss patterns. Each POAG eye was assigned a VF archetype based on the highest weighting coefficient. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using per-eye Cox proportional hazards models. Results We identified 14 archetypes: four representing advanced loss patterns, nine of early loss, and one of no VF loss. Compared to non-Hispanic whites, black participants had higher risk of early VF loss archetypes (HR = 1.98; 95% CI, 1.48–2.66) and even higher risk for advanced loss archetypes (HR = 6.17; 95% CI, 3.69–10.32; P-contrast = 0.0002); no differences were observed for Asians or Hispanic whites. Hispanic white participants had significantly higher risks of POAG with paracentral defects and advanced superior loss; black participants had significantly higher risks of all advanced loss archetypes and three early loss patterns, including paracentral defects. Conclusions Blacks, compared to non-Hispanic whites, had higher risks of POAG with early central and advanced VF loss. Translational Relevance In POAG, risks of VF loss regional patterns derived from machine learning algorithms showed racial differences.
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Affiliation(s)
- Jae H Kang
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mengyu Wang
- Harvard Ophthalmology AI Lab, Schepens Research Eye Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.,Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Lisa Frueh
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bernard Rosner
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Janey L Wiggs
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Tobias Elze
- Harvard Ophthalmology AI Lab, Schepens Research Eye Institute of Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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20
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Glaucoma – risk factors and current challenges in the diagnosis of a leading cause of visual impairment. Maturitas 2022; 163:15-22. [DOI: 10.1016/j.maturitas.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/01/2022] [Accepted: 05/09/2022] [Indexed: 11/21/2022]
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21
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Dermenoudi M, Matsou A, Keskini C, Anastasopoulos E. Ocular Surface Disease Signs and Symptoms in Patients with Pseudoexfoliative Glaucoma: A Case—Control Study. Vision (Basel) 2022; 6:vision6010011. [PMID: 35225970 PMCID: PMC8883900 DOI: 10.3390/vision6010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose: The present study evaluates the differences in the prevalence of the signs and symptoms of ocular surface disease (OSD) in patients with PEX glaucoma (PEXG), compared to other glaucoma types (non-PEXG). Methods: Patients with non-PEXG and PEXG were prospectively examined for the presence and severity of OSD signs and questioned for symptoms using the OSDI (ocular surface disease index) questionnaire. Results: 116 patients were prospectively enrolled (58 non-PEXG and 58 PEXG). PEXG subjects who were older, had lower central corneal thickness (CCT) values, at a more advanced glaucoma stage and required more IOP lowering drops. OSD signs were prevalent in both groups: conjunctival hyperemia (74.5% non-PEXG vs. 94.8% PEXG), eyelid redness (70.7% vs. 96.6%), conjunctival (74.1% vs. 93.1%) and corneal fluorescein staining (81% vs. 93.1%) and abnormal TFBUT (82.8% vs. 87.9%). When adjusted for potential confounders, (older age, thinner CCT, more advanced glaucoma in PEXG) eyelid redness remained the only parameter significantly associated with PEXG, being 11 times more likely to occur in this group (p = 0.037). Conclusion: Subjects with PEXG presented a higher frequency of signs of OSD compared to other glaucoma types. When accounting for confounding factors, the only difference between the groups was the significantly higher presence (11 times more likely) of eyelid redness in PEXG, suggesting, in addition to glaucoma treatment, the impact of PEX on ocular surface integrity.
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Affiliation(s)
| | - Artemis Matsou
- Ophthalmology Department, Queen Victoria Hospital NHS Foundation Trust, East Grinstead RH19 3DZ, UK;
| | - Christina Keskini
- 1st Department of Ophthalmology, Aristotle University of Thessaloniki, 54621 Thessaloniki, Greece;
| | - Eleftherios Anastasopoulos
- 2nd Department of Ophthalmology, Aristotle University of Thessaloniki, 56403 Thessaloniki, Greece
- Correspondence: ; Tel.: +30-231-3323675; Fax: +30-231-0444105
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22
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Keller KE, Peters DM. Pathogenesis of glaucoma: Extracellular matrix dysfunction in the trabecular meshwork-A review. Clin Exp Ophthalmol 2022; 50:163-182. [PMID: 35037377 DOI: 10.1111/ceo.14027] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 11/19/2021] [Accepted: 11/26/2021] [Indexed: 12/11/2022]
Abstract
The trabecular meshwork regulates aqueous humour outflow from the anterior chamber of the eye. It does this by establishing a tunable outflow resistance, defined by the interplay between cells and their extracellular matrix (ECM) milieu, and the molecular interactions between ECM proteins. During normal tissue homeostasis, the ECM is remodelled and trabecular cell behaviour is modified, permitting increased aqueous fluid outflow to maintain intraocular pressure (IOP) within a relatively narrow physiological pressure. Dysfunction in the normal homeostatic process leads to increased outflow resistance and elevated IOP, which is a primary risk factor for glaucoma. This review delineates some of the changes in the ECM that lead to gross as well as some more subtle changes in the structure and function of the ECM, and their impact on trabecular cell behaviour. These changes are discussed in the context of outflow resistance and glaucoma.
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Affiliation(s)
- Kate E Keller
- Casey Eye Institute, Oregon Health &Science University, Portland, Oregon, USA
| | - Donna M Peters
- Department of Pathology & Laboratory Medicine, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin, USA
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23
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AlGethami R, AlGhamdi A, Almalki N, Al-Amri A, Al-Barry M. The preferences and practices regarding refractive surgeries among Saudi Ophthalmology Society members of ophthalmologists. SAUDI JOURNAL FOR HEALTH SCIENCES 2022. [DOI: 10.4103/sjhs.sjhs_81_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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24
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Abstract
Background/Aim. Complications of diabetes mellitus (DM) in the eye are the leading cause of blindness in the world. Although research on eye complications of DM is mainly focused on retinal damage, changes in the cornea are also associated with DM. Central corneal thickness (CCT) reflects the metabolic status of the cornea and is also affected by DM. Knowledge of CCT changes that occur within DM is important for accurate IOP measurement, diagnosis, and monitoring of patients with glaucoma. The aim of the study was to examine the effect of DM type 2 on the central corneal thickness. Methods. The study was designed as a clinical, cross-sectional, observational study. It consists of 96 patients, divided into two groups. The first group consisted of 49 patients diagnosed with DM type 2. The second group was the control group and consisted of 47 healthy subjects. The DM group was divided into subgroups depending on the status of diabetic retinopathy, the length of DM treatment, and the levels of glycosylated hemoglobin (HbA1C). Results. A statistically significant difference in CCT was observed among DM patients and the control group. Analyzing only DM patients, the highest CCT values were observed in patients who had HbA1C > 7.0%, as well as those who have treated DM for more than 15 years, with a statistically significant difference in relation to the corresponding patient sub-groups (p = 0.002 and p = 0.037, respectively). No statistically significant difference was observed depending on the status of retinopathy. Intraocular pressure (IOP) was statistically significantly higher in patients with DM compared to the control group. Conclusion. Our research demonstrated that the status of retinopathy had no statistically significant influence on CCT. Knowing that the increase in CCT also affects the measured IOP values, this research will be useful in better understanding and control of the patients who have glaucoma in addition to DM type 2.
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25
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Kolačko Š, Predović J, Kokot A, Bosnar D, Brzović-Šarić V, Šarić B, Balog S, Milanovic K, Ivastinovic D. Do Gender, Age, Body Mass and Height Influence Eye Biometrical Properties in Young Adults? A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111719. [PMID: 34770229 PMCID: PMC8582935 DOI: 10.3390/ijerph182111719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/03/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Do gender, age, body mass and height influence eye biometrical properties in young adults? METHODS A total of 155 eyes (92 female, 63 male) of healthy subjects between the ages of 18 and 39 years were included in the study. The subjects' gender and age were recorded, and their body mass, height and biometrical properties of the eyes were measured. RESULTS The male subjects had significantly thicker and flatter corneas and lower minimal rim-to-disk ratios than the female subjects did. In both genders, age showed strong, negative correlations with anterior chamber depth and pupil diameter and a positive correlation with lens thickness. We also found significant, negative correlations between body height and mass with keratometry measurements, negative correlations between body height and optic disk rim area and rim volume, and positive correlations between body mass and axial length in both genders. CONCLUSIONS Biometric eye parameters differ among people. In addition to age and gender, which are usually taken into consideration when interpreting ocular biometry findings, we strongly suggest that body height and mass should be also routinely considered when interpreting eye biometry data, as these factors have an impact on ocular biometry.
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Affiliation(s)
- Štefanija Kolačko
- University Hospital “Sveti Duh”, 10000 Zagreb, Croatia; (Š.K.); (D.B.); (V.B.-Š.); (B.Š.)
- Department of Nursing and Palliative Medicine, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Jurica Predović
- University Hospital “Sveti Duh”, 10000 Zagreb, Croatia; (Š.K.); (D.B.); (V.B.-Š.); (B.Š.)
- Department of Ophthalmology and Optometry, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Ophthalmology and Optometry, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Correspondence: (J.P.); (A.K.)
| | - Antonio Kokot
- Department of Ophthalmology and Optometry, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Anatomy and Neuroscience, Faculty of medicine, University of Josip Juraj Strossmayer, 31000 Osijek, Croatia; (S.B.); (K.M.)
- Correspondence: (J.P.); (A.K.)
| | - Damir Bosnar
- University Hospital “Sveti Duh”, 10000 Zagreb, Croatia; (Š.K.); (D.B.); (V.B.-Š.); (B.Š.)
- Department of Ophthalmology and Optometry, Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
- Department of Ophthalmology and Optometry, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Vlatka Brzović-Šarić
- University Hospital “Sveti Duh”, 10000 Zagreb, Croatia; (Š.K.); (D.B.); (V.B.-Š.); (B.Š.)
| | - Borna Šarić
- University Hospital “Sveti Duh”, 10000 Zagreb, Croatia; (Š.K.); (D.B.); (V.B.-Š.); (B.Š.)
| | - Slaven Balog
- Department of Anatomy and Neuroscience, Faculty of medicine, University of Josip Juraj Strossmayer, 31000 Osijek, Croatia; (S.B.); (K.M.)
- Dr. Balog Ophthalmology Clinic, 31000 Osijek, Croatia
| | - Kristina Milanovic
- Department of Anatomy and Neuroscience, Faculty of medicine, University of Josip Juraj Strossmayer, 31000 Osijek, Croatia; (S.B.); (K.M.)
| | - Domagoj Ivastinovic
- Department of Ophthalmology, Medical University of Graz, 8036 Graz, Austria;
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Li W, Pan J, Wei M, Lv Z, Chen S, Qin Y, Li N. Nonocular Influencing Factors for Primary Glaucoma: An Umbrella Review of Meta-Analysis. Ophthalmic Res 2021; 64:938-950. [PMID: 34517373 DOI: 10.1159/000519247] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 08/22/2021] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Glaucoma is the main cause of irreversible blindness worldwide. Still, little is known about nonocular risk factors. We use an umbrella review to examine the meta-analytic evidence of the correlation between nonocular factors and glaucoma. METHOD We searched PubMed and Embase databases up to July 24, 2020. Eligible meta-analyses (MAs) included cohort, case-control, and randomized controlled study designs. Two authors independently extracted the data and evaluated the methodological quality of the MAs. AMSTAR 2 was used to assess the methodological quality of each included MA. RESULTS This umbrella review contains 22 MAs with 22 unique nonocular factors in total. We identified 11 factors that increase the risk of glaucoma: hyperlipidemia, nocturnal dip in blood pressure, infection with Helicobacter pylori, myopia, obstructive sleep apnea syndrome, corneal properties, diabetes, hypertension, hypothyroidism, migraine, and plasma homocysteine. We identified 3 factors that reduce the risk of glaucoma: dietary intake of vitamin A, dietary intake of vitamin C, and short-term statin use. We identified 8 factors that had no association with glaucoma: dietary intake of vitamin B, dietary intake of vitamin E, cigarette smoking, Alzheimer's disease, serum folic acid, serum vitamin B6, serum vitamin B12, and serum vitamin D. CONCLUSIONS In this umbrella review of MAs, evidence was found for associations of various nonocular factors with glaucoma to different degrees. However, risk factors were only mildly associated, suggesting low impact of systemic risk factors. Additional higher quality studies are needed to provide robust evidence.
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Affiliation(s)
- Wenman Li
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China,
| | - Jiaxing Pan
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Maoling Wei
- The Center for Evidence-Based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhiqing Lv
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Sijie Chen
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Yang Qin
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Ni Li
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
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Kyei S, Assiamah F, Kwarteng MA, Gboglu CP. The Association of Central Corneal Thickness and Intraocular Pressure Measures by Non-Contact Tonometry and Goldmann Applanation Tonometry among Glaucoma Patients. Ethiop J Health Sci 2021; 30:999-1004. [PMID: 33883845 PMCID: PMC8047243 DOI: 10.4314/ejhs.v30i6.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background The aim of this study was to determine whether Central Corneal Thickness (CCT) is associated with intraocular pressure measurement (IOP) with a Non-contact tonometer and the Goldmann applanation tonometer in glaucoma patients. Materials and Methods The study involved two hundred and thirty-two eyes of clinically diagnosed glaucoma patients receiving care at a referral facility. IOP measurements were obtained using both the Non-Contact Tonometer (NCT) and Goldmann Applanation Tonometer (GAT). The association between age, ethnicity, and CCT, as well as CCT on the measures of NCT and GAT, were analyzed. Results There were 64(55.2%) males and 52 (44.8%) females and their ages ranged from 18 to 85 years (mean age = 47.72; SD ± 15.75 years). There was a weak positive correlation between the CCT and NCT findings in the right eye (r = 0.19, n = 116, p < 0.05) and in the left eye (r = 0.25, n = 116, p < 0.05). However, there was no correlation between CCT and GAT measurements. Age had a significant correlation with CCT while gender and ethnicity had no significant correlation. Conclusion The study found a significant association between CCT and NCT. However, there was no significant association between CCT and GAT. CCT had an association with age but independent of gender and ethnicity since there was no significant relationship between these variables.
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Affiliation(s)
- Samuel Kyei
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana.,Department of Optometry, Faculty of Science and Engineering, Bindura University of Science Education, Bindura, Zimbabwe
| | - Frank Assiamah
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Michael Agyemang Kwarteng
- Department of Optometry, Faculty of Science and Engineering, Bindura University of Science Education, Bindura, Zimbabwe.,Discipline of Optometry, College of Health Sciences, University of KwaZulu-Natal, South Africa
| | - Cynthia Pakyennu Gboglu
- Department of Optometry and Vision Science, School of Allied Health Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Sahi AK, Varshney N, Poddar S, Gundu S, Mahto SK. Fabrication and Characterization of Silk Fibroin-Based Nanofibrous Scaffolds Supplemented with Gelatin for Corneal Tissue Engineering. Cells Tissues Organs 2021; 210:173-194. [PMID: 34252899 DOI: 10.1159/000515946] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 03/15/2021] [Indexed: 11/19/2022] Open
Abstract
Tissue engineering is a promising approach to overcome the severe worldwide shortage of healthy donor corneas. In this work, we have developed a silk-gelatin composite scaffold using electrospinning and permeation techniques to achieve the properties comparable to cornea analog. In particular, we present the fabrication and comparative evaluation of the novel gelatin sheets consisting of silk fibroin nanofibers, which are prepared using silk fibroin (SF) (in formic acid) and SF (in aqueous) electrospun scaffolds, for its suitability as corneal stromal analogs. All the fabricated samples were treated with ethanol vapor (T) to physically crosslink the silk nanofibers. Micro/nano-scale features of the fabricated scaffolds were analyzed using scanning electron microscopy micrographs. Fourier transform infrared spectroscopy revealed characteristic peaks of polymeric functional groups and modifications upon ethanol vapor treatment. Transparency of the scaffolds was determined using UV-visible spectra. Among all the fabricated samples, the gelatin-permeated SF (in formic acid; T) scaffold showed the highest level of transparency, i.e., 77.75 ± 2.3%, which is similar to that of the native cornea (∼70%-90% [variable with age group]) with healthy acute vision. Contact angle of the samples was studied to estimate the hydrophilicity of the scaffolds. All the scaffolds except non-treated SF (in aqueous; NT) were found to be significantly stable up to 14 days when incubated in phosphate buffered saline at 37°C. Treated samples showed significantly better stability, both physically and microscopically, in comparison to nontreated samples. Proliferation and viability assays of rabbit corneal fibroblast cells (SIRC) and mouse fibroblast cells (L929 RFP) when cultured on fabricated scaffolds revealed remarkable cellular compatibility with gelatin-permeated SF (in formic acid; T) scaffolds compared to SF (in aqueous; T). Unlike other reports in the existing literature, this work presents the design and development of a nanofibrous silk-gelatin composite that exhibits acceptable transparency, cellular biocompatibility, as well as improved mechanical stability comparable to that of native cornea. Therefore, we anticipate that the fabricated novel scaffold is likely to be a good candidate for corneal tissue construct. Moreover, among the fabricated scaffolds, the outcomes depict gelatin-permeated SF (in formic acid; T) composite scaffold to be a better candidate as a corneal stromal analog that carries properties of both the silk and gelatin, i.e., optimal transparency, better stability, and enhanced cytocompatibility.
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Affiliation(s)
- Ajay Kumar Sahi
- Tissue Engineering and Biomicrofluidics Laboratory, School of Biomedical Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi, India
| | - Neelima Varshney
- Tissue Engineering and Biomicrofluidics Laboratory, School of Biomedical Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi, India
| | - Suruchi Poddar
- Tissue Engineering and Biomicrofluidics Laboratory, School of Biomedical Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi, India
| | - Shravanya Gundu
- Tissue Engineering and Biomicrofluidics Laboratory, School of Biomedical Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi, India
| | - Sanjeev Kumar Mahto
- Tissue Engineering and Biomicrofluidics Laboratory, School of Biomedical Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi, India.,Centre for Advanced Biomaterials and Tissue Engineering, Indian Institute of Technology (Banaras Hindu University), Varanasi, India
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Sharma R, Sharma A. Corneal anthropology: Ethnicity-based central corneal thickness measurements in managing corneal disorders. Indian J Ophthalmol 2021; 69:1338. [PMID: 33913899 PMCID: PMC8186617 DOI: 10.4103/ijo.ijo_385_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
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Abstract
To investigate effects of beta blocker (BB; timolol or betaxolol), latanoprost, and latanoprost-timolol combination (LTC) drugs on corneal endothelial cell density (ECD) and central corneal thickness (CCT) in primary open-angle glaucoma (POAG) patients. Sixty-one patients in BB group, 64 patients in latanoprost group, 59 patients in LTC group, and 58 healthy cases in control group were included. Intraocular pressures (IOP), ECDs, and CCTs of groups were recorded at initial (pre-treatment) period, first and third years after treatment, and comparisons were done. In groups, changes of ECDs according to time were not significant (p > 0.05). In BB and control groups, changes of CCTs according to time were not significant (p > 0.05). In latanoprost and LTC groups, CCTs in both first and third years were significantly thinner than initial CCTs (p = 0.039 for latanoprost, p = 0.041 for LTC at first year; p = 0.018 for latanoprost, p = 0.032 for LTC at third year). In latanoprost and LTC groups, CCTs of patients using drugs for 1 year were similar to those of patients using drugs for 3 years (p > 0.05). In our study, uses of BB, latanoprost or LTC did not affect ECD. BB drugs had no effect on CCT. Although latanoprost and LTC appeared to reduce CCT at 3-year follow-up from the statistical point of view, this 8-10 μm difference in CCT was not clinically significant.
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Affiliation(s)
- İrfan Botan Güneş
- Department of Ophthalmology, Medical Park Kocaeli Hospital, Kocaeli, Turkey
| | - Hakan Öztürk
- Department of Ophthalmology, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Bediz Özen
- Department of Ophthalmology, Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey
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Jin Y, McAlinden C, Sun Y, Wen D, Wang Y, Yu J, Feng K, Song B, Wang Q, Chen S, Huang J. Sirius Scheimpflug-Placido versus ultrasound pachymetry for central corneal thickness: meta-analysis. EYE AND VISION 2021; 8:5. [PMID: 33602345 PMCID: PMC7891160 DOI: 10.1186/s40662-021-00227-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 01/13/2021] [Indexed: 11/26/2022]
Abstract
Background To compare the difference in central corneal thickness (CCT) measurements in normal eyes between a rotating Scheimpflug camera combined with a Placido-disk corneal topographer (Sirius, CSO, Italy) and ultrasound pachymetry (USP). Methods A systematic literature search was conducted for relevant studies published on PubMed, Medline, EMBASE, and the Cochrane Library and ClinicalTrials.gov from inception to August 1st, 2019. Primary outcome measures were CCT measurements between Sirius and USP. A random effects model was used to pool CCT measurements. Results A total of twelve studies involving 862 eyes were included in this meta-analysis. The meta-analysis found CCT measurements between Sirius and USP to be statistically significantly different (P < 0.0001). The mean difference between Sirius and USP was −11.26 μm with a 95% confidence interval (CI) (−16.92 μm, −5.60 μm). The heterogeneity was I2 = 60% (P = 0.004). Conclusion CCT measurements with the Sirius Scheimpflug-Placido topographer were statistically significantly lower than USP. However, it may be argued that the mean difference of 11.26 μm is not a clinically significant difference.
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Affiliation(s)
- Yili Jin
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Colm McAlinden
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Department of Ophthalmology, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
| | - Yong Sun
- Shenzhen Hospital of Integrated Traditional and Western Medicine, Shenzhen, China
| | - Daizong Wen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yiran Wang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Jinjin Yu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ke Feng
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Benhao Song
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qinmei Wang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China
| | - Shihao Chen
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China. .,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China. .,Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China.
| | - Jinhai Huang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China. .,Key Laboratory of Vision Science, Ministry of Health P.R. China, Wenzhou, Zhejiang, China. .,Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, 325027, Zhejiang, China.
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Measurement and Analysis of Central Corneal Thickness at Different Postnatal Stages in Chinese Premature Infants. J Ophthalmol 2020; 2020:7313909. [PMID: 33014441 PMCID: PMC7519199 DOI: 10.1155/2020/7313909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/26/2020] [Accepted: 09/01/2020] [Indexed: 11/22/2022] Open
Abstract
Purpose The objective of this study was to evaluate central corneal thickness (CCT) in Chinese premature infants at different postnatal stages to study the peak point and analyze influential factors on CCT development. Methods This was a cross-sectional study of premature infants. Initial CCT measurement was taken at 34 weeks of gestational age (GA) and at intervals until 88 weeks of postmenstrual age (PMA) was reached. The comparison and correlation analysis were carried out to access the association of CCT with gender, birth weight (BW), GA, and retinopathy of prematurity (ROP) for each PMA. The premature infants were divided into the thick CCT group and the thin CCT group according to the average CCT at 40 w. And the difference in CCT between the two groups at subsequent 52 w and 64 w was compared. Results A total of 1726 premature infants (3463 measurements) with an average of 2.21 ± 1.57 measurements were included in this study. The CCT decreased from 34 w GA to 52 w PMA (R = 92.36, P < 0.0001) and then reached a plateau (R = 2.541, P=0.3567). Male (P < 0.05), low BW (P < 0.05), and low GA (P < 0.05) were associated with thicker CCT at the early stage of PMA. The premature infants who had thick CCT at 40 w would have thick CCT at 52 w and 64 w accordingly. Conclusions The CCT values of premature infants decreased over time and plateaued at 52 w PMA. Gender, BW, and GA were considered as the influential factors of CCT at the early stage of PMA. Moreover, CCT at 40 w could forecast its development trend at 52 w or 64 w after birth.
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Choquet H, Melles RB, Yin J, Hoffmann TJ, Thai KK, Kvale MN, Banda Y, Hardcastle AJ, Tuft SJ, Glymour MM, Schaefer C, Risch N, Nair KS, Hysi PG, Jorgenson E. A multiethnic genome-wide analysis of 44,039 individuals identifies 41 new loci associated with central corneal thickness. Commun Biol 2020; 3:301. [PMID: 32528159 PMCID: PMC7289804 DOI: 10.1038/s42003-020-1037-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/22/2020] [Indexed: 02/08/2023] Open
Abstract
Central corneal thickness (CCT) is one of the most heritable human traits, with broad-sense heritability estimates ranging between 0.68 to 0.95. Despite the high heritability and numerous previous association studies, only 8.5% of CCT variance is currently explained. Here, we report the results of a multiethnic meta-analysis of available genome-wide association studies in which we find association between CCT and 98 genomic loci, of which 41 are novel. Among these loci, 20 were significantly associated with keratoconus, and one (RAPSN rs3740685) was significantly associated with glaucoma after Bonferroni correction. Two-sample Mendelian randomization analysis suggests that thinner CCT does not causally increase the risk of primary open-angle glaucoma. This large CCT study explains up to 14.2% of CCT variance and increases substantially our understanding of the etiology of CCT variation. This may open new avenues of investigation into human ocular traits and their relationship to the risk of vision disorders.
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Affiliation(s)
- Hélène Choquet
- Kaiser Permanente Northern California (KPNC), Division of Research, Oakland, CA, 94612, USA.
| | - Ronald B Melles
- KPNC, Department of Ophthalmology, Redwood City, CA, 94063, USA
| | - Jie Yin
- Kaiser Permanente Northern California (KPNC), Division of Research, Oakland, CA, 94612, USA
| | - Thomas J Hoffmann
- Institute for Human Genetics, University of California San Francisco (UCSF), San Francisco, CA, 94143, USA
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, 94158, USA
| | - Khanh K Thai
- Kaiser Permanente Northern California (KPNC), Division of Research, Oakland, CA, 94612, USA
| | - Mark N Kvale
- Institute for Human Genetics, University of California San Francisco (UCSF), San Francisco, CA, 94143, USA
| | - Yambazi Banda
- Institute for Human Genetics, University of California San Francisco (UCSF), San Francisco, CA, 94143, USA
| | - Alison J Hardcastle
- UCL Institute of Ophthalmology, University College London, London, UK
- National Institute of Health Research Biomedical Research Centre for Ophthalmology, and UCL Institute of Ophthalmology, London, UK
| | | | - M Maria Glymour
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, 94158, USA
| | - Catherine Schaefer
- Kaiser Permanente Northern California (KPNC), Division of Research, Oakland, CA, 94612, USA
| | - Neil Risch
- Kaiser Permanente Northern California (KPNC), Division of Research, Oakland, CA, 94612, USA
- Institute for Human Genetics, University of California San Francisco (UCSF), San Francisco, CA, 94143, USA
- Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, 94158, USA
| | - K Saidas Nair
- Departments of Ophthalmology and Anatomy, School of Medicine, UCSF, San Francisco, CA, 94143, USA
| | - Pirro G Hysi
- King's College London, Section of Ophthalmology, School of Life Course Sciences, London, UK
- King's College London, Department of Twin Research and Genetic Epidemiology, London, UK
- University College London, Great Ormond Street Hospital Institute of Child Health, London, UK
| | - Eric Jorgenson
- Kaiser Permanente Northern California (KPNC), Division of Research, Oakland, CA, 94612, USA.
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Nuzzi R, Marolo P, Nuzzi A. The Hub-and-Spoke Management of Glaucoma. Front Neurosci 2020; 14:180. [PMID: 32256306 PMCID: PMC7090234 DOI: 10.3389/fnins.2020.00180] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 02/18/2020] [Indexed: 12/19/2022] Open
Abstract
Glaucoma is an extremely significant public health issue, since it is the most common cause of irreversible blindness worldwide, nevertheless it is still widely undiagnosed because of its devious nature. Glaucoma diagnosis criteria are well-defined and have to be strictly observed and recognized: the earlier the disease is diagnosed, the earlier the patient can undergo the most suitable treatment, the better can be the prognosis. The three levels of prevention are essential in the approach to the disease and its pathophysiological features make it eligible for screening. This review provides an overview of the current state of the art in glaucoma management, starting from its prevention and coming to the hub-and-spoke organization. This model applied to glaucoma aims to direct patients toward professional and not professional figures who may guide them in integrated care pathway. This path should be designed in accordance with best practice to coordinate glaucoma prevention, diagnosis, treatment and follow up with the best cost-benefit ratio, protecting both the interests of the patient and of the society.
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Affiliation(s)
- Raffaele Nuzzi
- Eye Clinic Section, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Paola Marolo
- Eye Clinic Section, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Alessia Nuzzi
- Department of Clinical Sciences and Community Health, Eye Clinic San Giuseppe Hospital, IRCCS Multimedica, University of Milan, Milan, Italy
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Omodaka K, Fujioka S, An G, Udagawa T, Tsuda S, Shiga Y, Morishita S, Kikawa T, Pak K, Akiba M, Yokota H, Nakazawa T. Structural Characterization of Glaucoma Patients with Low Ocular Blood Flow. Curr Eye Res 2020; 45:1302-1308. [PMID: 32134693 DOI: 10.1080/02713683.2020.1736306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: There is an unclear relationship between ocular blood flow (OBF) and the structural characteristics of the optic nerve head (ONH) in glaucoma, a multifactorial disease. This study used laser speckle flowgraphy (LSFG) to identify low-OBF glaucoma patients and investigated the ONH in these patients. Materials and Methods: In 533 eyes with glaucoma, we determined confounding factors for LSFG-measured OBF (tissue-area mean blur rate: MT) and corrected MT with a linear mixed-effects model (LMM). Structural ONH data (from fundus stereo photography), OCT data, and clinical characteristics were then compared in patients with corrected MT in the upper and lower quartiles using the LMM. Results: Single regression showed significant correlations between MT and age, spherical equivalent (SE), central corneal thickness (CCT), and a weighted count of retinal ganglion cells (wRGC), but not axial length or systemic blood pressure. Gender also significantly influenced MT; MT was corrected for these correlated factors and also glaucoma type with the LMM. The lower-quartile MT group had a significantly larger cup area and cup-disc area ratio and lower temporal quadrant circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and macular ganglion cell complex (GCC) than the upper-quartile group. Conclusions: Low-OBF glaucoma patients were characterized by a larger cup-disc ratio, and higher susceptibility to damage in the temporal disc and the macular area.
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Affiliation(s)
- Kazuko Omodaka
- Department of Ophthalmology, Graduate School of Medicine, Tohoku University , Sendai, Japan
| | - Shunsuke Fujioka
- Department of Ophthalmology, Graduate School of Medicine, Tohoku University , Sendai, Japan
| | - Guangzhou An
- R&D Division, Topcon Corporation.,Cloud-Based Eye Disease Diagnosis Joint Research Team, Riken
| | | | - Satoru Tsuda
- Department of Ophthalmology, Graduate School of Medicine, Tohoku University , Sendai, Japan
| | - Yukihiro Shiga
- Department of Ophthalmology, Graduate School of Medicine, Tohoku University , Sendai, Japan.,Department of Ophthalmic Imaging and Information Analytics, Graduate School of Medicine, Tohoku University , Sendai, Japan
| | | | | | - Kyongsun Pak
- Division of Biostatistics, Center for Clinical Research, National Center for Child Health and Development , Tokyo, Japan
| | - Masahiro Akiba
- R&D Division, Topcon Corporation.,Cloud-Based Eye Disease Diagnosis Joint Research Team, Riken
| | - Hideo Yokota
- Cloud-Based Eye Disease Diagnosis Joint Research Team, Riken.,Image Processing Research Team, Riken
| | - Toru Nakazawa
- Department of Ophthalmology, Graduate School of Medicine, Tohoku University , Sendai, Japan.,Department of Ophthalmic Imaging and Information Analytics, Graduate School of Medicine, Tohoku University , Sendai, Japan
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Prospective cohort study of risk factors for choroidal detachment after trabeculectomy. Int Ophthalmol 2020; 40:1077-1083. [PMID: 31989350 DOI: 10.1007/s10792-019-01267-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 12/30/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To investigate risk factors for choroidal detachment after trabeculectomy. METHODS We prospectively evaluated 97 patients with open-angle glaucoma who underwent primary trabeculectomy to investigate risk factors for choroidal detachment after trabeculectomy. The primary outcome measure was risk factors for the occurrence and severity of choroidal detachment after trabeculectomy. Choroidal detachment severity was quantified as the number of fundus quadrants with choroidal detachment. RESULTS Sixteen patients (16.5%) had choroidal detachment. Mean period between surgery and occurrence of choroidal detachment was 7.9 ± 5.7 days. Mean intraocular pressure (IOP) on the first day of choroidal detachment was 6.1 ± 3.0 mm Hg. Multivariable analyses revealed that the exfoliation glaucoma, greater ΔIOP between preoperative and lowest postoperative IOPs, and thicker cornea were associated with choroidal detachment (P = 0.022, P = 0.002, and P = 0.013, respectively). These factors were also associated with the severity of choroidal detachment (exfoliation glaucoma; P = 0.013, greater ΔIOP; P < 0.001, and thicker cornea; P = 0.006). CONCLUSIONS Exfoliation glaucoma, more IOP reduction, and thicker cornea are associated with the occurrence and severity of choroidal detachment after trabeculectomy.
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Bennett A, Davidovitch E, Beiderman Y, Agadarov S, Beiderman Y, Moshkovitz A, Polat U, Zalevsky Z. Corneal thickness measurement by secondary speckle tracking and image processing using machine-learning algorithms. JOURNAL OF BIOMEDICAL OPTICS 2019; 24:1-10. [PMID: 31797646 PMCID: PMC7005539 DOI: 10.1117/1.jbo.24.12.126001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 11/04/2019] [Indexed: 06/10/2023]
Abstract
Corneal thickness (CoT) is an important tool in the evaluation process for several disorders and in the assessment of intraocular pressure. We present a method enabling high-precision measurement of CoT based on secondary speckle tracking and processing of the information by machine-learning (ML) algorithms. The proposed configuration includes capturing by fast camera the laser beam speckle patterns backscattered from the corneal-scleral border, followed by ML processing of the image. The technique was tested on a series of phantoms having different thicknesses as well as in clinical trials on human eyes. The results show high accuracy in determination of eye CoT, and implementation is speedy in comparison with other known measurement methods.
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Affiliation(s)
- Aviya Bennett
- Bar-Ilan University, Faculty of Engineering, Nanotechnology Center, Ramat-Gan, Israel
| | - Elnatan Davidovitch
- Bar-Ilan University, Faculty of Engineering, Nanotechnology Center, Ramat-Gan, Israel
| | - Yafim Beiderman
- Bar-Ilan University, Faculty of Engineering, Nanotechnology Center, Ramat-Gan, Israel
| | - Sergey Agadarov
- Bar-Ilan University, Faculty of Engineering, Nanotechnology Center, Ramat-Gan, Israel
| | - Yevgeny Beiderman
- Bar-Ilan University, Faculty of Engineering, Nanotechnology Center, Ramat-Gan, Israel
| | - Avital Moshkovitz
- Bar-Ilan University, School of Optometry and Vision Science, Ramat-Gan, Israel
| | - Uri Polat
- Bar-Ilan University, School of Optometry and Vision Science, Ramat-Gan, Israel
| | - Zeev Zalevsky
- Bar-Ilan University, Faculty of Engineering, Nanotechnology Center, Ramat-Gan, Israel
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Potop V, Corbu C, Coviltir V, Schmitzer S, Constantin M, Burcel M, Ionescu C, Dăscălescu D. The importance of corneal assessment in a glaucoma suspect - a review. Rom J Ophthalmol 2019; 63:321-326. [PMID: 31915729 PMCID: PMC6943289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Glaucoma represents the main cause of irreversible blindness in the world and for this consideration, the interest in a quick and precise diagnosis and progression of the disease, prior to the appearance of irreversible damage, has been continuously rising. Glaucoma risk factors are already well known, but current studies reveal that it is necessary to make a proper analysis of the intraocular pressure (IOP) to obtain an accurate diagnosis, so we must take into consideration corneal properties that might affect IOP measurements. Starting from corneal geometrical properties represented by central corneal thickness (CCT) and continuing with biomechanical properties represented by corneal hysteresis (CH) and corneal resistance factor (CRF) we reviewed the value of investigating corneal properties in ocular hypertension (OH), primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients. We can now say that CCT plays an important role in diagnosing glaucoma because it may mask the real value of the IOP and also, in setting the target for the IOP needed to stop disease progression. Also, CH is a factor that needs to be screened from the first consult of a glaucoma patient or suspect because it is correlated to the response to treatment, visual field (VF) and retinal nerve fiber layer (RNFL) progression and could anticipate the future evolution and patients prognosis. Both CCT and CH are factors that must be thought-about when we encounter a glaucoma suspect. CCT has a predictive role in OH and NTG patients, while CH has on the other hand a prognostic role in POAG, OH and NTG patients.
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Affiliation(s)
- Vasile Potop
- “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
,Clinical Hospital of Ophthalmologic Emergencies Bucharest, Romania
| | - Cătălina Corbu
- Clinical Hospital of Ophthalmologic Emergencies Bucharest, Romania
| | - Valeria Coviltir
- “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
,Clinical Hospital of Ophthalmologic Emergencies Bucharest, Romania
| | - Speranţa Schmitzer
- “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
,Clinical Hospital of Ophthalmologic Emergencies Bucharest, Romania
| | | | | | | | - Dana Dăscălescu
- “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
,Oftaclinic Bucharest, Romania
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Muhsen S, Alkhalaileh F, Hamdan M, AlRyalat SA. Central corneal thickness in a Jordanian population and its association with different types of Glaucoma: cross-sectional study. BMC Ophthalmol 2018; 18:279. [PMID: 30373555 PMCID: PMC6206916 DOI: 10.1186/s12886-018-0944-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 10/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Central corneal thickness (CCT) has long been implicated to affect glaucoma predisposition. Several reports have identified that thinner CCT is a risk factor for open-angle glaucoma, and that CCT can be very variable between different ethnic groups. In this study, we aim to identify the relation between CCT and different glaucoma parameters in different types of glaucoma in an Arabian ethnicity. METHODS We classified our participants into four main groups: primary open-angle glaucoma (POAG), primary angle-closure glaucoma (PACG), pseudoexfoliative glaucoma (PXFG), and a control group. We obtained demographics, intraocular pressure (IOP), cup to disc ratio (CDR), visual field mean deviation (MD) and pattern standard deviation (PSD), CCT, and retinal nerve fiber layer (RNFL) thickness for each participant. RESULTS We included A total of 119 eyes with glaucoma, including POAG (54 eyes), PXFG (31 eyes) and PACG (34 eyes), we also included 57 control eyes. We found that PACG eyes have the thinnest CCT. Mean measurements of CCT for our groups were: 538.31 μm (SD = 36.30) in eyes with POAG, 544.45 μm (SD = 28.57) in eyes with PXFG, 506.91 μm (SD = 34.55) in eyes with PACG and 549.63 μm (SD = 42.9) in the control group. We found that CCT is significantly correlated with CDR (p = 0.012, r = - 0.231), MD (p < 0.001, r = 0.327),and RNFL thickness (p = .007, r = .283). CONCLUSION In Arabian ethnicity, PACG patients have the thinnest CCT compared to other types of glaucoma, namely POAG and PXFG. We demonstrated that glaucomatous eyes with thinner corneas will probably have more advanced glaucomatous optic neuropathy. Our results emphasize the importance of taking ethnicity into account upon glaucoma management.
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Affiliation(s)
- Sana' Muhsen
- Ophthalmology, Glaucoma and Anterior Segment Surgeon, University of Jordan Hospital, The University of Jordan, Amman, Jordan
| | | | - Mohammad Hamdan
- School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Saif Aldeen AlRyalat
- Department of Ophthalmology, University of Jordan Hospital, The University of Jordan, Amman, 11942, Jordan.
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Dutca LM, Rudd D, Robles V, Galor A, Garvin MK, Anderson MG. Effects of sustained daily latanoprost application on anterior chamber anatomy and physiology in mice. Sci Rep 2018; 8:13088. [PMID: 30166564 PMCID: PMC6117323 DOI: 10.1038/s41598-018-31280-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 08/13/2018] [Indexed: 12/04/2022] Open
Abstract
Latanoprost is a common glaucoma medication. Here, we study longitudinal effects of sustained latanoprost treatment on intraocular pressure (IOP) in C57BL/6J mice, as well as two potential side-effects, changes in iris pigmentation and central corneal thickness (CCT). Male C57BL/6J mice were treated daily for 16 weeks with latanoprost. Control mice were treated on the same schedule with the preservative used with latanoprost, benzalkonium chloride (BAK), or handled, without ocular treatments. IOP and CCT were studied at pre-treatment, 2 "early" time points, and 2 "late" time points; slit-lamp analysis performed at a late time point; and expression of corneal and iridial candidate genes analyzed at the end of the experiment. Latanoprost lowered IOP short, but not long-term. Sustained application of BAK consistently resulted in significant corneal thinning, whereas sustained treatment with latanoprost resulted in smaller and less consistent changes. Neither treatment affected iris pigmentation, corneal matrix metalloprotease expression or iridial pigment-related genes expression. In summary, latanoprost initially lowered IOP in C57BL/6J mice, but became less effective with sustained treatment, likely due to physiological adaptation. These results identify a new resource for studying changes in responsiveness associated with long-term treatment with latanoprost and highlight detrimental effects of commonly used preservative BAK.
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Affiliation(s)
- Laura M Dutca
- Center for Prevention and Treatment of Visual Loss Iowa City Veterans Administration Medical Center, Iowa City, IA, USA
- Department of Ophthalmology and Visual Science, University of Iowa, Iowa City, IA, USA
| | - Danielle Rudd
- Center for Prevention and Treatment of Visual Loss Iowa City Veterans Administration Medical Center, Iowa City, IA, USA
| | - Victor Robles
- Electrical and Computer Engineering, University of Iowa, Iowa City, IA, USA
| | - Anat Galor
- Miami Veterans Administration Medical Center and Bascom Palmer Institute, University of Miami, Miami, FL, USA
| | - Mona K Garvin
- Center for Prevention and Treatment of Visual Loss Iowa City Veterans Administration Medical Center, Iowa City, IA, USA
- Electrical and Computer Engineering, University of Iowa, Iowa City, IA, USA
| | - Michael G Anderson
- Center for Prevention and Treatment of Visual Loss Iowa City Veterans Administration Medical Center, Iowa City, IA, USA.
- Department of Ophthalmology and Visual Science, University of Iowa, Iowa City, IA, USA.
- Molecular Physiology and Biophysics, University of Iowa, Iowa City, IA, USA.
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Michaud L, Samaha D, Giasson CJ. Intra-ocular pressure variation associated with the wear of scleral lenses of different diameters. Cont Lens Anterior Eye 2018; 42:104-110. [PMID: 30054088 DOI: 10.1016/j.clae.2018.07.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/13/2018] [Accepted: 07/19/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE To evaluate the variation of intra-ocular pressure during scleral lens wear, and the influence of the lens diameter on the results. METHODS This is a prospective, randomized study performed on Caucasian subjects (16 F; 5 M), aged 24.7 + 4.1 y.o. A diurnal variation pattern (IOPg) was established, then, transpalpebral IOP (IOPt) was taken before and during SL wear. One eye, randomly fitted with a 15.8 diameter SL (L1), was compared to the fellow eye, fitted with an 18 mm SL of the same design, thickness and material (L2). Anterior segment tomography was taken pre-and after lens removal. RESULTS Baseline IOPg (L1:15.2 + 3.1 mm HG; L2: 15.1 +/- 2.8 mm) did not reveal significant diurnal variations. Wearing L1, IOPt rose from 10.1 + 1.9 mm HG to 14.4 + 5.5 mm HG after 4.5 + 0.3 hrs, while with L2, it rose from 9.2 + 2.1 mm HG to 14.4 + 4.8 mm Hg. This difference is statistically significant based on time but not on lenses. Anterior segment parameters did not vary except for the anterior chamber volume (L1: -1.53 + 7.61 mm3; L2: -3.47 + 6.4 mm3), and for the corneal thickness (+2.1% with L1 and L2). CONCLUSION These results suggest that, as evaluated with a non-standard transpalpebral methodology, IOP during scleral lens wear may be increased in average by 5 mm Hg, regardless of the lens diameter. More work is needed to confirm if practitioners should be warned when using SL on populations at risk for glaucoma.
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Affiliation(s)
- Langis Michaud
- École d'optométrie, Université de Montréal, 3744 Jean-Brillant, Suite 270, Montreal H3T 1P1, Canada.
| | - Dan Samaha
- École d'optométrie, Université de Montréal, 3744 Jean-Brillant, Suite 270, Montreal H3T 1P1, Canada
| | - Claude J Giasson
- École d'optométrie, Université de Montréal, 3744 Jean-Brillant, Suite 270, Montreal H3T 1P1, Canada; Centre de Recherche en Organogénèse Expérimentale de l'Université Laval/LOEX et le Centre Hospitalier Universitaire de Québec, Hôpital du Saint-Sacrement, Québec, Canada
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Thompson AC, Vu DM, Cowan LA, Asrani S. Risk Factors Associated with Missed Diagnoses of Narrow Angles by the Van Herick Technique. Ophthalmol Glaucoma 2018; 1:108-114. [PMID: 32672561 DOI: 10.1016/j.ogla.2018.08.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 07/31/2018] [Accepted: 08/01/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To identify which factors are associated with a deep-appearing anterior chamber on slit-lamp examination by the Van Herick (VH) technique in eyes with a diagnosis of narrow angle (NA) on gonioscopy. DESIGN Retrospective review. PARTICIPANTS One thousand three hundred fourteen eyes in 696 participants with NA on indirect gonioscopy. METHODS All included eyes were graded as narrow with iridotrabecular contact on indirect gonioscopy in a darkened room by a single trained glaucoma specialist. Before gonioscopy, eyes were graded as narrow or deep by VH slit-lamp examination technique. Demographic and clinical factors predictive of a deep VH grading were assessed using logistic regression with generalized estimating equations. MAIN OUTCOME MEASURES Factors associated with deep versus narrow VH grade. RESULTS Using the VH technique, 13.7% of eyes (n = 180/1314) with NA on gonioscopy were classified as deep. Eyes with primary angle-closure glaucoma (PACG; odds ratio, 2.43; P < 0.001) and primary angle closure (PAC; odds ratio, 1.38; P = 0.006) were significantly more likely to be graded as deep by the VH technique relative to eyes that were primary angle-closure suspects (PACSs). In multivariate analysis, male gender (odds ratio, 2.22; P < 0.001), myopia (odds ratio, 1.4; P = 0.048), and black (odds ratio, 4.11; P < 0.001) and Asian (odds ratio, 2.24; P = 0.044) race were independent risk factors for a deep grading with the VH technique in eyes with NA on gonioscopy. CONCLUSIONS Patients with NAs on gonioscopy who are men, myopic, and of black or Asian race are at increased risk of being misdiagnosed with deep angles if examined with the VH technique alone. Eyes with PACG and PAC may be more likely than those with PACS to be misdiagnosed as deep with the VH technique. It is possible that by being missed by the VH technique, these eyes could have progressed from PACS to PAC and PACG. Patients with these demographic and clinical characteristics in the presence of other risk factors for glaucoma should undergo careful gonioscopy.
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Affiliation(s)
- Atalie C Thompson
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Daniel M Vu
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Lisa A Cowan
- Department of Ophthalmology, Southern California Permanente Medical Group, Bakersfield, California
| | - Sanjay Asrani
- Department of Ophthalmology, Duke University, Durham, North Carolina.
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