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Mejía-Salgado G, Muñoz-Vargas PT, Cifuentes-González C, Flórez-Esparza G, Paquentín-Jiménez R, Castro-Monreal MÁ, Medina-Galindo N, Hernández-Herrera GN, Concha-del-Río LE, de-la-Torre A. Quantitative changes in the corneal endothelium and central corneal thickness during anterior chamber inflammation: A systematic review and meta-analysis. PLoS One 2024; 19:e0296784. [PMID: 38181008 PMCID: PMC10769021 DOI: 10.1371/journal.pone.0296784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 12/19/2023] [Indexed: 01/07/2024] Open
Abstract
PURPOSE To establish the effects of anterior chamber inflammation (ACI) on the corneal endothelium parameters and central corneal thickness (CCT). METHODS We conducted a comprehensive literature review using medical databases (PubMed, EMBASE, VHL, and medRxiv) on March 8, 2023, for studies that included patients with ACI who had undergone specular microscopy or pachymetry. Case series with >10 patients, cross-sectional, case-control, and cohort studies were included. The risk of bias was assessed using CLARITY tools and validated scales such as those by Hassan Murad et al. and Hoy et al. A narrative synthesis and a quantitative standardized mean difference meta-analysis, I2 heterogeneity assessment, and publication bias tests were conducted. The study was registered in PROSPERO (CRD42023420148) and approved by the Universidad del Rosario ethical committee (DVO005 2277- CV1712). RESULTS Thirty-four studies, encompassing 1,388 eyes with ACI, were included. Compared with healthy controls, overall, ACI eyes show significant mean differences in endothelial parameters (endothelial cell density (ECD), coefficient of variation (CV), and hexagonality (HEX)) (P < 0.05). In the subgroup analysis compared with healthy controls, both active and chronic-recurrent ACI demonstrated a reduced ECD. An increased CV was observed in active, inactive, and chronic-recurrent ACI. Lower HEX was evident in inactive, acute, and chronic-recurrent ACI, while both active and acute ACI exhibited high CCT. CONCLUSION ACI leads to significant alterations in endothelial parameters and CCT. The primary contributors to these changes are increased IOP, uveitis duration, and intraocular surgeries. Further studies are needed to explore the impact of ACI etiology on the endothelium, potential biases in IOP measurements during acute ACI episodes, and the potential necessity for monitoring the endothelial parameters and CCT in patients with chronic ACI.
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Affiliation(s)
- Germán Mejía-Salgado
- Institute of Translational Medicine (IMT), Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
- Institute of Translational Medicine (IMT), Ophthalmology Interest Group, Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Paula Tatiana Muñoz-Vargas
- Postgraduate Master’s Program in Epidemiology Universidad CES, Medellín, Colombia
- Post-gradual Master’s Program in Epidemiology Universidad del Rosario, Bogotá Colombia
| | - Carlos Cifuentes-González
- Institute of Translational Medicine (IMT), Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
- Postgraduate Master’s Program in Epidemiology Universidad CES, Medellín, Colombia
- Post-gradual Master’s Program in Epidemiology Universidad del Rosario, Bogotá Colombia
| | - Gabriela Flórez-Esparza
- Institute of Translational Medicine (IMT), Ophthalmology Interest Group, Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
| | - Rebeca Paquentín-Jiménez
- Inflammatory Eye Disease Clinic, Asociación Para Evitar la Ceguera en México, Hospital “Dr. Luis Sánchez Bulnes,” México City, México
| | - Miguel Ángel Castro-Monreal
- Inflammatory Eye Disease Clinic, Asociación Para Evitar la Ceguera en México, Hospital “Dr. Luis Sánchez Bulnes,” México City, México
| | - Naomi Medina-Galindo
- Inflammatory Eye Disease Clinic, Asociación Para Evitar la Ceguera en México, Hospital “Dr. Luis Sánchez Bulnes,” México City, México
| | - Gilma Norella Hernández-Herrera
- Postgraduate Master’s Program in Epidemiology Universidad CES, Medellín, Colombia
- Post-gradual Master’s Program in Epidemiology Universidad del Rosario, Bogotá Colombia
| | - Luz Elena Concha-del-Río
- Inflammatory Eye Disease Clinic, Asociación Para Evitar la Ceguera en México, Hospital “Dr. Luis Sánchez Bulnes,” México City, México
| | - Alejandra de-la-Torre
- Institute of Translational Medicine (IMT), Ophthalmology Interest Group, Neuroscience (NEUROS) Research Group, Neurovitae Research Center, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá, Colombia
- Post-gradual Master’s Program in Epidemiology Universidad del Rosario, Bogotá Colombia
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Dikmetas O, Aygün O, Bolek EÇ, Kocabeyoglu S, Karadag O, Karakaya J, Kadayıfçılar S, Irkec M. Investigation of anterior segment structures of the eye in Behçet's disease using in vivo confocal microscopy. Graefes Arch Clin Exp Ophthalmol 2022; 260:3897-3902. [PMID: 36178506 DOI: 10.1007/s00417-022-05846-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/28/2022] [Accepted: 09/10/2022] [Indexed: 11/26/2022] Open
Abstract
PURPOSE We sought to investigate alterations in the corneal subbasal nerve plexus and endothelium in patients with Behçet's disease (BD). METHODS This cross-sectional study included 64 patients with BD and 30 age- and gender-matched healthy control subjects. Those with BD were classified as having ocular or non-ocular disease. All subjects underwent a corneal endothelial and subbasal nerve density evaluation using in vivo confocal microscopy (IVCM). The differences among groups were analyzed using the Kruskal-Wallis test followed by Dunn's multiple comparison procedure. RESULTS The mean age of study participants was 35.7 ± 10.2 years (16-58) in the ocular BD group, 39.6 ± 14.9 years (11-66) in the non-ocular BD group, and 34.1 ± 11.2 years (21-55) in the control group. No statistical significance was found in terms of age (p = 0.259) or sex (p = 0.560) between groups. The mean endothelial cell density determined with IVCM was 2124.9 [Formula: see text] 417.4 cells/mm2 (1811-3275) in the ocular group and 2546 [Formula: see text] 335 cells/mm2 (1798-3280) in the control group (p = 0.000). In the ocular group, the mean density of the subbasal nerve plexus was significantly lower (p = 0.004), and nerve tortuosity was significantly higher (p = 0.002). CONCLUSIONS Ocular BD could be responsible for changes in the corneal layers, especially endothelial and corneal nerve structures. Nerve density and tortuosity differences could be inflammatory indicators for BD.
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Affiliation(s)
- Ozlem Dikmetas
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Orhan Aygün
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ertugrul Çagri Bolek
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University Vasculitis Centre (HUVAC), Hacettepe University, Ankara, Turkey
| | - Sibel Kocabeyoglu
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Omer Karadag
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Hacettepe University Vasculitis Centre (HUVAC), Hacettepe University, Ankara, Turkey
| | - Jale Karakaya
- Department of Biostatistics, Hacettepe University School of Medicine, Ankara, Turkey
| | - Sibel Kadayıfçılar
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Murat Irkec
- Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey
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Huang YH, Hung JH. In vivo confocal microscopy for eyes with Behçet's disease: a missing piece of the puzzle. Graefes Arch Clin Exp Ophthalmol 2022; 260:3779-3780. [PMID: 36171458 DOI: 10.1007/s00417-022-05848-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 09/17/2022] [Accepted: 09/21/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- Yi-Hsun Huang
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan 701, Taiwan
| | - Jia-Horung Hung
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.1, University Road, Tainan 701, Taiwan.
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Evaluation of corneal endothelial cell morphology by specular microscopy in patients with acute anterior uveitis. Int Ophthalmol 2021; 42:1339-1345. [PMID: 34822052 DOI: 10.1007/s10792-021-02122-3] [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: 09/15/2020] [Accepted: 11/12/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To determine the structure and morphology of corneal endothelial cell layer in patients with acute anterior uveitis. METHODS Thirty-four eyes of 34 acute anterior uveitis patients and 34 eyes of 34 healthy subjects were included. Mean cell density, coefficient of variation, maximum cell area, minimum cell area, average cell area and hexagonality ratio values were evaluated by non-contact specular microscopy. Parameters recorded in both groups were compared. RESULTS The mean maximum cell area was 1054,44 ± 251,14 µm2, minimum cell area was 152.29 ± 53.65 µm2 and average cell area was 386.91 ± 41.73 µm2 in acute anterior uveitis group and the mean maximum cell area was 1057.65 ± 261.23 µm2, minimum cell area was 147.26 ± 20.45 µm2 and average cell area was 383.53 ± 43.12 µm2 in the control group. There were no significant differences between the two groups in terms of maximum, minimum and average cell area (respectively, p = 0.080, p = 0.72, p = 0.62, p = 0.67). The mean cell density was 2607.74 ± 277.63 cells/ µm2 in acute anterior uveitis group and 2669.35 ± 265.22 cells/µm2 in the control group. (p = 0.358). In acute anterior uveitis group the mean coefficient of variation was 31.68 ± 8.16, hexagonality ratio was 63.85 ± 11.14 and mean central corneal thickness was 571.47 ± 55.99 µm; in control group the mean coefficient of variation was 25.29 ± 3.00, mean hexagonality ratio was 72.6 ± 4.80% and mean central corneal thickness was 534.82 ± 33.84 µm. Statistically significant differences were seen between the two groups (respectively, P = 0,00, P = 0,00, P = 0.02). CONCLUSION The mean central corneal thickness and coefficient of variation values were found higher, and the hexagonality ratio was found lower in acute anterior uveitis group. Our findings suggest that intraocular inflammation in anterior chamber negatively affects the endothelial function in patients with acute anterior uveitis.
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Wong SW, Carley F, Jones NP. Corneal Decompensation in Uveitis Patients: Incidence, Etiology, and Outcome. Ocul Immunol Inflamm 2020; 29:771-775. [DOI: 10.1080/09273948.2019.1698747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Shiao W. Wong
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Fiona Carley
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Nicholas P. Jones
- Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, UK
- Medical Academic Health Science Centre, University of Manchester, Manchester, UK
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Kösekahya P, Üçgül Atılgan C, Atılgan KG, Koç M, Tekin K, Çağlayan M, Göker YŞ. Corneal Endothelial Morphology and Thickness Changes in Patients with Gout. Turk J Ophthalmol 2019; 49:178-182. [PMID: 31486603 PMCID: PMC6761378 DOI: 10.4274/tjo.galenos.2018.01947] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objectives: To investigate corneal endothelial cell density (ECD), morphology, and central corneal thickness (CCT) in patients with gout compared with healthy subjects. Materials and Methods: Fifty eyes of 50 gout patients and 50 eyes of 50 healthy subjects without gout or any other systemic disease were included in this study. After detailed ophthalmologic examination, specular microscopy (Tomey EM-4000; Tomey Corp) measurement was performed for all participants. ECD, average cell area (ACA), coefficient of variation (CV), hexagonality ratio, and CCT values were recorded. Results: Mean ECD and hexagonality ratio were lower (p=0.004 and p=0.002) and CV, ACA, and CCT values were higher (p=0.001, p=0.007, and p=0.001) in patients with gout when compared to healthy subjects. There were significant correlations between gout disease duration and CD and hexagonality ratio (p=0.019 and p=0.043) and also between uric acid value and hexagonality ratio and CCT (p=0.044 and p=0.003). Conclusion: Altered corneal endothelial function was found in patients with gout when compared to healthy subjects and the alteration increased as gout duration and uric acid value increased.
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Affiliation(s)
- Pınar Kösekahya
- Ulucanlar Eye Training and Research Hospital, Ophthalmology Clinic, Ankara, Turkey
| | | | | | - Mustafa Koç
- Ulucanlar Eye Training and Research Hospital, Ophthalmology Clinic, Ankara, Turkey
| | - Kemal Tekin
- Van Erciş State Hospital, Ophthalmology Clinic, Van, Turkey
| | - Mehtap Çağlayan
- Gazi Yaşargil Training and Research Hospital, Ophthalmology Clinic, Diyarbakır, Turkey
| | - Yasin Şakir Göker
- Ulucanlar Eye Training and Research Hospital, Ophthalmology Clinic, Ankara, Turkey
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