1
|
Lee J, Lee H, Kwak G. Aramid-Reinforced UV Curable Adhesive Resins for Use As an Interlayer in Laminated Glass. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024:e2404907. [PMID: 39051519 DOI: 10.1002/smll.202404907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/09/2024] [Indexed: 07/27/2024]
Abstract
Colorless, transparent, and mechanically robust aramid polymers are synthesized from two diamine monomers with strong electron-withdrawing groups, using low-temperature solution condensation with diacid chloride. The aramids dissolved very well in the liquid acrylamide monomers. When N,N-dimethylacrylamide (DMA) is used as a reactive diluent, films with the desired features are produced from the hybrid aramid-DMA resins via ultraviolet (UV) curing. The hybrid films are colorless and transparent in the visible region and showed an increase in the glass transition temperature, tensile strength, and elastic modulus in proportion to the aramid content. Laminated glass is manufactured using the hybrid resin as an interlayer, which exhibits very strong adhesion between the two sheets of glass, is not easily broken by an external impact, and do not scatter fragments. Moreover, the laminated glass do not distort images and functioned very effectively in UV blocking, soundproofing, and suppressing changes in the ambient temperature. Heat treatment further improves the light transmittance and impact resistance of the laminated glass. Laminated glass specimens with various fluorescence colors are also manufactured. Aramid-reinforced films prepared using N,N-diethylacrylamide as a reactive diluent underwent thermally induced phase separation in a wet state, providing smart glass with a privacy protection function.
Collapse
Affiliation(s)
- Jineun Lee
- Department of Polymer Science & Engineering, Polymeric Nanomaterials Laboratory, Kyungpook National University, 1370 Sankyuk-Dong, Buk-Ku, Daegu, 702-701, Republic of Korea
| | - Hanna Lee
- Department of Polymer Science & Engineering, Polymeric Nanomaterials Laboratory, Kyungpook National University, 1370 Sankyuk-Dong, Buk-Ku, Daegu, 702-701, Republic of Korea
| | - Giseop Kwak
- Department of Polymer Science & Engineering, Polymeric Nanomaterials Laboratory, Kyungpook National University, 1370 Sankyuk-Dong, Buk-Ku, Daegu, 702-701, Republic of Korea
| |
Collapse
|
2
|
Bhattacharya P, Edwards K, Harkin D, Schmid KL. Corneal Epithelial Cell Density Is Reduced in Young Adults With Conjunctival Ultraviolet Autofluorescence. Cornea 2024; 43:693-701. [PMID: 37713663 DOI: 10.1097/ico.0000000000003389] [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: 05/14/2023] [Accepted: 08/08/2023] [Indexed: 09/17/2023]
Abstract
PURPOSE The aim of this study was to investigate the effects of chronic ultraviolet (UV) radiation exposure on the corneal microstructure using conjunctival UV autofluorescence (CUVAF) as a marker of exposure. METHODS Young healthy adults aged 18 to 35 years were recruited. Participant's demographics and sun exposure behavior were recorded using questionnaires. Images of the bulbar conjunctiva from the right eye were captured and analyzed for the CUVAF area. Corneal microstructure was assessed by in vivo confocal microscopy and anterior segment optical coherence tomography. The presence of palisades of Vogt in all 4 limbal quadrants was recorded. RESULTS CUVAF was observed in 31 of 52 eyes (60%), with a mean (±SD) nasal, temporal, and total CUVAF area of 5.39 ± 4.16 mm 2 , 4.29 ± 4.27 mm 2 , and 9.67 ± 7.01 mm 2 , respectively. Individuals with CUVAF were significantly more likely to report undertaking moderate-intensity to high-intensity outdoor exercise ( P = 0.021). Individuals with CUVAF were less likely to have visible nasal and temporal palisades of Vogt ( P = 0.011). Corneal basal cell densities anterior to the nerve whorl ( P < 0.001) and nasally ( P = 0.005) were lower in individuals with CUVAF. Wing cell density anterior to the nerve whorl was lower in individuals with CUVAF ( P = 0.011). No significant changes in the central and limbal corneal epithelial thickness were observed. CONCLUSIONS Significant reductions in corneal epithelial cell density were observed in individuals with CUVAF, a biomarker of chronic UV exposure. This observation suggests that chronic UV exposure is damaging to the corneal microstructure.
Collapse
Affiliation(s)
- Pradipta Bhattacharya
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; and
| | - Katie Edwards
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; and
| | - Damien Harkin
- School of Biomedical Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Katrina L Schmid
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia; and
| |
Collapse
|
3
|
Anderson G, Borooah S, Megaw R, Bagnaninchi P, Weller R, McLeod A, Dhillon B. UVR and RPE - The Good, the Bad and the degenerate Macula. Prog Retin Eye Res 2024; 100:101233. [PMID: 38135244 DOI: 10.1016/j.preteyeres.2023.101233] [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: 01/22/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023]
Abstract
Ultraviolet Radiation (UVR) has a well-established causative influence within the aetiology of conditions of the skin and the anterior segment of the eye. However, a grounded assessment of the role of UVR within conditions of the retina has been hampered by a historical lack of quantitative, and spectrally resolved, assessment of how UVR impacts upon the retina in terms congruent with contemporary theories of ageing. In this review, we sought to summarise the key findings of research investigating the connection between UVR exposure in retinal cytopathology while identifying necessary avenues for future research which can deliver a deeper understanding of UVR's place within the retinal risk landscape.
Collapse
Affiliation(s)
- Graham Anderson
- Centre for Regenerative Medicine, University of Edinburgh, Edinburgh BioQuarter, EH16 4UU, UK
| | - Shyamanga Borooah
- Viterbi Family Department of Ophthalmology, Shiley Eye Institute, UC San Diego, CA, 92093-0946, USA
| | - Roly Megaw
- Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital, EH4 2XU, UK; Department of Clinical Ophthalmology, National Health Service Scotland, Edinburgh, EH3 9HA, UK
| | - Pierre Bagnaninchi
- Centre for Regenerative Medicine, University of Edinburgh, Edinburgh BioQuarter, EH16 4UU, UK; Robert O Curle Eyelab, Instute for Regeneration and Repair, Edinburgh BioQuarter, 4-5 Little France Drive, Edinburgh, EH16 4UU, UK
| | - Richard Weller
- Centre for Inflammation Research, University of Edinburgh, Edinburgh BioQuarter, EH16 4TJ, UK
| | - Andrew McLeod
- School of GeoSciences, University of Edinburgh, Crew Building, King's Buildings, EH9 3FF, UK
| | - Baljean Dhillon
- Department of Clinical Ophthalmology, National Health Service Scotland, Edinburgh, EH3 9HA, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh BioQuarter, EH16 4SB, UK; Robert O Curle Eyelab, Instute for Regeneration and Repair, Edinburgh BioQuarter, 4-5 Little France Drive, Edinburgh, EH16 4UU, UK.
| |
Collapse
|
4
|
Masili M, Duarte FO, Ventura L. Calculation of solar ultraviolet influx in the eye considering the field of view and pupillary dilation due to sunglasses. Sci Rep 2024; 14:6604. [PMID: 38503785 PMCID: PMC10951290 DOI: 10.1038/s41598-023-50831-9] [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: 04/28/2023] [Accepted: 12/26/2023] [Indexed: 03/21/2024] Open
Abstract
The media and even the specialized literature report that the ultraviolet (UV) protection for sunglasses is critical, on the grounds that sunglasses can have a counter effect if the lenses do not provide adequate UV protection. They reason that the primary and natural mechanism is that the pupil of the eye contracts to attenuate radiation and protect the inner eye under sun exposure. Therefore, if dark lenses do not provide appropriate UV protection, there is an increased UV incidence in the inner eye due to pupil dilation, which enhances the adverse effects and impacts the ocular tissues more severely than in situations without UV protection. However, no existing literature properly quantified or supported this argument. In this work, the influx of solar UV throughout the pupil of the eye was calculated in two situations: when a person wear sunglasses and when he/she does not. In both situations, the pupil dilation and the field of view (squint) were considered with their dependence on the brightness of the ambient, calculated by modeling the solar irradiation. Finally, it was assessed whether sunglasses with poor UV protection actually increase the UV influx throughout the dilated pupil compared to the non-dilated pupil. A set of 214 sunglasses lenses were tested and the results show that pupil dilation does not play an important role in the UV influx throughout the pupil. It was observed that the FOV is the main player, surpassing the pupil size contribution by up to 314.3%, disproving the common explanation. Because of the major role of the FOV, our results show that sunglasses with UV-A protection below 86% may have a slight potential to increase hazards to the eye compared to not wearing sunglasses at all. These results can have direct impact on sunglasses standards regarding the UV protection linked to the category of the lenses.
Collapse
Affiliation(s)
- Mauro Masili
- Department of Electrical and Computing Engineering, São Carlos School of Engineering, University of São Paulo, Av. Trabalhador Sancarlense 400, São Carlos, SP, 13566-590, Brazil
| | - Fernanda O Duarte
- Department of Electrical and Computing Engineering, São Carlos School of Engineering, University of São Paulo, Av. Trabalhador Sancarlense 400, São Carlos, SP, 13566-590, Brazil
| | - Liliane Ventura
- Department of Electrical and Computing Engineering, São Carlos School of Engineering, University of São Paulo, Av. Trabalhador Sancarlense 400, São Carlos, SP, 13566-590, Brazil.
| |
Collapse
|
5
|
Hӧllhumer R, Michelow P, Williams S. Demographics, clinical presentation and risk factors of ocular surface squamous neoplasia at a tertiary hospital, South Africa. Eye (Lond) 2023; 37:3602-3608. [PMID: 37258660 PMCID: PMC10686408 DOI: 10.1038/s41433-023-02565-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 04/11/2023] [Accepted: 04/24/2023] [Indexed: 06/02/2023] Open
Abstract
AIMS The aim of this study is to describe the demographic, presenting features and associated risk factors of ocular surface squamous neoplasia (OSSN) at a tertiary eye hospital in Johannesburg, South Africa. METHODS An interventional prospective study of patients presenting with conjunctival masses was conducted. An electronic questionnaire was completed to document demographic data, presenting history, and associated risk factors. A slit lamp examination and photos were used to document and describe the clinical features at presentation. Cases (OSSN) and controls (benign lesions) were determined by histology. RESULTS There were 130 cases and 45 controls. Median age was 44 years (IQR: 35-51) with an equal gender distribution in cases. The prevalence of HIV in cases was 74% and was strongly associated with OSSN (p < 0.001). Vascularisation, leukoplakia and pigmentation were clinical features that distinguished cases from controls. A fibrovascular morphology was strongly associated with a benign histology (p < 0.001), whereas leukoplakic and gelatinous morphologies were associated with OSSN. Conjunctival intra-epithelial neoplasia made up 82% of cases. CONCLUSION Our study describes a sample of OSSN that is young and has no gender predisposition. The majority of cases presented with CIN lesions, rather than SCC reported in other African countries. HIV was the most significant risk factor in this study population.
Collapse
Affiliation(s)
- Roland Hӧllhumer
- Department of Neurosciences, Division of Ophthalmology, University of the Witwatersrand, Johannesburg, South Africa.
- The Cornea Foundation, Johannesburg, South Africa.
| | - Pamela Michelow
- Cytology Unit, National Health Laboratory Service and Department of Anatomical Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Susan Williams
- Department of Neurosciences, Division of Ophthalmology, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
6
|
Oliva-Biénzobas V, Nava-Castañeda A, Jimenez-Corona A, Kahuam-López N, Ramirez-Miranda A, Navas A, Graue-Hernandez EO. Comparison of mini-simple limbal epithelial transplantation and conjunctival-limbal autograft for the treatment of primary pterygium: a randomised controlled trial. Br J Ophthalmol 2023; 107:1776-1781. [PMID: 37739769 PMCID: PMC10715557 DOI: 10.1136/bjo-2021-320707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 07/24/2022] [Indexed: 09/24/2023]
Abstract
PURPOSE The purpose of this double-masked, parallel randomised controlled trial was to compare the recurrence rate and other outcomes between conjunctival-limbal autograft (CLAu) and mini-simple limbal epithelial transplantation (mini-SLET) after excision of pterygium. METHODS Eligibility criteria for participants was the presence of a primary nasal pterygium extending equally to or greater than two millimetres on the cornea on its horizontal axis from the nasal limbus. The participants were allocated into two groups (CLAu and mini-SLET) using simple randomisation with a table of random numbers. Participants and the outcome assessor were masked to the intervention. The study protocol is listed and available on https://clinicaltrials.gov (Identifier: NCT03363282). RESULTS A total of 61 eyes were enrolled in the study, 33 underwent CLAu (group 1) and 28 mini-SLET (group 2), all eyes were analysed in each group. At 2, 3, 6 and 12 months the CLAu group exhibited a recurrence of 0%, 6.1%, 8.1% and 8.1%, while the mini-SLET exhibited a recurrence of 0%, 17.9%, 50% and 53.5% (p<0.05). There were no intraoperative or postoperative complications in either of the two groups. CONCLUSION The findings of this study suggest that mini-SLET has a higher recurrence rate and provides no advantage over CLAu in the treatment of primary pterygium.
Collapse
Affiliation(s)
- Valeria Oliva-Biénzobas
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico
| | - Angel Nava-Castañeda
- Department of Oculoplastics, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico
| | - Aida Jimenez-Corona
- Ocular Epidemiology and Visual Health, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico
| | - Nicolás Kahuam-López
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico
| | - Arturo Ramirez-Miranda
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico
| | - Alejandro Navas
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico
| | - Enrique O Graue-Hernandez
- Department of Cornea and Refractive Surgery, Instituto de Oftalmología Fundación Conde de Valenciana IAP, Mexico City, Mexico
| |
Collapse
|
7
|
Sureshkumar I, Gunalan V, Nareshkumar RN, Sripriya K, Ronnie G, Sharada R, Asokan R. Evaluating the impact of ocular UV exposure for the development for pseudoexfoliation syndrome in a South Indian population. Clin Exp Optom 2023; 106:734-740. [PMID: 36375140 DOI: 10.1080/08164622.2022.2134762] [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: 01/18/2022] [Revised: 05/16/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022] Open
Abstract
CLINICAL RELEVANCE Pathophysiology of pseudoexfoliation syndrome (XFS) can be influenced by environmental factors such as solar exposure/occupational factors and genetic factors. BACKGROUND The study aims to assess the association of lifetime ocular UV exposure and its impact on the risk of development of XFS. METHODS All eligible subjects underwent a comprehensive ocular examination. XFS was defined as precipitates on the pupillary border, cornea, and angle of anterior chamber or lens in at least one eye without any clinical signs of glaucoma. A standardised questionnaire was administered to assess the lifetime UV exposure. Conjunctival ultraviolet autofluorescence (CUVAF) photography was taken to detect the conjunctival changes with exposure to UV radiation. Ascorbic acid concentration in the aqueous humour was measured. RESULTS A total of 404 subjects of which 274 (controls) and 130 (XFS cases) were studied. There were 204 males (50.5%) and 200 females (49.5%).Lifetime UV exposure (OR: 1.14, 95% CI: 1.02-1.30, p: 0.032), CUVAF damage (OR: 1.03, 95% CI: 1.01-1.06, p: 0.008) and outdoor worker (OR: 1.87, 95% CI: 1.18-3.00, p: 0.008) were positively associated with XFS. Usage of spectacles (OR: 0.63, 95% CI: 0.39-0.95, p: 0.030) and ascorbic acid concentration in aqueous (OR: 0.47, 95% CI: 0.23-0.99, p: 0.038) were found to be protective against XFS. CONCLUSION Besides genetic factors, environmental factors such as lifetime ocular UV exposure and outdoor work are significantly associated with the risk of XFS. CUVAF can be used as a non-invasive tool to detect preclinical sun damage in outdoor workers.
Collapse
Affiliation(s)
- Ishwarya Sureshkumar
- Research Fellow, Vision Research Foundation, Glaucoma services Sankara Nethralaya, Chennai, India
| | - Vaishaali Gunalan
- Research Fellow, Vision Research Foundation, Glaucoma services Sankara Nethralaya, Chennai, India
| | - R N Nareshkumar
- RS Mehta Jain Department of Biochemistry and Cell Biology, Vision Research Foundation Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Krishnamoorthy Sripriya
- Glaucoma Services, Medical Research Foundation Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - George Ronnie
- Research Fellow, Vision Research Foundation, Glaucoma services Sankara Nethralaya, Chennai, India
- Glaucoma Services, Medical Research Foundation Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Ramasubramanyan Sharada
- RS Mehta Jain Department of Biochemistry and Cell Biology, Vision Research Foundation Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Rashima Asokan
- Research Fellow, Vision Research Foundation, Glaucoma services Sankara Nethralaya, Chennai, India
- Glaucoma Services, Medical Research Foundation Sankara Nethralaya, Chennai, Tamil Nadu, India
| |
Collapse
|
8
|
Serra HM, Moro PA. Climatic Droplet Keratopathy Is a Misnomer for This Corneal Degeneration. Semin Ophthalmol 2023:1-6. [PMID: 36794906 DOI: 10.1080/08820538.2023.2176240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
PURPOSE To describe a new insight into the Climate Droplet Keratopathy (CDK) pathophysiology and its major predisposing factors. METHOD A literature search was undertaken on PubMed to compile papers published on CDK. The following is a focused opinion tempered by synthesis of current evidence, and research of the authors. RESULTS CDK is a multifactorial rural disease common in regions with high incidence of pterygium, but not related to the type of climate or ozone concentrations. Although it has been thought that climate is the cause of this disease, recent investigations deny that and reveal that other environmental factors such as dietary intake, eye protection, oxidative stress, and ocular inflammatory pathways play an important role in the pathogenesis of CDK. CONCLUSION Considering the negligible effect of climate, the present name " CDK" for this illness can be confusing for young ophthalmologists. Based on these remarks, it is imperative to start using an accurate name like "Environmental Corneal Degeneration (ECD)" that fits the most recent evidence related to its etiology.
Collapse
Affiliation(s)
- Horacio M Serra
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI), Departamento de Bioquímica Clínica, Facultad de Ciencia Químicas, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Pablo A Moro
- Departamento segmento anterior del ojo, Instituto de Microcirugía Ocular Córdoba (IMOC), Córdoba, Argentina
| |
Collapse
|
9
|
The Relationship between Pinguecula and Diabetes Mellitus: A Comparative Cross-Sectional Study. J Ophthalmol 2023; 2023:9060495. [PMID: 36895265 PMCID: PMC9991467 DOI: 10.1155/2023/9060495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 12/26/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Purpose To assess the relationship between diabetes mellitus (DM) and the presence of pinguecula and to identify other risk factors associated with pinguecula in patients attending the eye clinic at two tertiary university hospitals in Jordan. Methods This was a comparative cross-sectional hospital-based study of 241 consecutive patients (122 patients with DM and 119 patients with no diabetes). All patients underwent complete ophthalmic examination, and data were collected regarding age, sex, occupational activity, presence and grade of pinguecula, glycosylated hemoglobin (HbA1c), and presence of diabetic retinopathy. Results The mean (standard deviation, SD) ages of the DM and non-DM groups were 59.5 (10.8) years and 59.0 (11.6) years (p-value = 0.729), respectively. There was no significant difference in the prevalence of pinguecula between the diabetic and nondiabetic groups (66.4% vs. 66.5%, p = 0.998). Multivariate logistic regression analysis revealed that only outdoor occupational activity (OR = 5.16, 95% CI: 1.98-13.44, p = 0.001) was associated with increased prevalence of pinguecula. DM was not significantly associated with pinguecula (OR = 0.96, 95% confidence interval (CI): 0.55-1.67, p = 0.873). Neither age nor sex were significantly associated with pinguecula (p-value = 0.808, p-value = 0.390), respectively. Conclusion DM was not significantly associated with the development of pinguecula in this Jordanian population. The prevalence of pinguecula was significantly associated with an outdoor occupational activity.
Collapse
|
10
|
Mi Y, Wei C, Sun L, Liu H, Zhang J, Luo J, Yu X, He J, Ge H, Liu P. Melatonin inhibits ferroptosis and delays age-related cataract by regulating SIRT6/p-Nrf2/GPX4 and SIRT6/NCOA4/FTH1 pathways. Biomed Pharmacother 2023; 157:114048. [PMID: 36463827 DOI: 10.1016/j.biopha.2022.114048] [Citation(s) in RCA: 40] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/21/2022] [Accepted: 11/25/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cataracts are the main cause of reversible blindness worldwide. The ageing of the lens caused by ultraviolet B (UVB) radiation is mostly related to oxidative stress (OS). Little is known about whether OS induced by UVB enhances the sensitivity of lens epithelial cells to ferroptotic stress, which may be a new mechanism leading to age-related cataracts (ARCs). METHODS Ferroptosis was detected by transmission electron microscopy (TEM), iron assay, lipid peroxidation (MDA) assay, real-time PCR, western blotting, and immunofluorescence. Genetic engineering technology was used to investigate the regulatory relationship among Sirtuin 6 (SIRT6), nuclear factor erythroid 2-related factor 2 (Nrf2), nuclear receptor coactivator 4 (NCOA4), glutathione peroxidase 4 (GPX4) and ferritin heavy chain (FTH1). Knockdown and overexpression of SIRT6 locally in vivo in rats were performed to probe the regulatory mechanism of SIRT6 in ferroptosis in ARCs. FINDINGS Here, we observed that UVB can drastically induce ferroptosis in lens epithelial cells in vivo and in vitro. Surprisingly, inhibition of ferroptosis was the direct reason that melatonin rescued B-3, SRA01/04 and HEK-293 T cells survival; the pan-caspase inhibitor Z-Vad-FMK did not significantly reverse the death of UVB-irradiated cells compared with that in the UVB+DMSO group. SIRT6 was an upstream regulator of phosphorylated Nrf2 (p-Nrf2) and NCOA4 in B-3, SRA01/04 and HEK-293 T cells. Melatonin inhibited ferroptosis through the SIRT6/p-Nrf2/GPX4 and SIRT6/COA4/FTH1 pathways to neutralize lipid peroxidation toxicity, which protected cells against ferroptotic stress in vitro and delayed cataract formation caused by UVB exposure in rats. INTERPRETATION Our findings reveal a novel causal role of melatonin in the pathogenesis of ARCs, which raises the possibility of selectively targeting the activation of SIRT6 and ferroptotic resistance as a latent antioxidative therapeutic strategy for ARCs.
Collapse
Affiliation(s)
- Yu Mi
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, 23 Youzheng Street, Harbin 150001, China; Key Laboratory of Ischemia-reperfusion, Harbin Medical University, Ministry of Education, Harbin 150001, China; Experimental Animal Centre, the Second Affiliated Hospital, Harbin Medical University, Harbin 150001, China
| | - Chaoqun Wei
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, 23 Youzheng Street, Harbin 150001, China; Key Laboratory of Ischemia-reperfusion, Harbin Medical University, Ministry of Education, Harbin 150001, China; Experimental Animal Centre, the Second Affiliated Hospital, Harbin Medical University, Harbin 150001, China
| | - Liyao Sun
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, 23 Youzheng Street, Harbin 150001, China
| | - Huirui Liu
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, 23 Youzheng Street, Harbin 150001, China; Key Laboratory of Ischemia-reperfusion, Harbin Medical University, Ministry of Education, Harbin 150001, China; Experimental Animal Centre, the Second Affiliated Hospital, Harbin Medical University, Harbin 150001, China
| | - Jiayue Zhang
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, 23 Youzheng Street, Harbin 150001, China; Key Laboratory of Ischemia-reperfusion, Harbin Medical University, Ministry of Education, Harbin 150001, China; Experimental Animal Centre, the Second Affiliated Hospital, Harbin Medical University, Harbin 150001, China
| | - Jialin Luo
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, 23 Youzheng Street, Harbin 150001, China
| | - Xiaohan Yu
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, 23 Youzheng Street, Harbin 150001, China
| | - Jie He
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, 23 Youzheng Street, Harbin 150001, China
| | - Hongyan Ge
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, 23 Youzheng Street, Harbin 150001, China.
| | - Ping Liu
- Eye Hospital, First Affiliated Hospital, Harbin Medical University, 23 Youzheng Street, Harbin 150001, China.
| |
Collapse
|
11
|
Ji Y, Liu S, Hong X, Lu Y, Wu X, Li K, Li K, Liu Y. Advances in artificial intelligence applications for ocular surface diseases diagnosis. Front Cell Dev Biol 2022; 10:1107689. [PMID: 36605721 PMCID: PMC9808405 DOI: 10.3389/fcell.2022.1107689] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 12/05/2022] [Indexed: 01/07/2023] Open
Abstract
In recent years, with the rapid development of computer technology, continual optimization of various learning algorithms and architectures, and establishment of numerous large databases, artificial intelligence (AI) has been unprecedentedly developed and applied in the field of ophthalmology. In the past, ophthalmological AI research mainly focused on posterior segment diseases, such as diabetic retinopathy, retinopathy of prematurity, age-related macular degeneration, retinal vein occlusion, and glaucoma optic neuropathy. Meanwhile, an increasing number of studies have employed AI to diagnose ocular surface diseases. In this review, we summarize the research progress of AI in the diagnosis of several ocular surface diseases, namely keratitis, keratoconus, dry eye, and pterygium. We discuss the limitations and challenges of AI in the diagnosis of ocular surface diseases, as well as prospects for the future.
Collapse
Affiliation(s)
- Yuke Ji
- The Laboratory of Artificial Intelligence and Bigdata in Ophthalmology, Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Sha Liu
- The Laboratory of Artificial Intelligence and Bigdata in Ophthalmology, Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Xiangqian Hong
- Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Yi Lu
- Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Xingyang Wu
- Shenzhen Eye Hospital, Jinan University, Shenzhen, China
| | - Kunke Li
- Shenzhen Eye Hospital, Jinan University, Shenzhen, China,*Correspondence: Yunfang Liu, ; Keran Li, ; Kunke Li,
| | - Keran Li
- The Laboratory of Artificial Intelligence and Bigdata in Ophthalmology, Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China,*Correspondence: Yunfang Liu, ; Keran Li, ; Kunke Li,
| | - Yunfang Liu
- Department of Ophthalmology, First Affiliated Hospital of Huzhou University, Huzhou, China,*Correspondence: Yunfang Liu, ; Keran Li, ; Kunke Li,
| |
Collapse
|
12
|
Chawda D, Shinde P. Effects of Solar Radiation on the Eyes. Cureus 2022; 14:e30857. [DOI: 10.7759/cureus.30857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022] Open
|
13
|
Lee BWH, Sidhu AS, Francis IC, Coroneo MT. 5-Fluorouracil in primary, impending recurrent and recurrent pterygium: Systematic review of the efficacy and safety of a surgical adjuvant and intralesional antimetabolite. Ocul Surf 2022; 26:128-141. [PMID: 35961535 DOI: 10.1016/j.jtos.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/29/2022] [Accepted: 08/04/2022] [Indexed: 10/15/2022]
Abstract
Pterygium is an ultraviolet-related disease characterized by an aberrant, wing-shaped and active wound-healing process. There is nothing quite as disheartening for the surgeon or patient as the recurrence of pterygium, and various adjuvants have been studied to ameliorate this. This systematic review provides a comprehensive summary of the efficacy and safety of 5-Fluorouracil (5-FU) as an antimetabolite agent for pterygium management. An appraisal of electronic searches of six databases identified 34 clinical studies reporting recurrence outcomes of 5-FU use in primary, impending recurrent and recurrent pterygia. In vitro and in vivo studies of 5-FU showed dose- and duration-dependent cytostatic and cytotoxic effects in human cells. 5-FU is relatively inexpensive, available, and easy to administer, making it attractive for resource-limited scenarios. However, the published evidence demonstrates a recurrence rate of 11.4-60% with the bare scleral technique, 3.5-35.8% with conjunctival rotational flaps, 3.7-9.6% with conjunctival autografts for intraoperative topical 5-FU, and 14-35.8% for preoperative and intraoperative injections. This suboptimal efficacy brings the role of 5-FU as an adjuvant for pterygium surgery into question and the authors do not recommend its use. In contrast, postoperative intralesional injections of 5-FU to arrest progression in impending recurrent pterygium and true recurrent pterygia were more promising, with success rates of 87.2-100% and 75-100%, respectively. Furthermore, 5-FU as a treatment modality, without surgery, effectively arrested progression in 81.3-96% of primary and recurrent pterygia. Other treatments such as topical and intralesional corticosteroids, cyclosporine and anti-VEGF agents are discussed. Complications of 5-FU increase with higher doses and range from transient and reversible to severe and sight-threatening. For pterygium, 5-FU has a predilection for causing scleral thinning, corneal toxicity, and graft-related complications. Additional study with extended follow-up is needed to elucidate the optimal dose, frequency, duration, and long-term safety of 5-FU injections. If 5-FU is used in the management of pterygium, it should be with caution, in selected patients and with vigilant long-term monitoring.
Collapse
Affiliation(s)
- Brendon W H Lee
- Department of Ophthalmology, Prince of Wales Hospital, Randwick, Australia; Faculty of Medicine, University of New South Wales, Kensington, Australia; University of Sydney Medical School, University of Sydney, Camperdown, Australia.
| | - Amitouj S Sidhu
- Department of Ophthalmology, Prince of Wales Hospital, Randwick, Australia; Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Ian C Francis
- Department of Ophthalmology, Prince of Wales Hospital, Randwick, Australia; Faculty of Medicine, University of New South Wales, Kensington, Australia
| | - Minas T Coroneo
- Department of Ophthalmology, Prince of Wales Hospital, Randwick, Australia; Faculty of Medicine, University of New South Wales, Kensington, Australia
| |
Collapse
|
14
|
Habibalahi A, Allende A, Michael J, Anwer AG, Campbell J, Mahbub SB, Bala C, Coroneo MT, Goldys EM. Pterygium and Ocular Surface Squamous Neoplasia: Optical Biopsy Using a Novel Autofluorescence Multispectral Imaging Technique. Cancers (Basel) 2022; 14:1591. [PMID: 35326744 PMCID: PMC8946656 DOI: 10.3390/cancers14061591] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/07/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023] Open
Abstract
In this study, differentiation of pterygium vs. ocular surface squamous neoplasia based on multispectral autofluorescence imaging technique was investigated. Fifty (N = 50) patients with histopathological diagnosis of pterygium (PTG) and/or ocular surface squamous neoplasia (OSSN) were recruited. Fixed unstained biopsy specimens were imaged by multispectral microscopy. Tissue autofluorescence images were obtained with a custom-built fluorescent microscope with 59 spectral channels, each with specific excitation and emission wavelength ranges, suitable for the most abundant tissue fluorophores such as elastin, flavins, porphyrin, and lipofuscin. Images were analyzed using a new classification framework called fused-classification, designed to minimize interpatient variability, as an established support vector machine learning method. Normal, PTG, and OSSN regions were automatically detected and delineated, with accuracy evaluated against expert assessment by a specialist in OSSN pathology. Signals from spectral channels yielding signals from elastin, flavins, porphyrin, and lipofuscin were significantly different between regions classified as normal, PTG, and OSSN (p < 0.01). Differential diagnosis of PTG/OSSN and normal tissue had accuracy, sensitivity, and specificity of 88 ± 6%, 84 ± 10% and 91 ± 6%, respectively. Our automated diagnostic method generated maps of the reasonably well circumscribed normal/PTG and OSSN interface. PTG and OSSN margins identified by our automated analysis were in close agreement with the margins found in the H&E sections. Such a map can be rapidly generated on a real time basis and potentially used for intraoperative assessment.
Collapse
Affiliation(s)
- Abbas Habibalahi
- ARC Centre of Excellence for Nanoscale Biophotonics, University of New South Wales, Sydney, NSW 2032, Australia; (J.M.); (A.G.A.); (J.C.); (S.B.M.); (E.M.G.)
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW 2032, Australia
| | - Alexandra Allende
- Douglass Hanly Moir Pathology, Macquarie Park, NSW 2113, Australia;
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW 2109, Australia
| | - Jesse Michael
- ARC Centre of Excellence for Nanoscale Biophotonics, University of New South Wales, Sydney, NSW 2032, Australia; (J.M.); (A.G.A.); (J.C.); (S.B.M.); (E.M.G.)
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW 2032, Australia
| | - Ayad G. Anwer
- ARC Centre of Excellence for Nanoscale Biophotonics, University of New South Wales, Sydney, NSW 2032, Australia; (J.M.); (A.G.A.); (J.C.); (S.B.M.); (E.M.G.)
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW 2032, Australia
| | - Jared Campbell
- ARC Centre of Excellence for Nanoscale Biophotonics, University of New South Wales, Sydney, NSW 2032, Australia; (J.M.); (A.G.A.); (J.C.); (S.B.M.); (E.M.G.)
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW 2032, Australia
| | - Saabah B. Mahbub
- ARC Centre of Excellence for Nanoscale Biophotonics, University of New South Wales, Sydney, NSW 2032, Australia; (J.M.); (A.G.A.); (J.C.); (S.B.M.); (E.M.G.)
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW 2032, Australia
| | - Chandra Bala
- Department of Ophthalmology, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW 2109, Australia;
| | - Minas T. Coroneo
- Department of Ophthalmology, University of New South Wales at Prince of Wales Hospital, High Street, Randwick, NSW 2031, Australia;
| | - Ewa M. Goldys
- ARC Centre of Excellence for Nanoscale Biophotonics, University of New South Wales, Sydney, NSW 2032, Australia; (J.M.); (A.G.A.); (J.C.); (S.B.M.); (E.M.G.)
- Graduate School of Biomedical Engineering, University of New South Wales, Sydney, NSW 2032, Australia
| |
Collapse
|
15
|
Modabber M, Lent-Schochet D, Li JY, Kim E. Histopathological Rate of Ocular Surface Squamous Neoplasia in Clinically Suspected Pterygium Specimens: 10-Year Results. Cornea 2022; 41:149-154. [PMID: 34690264 DOI: 10.1097/ico.0000000000002780] [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: 12/01/2020] [Accepted: 04/10/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this study was to evaluate the prevalence of histopathologically confirmed ocular surface squamous neoplasia (OSSN) in clinically diagnosed pterygium samples at a tertiary center in Northern California, over a 10-year period (2009-2019). METHODS A retrospective chart review of patients older than 18 years with clinically diagnosed benign pterygium requiring excision was conducted. Clinically suspected pterygia were excised using standard techniques and routinely submitted to the University of California Davis for pathologic evaluation. Demographic, clinical, surgical, and pathological information were recorded and analyzed. The prevalence rate of OSSN was calculated. RESULTS A total of 348 consecutive specimens were evaluated. The mean (±SD) age of the patients was 58 ± 12 years, with a near equal sex representation. A total of 57 (16%) pterygia were recurrent at initial presentation. Histopathologic results demonstrated a single case of OSSN. This patient did not have a documented history of carcinoma in other organs or any history of herpes virus, human papilloma virus, or human immunodeficiency virus infection. CONCLUSIONS The prevalence of histopathological OSSN in clinically suspected pterygia within our sample was approximately 0.3%. Because of shared clinical characteristics of pterygia and OSSN, a high index of suspicion and judicious use of anterior segment optical coherence tomography enable for effective preoperative diagnosis of OSSN. However, in the absence of clinical expertise or high-resolution optical coherence tomography, routine tissue pathologic examination may be warranted.
Collapse
Affiliation(s)
- Milad Modabber
- UC Davis Eye Center, University of California, Davis, Sacramento, CA; and
| | | | - Jennifer Y Li
- UC Davis Eye Center, University of California, Davis, Sacramento, CA; and
| | - Esther Kim
- UC Davis Eye Center, University of California, Davis, Sacramento, CA; and
| |
Collapse
|
16
|
Hampel U, Elflein HM, Kakkassery V, Heindl LM, Schuster AK. [Alterations of the anterior segment of the eye caused by exposure to UV radiation]. Ophthalmologe 2021; 119:234-239. [PMID: 34860283 DOI: 10.1007/s00347-021-01531-0] [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] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND By identifying diseases of the anterior segment of the eye associated with exposure to UV light, recommendations for action can be derived. AIM After reading this review, the reader should be familiar with UV light-associated diseases of the anterior segment of the eye. METHOD Using a selective literature search, UV light-associated diseases of the anterior segment of the eye were identified and protective mechanisms are described. RESULTS The UV light-associated lesions of the anterior segment of the eye include basal cell and squamous cell carcinomas, malignant melanoma of the eyelids and conjunctiva, pterygium, keratoconjunctivitis photoelectrica and climatic droplet keratopathy as well as cortical cataract. CONCLUSION Eyeglasses for filtering UV light, sunglasses and special safety glasses, such as welding helmets and wearing headgear protect against UV light exposure to the anterior segment of the eye and the associated diseases.
Collapse
Affiliation(s)
- Ulrike Hampel
- Poliklinik und Klinik, Universitätsmedizin Mainz, Langenbeckstr 1, 55131, Mainz, Deutschland. .,Klinik und Poliklinik für Augenheilkunde, Universität Leipzig, Leipzig, Deutschland.
| | - Heike M Elflein
- Poliklinik und Klinik, Universitätsmedizin Mainz, Langenbeckstr 1, 55131, Mainz, Deutschland
| | - V Kakkassery
- Klinik für Augenheilkunde, Universitätsklinikum Schleswig-Holstein, Lübeck, Deutschland
| | - Ludwig M Heindl
- Klinik für Augenheilkunde, Universitätsklinikum Köln, Köln, Deutschland.,Center for Integrated Oncology (CIO) Aachen-Bonn-Köln-Düsseldorf, Köln, Deutschland
| | - Alexander K Schuster
- Poliklinik und Klinik, Universitätsmedizin Mainz, Langenbeckstr 1, 55131, Mainz, Deutschland
| |
Collapse
|
17
|
Lingham G, Kugelman J, Charng J, Lee SS, Yazar S, McKnight CM, Coroneo MT, Lucas RM, Brown H, Stevenson LJ, Mackey DA, Alonso-Caneiro D. Conjunctival ultraviolet autofluorescence area decreases with age and sunglasses use. Br J Ophthalmol 2021; 107:614-620. [PMID: 34815236 DOI: 10.1136/bjophthalmol-2021-320284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 11/06/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Conjunctival ultraviolet autofluorescence (CUVAF) is a method of detecting conjunctival damage related to ultraviolet radiation exposure. In cross-sectional studies, CUVAF area is positively associated with self-reported time spent outdoors and pterygium and negatively associated with myopia; however, longitudinal studies are scarce. AIMS To use a novel deep learning-based tool to assess 8-year change in CUVAF area in young adults, investigate factors associated with this change and identify the number of new onset pterygia. METHODS A deep learning-based CUVAF tool was developed to measure CUVAF area. CUVAF area and pterygium status were assessed at three study visits: baseline (participants were approximately 20 years old) and at 7-year and 8-year follow-ups. Participants self-reported sun protection behaviours and ocular history. RESULTS CUVAF data were available for 1497 participants from at least one study visit; 633 (43%) participants had complete CUVAF data. Mean CUVAF areas at baseline and the 7-year and 8-year follow-ups were 48.4, 39.3 and 37.7 mm2, respectively. There was a decrease in mean CUVAF area over time (change in total CUVAF area=-0.96 mm2 per year (95% CI: -1.07 to -0.86)). For participants who wore sunglasses ≥1/2 of the time, CUVAF area decreased by an additional -0.42 mm2 per year (95% CI: -0.72 to -0.12) on average. Fourteen (1.5%) participants developed a pterygium. CONCLUSIONS In this young adult cohort, CUVAF area declined over an 8-year period. Wearing sunglasses was associated with a faster reduction in CUVAF area. Deep learning-based models can assist in accurate and efficient measurement of CUVAF area.
Collapse
Affiliation(s)
- Gareth Lingham
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Jason Kugelman
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Jason Charng
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Samantha Sy Lee
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia.,Garvan-Weizmann Centre for Cellular Genomics, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Charlotte M McKnight
- Ophthalmology, St John of God Health Care, West Perth, Western Australia, Australia
| | - Minas T Coroneo
- Department of Ophthalmology, University of New South Wales, Sydney, New South Wales, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Holly Brown
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Louis J Stevenson
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science (incorporating Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - David Alonso-Caneiro
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| |
Collapse
|
18
|
Xu W, Jin L, Zhu PZ, He K, Yang WH, Wu MN. Implementation and Application of an Intelligent Pterygium Diagnosis System Based on Deep Learning. Front Psychol 2021; 12:759229. [PMID: 34744935 PMCID: PMC8569253 DOI: 10.3389/fpsyg.2021.759229] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/04/2021] [Indexed: 12/27/2022] Open
Abstract
Objective: This study aims to implement and investigate the application of a special intelligent diagnostic system based on deep learning in the diagnosis of pterygium using anterior segment photographs. Methods: A total of 1,220 anterior segment photographs of normal eyes and pterygium patients were collected for training (using 750 images) and testing (using 470 images) to develop an intelligent pterygium diagnostic model. The images were classified into three categories by the experts and the intelligent pterygium diagnosis system: (i) the normal group, (ii) the observation group of pterygium, and (iii) the operation group of pterygium. The intelligent diagnostic results were compared with those of the expert diagnosis. Indicators including accuracy, sensitivity, specificity, kappa value, the area under the receiver operating characteristic curve (AUC), as well as 95% confidence interval (CI) and F1-score were evaluated. Results: The accuracy rate of the intelligent diagnosis system on the 470 testing photographs was 94.68%; the diagnostic consistency was high; the kappa values of the three groups were all above 85%. Additionally, the AUC values approached 100% in group 1 and 95% in the other two groups. The best results generated from the proposed system for sensitivity, specificity, and F1-scores were 100, 99.64, and 99.74% in group 1; 90.06, 97.32, and 92.49% in group 2; and 92.73, 95.56, and 89.47% in group 3, respectively. Conclusion: The intelligent pterygium diagnosis system based on deep learning can not only judge the presence of pterygium but also classify the severity of pterygium. This study is expected to provide a new screening tool for pterygium and benefit patients from areas lacking medical resources.
Collapse
Affiliation(s)
- Wei Xu
- Department of Optometry, Jinling Institute of Technology, Nanjing, China.,Nanjing Key Laboratory of Optometric Materials and Application Technology, Nanjing, China
| | - Ling Jin
- Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Peng-Zhi Zhu
- Guangdong Medical Devices Quality Surveillance and Test Institute, Guangzhou, China
| | - Kai He
- School of Information Engineering, Huzhou University, Huzhou, China.,Zhejiang Province Key Laboratory of Smart Management & Application of Modern Agricultural Resources, Huzhou, China
| | - Wei-Hua Yang
- Affiliated Eye Hospital of Nanjing Medical University, Nanjing, China
| | - Mao-Nian Wu
- School of Information Engineering, Huzhou University, Huzhou, China.,Zhejiang Province Key Laboratory of Smart Management & Application of Modern Agricultural Resources, Huzhou, China
| |
Collapse
|
19
|
Lee J, Kim UJ, Lee Y, Han E, Ham S, Lee W, Choi WJ, Kang SK. Sunlight exposure and eye disorders in an economically active population: data from the KNHANES 2008-2012. Ann Occup Environ Med 2021; 33:e24. [PMID: 34754485 PMCID: PMC8367748 DOI: 10.35371/aoem.2021.33.e24] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/11/2021] [Accepted: 07/12/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Sunlight exposure is a major risk factor for eye disorders. Most outdoor workers cannot avoid sunlight exposure. This study aimed to analyze the relationship between outdoor sunlight exposure and eye disorders in an economically active population. METHODS This study analyzed the 2008-2012 Korea National Health and Nutritional Examination Survey data. Sunlight exposure was categorized as < 5 hours and > 5 hours. We also analyzed the dose-dependent relationship between exposure to sunlight and eye disorders (cataracts, pterygium, and age-related macular degeneration [AMD]) using data from 2010 to 2012 by subdividing the exposure groups into < 2 hours, 2-5 hours, and ≥ 5 hours. Eye disorders were diagnosed by an ophthalmologist. The study participants were stratified by sex, and the results were analyzed using the χ2 test and multiple logistic regression analysis. RESULTS In the female group, the odds ratio of pterygium in the high-level sunlight exposure group was 1.47 (95% confidence interval [CI]: 1.15-1.89). Regarding AMD, the odds ratios were 1.42 (95% CI: 1.16-1.73), 1.33 (95% CI: 1.03-1.73), and 1.58 (95% CI: 1.15-2.16) in the total, male, and female groups, respectively. Analysis of the dose-response relationship revealed that the odds ratios of pterygium in the high-level sunlight exposure subgroups of the total and female groups were 1.62 (95% CI: 1.25-2.08) and 2.00 (95% CI: 1.39-2.88), respectively. CONCLUSIONS This study demonstrated a relationship between sunlight exposure and eye disorders in an economically active population. Women were found to be especially vulnerable to pterygium. However, additional prospective studies to clarify the pathophysiology of pterygium are needed.
Collapse
Affiliation(s)
- Junhyeong Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Korea
- Graduate School, Gachon University, Incheon, Korea
| | - Ui-Jin Kim
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Korea
- Graduate School, Gachon University, Incheon, Korea
| | - Yongho Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Korea
- Graduate School, Gachon University, Incheon, Korea
| | - Eunseun Han
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Korea
- Graduate School, Gachon University, Incheon, Korea
| | - Seunghon Ham
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Korea
- Graduate School, Gachon University, Incheon, Korea
- Department of Occupational and Environmental Medicine, College of Medicine, Gachon University, Incheon, Korea
| | - Wanhyung Lee
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Korea
- Graduate School, Gachon University, Incheon, Korea
- Department of Occupational and Environmental Medicine, College of Medicine, Gachon University, Incheon, Korea
| | - Won-Jun Choi
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Korea
- Graduate School, Gachon University, Incheon, Korea
- Department of Occupational and Environmental Medicine, College of Medicine, Gachon University, Incheon, Korea
| | - Seong-Kyu Kang
- Department of Occupational and Environmental Medicine, Gil Medical Center, Incheon, Korea
- Graduate School, Gachon University, Incheon, Korea
- Department of Occupational and Environmental Medicine, College of Medicine, Gachon University, Incheon, Korea
| |
Collapse
|
20
|
Diversity in Primate External Eye Morphology: Previously Undescribed Traits and Their Potential Adaptive Value. Symmetry (Basel) 2021. [DOI: 10.3390/sym13071270] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Comparative examinations of external eye morphology in primates initially focused on communicative functions of the eye. Subsequent work has failed to find consistent associations between specific eye morphologies and communicative functions. In this article, we review the field of primate external eye morphology and inspect publicly available and unpublished photographs. We identify and describe five commonly occurring traits that have not received attention so far. We cross-examined the clinical and psychological literature to propose potential adaptive functions. These potential adaptive functions include communicative functions, but also photoregulatory functions and photoprotective functions.
Collapse
|
21
|
Computational Model of Sclerotic Scatter. Cornea 2021; 39:1157-1163. [PMID: 32243418 DOI: 10.1097/ico.0000000000002322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE A clinical examination technique to detect pathology within the anterior eye is known as "sclerotic scatter" (SS). Its propagation pathway has not been thoroughly investigated. Although conventionally theorized to occur by "total internal reflection" (TIR) within the cornea, existing data suggest that this may be an incomplete explanation. METHODS An anterior eye model representative of a human eye has been constructed using nonsequential ray tracing (OpticStudio 18.1). Three generations of the model were constructed to support the analyses of the pathway of light in SS. A design of experiment methodology involving the key parameters was used to determine the slit-lamp setup for optimum clinical visualization. RESULTS Most of the light directed into the temporal limbus in SS is lost (52%) into the sclera or reemitted back to the clinician. Only 0.006% of light that transits the central cornea undergoes TIR off the anterior cornea and more significantly 0.000125% off the posterior cornea. The optimal slit-lamp setup parameters to maximize the clinician's visualization are also summarized. CONCLUSIONS The propagation of light within SS primarily does not occur by TIR off the posterior cornea but rather the direct transcameral propagation of light. SS also represents an inefficient usage of light, with approximately half of the light creating a potential glare source for clinicians. We have formulated a recommended set of parameters for the slit-lamp setup to maximize clinical visualization. We also describe the transcameral pathways involved in SS that create a corneal "backlighting" effect. Almost a century after Graves original description, the optics of this phenomenon are described here.
Collapse
|
22
|
Hatsusaka N, Seki Y, Mita N, Ukai Y, Miyashita H, Kubo E, Sliney D, Sasaki H. UV Index Does Not Predict Ocular Ultraviolet Exposure. Transl Vis Sci Technol 2021; 10:1. [PMID: 34061949 PMCID: PMC8185396 DOI: 10.1167/tvst.10.7.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Purpose The ultraviolet index (UVI), available online, is an international linear scale of levels from 0 to 13+ that warns about the risk of sunburn; however, it does not address the risk to eyes. Our purpose was to develop a useful instrument to warn the public against ocular ultraviolet (OUV) exposure and to serve as a tool for researching UV-induced ocular diseases. Methods A rotating model head that included ultraviolet B (UVB) sensors documented UV irradiance at the crown and at the eyes spanning eight azimuths from sunrise to sunset under different climatic conditions in each season. The dose intensities obtained were compared with their respective UVI levels. Doses to the eyes were mathematically transformed to develop an OUV index with linear levels from 0 to 13+, similar to the UVI. Then, readings from both instruments were compared. Results UV exposure at the crown increases with solar culmination, whereas that to the eye is greater under low rather than maximum solar altitude. The OUV index levels were higher than recorded UVI levels in the summer under low solar altitude in the early morning and mid- to late afternoon and were markedly higher all day in winter when solar altitude remains low. Conclusions The UVI does not provide sufficient warning about the risks of ocular UV damage. The proposed OUV index is a useful instrument to warn the public against OUV exposure and to serve as a tool for researching UV-induced ocular diseases. Translational Relevance The OUV index is useful to prevent ocular UV-related diseases.
Collapse
Affiliation(s)
- Natsuko Hatsusaka
- Department of Ophthalmology, School of Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan.,Division of Vision Research for Environmental Health, Project Research Center, Medical Research Institute, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Yusuke Seki
- Department of Ophthalmology, School of Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Norihiro Mita
- Department of Ophthalmology, School of Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Yuki Ukai
- Department of Ophthalmology, School of Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Hisanori Miyashita
- Department of Ophthalmology, School of Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - Eri Kubo
- Department of Ophthalmology, School of Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| | - David Sliney
- Department of Environmental Health Science and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Hiroshi Sasaki
- Department of Ophthalmology, School of Medicine, Kanazawa Medical University, Kahoku, Ishikawa, Japan.,Division of Vision Research for Environmental Health, Project Research Center, Medical Research Institute, Kanazawa Medical University, Kahoku, Ishikawa, Japan
| |
Collapse
|
23
|
Hamed-Azzam S, Edison N, Briscoe D, Frenkel S, Mukari A, Strauss M, Camacho H, Elmalah I, Krausz J. Role of oncogenic viruses in the development ocular surface squamous neoplasia. Int Ophthalmol 2021; 41:3599-3605. [PMID: 34173153 DOI: 10.1007/s10792-021-01933-8] [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: 12/13/2020] [Accepted: 06/19/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE The pathogenesis of ocular surface squamous neoplasia is not fully understood. Therefore, we evaluated the role of oncogenic viruses in the pathogenesis of ocular surface squamous neoplasia in Israel. METHODS Patients with ocular surface squamous neoplasia were enrolled in this retrospective study. The specimens were taken during 2004-2015 from two big centers: Emek Medical Center, Afula and the Hadassah Medical Center, Jerusalem. All the specimens (totally 26) were analyzed by immunohistochemistry for evidence of oncogenic viruses that included Human Papilloma virus, Herpes Simplex virus and Cytomegalovirus infection and 14 samples were examined by polymerase chain reaction. In addition, all the samples were examined for Epstein Barr virus infection by immunohistochemistry and Epstein Barr encoding region test. RESULTS Twenty-six patients were included with a mean age of 61.81 [Formula: see text] 3.83 years (mean [Formula: see text]. Immunohistochemistry staining and Epstein Barr encoding region test did not detect any of the oncogenic viruses in the 26 samples. Human Papilloma virus-16 and -18, and Herpes Simplex virus were detected by polymerase chain reaction in 14.2%, 7% and 7%, respectively. CONCLUSION We conclude from our study that oncogenic viruses may play a role in the pathogenesis of ocular surface squamous neoplasia in Israel.
Collapse
Affiliation(s)
- Shirin Hamed-Azzam
- Department of Ophthalmology, Baruch Padeh Medical Center, Dov Hoz 0, Tiberias, Poriya, Israel.
| | - Natalia Edison
- The Institute of Tissue Diagnostics and Cancer Research, Emek Medical Center, Afula, Israel
| | - Daniel Briscoe
- Department of Ophthalmology, Emek Medical Center, Afula, Israel
| | - Shahar Frenkel
- Division of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.,The Wohl Institute for Translational Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Abed Mukari
- Department of Ophthalmology, Emek Medical Center, Afula, Israel
| | - Meirav Strauss
- Microbiology Laboratory, Emek Medical Center, Afula, Israel
| | - Hector Camacho
- Department of Ophthalmology, Emek Medical Center, Afula, Israel
| | - Irit Elmalah
- The Institute of Tissue Diagnostics and Cancer Research, Emek Medical Center, Afula, Israel
| | - Judit Krausz
- The Institute of Tissue Diagnostics and Cancer Research, Emek Medical Center, Afula, Israel
| |
Collapse
|
24
|
Van Acker SI, Van den Bogerd B, Haagdorens M, Siozopoulou V, Ní Dhubhghaill S, Pintelon I, Koppen C. Pterygium-The Good, the Bad, and the Ugly. Cells 2021; 10:cells10071567. [PMID: 34206333 PMCID: PMC8305200 DOI: 10.3390/cells10071567] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 12/19/2022] Open
Abstract
Pterygium is a multifaceted pathology that displays apparent conflicting characteristics: benign (e.g., self-limiting and superficial), bad (e.g., proliferative and potentially recurrent) and ugly (e.g., signs of preneoplastic transformation). The natural successive question is: why are we lacking reports showing that pterygium lesions become life-threatening through metastasis, especially since pterygium has considerable similarities with UV-related malignancies on the molecular level? In this review, we consider how our pathophysiological understanding of the benign pterygium pathology overlaps with ocular surface squamous neoplasia and skin cancer. The three UV-related disorders share the same initial insult (i.e., UV radiation) and responsive repair mechanisms to the ensuing (in)direct DNA damage. Their downstream apoptotic regulators and other cellular adaptations are remarkably alike. However, a complicating factor in understanding the fine line between the self-limiting nature of pterygium and the malignant transformation in other UV-related diseases is the prominent ambiguity in the pathological evaluation of pterygium biopsies. Features of preneoplastic transformation (i.e., dysplasia) are used to define normal cellular reactions (i.e., atypia and metaplasia) and vice versa. A uniform grading system could help in unraveling the true nature of this ancient disease and potentially help in identifying the earliest intervention point possible regarding the cellular switch that drives a cell’s fate towards cancer.
Collapse
Affiliation(s)
- Sara I. Van Acker
- Antwerp Research Group for Ocular Science (ARGOS), Translational Neurosciences, Faculty of Medicine, University of Antwerp, 2610 Wilrijk, Belgium; (B.V.d.B.); (M.H.); (S.N.D.); (C.K.)
- Correspondence: ; Tel.: +32-3-265-2851
| | - Bert Van den Bogerd
- Antwerp Research Group for Ocular Science (ARGOS), Translational Neurosciences, Faculty of Medicine, University of Antwerp, 2610 Wilrijk, Belgium; (B.V.d.B.); (M.H.); (S.N.D.); (C.K.)
| | - Michel Haagdorens
- Antwerp Research Group for Ocular Science (ARGOS), Translational Neurosciences, Faculty of Medicine, University of Antwerp, 2610 Wilrijk, Belgium; (B.V.d.B.); (M.H.); (S.N.D.); (C.K.)
| | - Vasiliki Siozopoulou
- Department of Pathology, Antwerp University Hospital, University of Antwerp, 2650 Edegem, Belgium;
- Center for Oncological Research (CORE), Integrated Personalized and Precision Oncology Network (IPPON), University of Antwerp, 2610 Wilrijk, Belgium
| | - Sorcha Ní Dhubhghaill
- Antwerp Research Group for Ocular Science (ARGOS), Translational Neurosciences, Faculty of Medicine, University of Antwerp, 2610 Wilrijk, Belgium; (B.V.d.B.); (M.H.); (S.N.D.); (C.K.)
- Department of Ophthalmology, Antwerp University Hospital, 2650 Edegem, Belgium
| | - Isabel Pintelon
- Laboratory of Cell Biology and Histology, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, 2610 Wilrijk, Belgium;
| | - Carina Koppen
- Antwerp Research Group for Ocular Science (ARGOS), Translational Neurosciences, Faculty of Medicine, University of Antwerp, 2610 Wilrijk, Belgium; (B.V.d.B.); (M.H.); (S.N.D.); (C.K.)
- Department of Ophthalmology, Antwerp University Hospital, 2650 Edegem, Belgium
| |
Collapse
|
25
|
Bilak Ş, Yılmaz S, Bilgin B. Comparison of vitamin D levels between patients with pterygium and healthy subjects. Int Ophthalmol 2021; 41:3057-3064. [PMID: 33881669 DOI: 10.1007/s10792-021-01868-0] [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: 09/11/2020] [Accepted: 04/15/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE The purpose of this study was to compare vitamin D (VD) deficiency frequency among patients with pterygium to that of healthy subjects and to investigate the VD deficiency among patients with pterygium. METHODS One-hundred eight pterygium patients and 94 healthy subjects were included in the study. Blood samples were collected from groups during the same time interval and the samples were saved. Serum 25-hydroxyvitamin D (25(OH)D) and parathormone (PTH) levels were measured and analyzed. RESULTS The pterygium group consisted of 57 female and 51 male patients, while the control group consisted of 47 female and 47 male patients. The mean age, sex and mean BMI were similar in the two groups (p > 0.05). The percentage of time that individuals spent outdoors was higher in the pterygium group (p = 0.02). The percentage of VD deficiency was 83.3% in the pterygium group and 61.7% in the control group (p = 0.001). There was a positive correlation between VD and time spent outdoors (p < 0.05). CONCLUSIONS VD deficiency can play a role in pterygium etiopathogenesis. Wide population-based studies in different regions are needed to evaluate this result.
Collapse
Affiliation(s)
- Şemsettin Bilak
- Department of Ophthalmology School of Medicine, Adıyaman University, Adıyaman, Turkey
| | - Sedat Yılmaz
- Department of Biochemistry, School of Medicine, Adıyaman University, Adıyaman, Turkey
| | - Burak Bilgin
- Department of Ophthalmology, Medicalpark Hospital, Gaziantep, Turkey.
| |
Collapse
|
26
|
Zaidi SBH, Ali Khan W. Is Pterygium Morphology Related to Loss of Corneal Endothelial Cells? A Cross-Sectional Study. Clin Ophthalmol 2021; 15:1259-1266. [PMID: 33790533 PMCID: PMC8001716 DOI: 10.2147/opth.s296531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 02/24/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine the difference in mean corneal endothelial cell density (CECD) between the healthy and diseased eyes of the patients with unilateral pterygium with different morphology patterns by using a non-contact specular microscope (SP2000: Topcon Corporation, Japan) and to find out any relationship between severity of pterygium and daily sunlight exposure with the CECD loss. Methods A descriptive cross-sectional prospective study was carried out at Al-Shifa Trust Eye Hospital (ASTEH), Rawalpindi, Pakistan from 21st January 2019 to 22nd January 2020. Two hundred eyes (n= 100 patients) of age range18 -68 years with unilateral pterygium were selected. Necessary demographic data and essential variables like age, smoking status, occupation, and daily direct sunlight exposure were determined. The severity of pterygium (grading) based on its morphology was determined by slit-lamp examination. CECD of each patient was carried out using a non-contact Specular Microscope. The healthy eye (without pterygium) of a patient was considered as control. Results The age range in this study was 18–68 years, with a mean age of 43.80 ± 24.37 years with a male to female ratio of 1.6:1 (62.00% males vs 38% females). Out of six occupations, the most common occupation was labour/construction work (n=31) followed by farming (n=27). The study reported a mean corneal endothelial cell density (CECD) of 2411.61±143.64 vs 2751.41 ± 123.674 cells/mm2 in diseased and normal eyes, respectively (p-value = 0.0001). CECD was lower in grade 3 pterygium compared to less severe pterygium { grade 3 (Fleshy) =2261 cells/mm2 vs grade 2 (Intermediate)= 2413 cells/mm2 vs grade 1 (Atrophic)=2459 cells/mm2} although this difference between the groups was not found to be significant (p=0.065). No significant association between sunlight exposure and CECD loss was observed (p=0.065). Conclusion This study concluded that the mean corneal endothelial cell density in patients with unilateral pterygium using a non-contact specular microscope were 2411.61±143.64 cells/mm2.
Collapse
Affiliation(s)
| | - Wajid Ali Khan
- Pakistan Institute of Ophthalmology (PIO), Department of Cornea and Refractive Surgery, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| |
Collapse
|
27
|
Histopathological Variability and Concomitant Lesions in Pterygium in a Large Case Series. J Ophthalmol 2021; 2021:6623794. [PMID: 33828861 PMCID: PMC8004360 DOI: 10.1155/2021/6623794] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 01/02/2023] Open
Abstract
Pterygium is a common lesion consisting of fleshy conjunctival growth extending towards the cornea. There is no documented risk of malignant transformation; however, concomitant disease is not rare, and its link to sunlight exposure indicates a risk of other malignancies. The purpose of our study is to describe histopathological features of resected pterygiums and to recognize patients at risk of other conjunctival diseases. One hundred and forty-nine formalin-fixed and paraffin-embedded pterygium samples were subjected to histopathological analysis. Histological H&E sections were obtained and digitalized using a Zeiss Axio Scan.Z1 slide scanner. Thirteen predefined morphological features were used to record histopathological changes in the epithelium and substantia propria. Neovascularization was observed in 54% of the samples. Sun damage, comprising solar elastosis and stromal plaque, was present in 81% of the samples. Variation in epithelial thickness was the most common change, with acanthosis and atrophy being observed in 62% and 26% of the samples, respectively. In our series, 21% (31/149) of pterygiums showed mild to moderate dysplasia, a finding that may be associated to ocular surface squamous neoplasia (OSSN). Moreover, 32% (47/149) of the cases showed melanocytic hyperplasia, which could represent primary acquired melanosis (PAM). There is a positive correlation between dysplasia and chronic inflammation (p=0.012) and an inverse correlation with epithelial atrophy (p=0.001) and neovascularization (p=0.05). Similarly, a positive correlation is observed between goblet cell hyperplasia and melanocytic hyperplasia (p=0.02). Our findings show that pterygiums harbour histological features that may be suggestive of OSSN or PAM in 53% of our patients. Whilst being on the benign side of the spectrum, these two entities are known for their potential progression to malignancy. A recommendation is made for all surgically excised pterygiums to be sent for histopathological diagnosis, and clear guidelines for reporting of these lesions should be established. Associated histopathological findings suggestive of other concomitant diseases should be identified to insure adequate follow-up of these patients.
Collapse
|
28
|
Alves M, Castanheira EMS, Lira M. Interactions between contact lenses and lens care solutions: Influence in optical properties. Cont Lens Anterior Eye 2021; 44:101414. [PMID: 33579643 DOI: 10.1016/j.clae.2021.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/15/2021] [Accepted: 01/23/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Investigate changes in optical properties of contact lenses materials (transmittance and reflectance) and lens care solutions (absorption and fluorescence) resulting from its interaction. METHODS From an experimental study, triplicate measurements of transmittance and reflectance of five contact lenses (Senofilcon A, Lotrafilcon B, Balafilcon A, Comfilcon A, and Omafilcon A), as well as UV-vis absorption and fluorescence of four lens care solutions (LCS) (ReNu MultiPlus, Biotrue, OPTI-FREE PureMoist, and AOSept Plus), were evaluated before and after 8 h, one day and one week in storage. The outcomes were provided by Shimadzu UV3101-PC UV-vis-NIR spectrophotometer equipped with an integrating sphere, between 200-700 nm, and SPEX-Fluorolog 2 FL3-22 spectrofluorometer. RESULTS All variables exhibited statistically significant differences over time. Comfilcon A showed the lowest ultraviolet radiation (UVR) A & B attenuation. Balafilcon A and Lotrafilcon B displayed a slight suppression of UVR. Senofilcon A was effective in UVR protection and showed less effect on the fluorescence of lens care solutions. Overall, the reflectance decreased after storage (p < 0.05). AOSept Plus absorbance and fluorescence demonstrated lower interactions than multipurpose solutions (MPS), and Lotrafilcon B induced more remarkable changes in optical properties of LCS than the other materials. CONCLUSION The findings suggest that optical variables of lens care solutions and contact lenses changed mutually after storage, probably associated with biochemical and biophysical interactions between components and the release of some polymer compounds. These findings can provide additional information about the interaction of CL materials and LCS in clinical behavior.
Collapse
Affiliation(s)
- Micael Alves
- Centre of Physics, School of Sciences, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
| | - Elisabete M S Castanheira
- Centre of Physics, School of Sciences, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Madalena Lira
- Centre of Physics, School of Sciences, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| |
Collapse
|
29
|
Park JB, Nam S, Bang S, Jin KH. Xeroderma Pigmentosum in a Pediatric Patient with a Progressive Pterygium-like Lesion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.1.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
30
|
Tanriverdi B, Sarac O, Cubukcu HC, Caglayan M, Durak ZE, Durak I, Cagil N. Xanthine oxidase enzyme activity in keratoconic corneal epithelium. Int Ophthalmol 2021; 41:1063-1069. [PMID: 33389422 DOI: 10.1007/s10792-020-01665-1] [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: 05/30/2020] [Accepted: 11/27/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE To assess the activity of xanthine oxidase (XO) enzyme in keratoconic corneal epithelium and to evaluate its relationship with the keratoconus (KC) severity. METHODS This prospective and randomized study included 66 eyes of 54 KC patients who received corneal collagen cross-linking treatment and 43 eyes of 32 patients who underwent photorefractive keratectomy due to their refractive error. During surgical procedures, the corneal epithelium was mechanically scraped and gathered to analyze the XO enzyme activity spectrophotometrically. The KC group was subdivided into three groups (stages 1, 2, and 3) according to the Amsler-Krumeich classification. The results were compared between the KC and the control group and in between KC subgroups. RESULTS No significant differences in age and gender were found between the KC and control groups (p = 0.064 and p = 0.296, respectively). The mean XO activity levels of the KC and control groups were 173.57 ± 87.61 and 223.70 ± 99.52 mIU/mg, respectively (p < 0.001). In KC group, 33 eyes were at stage 1, 19 were at stage 2, and 14 were at stage 3. No significant difference was observed between KC subgroups regarding XO activity levels (p = 0.681). CONCLUSION In this study, our findings revealed that ultraviolet-related pro-oxidant XO enzyme may have a role in the etiopathogenesis of KC. Further studies are needed to support our result. CLINICAL TRIALS REGISTRATION When we started this study in 2018, we did not have a "Clinical Trials Registration." However, we have ethics committee approval (date: 21. 02. 2018/No: 22).
Collapse
Affiliation(s)
| | - Ozge Sarac
- Department of Ophthalmology, Yildirim Beyazit University, Ankara, Turkey
| | - Hikmet Can Cubukcu
- Department of Medical Biochemistry, Maresal Cakmak State Hospital, Erzurum, Turkey
| | - Mehtap Caglayan
- Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | | | - Ilker Durak
- Department of Medical Biochemistry, Faculty of Medicine, Ankara University, Morphology Building, Ankara, Turkey
| | - Nurullah Cagil
- Department of Ophthalmology, Yildirim Beyazit University, Ankara, Turkey
| |
Collapse
|
31
|
Handing it to pterygium: Explaining pterygium laterality. Ocul Surf 2020; 19:63-67. [PMID: 33309855 DOI: 10.1016/j.jtos.2020.12.001] [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] [Received: 05/12/2020] [Revised: 11/08/2020] [Accepted: 12/07/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE To evaluate any correlation between pterygium laterality and patient handedness. METHODS Our study represents a retrospective observational study of a series of consecutive pterygium patients recruited from two centres. Each patient was assessed for their handedness which was compared to the laterality of their presenting pterygium. Patients that possessed bilateral disease comparisons between pterygium size and handedness were made. Correlation statistics were performed to compare patient handedness and pterygium location (right or left). For patients possessing bilateral disease only, the pre-surgical differences between lengths and areas of pterygium were calculated and compared. RESULTS A total of 219 patients were recruited into our study. 172 patients possessed unilateral disease and in 47 patients, the disease was bilateral. A significant association was identified between handedness and pterygium laterality (p < 0.001). Patients with right-sided pterygia were more likely to be right-handed (OR 2.327) and left-sided presentations who were more likely to be left-handed (OR 5.717). For bilateral presentations, patients were found to have longer (mean increase 3.50 ± 0.47 mm) and larger (mean increase 4.38 ± 0.48 mm2) pterygia in the eye ipsilateral to their dominant hand. CONCLUSIONS A new insight of handedness as a contributing factor to pterygium laterality is consistent with evidence relating to the asymmetrical development of cortical cataract as well as to theories underlying the geometry of ocular UV exposure. A more complete understanding of factors contributing to ocular insolation may further inform as to improved protective measures and provides further evidence for the role of peripheral light focusing in pterygium pathogenesis.
Collapse
|
32
|
Buch J, Hammond B. Photobiomodulation of the Visual System and Human Health. Int J Mol Sci 2020; 21:ijms21218020. [PMID: 33126530 PMCID: PMC7662260 DOI: 10.3390/ijms21218020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/25/2020] [Accepted: 10/27/2020] [Indexed: 12/24/2022] Open
Abstract
Humans express an expansive and detailed response to wavelength differences within the electromagnetic (EM) spectrum. This is most clearly manifest, and most studied, with respect to a relatively small range of electromagnetic radiation that includes the visible wavelengths with abutting ultraviolet and infrared, and mostly with respect to the visual system. Many aspects of our biology, however, respond to wavelength differences over a wide range of the EM spectrum. Further, humans are now exposed to a variety of modern lighting situations that has, effectively, increased our exposure to wavelengths that were once likely minimal (e.g., “blue” light from devices at night). This paper reviews some of those biological effects with a focus on visual function and to a lesser extent, other body systems.
Collapse
Affiliation(s)
- John Buch
- Johnson & Johnson Vision, Research & Development, Jacksonville, FL 32256, USA
- Correspondence: ; Tel.: +1-904-443-1707
| | - Billy Hammond
- Department of Psychology, University of Georgia, Athens, GA 30602, USA;
| |
Collapse
|
33
|
Comment on “Pterygium Is Related to Short Axial Length”. Cornea 2020; 39:e19-e20. [DOI: 10.1097/ico.0000000000002365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
34
|
Reply. Cornea 2020; 39:e20-e21. [DOI: 10.1097/ico.0000000000002364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
35
|
Corneal UV Protective Effects of a Topical Antioxidant Formulation: A Pilot Study on In Vivo Rabbits. Int J Mol Sci 2020; 21:ijms21155426. [PMID: 32751471 PMCID: PMC7432813 DOI: 10.3390/ijms21155426] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 01/10/2023] Open
Abstract
This study aimed to evaluate the protective effect of a topical antioxidant and ultraviolet (UV) shielding action formulation containing riboflavin and D-α-tocopherol polyethylene glycol succinate (TPGS) vitamin E against corneal UV-induced damage in vivo rabbit eyes. In vivo experiments were performed using male albino rabbits, which were divided into four groups. The control group (CG) did not receive any UV irradiation; the first group (IG) was irradiated with a UV-B−UV-A lamp for 30 min; the second (G30) and third (G60) groups received UV irradiation for 30 and 60 min, respectively, and were topically treated with one drop of the antioxidant and shielding formulation every 15 min, starting one hour before irradiation, until the end of UV exposure. The cornea of the IG group showed irregular thickening, detachment of residual fragments of the Descemet membrane, stromal fluid swelling with consequent collagen fiber disorganization and disruption, and inflammation. The cornea of the G30 group showed edema, a mild thickening of the Descemet membrane without fibrillar collagen disruption and focal discoloration, or inflammation. In the G60 group, the cornea showed a more severe thickening, a more abundant fluid accumulation underneath the Descemet membrane with focal detachment, and no signs of severe tissue alterations, as were recorded in the IG group. Our results demonstrate that topical application of eye drops containing riboflavin and TPGS vitamin E counteracts UV corneal injury in exposed rabbits.
Collapse
|
36
|
Abstract
PURPOSE To investigate the effects of contact lens (CL) on the frequency of pinguecula, and the relationship between dry eye disease and pinguecula. METHODS Two hundred and 33 cases of soft CL wearers and 230 age-matched nonwearers were enrolled in the study. Schirmer I test (ST) scores and tear break-up time (TBUT) were determined in all participants. A questionnaire including ocular surface disease index (OSDI), age, sex, and duration of CL wear was implemented to the participants before the examination. RESULTS The prevalence of pinguecula was 27.8% (n: 65) in the CL group and 26.5% (n: 61) in the control group. There was no significant difference between the groups (P=0.841). The prevalence of pinguecula increased with age in both groups. There was no significant difference in the prevalence of pinguecula when users were divided into three groups according to the duration of CL wear (P=0.575). The TBUT scores were lower, and the OSDI scores were higher in the CL group. The TBUT scores were lower in patients with pinguecula in both groups. The OSDI scores were higher in the CL group. There was no significant difference regarding the OSDI scores between patients with pinguecula and healthy participants in the CL group; however, OSDI scores were significantly higher in patients with pinguecula in control group. There were no significant differences in the ST scores between the groups, and between patients with pinguecula and healthy participants. CONCLUSION This is the second study that evaluates the effects of soft CL wearing on pinguecula prevalence. We found that CL wearing does not affect the prevalence of pinguecula. Considering the OSDI scores in patients with pinguecula in the CL group, CL may suppress the irritant symptoms of pinguecula.
Collapse
|
37
|
Spectral Evaluation of Eyeglass Blocking Efficiency of Ultraviolet/High-energy Visible Blue Light for Ocular Protection. Optom Vis Sci 2020; 96:513-522. [PMID: 31274740 PMCID: PMC6615932 DOI: 10.1097/opx.0000000000001393] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Supplemental digital content is available in the text. SIGNIFICANCE We investigated, for safety and awareness, ultraviolet and high-energy violet light–blocking protection provided by assorted types of eyewear. Ultraviolet and high-energy violet light–filtering efficiency varied and did not correlate with price or advertised claims. Standardization of methods and specifications for lens spectral transmission evaluation is recommended. PURPOSE Studies have linked exposure of high-energy visible blue light to effect and damage on retinal epithelial cells, photoreceptors, and ganglion cells. “Blue light” is more accurately differentiated into “high-energy visible blue-violet light” and “circadian rhythm blue-turquoise light.” This study measured and compared spectral transmission of ultraviolet and high-energy violet light of low-, medium-, and high-priced sunglasses. METHODS Sunglasses and lens blanks were obtained from the University of Texas Medical Branch Optical Shop and vendors. Groups were based on promotional, retail, designer sunglasses, or “blue blocker” lenses. The percent transmittance of ultraviolet/visible spectral scans (800 to 350 nm) was measured using an Agilent Cary 50 spectrophotometer. High-energy violet/blue light was defined as 400 to 450 nm. RESULTS Promotional sunglasses (tinted polycarbonate) blocked 100% ultraviolet and 67 to 99.8% high-energy violet blue light. Retail sunglasses filtered out 95 to 100% ultraviolet A and 67% high-energy violet light. The tested designer sunglasses varied widely in their optical transmissibility with respect to their ultraviolet A and high-energy violet light–blocking properties, with some not blocking ultraviolet A. Clear and colorless Kodak Total Blue provided maximal high-energy violet protection, whereas clear Essilor Crizal Prevencia provided less high-energy violet blocking between 400 and 450 nm. CONCLUSIONS The ultraviolet and high-energy violet (400 to 450 nm) light–filtering efficiency varied between sunglasses and clear lenses and did not correlate with price or advertised claims. Standardization of methods and specifications for lens spectral transmission evaluation is recommended.
Collapse
|
38
|
Fernandes AG, Salomão SR, Ferraz NN, Mitsuhiro MH, Furtado JM, Muñoz S, Cypel MC, Cunha CC, Vasconcelos GC, Sacai PY, Morales PH, Cohen MJ, Cohen JM, Watanabe SS, Campos M, Belfort Junior R, Berezovsky A. Pterygium in adults from the Brazilian Amazon Region: prevalence, visual status and refractive errors. Br J Ophthalmol 2019; 104:757-763. [PMID: 31533928 DOI: 10.1136/bjophthalmol-2019-314131] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 06/19/2019] [Accepted: 08/29/2019] [Indexed: 11/04/2022]
Abstract
AIMS To determine prevalence of pterygium, its role as main cause of unilateral and bilateral visual impairment and blindness and its impact on refractive errors from adults living in a high ultraviolet exposure area in the Brazilian Amazon Region. METHODS Cluster sampling was used in randomly selecting subjects ≥45 years of age from urban and rural areas of Parintins city. Eligible subjects were enumerated through a door-to-door household survey and invited for an eye exam including refraction. Pterygium was assessed considering location (nasal, temporal or both) and size (<3 mm or ≥3 mm reaching or not pupillary margin). RESULTS A total of 2384 persons were enumerated and 2041 (85.6%) were examined. Prevalence of pterygium was 58.8% (95% CI 53.8% to 63.7%) and associated with male gender (OR=1.63; 95% CI 1.37 to 1.94; p=0.001), while higher education was a protective factor (OR=0.63; 95% CI 0.44 to 0.92; p=0.018). Older age and rural residence were associated with pterygium ≥3 mm reaching or not pupillary margin, while higher education was a protective factor for pterygium ≥3 mm reaching pupillary margin. Prevalence of pterygium as cause of visual impairment and blindness was 14.3% and 3.9%, respectively. Significantly higher hyperopic refractive errors were found in eyes with pterygium ≥3 mm reaching or not pupillary margin. CONCLUSIONS Pterygium was highly prevalent and the second cause of visual impairment and blindness after provision of refractive correction. Risk factors for pterygium were male gender, advanced age, lower education and rural residency. Strategies to provide pterygium early detection and proper management should be considered by healthcare authorities in this population.
Collapse
Affiliation(s)
- Arthur G Fernandes
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Solange R Salomão
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Nívea N Ferraz
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Márcia H Mitsuhiro
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Joao M Furtado
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil.,Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Sergio Muñoz
- Departamento de Salud Publica, Universidad de La Frontera, Temuco, Chile
| | - Marcela C Cypel
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Cristina C Cunha
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Galton C Vasconcelos
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil.,Departamento de Oftalmologia e Otorrinolaringologia, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paula Y Sacai
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Paulo H Morales
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Marcos J Cohen
- Divisão de Oftalmologia, Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Amazonas, Manaus, AM, Brazil
| | - Jacob M Cohen
- Divisão de Oftalmologia, Departamento de Cirurgia, Faculdade de Medicina, Universidade Federal do Amazonas, Manaus, AM, Brazil
| | - Sung S Watanabe
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Mauro Campos
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Rubens Belfort Junior
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| | - Adriana Berezovsky
- Departamento de Oftalmologia e Ciências Visuais, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP, São Paulo, SP, Brazil
| |
Collapse
|
39
|
Enhancement of corneal epithelium cell survival, proliferation and migration by red light: Relevance to corneal wound healing. Exp Eye Res 2019; 180:231-241. [DOI: 10.1016/j.exer.2019.01.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 12/13/2018] [Accepted: 01/02/2019] [Indexed: 02/04/2023]
|
40
|
Lucas RM, Yazar S, Young AR, Norval M, de Gruijl FR, Takizawa Y, Rhodes LE, Sinclair CA, Neale RE. Human health in relation to exposure to solar ultraviolet radiation under changing stratospheric ozone and climate. Photochem Photobiol Sci 2019; 18:641-680. [PMID: 30810559 DOI: 10.1039/c8pp90060d] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The Montreal Protocol has limited increases in the UV-B (280-315 nm) radiation reaching the Earth's surface as a result of depletion of stratospheric ozone. Nevertheless, the incidence of skin cancers continues to increase in most light-skinned populations, probably due mainly to risky sun exposure behaviour. In locations with strong sun protection programs of long duration, incidence is now reducing in younger age groups. Changes in the epidemiology of UV-induced eye diseases are less clear, due to a lack of data. Exposure to UV radiation plays a role in the development of cataracts, pterygium and possibly age-related macular degeneration; these are major causes of visual impairment world-wide. Photodermatoses and phototoxic reactions to drugs are not uncommon; management of the latter includes recognition of the risks by the prescribing physician. Exposure to UV radiation has benefits for health through the production of vitamin D in the skin and modulation of immune function. The latter has benefits for skin diseases such as psoriasis and possibly for systemic autoimmune diseases such as multiple sclerosis. The health risks of sun exposure can be mitigated through appropriate sun protection, such as clothing with both good UV-blocking characteristics and adequate skin coverage, sunglasses, shade, and sunscreen. New sunscreen preparations provide protection against a broader spectrum of solar radiation, but it is not clear that this has benefits for health. Gaps in knowledge make it difficult to derive evidence-based sun protection advice that balances the risks and benefits of sun exposure.
Collapse
Affiliation(s)
- R M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia. and Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia
| | - S Yazar
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia and MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | | | - M Norval
- Biomedical Sciences, University of Edinburgh Medical School, Edinburgh, Scotland, UK
| | - F R de Gruijl
- Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Y Takizawa
- Akita University School of Medicine, National Institute for Minamata Disease, Nakadai, Itabashiku, Tokyo, Japan
| | - L E Rhodes
- Centre for Dermatology Research, School of Biological Sciences, Faculty of Biology, Medicine, and Health, The University of Manchester and Salford Royal NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | - R E Neale
- QIMR Berghofer Institute of Medical Research, Herston, Brisbane, Australia and School of Public Health, University of Queensland, Australia
| |
Collapse
|
41
|
Shrestha T, Choi W, Kim GE, Yang JM, Yoon KC. Human papilloma virus identification in ocular surface squamous neoplasia by p16 immunohistochemistry and DNA chip test: A strobe-compliant article. Medicine (Baltimore) 2019; 98:e13944. [PMID: 30633172 PMCID: PMC6336645 DOI: 10.1097/md.0000000000013944] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The aim of this study was to identify the association between human papilloma virus (HPV) infection and ocular surface squamous neoplasia (OSSN) using p16 immunohistochemistry (IHC) and deoxyribonucleic acid (DNA) chip test.Thirty-eight patients who underwent surgical excision of OSSN were retrospectively studied using tissue samples. The IHC was performed to assess the expression of p16 and DNA chip test was used to detect 24 HPV serotypes.Among the 38 OSSN samples, 32 cases (84.2%) were histopathologically categorized as pre-invasive type and 6 cases (15.8%) as invasive type. The IHC for p16 showed strong positivity in 12 cases (31.6%), whereas it was negative in 26 cases (68.4%). On the other hand, only one case (2.6%) of invasive OSSN was positive for the HPV16 serotype, as assessed by DNA chip test.In OSSN, p16 expression was positive in approximately 1/3rd of the cases, whereas the majority of the 24 HPV serotypes were negative for p16. Our findings suggest that only a weak association exists between HPV infection and OSSN.
Collapse
Affiliation(s)
- Tina Shrestha
- Department of Ophthalmology and Research Institute of Medical Sciences
- Department of ophthalmology, Dhulikhel hospital, Kathmandu university school of medical science, Nepal
| | - Won Choi
- Department of Ophthalmology and Research Institute of Medical Sciences
| | - Ga Eon Kim
- Department of Pathology and Research Institute of Medical Sciences, Chonnam National University Medical School and Hospital, Gwangju
| | - Jee Myung Yang
- Department of Ophthalmology and Research Institute of Medical Sciences
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - Kyung Chul Yoon
- Department of Ophthalmology and Research Institute of Medical Sciences
| |
Collapse
|
42
|
Aslam A, Gupta N, Velpandian T, Sen S. Does ocular inflammation play a role in xeroderma pigmentosum with endothelial dysfunction: an immunological study. BMJ Case Rep 2018; 11:11/1/e225384. [PMID: 30567087 DOI: 10.1136/bcr-2018-225384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We report a case of xeroderma pigmentosum (XP) with endothelial dysfunction where the analysis of tears revealed elevated levels of proinflammatory cytokines, even in the absence of active inflammation and neovascularisation of the ocular surface. Although the role of ultraviolet (UV) radiation-induced inflammation in the occurrence of ocular manifestations of XP is known, little is published on the molecular mechanisms and there are no reports quantifying the presence of inflammatory cytokines in the tears of patients with ocular involvement of XP. Tear analysis demonstrated an increase in inflammatory cytokines and chemokines, especially interleukin-8 (2.38 ng/µg), tumour necrosis factor alpha (0.87 ng/µg) and granulocyte monocyte colony stimulating factor (0.44 ng/µg) as compared with the control eye. Effective management of the underlying UV-induced inflammation and promoting DNA repair may play a vital role in managing ocular manifestations and its sequelae in patients of XP.
Collapse
Affiliation(s)
- Amreen Aslam
- Cataract, Cornea, Ocular Surface Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Noopur Gupta
- Cataract, Cornea, Ocular Surface Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Thirumurthy Velpandian
- Ocular Pharmacology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi
| | - Seema Sen
- Ocular Pathology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi
| |
Collapse
|
43
|
Grupcheva CN, Grupchev DI, Radeva MN, Hristova EG. UV damage of the anterior ocular surface - microstructural evidence by in vivo confocal microscopy. Cont Lens Anterior Eye 2018; 41:482-488. [PMID: 30458934 DOI: 10.1016/j.clae.2018.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 06/10/2018] [Accepted: 06/24/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE To evaluate and describe the microstructural changes at the ocular surface in response to habitual ocular sun exposure, correlate them with the UV protection habits and follow their dynamics using in vivo confocal microscopy(ICM). METHODS For a period of minimum 4 months 200 subjects (400 eyes), aged 28 ± 7.3 years, were recruited with the agreement that they will spend their summer exclusively in the region of the Black Sea coast at 43 °N latitude and will be examined before and after the summer. All subjects filled in a questionnaire about habitual UV protection and were examined clinically and by ICM. RESULTS Questionnaire results demonstrated that 83.5% (167 participants) of the subjects considered the sun dangerous for their eyes, but 78% (156 subjects) believed that there is danger exclusively during the summer period. Although no clinical changes were detected, microstructural analysis of the cornea demonstrated statistically significant (p = 0.021) decrease of the basal epithelial density - from 6167 ± 151 cells/mm2 before to 5829 ± 168 cells/mm2 after the summer period. Microstructural assessment of the conjunctiva demonstrated characteristic cystic lesions with dark centres and bright borders encountered in only 25 eyes(6%) before, and affecting 118 eyes(29.5%) after the summer. The total area of the cysts after the summer increased fivefold. Spearman analysis proved negative correlation between sun protection habits and number of cysts. CONCLUSION Summer sun exposure for one season leads to clinically undetectable, microstructural changes affecting the cornea, bulbar and palpebral conjunctiva with transient, but possibly cumulative nature.
Collapse
Affiliation(s)
- Christina N Grupcheva
- Department of Ophthalmology and Visual Science, Medical University, 55 Marin Drinov Str., Varna, 9002, Bulgaria.
| | - Dimitar I Grupchev
- Department of Ophthalmology and Visual Science, Medical University, 55 Marin Drinov Str., Varna, 9002, Bulgaria.
| | - Mladena N Radeva
- Department of Ophthalmology and Visual Science, Medical University, 55 Marin Drinov Str., Varna, 9002, Bulgaria.
| | - Elitsa G Hristova
- Department of Ophthalmology and Visual Science, Medical University, 55 Marin Drinov Str., Varna, 9002, Bulgaria.
| |
Collapse
|
44
|
Lingham G, Burton A, Brown HA, Huynh E, Yazar S, Coroneo MT, Mackey DA. Repurposing blue laser autofluorescence to measure ocular sun exposure. Clin Exp Ophthalmol 2018; 47:445-452. [PMID: 30345715 DOI: 10.1111/ceo.13423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/05/2018] [Accepted: 10/15/2018] [Indexed: 11/29/2022]
Abstract
IMPORTANCE Excessive ocular sun exposure is linked to various eye pathologies. Conjunctival ultraviolet autofluorescence (CUVAF) is a method of detecting sun-related conjunctival damage; however, the custom-built camera system required is not readily available. BACKGROUND We investigated whether blue laser autofluorescence (BAF) on a commonly used confocal scanning laser ophthalmoscope (cSLO) can be utilized to measure CUVAF area. DESIGN Cross-sectional evaluation of a diagnostic technology at a medical research institute. PARTICIPANTS Sixty-four participants recruited from three on-going observational eye studies in Western Australia. METHODS All participants had four images, two of each eye, captured using the CUVAF camera and BAF on the same day. Participants with pterygium or poor quality images were excluded from the analysis. Two graders measured CUVAF area in each image twice. CUVAF area measured by BAF was then compared to measurements determined with the conventional camera system. MAIN OUTCOME MEASURES CUVAF area. RESULTS After exclusions, 50 participants' images were analysed. Intra- and inter-observer repeatability were similar between the two systems. When comparing CUVAF area measured by BAF to the camera measurement, grader 1 had a mean difference of +1.00 mm2 , with 95% limits of agreement -5.75 to 7.77 mm2 . Grader 2 had a mean difference of +0.21mm2 , with 95% limits of agreement -7.22 to 7.64 mm2 . CONCLUSIONS AND RELEVANCE BAF on a commercially available cSLO is a valid method for measuring CUVAF area. This finding provides broader opportunity for identifying, monitoring and educating patients with sun-exposure-related ocular conditions and for researching the ocular impacts of sun exposure.
Collapse
Affiliation(s)
- Gareth Lingham
- Centre for Ophthalmology and Visual Science and the Lions Eye Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Alex Burton
- Centre for Ophthalmology and Visual Science and the Lions Eye Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Holly A Brown
- Centre for Ophthalmology and Visual Science and the Lions Eye Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Emily Huynh
- Centre for Ophthalmology and Visual Science and the Lions Eye Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Science and the Lions Eye Institute, University of Western Australia, Nedlands, Western Australia, Australia
| | - Minas T Coroneo
- Department of Ophthalmology, University of New South Wales, Kensington, New South Wales, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science and the Lions Eye Institute, University of Western Australia, Nedlands, Western Australia, Australia
| |
Collapse
|
45
|
Modenese A, Korpinen L, Gobba F. Solar Radiation Exposure and Outdoor Work: An Underestimated Occupational Risk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2063. [PMID: 30241306 PMCID: PMC6209927 DOI: 10.3390/ijerph15102063] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 09/17/2018] [Accepted: 09/18/2018] [Indexed: 12/22/2022]
Abstract
A considerably high number of outdoor workers worldwide are constantly exposed for the majority of their working life to solar radiation (SR); this exposure is known to induce various adverse health effects, mainly related to its ultraviolet (UV) component. The skin and the eye are the principal target organs for both acute and long-term exposure. Actinic keratosis, non-melanoma skin cancers, and malignant melanoma are the main long-term adverse skin effects, whereas in the eye pterygium, cataracts, and according to an increasing body of evidence, macular degeneration may be induced. Despite this, SR exposure risk is currently undervalued, if not neglected, as an occupational risk factor for outdoor workers. SR exposure is influenced by various environmental and individual factors, and occupation is one of the most relevant. For a better understanding of this risk and for the development of more effective prevention strategies, one of the main problems is the lack of available and adequate methods to estimate SR worker exposure, especially long-term exposure. The main aims of this review were to provide a comprehensive overview of SR exposure risk of outdoor workers, including the UV exposure levels and the main methods recently proposed for short-term and cumulative exposure, and to provide an update of knowledge on the main adverse eye and skin effects. Finally, we also outline here preventive interventions to reduce occupational risk.
Collapse
Affiliation(s)
- Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41124 Modena, Italy.
| | - Leena Korpinen
- Clinical Physiology and Neurophysiology Unit, The North Karelia Central Hospital, 80210 Joensuu, Finland.
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41124 Modena, Italy.
| |
Collapse
|
46
|
Essential role of ultraviolet radiation in the decrease of corneal endothelial cell density caused by pterygium. Eye (Lond) 2018; 32:1886-1892. [PMID: 30158575 DOI: 10.1038/s41433-018-0188-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 06/11/2018] [Accepted: 07/09/2018] [Indexed: 01/16/2023] Open
Abstract
PURPOSE To investigate the essential role of ultraviolet (UV) radiation in the decrease of corneal endothelial cell density (ECD) caused by pterygium. METHODS In this retrospective controlled study, 76 consecutive patients with unilateral primary pterygium were enrolled from January 2016 to August 2016. The Central corneal ECD was measured in both eyes. Divide the subjects into two subgroups according to the UV exposure time, and the difference of corneal ECD between both eyes was analyzed using independent samples t-test. The relationship between the percentage of difference of corneal ECD and the disease duration, the percentage of pterygium to the cornea and the astigmatism value were analyzed. RESULTS For subjects with longer UV exposure, the average of ECD in pterygium group and control group were, respectively, 2264.83 ± 349.78 cells/mm2 and 2477.16 ± 300.36 cells/mm2 (P = 0.004). For subjects with short UV exposure, the average of ECD in pterygium group and control group were, respectively, 2596.46 ± 373.24 cells/mm2 and 2690.66 ± 321.34 cells/mm2 (P = 0.262). The decrease of corneal ECD was positively correlated with the period of the disease (P = 0.035). There was no statistical correlation between a decrease in the corneal ECD and the percentage of pterygium to cornea (R = -0.055, P = 0.635) and the astigmatism value in the pterygium eye (R = -0.135, P = 0.246). CONCLUSIONS UV radiation exposure played a significant role in the effect of pterygium decreasing the corneal ECD.
Collapse
|
47
|
Ivanov IV, Mappes T, Schaupp P, Lappe C, Wahl S. Ultraviolet radiation oxidative stress affects eye health. JOURNAL OF BIOPHOTONICS 2018; 11:e201700377. [PMID: 29603665 DOI: 10.1002/jbio.201700377] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/21/2018] [Indexed: 05/02/2023]
Abstract
In the eye, ultraviolet radiation (UVR) is not known to contribute to visual perception but to mainly damage multiple structures. UVR carries higher energy than visible light and high dose exposure to UVR causes direct cellular damage, which has an important role in the development of cancer. This review provides an overview on the most recent knowledge on the role of UVR in oxidative stress (OS) in relation to noncancer ocular pathologies: various corneal pathologies, cataract, glaucoma and age-related macular degeneration. Possible OS signaling streams and mechanisms in the aging eye are discussed. Excessive exposure to UVR through live may seriously contribute to increase in OS of various eye tissues and thus lead to the advancement of serious ocular pathologies. Children are especially vulnerable to UVR because of their larger pupils and more transparent ocular media: up to 80% of a person's lifetime exposure to UVR is reached before the age of 18. Therefore, efficient everyday protection of the sensitive tissues of the eye by wearing of sunglasses, clear UVR-blocking spectacles or contact lenses should be considered from early age on. Many initiatives are taken worldwide to inform and raise the population's awareness about these possible UVR hazards to the eye.
Collapse
Affiliation(s)
- Iliya V Ivanov
- Institute for Ophthalmic Research, University of Tuebingen, Tuebingen, Germany
| | - Timo Mappes
- Carl Zeiss Vision International GmbH, Aalen, Germany
| | | | | | - Siegfried Wahl
- Institute for Ophthalmic Research, University of Tuebingen, Tuebingen, Germany
- Carl Zeiss Vision International GmbH, Aalen, Germany
| |
Collapse
|
48
|
Rifai K, Hornauer M, Buechinger R, Schoen R, Barraza-Bernal M, Habtegiorgis S, Glasenapp C, Wahl S, Mappes T. Efficiency of ocular UV protection by clear lenses. BIOMEDICAL OPTICS EXPRESS 2018; 9:1948-1963. [PMID: 29675331 PMCID: PMC5905936 DOI: 10.1364/boe.9.001948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 03/14/2018] [Accepted: 03/16/2018] [Indexed: 06/08/2023]
Abstract
Ocular UV doses accumulate all-day, not only during periods of direct sun exposure. The UV protection efficiency of three clear lenses was evaluated experimentally, validated by simulation, and compared to non-UV protection: a first spectacle lens with a tailored UV absorber, a second spectacle lens, minimizing UV back reflections, as well as a third spectacle lens, combining both. A tailored UV-absorber efficiently reduced overall UV irradiance to 7 %, whereas reduction of back-reflections still left UV irradiance at 42 %. Thus, clear lenses with a tailored UV absorber efficiently protect the eye from UV, supplementing sun glasses wear to an all-day protection scenario.
Collapse
Affiliation(s)
- Katharina Rifai
- Institute for Ophthalmic Research, University of Tuebingen, Tuebingen, Germany
- Carl Zeiss Vision International GmbH, Aalen, Germany
- These authors contributed equally
| | | | | | | | | | - Selam Habtegiorgis
- Institute for Ophthalmic Research, University of Tuebingen, Tuebingen, Germany
| | | | - Siegfried Wahl
- Institute for Ophthalmic Research, University of Tuebingen, Tuebingen, Germany
- Carl Zeiss Vision International GmbH, Aalen, Germany
| | - Timo Mappes
- Carl Zeiss Vision International GmbH, Aalen, Germany
| |
Collapse
|
49
|
Wan Zaki WMD, Mat Daud M, Abdani SR, Hussain A, Mutalib HA. Automated pterygium detection method of anterior segment photographed images. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 154:71-78. [PMID: 29249348 DOI: 10.1016/j.cmpb.2017.10.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 09/21/2017] [Accepted: 10/30/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND BJECTIVE Pterygium is an ocular disease caused by fibrovascular tissue encroachment onto the corneal region. The tissue may cause vision blurring if it grows into the pupil region. In this study, we propose an automatic detection method to differentiate pterygium from non-pterygium (normal) cases on the basis of frontal eye photographed images, also known as anterior segment photographed images. METHODS The pterygium screening system was tested on two normal eye databases (UBIRIS and MILES) and two pterygium databases (Australia Pterygium and Brazil Pterygium). This system comprises four modules: (i) a preprocessing module to enhance the pterygium tissue using HSV-Sigmoid; (ii) a segmentation module to differentiate the corneal region and the pterygium tissue; (iii) a feature extraction module to extract corneal features using circularity ratio, Haralick's circularity, eccentricity, and solidity; and (iv) a classification module to identify the presence or absence of pterygium. System performance was evaluated using support vector machine (SVM) and artificial neural network. RESULTS The three-step frame differencing technique was introduced in the corneal segmentation module. The output image successfully covered the region of interest with an average accuracy of 0.9127. The performance of the proposed system using SVM provided the most promising results of 88.7%, 88.3%, and 95.6% for sensitivity, specificity, and area under the curve, respectively. CONCLUSION A basic platform for computer-aided pterygium screening was successfully developed using the proposed modules. The proposed system can classify pterygium and non-pterygium cases reasonably well. In our future work, a standard grading system will be developed to identify the severity of pterygium cases. This system is expected to increase the awareness of communities in rural areas on pterygium.
Collapse
Affiliation(s)
- Wan Mimi Diyana Wan Zaki
- Smart Engineering System Research Group (SESRG), Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, University Kebangsaan Malaysia, Selangor, Malaysia.
| | - Marizuana Mat Daud
- Smart Engineering System Research Group (SESRG), Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, University Kebangsaan Malaysia, Selangor, Malaysia
| | - Siti Raihanah Abdani
- Smart Engineering System Research Group (SESRG), Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, University Kebangsaan Malaysia, Selangor, Malaysia
| | - Aini Hussain
- Smart Engineering System Research Group (SESRG), Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, University Kebangsaan Malaysia, Selangor, Malaysia
| | - Haliza Abdul Mutalib
- Optometry and Vision Sciences Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
50
|
Mendoza PR, Craven CM, Ip MH, Wilson MW, Coroneo MT, Grossniklaus HE. Conjunctival Squamous Cell Carcinoma with Corneal Stromal Invasion in Presumed Pterygia: A Case Series. Ocul Oncol Pathol 2018; 4:240-249. [PMID: 30643769 DOI: 10.1159/000485425] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 11/15/2017] [Indexed: 12/29/2022] Open
Abstract
Aim To describe 4 cases of conjunctival squamous cell carcinoma (SCC) with corneal stromal invasion. Methods Retrospective, clinicopathologic case series. Results All patients had prior resections of presumed pterygia. The degree of corneal involvement dictated the extent of surgical management. One eye with localized invasion was treated with lamellar keratoplasty and plaque brachytherapy. Another case with widespread invasion warranted penetrating keratoplasty and eventual enucleation. Two cases were treated medically prior to surgical intervention: one with localized invasion was treated with topical interferon and retinoic acid; another with significant inflammation was treated with doxycycline and fluorometholone. The patient who underwent keratoplasty and brachytherapy had no recurrence after 7 years of follow-up. Those initially treated medically had resections of recurrence but ultimately required enucleation. Histologically, specimens demonstrated SCC invading the deep corneal stroma, with 2 tumors of the mucoepidermoid type. Conclusions This series demonstrates the importance of maintaining clinical suspicion of conjunctival squamous neoplasia in pterygia. We recommend that all excised pterygia be submitted for histopathologic evaluation and be carefully evaluated for dysplasia and variants of SCC associated with increased risk of intraocular invasion. Undetected ocular surface squamous neoplasia may give rise to potentially vision- and eye-threatening invasive corneal SCC.
Collapse
Affiliation(s)
- Pia R Mendoza
- Department of Pathology and Laboratory Medicine, Atlanta, GA, USA
| | | | - Matthew H Ip
- Department of Department of Ophthalmology, University of New South Wales at Prince of Wales Hospital, Sydney, NSW, Australia
| | - Matthew W Wilson
- Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Minas T Coroneo
- Department of Department of Ophthalmology, University of New South Wales at Prince of Wales Hospital, Sydney, NSW, Australia
| | - Hans E Grossniklaus
- Department of Pathology and Laboratory Medicine, Atlanta, GA, USA.,Department of Ophthalmology, Emory University, Atlanta, GA, USA
| |
Collapse
|