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Jarvis I, McCullough S, Jarvis J. The topical azithromycin meibomian gland dysfunction survey: The effect of topical azithromycin on signs and symptoms of meibomian gland dysfunction. Ophthalmic Physiol Opt 2024; 44:910-916. [PMID: 38733248 DOI: 10.1111/opo.13330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 04/18/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024]
Abstract
INTRODUCTION The aim of this study was to assess the long-term effects of topical azithromycin on signs, symptoms and self-management of meibomian gland dysfunction (MGD). METHODS Forty participants were assessed for MGD and its effect on the fluorescein tear break-up time (FTBUT). Participants were treated with topical azithromycin twice daily for 2 weeks and then once daily for a further 2 weeks. One year after treatment, 31 participants completed a survey assessing pre- and post-treatment effect on symptoms, lifestyle and self-treatment methods. RESULTS Following treatment, there was a significant reduction in MGD grading from a median of grade 2 to grade 0 (z = 4.40, p < 0.0001) and an increase in FTBUT from a median of 3-8 s (z = 4.75, p < 0.0001). One year afterwards, the survey showed a significant improvement in symptoms (sensitivity to light, grittiness, burning, blurred vision, all p < 0.03) and reduction in required self-treatments (lid wipes, tear substitutes, both p < 0.03). There was also a reduced impact on lifestyle (reading, night driving, computer use and watching television, all p < 0.0001) and in all environmental conditions (all p < 0.0001). CONCLUSIONS This study confirms the positive effect of topical azithromycin on MGD and shows it has a long-term impact on symptoms, self-treatment methods and lifestyle. This has implications for both chair time and healthcare costs when managing patients with MGD. Pending further clinical trials in a larger population with different demographics, topical azithromycin should be considered by all eyecare practitioners as a viable pharmacological treatment when managing MGD.
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Affiliation(s)
| | - Sara McCullough
- Centre for Optometry & Vision Science, School of Biomedical Sciences, Ulster University, Coleraine, UK
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Cheng C, Zhu M, Lin T, Chen Z, Zeng W, Li K, Xue R, Duan F, Wu K. Recharacterization of superior limbic keratoconjunctivitis via a subdividing grading method in 236 Chinese patients. Graefes Arch Clin Exp Ophthalmol 2022; 260:2291-2298. [PMID: 35113250 DOI: 10.1007/s00417-022-05575-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 01/17/2022] [Accepted: 01/21/2022] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Superior limbic keratoconjunctivitis (SLK) is an uncommon and often overlooked chronic ocular surface disease. This retrospective consecutive case series study on Chinese patients aimed to characterize the features of this disease, including those undescribed in previous literature. METHODS Two hundred thirty-six patients diagnosed with SLK were enrolled into this consecutive case study from 2016 to 2019. The demographics, symptoms, Ocular Surface Disease Index, and ocular signs were collected and analyzed. A scoring system (SLK scale index, SSI) that integrated five major sign scores was applied to evaluate SLK severity. RESULTS Of the 236 SLK patients, dryness was the most common complaint (59.3%). Of 459 SLK eyes, superior limbus/conjunctival staining (SCS) was present in 98% eyes, followed by the superior tarsal conjunctival alterations (85.2%) and superior bulbar conjunctiva hyperemia (80.8%). Approximately 63% of eyes were accompanied by corneal staining. Superior bulbar conjunctivochalasis was a relatively rare sign (41.6%). Among the five major signs, only the prevalence of SCS gradually increased with its severity. In addition, fluorescein staining at the inferior limbus and adjacent conjunctiva (ICS) was found positive in 163 eyes of 84 patients (36%) who had significantly higher SSI than those without ICS (p = 0.013). CONCLUSIONS We found that SCS is the most common out of the 5 typical signs of SLK. ICS, a new sign, occurred in one-third of patients. SCS, a simple marker of SLK, as well as SSI, an integrated evaluation system, had the advantage of evaluating the severity and objectively characterizing SLK in clinical practice.
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Affiliation(s)
- Chao Cheng
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China
| | - Minyi Zhu
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China.,Department of Ophthalmology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, People's Republic of China
| | - Tianlan Lin
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China
| | - Ziyan Chen
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China
| | - Weiting Zeng
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China
| | - Kunke Li
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China
| | - Ran Xue
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China
| | - Fang Duan
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China
| | - Kaili Wu
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-Sen University, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, People's Republic of China.
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Walker MK, Tomiyama ES, Skidmore KV, Assaad JR, Ticak A, Richdale K. A comparison of subjective and objective conjunctival hyperaemia grading with AOS® Anterior software. Clin Exp Optom 2021; 105:494-499. [PMID: 34315357 DOI: 10.1080/08164622.2021.1945406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Clinical relevance: This study evaluates a commercially available conjunctival hyperaemia grading system, providing validation of an important tool for ocular surface research and clinical trials.Background: Bulbar conjunctival hyperaemia is a sign of ocular surface inflammation, and proper measurement is essential to clinical care and trials. The aim of this study was to assess the validity and repeatability of an objective grading system in comparison with subjective grading.Methods: This study was a retrospective, randomised analysis of 300 bulbar conjunctival images that were collected at an academic institution. The images used were de-identified and collected from the Keratograph K5 and Haag-Streit slitlamp. Six investigators graded the images with either a 0.1 or 0.5 unit scaling using a 0-4 Efron grading scale. Three of the investigators also imported the images into the AOS ® Anterior software and graded them objectively. All measurement techniques were assessed for repeatability and comparability to each other.Results: Mean hyperaemia with the objective system (1.1 ± 0.7) was significantly less than the subjective grading (2.0 ± 0.8) (P < 0.001). Both inter- and intra-subject repeatability of the objective system (0.15) was better than the subjective methods (1.70).Conclusion: The results showed excellent repeatability of the AOS ® Anterior objective conjunctival hyperaemia grading software, although they were not found to be interchangeable with subjective scores. This system has value in monitoring levels of hyperaemia in contact lens wearers and patients in clinical care and research trials.
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Affiliation(s)
- Maria K Walker
- College of Optometry, University of Houston, Houston, TX, USA
| | - Erin S Tomiyama
- College of Optometry, University of Houston, Houston, TX, USA
| | | | | | - Anita Ticak
- College of Optometry, University of Houston, Houston, TX, USA
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Efron N. Putting vital stains in context. Clin Exp Optom 2021; 96:400-21. [DOI: 10.1111/j.1444-0938.2012.00802.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 06/17/2012] [Accepted: 06/19/2012] [Indexed: 11/30/2022] Open
Affiliation(s)
- Nathan Efron
- Institute of Health and Biomedical Innovation, and School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Queensland, Australia,
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Wolffsohn JS, Dumbleton K, Huntjens B, Kandel H, Koh S, Kunnen CME, Nagra M, Pult H, Sulley AL, Vianya-Estopa M, Walsh K, Wong S, Stapleton F. CLEAR - Evidence-based contact lens practice. Cont Lens Anterior Eye 2021; 44:368-397. [PMID: 33775383 DOI: 10.1016/j.clae.2021.02.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 12/15/2022]
Abstract
Evidence-based contact lens -->practice involves finding, appraising and applying research findings as the basis for patient management decisions. These decisions should be informed by the strength of the research study designs that address the question, as well as by the experience of the practitioner and the preferences and environment of the patient. This reports reviews and summarises the published research evidence that is available to inform soft and rigid contact lens history and symptoms taking, anterior eye health examination (including the optimised use of ophthalmic dyes, grading scales, imaging techniques and lid eversion), considerations for contact lens selection (including the ocular surface measurements required to select the most appropriate lens parameter, lens modality and material selection), evaluation of lens fit, prescribing (teaching self-application and removal, adaptation, care regimen and cleaning instructions, as well as -->minimising risks of lens wear through encouraging compliance) and an aftercare routine.
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Affiliation(s)
| | - Kathy Dumbleton
- School of Optometry, University of California, Berkeley, CA, USA
| | - Byki Huntjens
- Division of Optometry and Visual Sciences at City, University of London, London, UK
| | - Himal Kandel
- Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Shizuka Koh
- Department of Innovative Visual Science, Osaka University Graduate School of Medicine, Japan
| | | | - Manbir Nagra
- Vision and Eye Research Institute, ARU, Cambridge, UK
| | - Heiko Pult
- Optometry and Vision Research, Weinheim, Germany
| | | | - Marta Vianya-Estopa
- Department of Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Karen Walsh
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Stephanie Wong
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW Sydney, Australia
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Vianya-Estopa M, Nagra M, Cochrane A, Retallic N, Dunning D, Terry L, Lloyd A, Wolffsohn JS, Alderson A, Mouat G, McDonnell C, Murphy O, Huntjens B, Mayhem M, Martin E, Sweeney L, Evans K, Naroo S, Conway R, Simo L, Maldonado-Codina C, Mallon C, Underwood J, Trivedy K, Joshi M. Optimising subjective anterior eye grading precision. Cont Lens Anterior Eye 2020; 43:489-492. [DOI: 10.1016/j.clae.2020.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 03/11/2020] [Accepted: 03/11/2020] [Indexed: 10/24/2022]
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Yoo YS, Kim DY, Byun YS, Ji Q, Chung IK, Whang WJ, Park MR, Kim HS, Na KS, Joo CK, Yoon G. Impact of peripheral optical properties induced by orthokeratology lens use on myopia progression. Heliyon 2020; 6:e03642. [PMID: 32274428 PMCID: PMC7132157 DOI: 10.1016/j.heliyon.2020.e03642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 01/22/2020] [Accepted: 03/18/2020] [Indexed: 11/18/2022] Open
Abstract
The objective of the present retrospective comparative cohort study was to compare the impact of wearing glasses versus an orthokeratology (Ortho-K) lens on peripheral optical properties and myopia progression in a population of South Korean children. Participants included children with myopia, between 8 and 12 years of age (n = 22 eyes), and divided into two groups: those who used glasses (Group I, n = 9) and those who used an Ortho-K lens (Group II, n = 13). Myopia progression over one year was quantified by changes in the central axial length of the eye. Keratometry and corneal aberrations on both the anterior and posterior surfaces of the eye were obtained using a Scheimpflug camera. A custom-developed Shack-Hartmann aberrometer was also used to measure peripheral aberrations across the horizontal visual field, up to 30°, and along the nasal-temporal meridian in 10-degree steps. Central axial elongation was larger in Group I (0.59 ± 0.21 mm) than in Group II (0.34 ± 0.18 mm) (P = .01). Relative peripheral spherical refractions at 10 and 20° nasally and at 10° temporally (P = 0.04, 0.049, and 0.042, respectively) relative to the fovea were positively correlated with central axial elongation in Group II. Group II exhibited an increase in peripheral ocular high order aberrations, such as horizontal coma and asymmetric trefoil. The use of Ortho-K lenses was found to slow the rate of central axis elongation in children with myopia. This effect might be related to an increase in both peripheral spherical refraction and peripheral ocular higher order aberrations with Ortho-K lens use.
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Affiliation(s)
- Young-Sik Yoo
- Department of Ophthalmology, College of Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, 271, Cheonbo-ro, Uijeongbu-si, Gyeonggi-do, South Korea
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, 135-710, Seoul, South Korea
| | - Dae Yu Kim
- Electrical Engineering, College of Engineering, Inha University, 100, Inha-ro, Michuhol-gu, Incheon, South Korea
| | - Yong-Soo Byun
- Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, South Korea
| | - Qiuzhi Ji
- Flaum Eye Institute, The Institute of Optics, Center for Visual Science, University of Rochester, 601 Elmwood Ave., Box 314, 14642, Rochester, New York, USA
| | - In-Kwon Chung
- Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, 170, Juhwa-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do, South Korea
| | - Woong-Joo Whang
- Department of Ophthalmology, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, 07345, Seoul, South Korea
| | - Mi Ra Park
- Department of Ophthalmology, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, 07345, Seoul, South Korea
| | - Hyun-Seung Kim
- Department of Ophthalmology and Visual Science, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, South Korea
| | - Kyung-Sun Na
- Department of Ophthalmology, College of Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, 10 63-ro, Yeongdeungpo-gu, 07345, Seoul, South Korea
- Corresponding author.
| | - Choun-Ki Joo
- CK St. Mary's Eye Center, 563, Gangnam-daero, Seocho-gu, Seoul, South Korea
| | - Geunyoung Yoon
- Flaum Eye Institute, The Institute of Optics, Center for Visual Science, University of Rochester, 601 Elmwood Ave., Box 314, 14642, Rochester, New York, USA
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Huntjens B, Basi M, Nagra M. Evaluating a new objective grading software for conjunctival hyperaemia. Cont Lens Anterior Eye 2020; 43:137-143. [DOI: 10.1016/j.clae.2019.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 07/03/2019] [Accepted: 07/13/2019] [Indexed: 11/29/2022]
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Cardona G, Esterich N. Awareness of treatment: A source of bias in subjective grading of ocular complications. PLoS One 2019; 14:e0226960. [PMID: 31877190 PMCID: PMC6932789 DOI: 10.1371/journal.pone.0226960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 12/10/2019] [Indexed: 11/22/2022] Open
Abstract
PURPOSE Bias has been described as one important obstacle in scientific research. The aim of this study was to explore "awareness of treatment" as a possible source of bias in subjective grading of ocular complications. METHODS Thirty subjects with similar, basic experience with grading scales participated in the study. The Efron grading scales were used to grade 24 images of three different ocular conditions (eight images each of bulbar hyperaemia, limbal vascularization and corneal staining). Three consecutive, two weeks apart, grading sessions were scheduled, in which the same images were graded, although in the third session images were deceptively labelled as either "treated" or "untreated". Grading results from the first and second sessions were compared to determine grading reliability and discrepancies with the third session informed of grading bias originating from "awareness of treatment". RESULTS Moderate to good test-retest reliability was found for all conditions, with median intraclass correlation values of 0.80 (0.62-0.84) for bulbar hyperaemia, 0.68 (0.65-0.77) for limbal vascularization and 0.68 (0.66-0.74) for corneal staining. Grading values from the first and third sessions evidenced negative and positive systematic errors (bias) for "treated" and "untreated" conditions, respectively. Statistically significant differences were found between the average grading discrepancies of session 1 and session 2 and those of session 1 and session 3 (all p<0.001). CONCLUSIONS "Awareness of treatment" may be considered a source of bias of subjective grading of ocular complications, although the actual effect of bias is unlikely to be of clinical significance.
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Affiliation(s)
- Genis Cardona
- Optics and Optometry Department, Universitat Politècnica de Catalunya, Terrassa, Spain
| | - Noelia Esterich
- Optics and Optometry Department, Universitat Politècnica de Catalunya, Terrassa, Spain
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Kunnen C, Heunen M, Mertz C, Chalmers R, Soeters N. Comparison of white and blue light assessment of the upper and lower palpebral conjunctiva. Cont Lens Anterior Eye 2018; 41:473-481. [DOI: 10.1016/j.clae.2018.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 08/13/2018] [Accepted: 08/13/2018] [Indexed: 10/28/2022]
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Romano V, Steger B, Brunner M, Kaye A, Zheng Y, Willoughby CE, Kaye SB. Detecting Change in Conjunctival Hyperemia Using a Pixel Densitometry Index. Ocul Immunol Inflamm 2017; 27:276-281. [DOI: 10.1080/09273948.2017.1387276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Vito Romano
- Department of Corneal and External Eye Diseases, St. Paul’s Eye Unit, The Royal Liverpool University Hospital, Liverpool, UK
| | - Bernhard Steger
- Department of Ophthalmology, Medical University of Innsbruck, Innsbruck, Austria
| | - Matthias Brunner
- Department of Corneal and External Eye Diseases, St. Paul’s Eye Unit, The Royal Liverpool University Hospital, Liverpool, UK
| | - Abigail Kaye
- Department of Ophthalmology, Worthing Hospital, Worthing, UK
| | - Yalin Zheng
- Department of Eye and Vision Science, University of Liverpool, Liverpool, UK
| | - Colin E. Willoughby
- Department of Corneal and External Eye Diseases, St. Paul’s Eye Unit, The Royal Liverpool University Hospital, Liverpool, UK
| | - Stephen B. Kaye
- Department of Corneal and External Eye Diseases, St. Paul’s Eye Unit, The Royal Liverpool University Hospital, Liverpool, UK
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Lyu B, Hwang KY, Kim SY, Kim SY, Na KS. Effectiveness of Toric Orthokeratology in the Treatment of Patients with Combined Myopia and Astigmatism. KOREAN JOURNAL OF OPHTHALMOLOGY 2016; 30:434-442. [PMID: 27980362 PMCID: PMC5156617 DOI: 10.3341/kjo.2016.30.6.434] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The purpose of this multi-institute, single-group clinical trial was to evaluate the effectiveness and safety of toric orthokeratology lenses for the treatment of patients with combined myopia and astigmatism. METHODS A total of 44 patients were included in this clinical trial. The patients ranged in age from 7 to 49 years, with myopia of -0.75 to -6.0 diopters (D) and astigmatism of 1.25 to 4.0 D. After excluding 21 subjects, 23 subjects (39 eyes) were analyzed after toric orthokeratology lens use. The subjects underwent ophthalmologic examination after 1 day and 1, 2, 3, and 4 weeks of wearing overnight toric orthokeratology lenses. RESULTS A total of 19 subjects (31 eyes) completed the trial after five subjects (eight eyes) dropped out. In the patients who completed the study by wearing lenses for 4 weeks, the myopic refractive error decreased significantly by 2.60 ± 2.21 D (p < 0.001), from -3.65 ± 1.62 to -1.05 ± 1.64 D. The astigmatic refractive error were also significantly decreased by 0.63 ± 0.98 D (p = 0.001), from 2.07 ± 0.83 to 1.44 ± 0.99 D. The mean uncorrected and corrected visual acuities before wearing the lenses were 2.14 ± 0.80 logarithm of the logMAR (logMAR) and 0.05 ± 0.13 logMAR, respectively, which changed to 0.12 ± 0.30 logarithm of the logMAR (p < 0.001) and 0.01 ± 0.04 logMAR (p = 0.156) after 4 weeks. No serious adverse reactions were reported during the clinical trial. CONCLUSIONS Our results suggest that toric orthokeratology is an effective and safe treatment for correcting visual acuity in patients with combined myopia and astigmatism.
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Affiliation(s)
- Byul Lyu
- Department of Ophthalmology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Kyu Yeon Hwang
- Department of Ophthalmology, Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon, Korea
| | - Sun Young Kim
- Department of Ophthalmology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Su Young Kim
- Department of Ophthalmology, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Kyung Sun Na
- Department of Ophthalmology, The Catholic University of Korea College of Medicine, Seoul, Korea
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Deng Z, Wang J, Jiang H, Fadli Z, Liu C, Tan J, Zhou J. Lid Wiper Microvascular Responses as an Indicator of Contact Lens Discomfort. Am J Ophthalmol 2016; 170:197-205. [PMID: 27542928 DOI: 10.1016/j.ajo.2016.08.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 08/04/2016] [Accepted: 08/05/2016] [Indexed: 01/15/2023]
Abstract
PURPOSE To analyze quantitatively the alterations in the microvascular network of the upper tarsal conjunctiva, lid wiper, and bulbar conjunctiva relative to ocular discomfort after contact lens wear. DESIGN A prospective, crossover clinical study. METHODS Functional slit-lamp biomicroscopy was used to image the microvascular network of the upper tarsal conjunctiva, lid wiper, and bulbar conjunctiva. The microvascular network was automatically segmented, and fractal analyses were performed to yield the fractal dimension (Dbox) that represented vessel density. Sixteen healthy subjects (9 female and 7 male) with an average age of 35.5 ± 6.7 years (mean ± standard deviation) were recruited. The right eye was imaged at 9 AM and 3 PM at the first visit (day 1) when the subject was not wearing contact lenses. During the second visit (day 2), the right eye was fitted with a contact lens for 6 hours. Microvascular imaging was performed before (at 9 AM) and after lens wear (at 3 PM). Ocular comfort was rated using a 50-point visual analog scale before and after 6 hours of lens wear, and its relationships with microvascular parameters were analyzed. RESULTS There were no significant differences in Dbox among the upper tarsal conjunctiva, lid wiper, and bulbar conjunctiva among the measurements at 9 AM (day 1 and day 2) and 3 PM (day 1) when the subjects were not wearing the lenses (P > .05), whereas after 6 hours of lens wear, the microvascular network densities were increased in all 3 of these locations. Dbox of the lid wiper increased from 1.411 ± 0.116 to 1.548 ± 0.079 after 6 hours of contact lens wear (P < .01). Dbox of the tarsal conjunctiva was 1.731 ± 0.026 at baseline and increased to 1.740 ± 0.030 (P < .05). Dbox of the bulbar conjunctiva increased from 1.587 ± 0.059 to 1.632 ± 0.060 (P < .001). The decrease in ocular discomfort was strongly related to the Dbox change in the lid wiper (r = 0.61, P < .05). There were no correlations between the changes of ocular comfort and the microvascular network densities of either the tarsal or bulbar conjunctivas (P > .05). CONCLUSIONS This study is the first to show that the microvascular network of the lid wiper can be quantitatively analyzed in contact lens wearers. The microvascular responses of the lid wiper were significantly correlated with contact lens discomfort.
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Benayoun Y, Rosenberg R, Casse G, Dallaudière B, Robert PY. [Imaging and quantification of corneal neovascularization]. J Fr Ophtalmol 2013; 36:693-703. [PMID: 23969009 DOI: 10.1016/j.jfo.2013.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Revised: 04/09/2013] [Accepted: 04/23/2013] [Indexed: 11/27/2022]
Abstract
Corneal neovascularization is defined as the invasion of vessels into the normally avascular clear corneal stroma, secondary to acute or chronic tissue injury. In addition to decreasing visual acuity, vascularity introduces circulating immune cells, reducing corneal immune privilege and the graft survival of subsequent keratoplasty. Thus, reducing neovascularization has become a recent therapeutic target in order to increase the success of corneal transplantation. Comparing the effects of antiangiogenic drugs assumes that we are able to quantify corneal neovascularization before and after treatment. In the first part of this literature review, we present the various methods to document neovessels (color photos, fluorescein and indocyanine green anterior segment angiography, in vivo confocal microscopy). Next, we report methods to classify and quantify corneal neovascularization.
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Affiliation(s)
- Y Benayoun
- Service d'ophtalmologie, hôpital Dupuytren, CHU de Limoges, 2, avenue Martin-Luther-King, 87042 Limoges cedex 1, France; Service d'ophtalmologie, clinique François-Chénieux, 18, rue du Général-Catroux, 87039 Limoges cedex, France.
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