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Feo A, Vinciguerra R, Antropoli A, Barone G, Criscuolo D, Vinciguerra P, Romano V, Romano MR. Pachychoroid pigment epitheliopathy in keratoconic eyes. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06612-9. [PMID: 39212800 DOI: 10.1007/s00417-024-06612-9] [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: 02/13/2024] [Revised: 07/18/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024] Open
Abstract
PURPOSE To report the association between keratoconus (KC) and pachychoroid pigment epitheliopathy (PPE). As secondary outcome, we explored the relation between subfoveal choroidal thickness (SFCT) and topometric indexes. METHODS Retrospective, observational, cross-sectional, case-control study. Multicentric study including patients with KC and healthy controls. Each subject underwent a complete ophthalmological visit, Placido-based corneal topography, Scheimpflug corneal tomography and spectral-domain OCT (SD-OCT) with the enhanced depth imaging (EDI) mode on. Linear mixed models (LMM) were employed for comparison between groups, and to examine the impact of different topometric factors on SFCT. KC stages were defined according to Belin grading. RESULTS Overall, 56 eyes from 35 KC patients and 52 eyes from 27 healthy, age- and axial length-matched control subjects were included in the study. PPE was found in 10 (17.9%) eyes from 8 KC patients, whereas was absent in all healthy controls. SFCT was statistically significantly higher in keratoconic eyes (median: 390 µm; interquartile range (IQR): 339 - 425 µm) compared to healthy eyes (median: 240 µm; IQR: 200 - 288 µm) (p < 0.001). SFCT did not differ across different KC stages and between keratoconic eyes with and without PPE. CONCLUSIONS PPE is a relatively frequent finding in eyes with KC, being present in about 1 out of 6 cases, regardless of disease stage. KEY MESSAGES What is known: Keratoconus (KC) is a corneal disorder commonly associated with other chorioretinal abnormalities. It is well known that keratoconic eyes display increased choroidal thickness, and the rare association between KC and central serous chorioretinopathy (CSC) has already been reported in the literature. WHAT IS NEW We identified an association between KC and pachychoroid pigment epitheliopathy (PPE), a precursor or forme fruste of pachychoroid diseases, such as CSC. PPE presence is independent from corneal parameters and is observed in about 1 out 6 KC eyes.
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Affiliation(s)
- Alessandro Feo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy.
| | | | - Alessio Antropoli
- Ophthalmology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gianmaria Barone
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy
| | - Daniele Criscuolo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy
| | - Paolo Vinciguerra
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy
| | - Vito Romano
- Opththalmic Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 15, 25123, Brescia, Italy
| | - Mario R Romano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072, Milan, Italy
- Department of Ophthalmology, Eye Unit Humanitas Gavazzeni-Castelli, Via Mazzini 11, Bergamo, Italy
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Leclaire MD, Storp JJ, Lahme L, Esser EL, Eter N, Alnawaiseh M. Reduced Retinal Blood Vessel Densities Measured by Optical Coherence Tomography Angiography in Keratoconus Patients Are Negatively Correlated with Keratoconus Severity. Diagnostics (Basel) 2024; 14:707. [PMID: 38611620 PMCID: PMC11011292 DOI: 10.3390/diagnostics14070707] [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: 02/24/2024] [Revised: 03/15/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
Keratoconus (KC) is the most common corneal ectasia. Optical coherence tomography angiography (OCT-A) is a relatively new non-invasive imaging technique that allows the visualization and quantification of retinal and choriocapillary blood vessels. The aim of this study is to assess retinal and choriocapillary vessel density (VD) differences between KC patients and healthy controls and to investigate correlations between VD and KC severity. Fifty-two eyes were included in this exploratory study: twenty-six eyes from 26 KC patients and twenty-six eyes from 26 age- and gender-matched healthy controls. All patients underwent Scheimpflug corneal topography with Pentacam, axis lengths measurement and optical coherence tomography angiography (OCT-A). The thinnest spot in corneal pachymetry, maximum K (Kmax) and KC severity indices from the Belin/Ambrósio enhanced ectasia display (BAD) were also assessed. There was a distinct reduction particularly in the retinal VD of the superficial capillary plexus (SCP). Correlation analyses showed strong and moderate negative correlations between the VD in the macular SCP and BAD KC scores and between the SCP VD and Kmax. There was no difference in retinal thickness between the KC and healthy controls. With this study, further evidence for altered VD measurements by OCT-A in KC patients is given. For the first time, we demonstrated negative correlations between BAD KC scores and retinal blood vessel alterations. A major limitation of the study is the relatively small sample size. Since an artefactual reduction of the quantitative OCT-A measurements due to irregular corneal topography in KC must be assumed, it remains to be investigated whether there are also actual changes in the retinal microcirculation in KC.
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Affiliation(s)
- Martin Dominik Leclaire
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Jens Julian Storp
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Larissa Lahme
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Eliane Luisa Esser
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Nicole Eter
- Department of Ophthalmology, University Medical Center Münster, 48149 Münster, Germany; (J.J.S.); (E.L.E.); (N.E.)
| | - Maged Alnawaiseh
- Department of Ophthalmology, Klinikum Bielefeld gem. GmbH, 33647 Bielefeld, Germany
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Sharif W, Elubous KA, Sharif Z, AlRyalat SA, Al Hawamdeh HE, Abu-Rumaileh MA, Khanfar A, Al Bdour MD, Ababneh OH. Association Between Keratoconus and Shoulder Dislocation: A Cross-Sectional Study. Cureus 2021; 13:e19279. [PMID: 34754705 PMCID: PMC8570123 DOI: 10.7759/cureus.19279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Few studies have highlighted the correlation between shoulder dislocation and keratoconus (KC). This study aimed to examine the association between KC and shoulder dislocation using patients with KC and matched controls. Methods This cross-sectional study was conducted at Jordan University Hospital. We included patients diagnosed with KC from Jordan University Hospital's Ophthalmology Department between 2015 and 2018. We also included age- and sex-matched controls recruited randomly from fitness centers and shopping malls. All participants had complete ophthalmic and orthopedic assessments. KC was diagnosed by clinical examination followed by Pentacam (Scheimpflug Images, Oculyzer, WaveLight, Alcon, USA) confirmation. Results A total of 238 patients, with a mean age of 29.53 (±11.20) years, were included in this study. They were 144 (60.5%) men and 94 (39.5%) women. Moreover, 120 (50.4%) had KC while 118 (49.6%) did not have KC. Only 11 (4.6%) patients had previous shoulder dislocation. We did not find a significant difference in the frequency of shoulder dislocation between patients with and without KC (p = 0.512). Conclusion This study provides further evidence on the lack of association between shoulder dislocation and KC, an association that was presumed due to shared collagen characteristics.
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Affiliation(s)
- Walid Sharif
- Department of Ophthalmology, Jordan University Hospital/The University of Jordan, Amman, JOR
| | - Khaled A Elubous
- Department of Ophthalmology, Jordan University Hospital/The University of Jordan, Amman, JOR
| | - Zuhair Sharif
- Department of Ophthalmology, Jordan University Hospital/The University of Jordan, Amman, JOR
| | - Saif Aldeen AlRyalat
- Department of Ophthalmology, Jordan University Hospital/The University of Jordan, Amman, JOR
| | - Hashem E Al Hawamdeh
- Department of Orthopaedics, Jordan University Hospital/The University of Jordan, Amman, JOR
| | | | - Aws Khanfar
- Department of Orthopaedics, Jordan University Hospital/The University of Jordan, Amman, JOR
| | - Muawyah D Al Bdour
- Department of Ophthalmology, Jordan University Hospital/The University of Jordan, Amman, JOR
| | - Osama H Ababneh
- Department of Ophthalmology, Jordan University Hospital/The University of Jordan, Amman, JOR
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Abdollahimajd F, Beheshti M, Moravvej H. Evaluation of the efficacy and safety of plasma exeresis in periorbital rejuvenation using the Reviscometer ®. J Cosmet Dermatol 2021; 21:2550-2558. [PMID: 34520602 DOI: 10.1111/jocd.14418] [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: 03/11/2021] [Revised: 06/25/2021] [Accepted: 08/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Periorbital rejuvenation is performed through various methods. Recently, plasma exeresis has been suggested for the treatment of dermatochalasis and periorbital wrinkles. AIMS To evaluate the clinical efficacy and safety of plasma exeresis in periorbital rejuvenation and palpebral laxity and assess its effectiveness using the Reviscometer® . PATIENTS/METHODS Fifty-six women with mild-to-severe dermatochalasis and periorbital wrinkles volunteered to participate in this clinical trial. They received plasma exeresis thrice at one-month intervals. The efficacy of the intervention was evaluated according to the Cutaneous Resonance Running Time (CRRT) value changes, photographic changes, patients' satisfaction, and clinical side effects. RESULTS This study showed significant clinical improvements in dermatochalasis and palpebral laxity after treatment compared with the baseline (p < 0.001). Most of the participants had relative satisfaction, and no significant or permanent side effects were observed. CONCLUSION The findings of this study suggest that plasma exeresis is a safe and effective nonsurgical method for periorbital rejuvenation. Furthermore, the procedure has no serious adverse effects if performed correctly and for the right patient.
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Affiliation(s)
- Fahimeh Abdollahimajd
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Clinical Research Development Unit of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Beheshti
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamideh Moravvej
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Clinical Research Development Unit of Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Chang Y, Weng S, Wang J, Tseng S, Wang J, Jan H, Ko S, Tsai W, Chen H, Liou C, Jan R. Association between keratoconus and the risk of adolescent- or adult-onset atopic dermatitis. Allergy 2020; 75:2946-2948. [PMID: 32289883 DOI: 10.1111/all.14320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/17/2020] [Accepted: 04/06/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Yuh‐Shin Chang
- Department of Ophthalmology Chi Mei Medical Center Tainan Taiwan
- Graduate Institute of Medical Science College of Health Science Chang Jung Christian University Tainan Taiwan
| | - Shih‐Feng Weng
- Department of Healthcare Administration and Medical Informatics Kaohsiung Medical University Kaohsiung Taiwan
| | - Jhi‐Joung Wang
- Department of Medical Research Chi Mei Medical Center Tainan Taiwan
- Department of Anesthesiology Chi Mei Medical Center Tainan Taiwan
- AI Biomed Center Southern Taiwan University of Science and Technology Tainan Taiwan
| | - Sung‐Huei Tseng
- Department of Ophthalmology Chi Mei Medical Center Tainan Taiwan
- Department of Ophthalmology National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
| | - Jiu‐Yao Wang
- Department of Pediatrics National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
| | - Han‐Yi Jan
- Graduate Institute of Medical Science College of Health Science Chang Jung Christian University Tainan Taiwan
| | - Shun‐Yao Ko
- Graduate Institute of Medical Science College of Health Science Chang Jung Christian University Tainan Taiwan
| | - Wen‐Hui Tsai
- Graduate Institute of Medical Science College of Health Science Chang Jung Christian University Tainan Taiwan
- Department of Pediatrics Chi Mei Medical Center Tainan Taiwan
| | - Hsien‐Yu Chen
- Department of Nursing Da‐Yeh University Changhua Taiwan
- Department of Pharmacy Chi Mei Medical Center Tainan Taiwan
| | - Cheng‐Wen Liou
- Department of Family Medicine Mackay Memorial Hospital Taipei Taiwan
| | - Ren‐Long Jan
- Graduate Institute of Medical Science College of Health Science Chang Jung Christian University Tainan Taiwan
- Department of Pediatrics Chi Mei Medical Center Liouying Tainan Taiwan
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Robati RM, Hamedani B, Namazi N, Niknejad N, Gheisari M. Efficacy of microneedling versus fractional Er:YAG laser in facial rejuvenation. J Cosmet Dermatol 2020; 19:1333-1340. [PMID: 32359018 DOI: 10.1111/jocd.13440] [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: 02/25/2020] [Revised: 03/31/2020] [Accepted: 04/08/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Microneedling and fractional lasers have been used in facial rejuvenation with acceptable results and low adverse effects. AIMS To compare the efficacy of microneedling with fractional Er:YAG in facial skin rejuvenation. PATIENTS/METHODS This study was planned as a split-face clinical trial. Volunteers were randomly allocated to receive three monthly treatments on each side of the face, one with fractional Er:YAG laser and one with microneedling. The assessments included investigating clinical outcomes by two blinded dermatologists accompanied by measuring skin biophysical characteristics including cutaneous resonance running time (CRRT) and transepidermal water loss (TEWL). Moreover, possible adverse effects, downtime, and patients' satisfaction were recorded at baseline, 1 month after each treatment, and 3 months after the last treatment session. The protocol was approved by the Iranian Registry of Clinical Trials (IRCT20160820029436N3). RESULTS Of the 32 selected volunteers, 24 subjects completed the study. The clinical assessment showed a significant improvement of the face appearance along with a significant reduction in dyschromia, and periorbital wrinkling (P-value < .05), with both procedures without any considerable difference between two methods. Moreover, the patients showed substantial satisfaction with both modalities with no statistically significant difference. Mean TEWL and CRRT values also decreased significantly in both groups with no considerable difference. The downtime was significantly shorter in the microneedling-treated side. There were no long-lasting or severe adverse effects after treatment with both methods. CONCLUSION Microneedling and fractional Er:YAG laser have comparable efficacy in facial rejuvenation, but little downtime of the former makes it preferable for many patients.
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Affiliation(s)
- Reza M Robati
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Dermatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behnaz Hamedani
- Department of Dermatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nastaran Namazi
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Dermatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasim Niknejad
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Gheisari
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Department of Dermatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Dadkhahfar S, Fadakar K, Robati RM. Efficacy and safety of long pulse Nd:YAG laser versus fractional erbium:YAG laser in the treatment of facial skin wrinkles. Lasers Med Sci 2018; 34:457-464. [PMID: 30117052 DOI: 10.1007/s10103-018-2614-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 08/07/2018] [Indexed: 12/28/2022]
Abstract
Fractional lasers such erbium:YAG (Er:YAG) are among popular options for facial rejuvenation. Lasers with infrared wavelength ranges such as long pulse Nd:YAG have been used in nonablative rejuvenation of skin with variable outcomes. In this study, we plan to compare safety and efficacy of fractional Er:YAG and long pulse Nd:YAG for facial rejuvenation applying objective and subjective measurements. Twenty-five patients with Glogau photo aging scale of II to IV were recruited in this randomized face-split double-blind controlled trial. Individuals received three monthly treatments on two sides of the face; one side was treated by fractional Er:YAG laser and the other side by long pulse Nd:YAG laser. Outcomes were evaluated by two blinded dermatologists, patient satisfaction reports and objective measurements of cutaneous resonance running time (CRRT). Both modalities significantly improved periorbital wrinkling, nasolabial folds, dyschromia and skin laxity, and sagging of jowls (p value < 0.05), with no noticeable difference between two lasers. Mean CRRT values decreased significantly after treatment with both lasers. The downtime was significantly lower for the Nd:YAG-treated side. Fractional Er:YAG laser and long pulse Nd:YAG has comparable effects in facial rejuvenation but little to no downtime of the latter makes it popular for many patients. ClinicalTrials.gov Identifier: IRCT2015120320468N3.
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Affiliation(s)
- Sahar Dadkhahfar
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kaveh Fadakar
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza M Robati
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Robati RM, Asadi E. Efficacy and safety of fractional CO 2 laser versus fractional Er:YAG laser in the treatment of facial skin wrinkles. Lasers Med Sci 2016; 32:283-289. [PMID: 27885522 DOI: 10.1007/s10103-016-2111-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 11/14/2016] [Indexed: 11/25/2022]
Abstract
Ablative fractional lasers were introduced for treating facial rhytides. Few studies have compared fractional CO2 and Er:YAG lasers on cutaneous photodamages by a split trial. The aim of the present study was to compare these modalities in a randomized controlled double-blind split-face design with multiple sessions and larger sample size compared to previous studies done before. Forty patients with facial wrinkles were enrolled. Patients were randomly assigned to receive three monthly treatments on each side of the face, one with a fractional CO2 and one with a fractional Er:YAG laser. The evaluations included investigating clinical outcome determined by two independent dermatologists not enrolled in the treatment along with measuring skin biomechanical property of cheeks using a sensitive biometrologic device with the assessment of cutaneous resonance running time (CRRT). Moreover, possible side effects and patients' satisfaction have been recorded at baseline, 1 month after each treatment, and 3 months after the last treatment session. Clinical assessment showed both modalities significantly reduce facial wrinkles (p value < 0.05), with no appreciable difference between two lasers. Mean CRRT values also decreased significantly after the laser treatment compared to the baseline in both laser groups. There was no serious long-standing adverse effect after both laser treatments, but the discomfort was more pronounced by the participants after CO2 laser treatment. According to the present study, both fractional CO2 and fractional Er:YAG lasers show considerable clinical improvement of facial skin wrinkles with no serious adverse effects, but post-treatment discomfort seems to be lower with Er:YAG laser.
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Affiliation(s)
- Reza M Robati
- Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Elmira Asadi
- Department of Dermatology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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