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Wang D, Chang Y, Nan W, Zhang Y. Comparative analysis of corneal parameters in simple myopic anisometropia using Scheimpflug technology. Front Bioeng Biotechnol 2024; 12:1366408. [PMID: 38840667 PMCID: PMC11150699 DOI: 10.3389/fbioe.2024.1366408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Purpose This study aims to investigate the differences in binocular corneal parameters and their interrelation with binocular biometric parameters asymmetry in patients with simple myopic anisometropia, thereby elucidating the influence of myopia process on various corneal parameters. Methods In this cross-sectional study, 65 patients with anisometropia in monocular myopia were included. They were divided into low anisometropia group: 3.00D<Δ spherical equivalent (SE)≤-1.00D (Δ represents the difference between the two eyes, i.e., myopic data minus emmetropic data) and high anisometropia group: ΔSE ≤ -3.00D. Corneal and ocular biometric parameters were measured using Pentacam, Corvis ST, and IOL Master 700. Statistical analyses focused on the binocular corneal parameters asymmetry, using the contralateral emmetropia as a control. Results The mean age of participants was 18.5 ± 1.3 years, with the average SE for myopia and emmetropia being -2.93 ± 1.09D and -0.16 ± 0.41D, respectively. The central corneal thickness (CCT), flat keratometry (Kf), keratometry astigmatism (Ka), total corneal aberration (6 mm) (TOA), surface variance index (ISV), vertical asymmetry index (IVA), stress-strain index (SSI), and first applanation stiffness parameter (SPA1) and ambrosia relational thickness-horizontal (ARTh) showed significant differences between anisometropic fellow eyes (p < 0.05). There were significant differences in ΔIVA, Δ the difference between the mean refractive power of the inferior and superior corneas (I-S), Δ deviation value of Belin/Ambrósio enhanced ectasia display (BAD-D), Δ deformation amplitude ratio max (2 mm) (DAR)and Δ tomographic biomechanical index (TBI) (p < 0.05) in two groups. Asymmetry of corneal parameters was correlated with asymmetry of ocular biometric parameters. Anisometropia (ΔSE) was positively correlated with ΔIVA (r = 0.255, p = 0.040), ΔBAD-D (r = 0.360, p = 0.006), and ΔSSI (r = 0.276, p = 0.039) and negatively correlated with ΔDAR (r = -0.329, p = 0.013) in multiple regression analysis. Δ mean keratometry (Km), Δ anterior chamber depth (ACD), and Δ biomechanically corrected intraocular pressure (bIOP) were also associated with binocular corneal differences. Conclusion Compared to contralateral emmetropia, myopic eyes have thinner corneas and smaller corneal astigmatism. Myopic corneas exhibit relatively more regular surface morphology but are more susceptible to deformation and possess marginally inferior biomechanical properties. In addition, there is a certain correlation between anisometropia and corneal parameter asymmetry, which would be instrumental in predicting the development of myopia.
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Affiliation(s)
- Di Wang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Yue Chang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
| | - Weijin Nan
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Zhang
- Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Van L, Bennett S, Nicholas SE, Hjortdal J, McKay TB, Karamichos D. Prospective Observational Study Evaluating Systemic Hormones and Corneal Crosslinking Effects in Keratoconus. OPHTHALMOLOGY SCIENCE 2024; 4:100364. [PMID: 37868794 PMCID: PMC10585634 DOI: 10.1016/j.xops.2023.100364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 10/24/2023]
Abstract
Purpose To evaluate associations between hormone levels and corneal parameters in patients with keratoconus (KC), before and after photooxidative corneal collagen crosslinking (CXL). Design Prospective, observational cohort study. Participants Twenty-eight patients with KC who were scheduled for CXL at Aarhus University Hospital in Denmark. Methods Androgen (dehydroepiandrosterone sulfate [DHEA-S]) and estrogen (estrone and estriol) plasma levels were measured and clinical assessments were performed before CXL and 2 to 3 months post-CXL, comparing the CXL eye with the control eye from the same participant. Main Outcome Measures Associations between hormone levels and maximum corneal curvature (Kmax) and minimum central corneal thickness (CCtmin) before and after CXL. Results Corneal collagen crosslinking was associated with a 2% reduction in Kmax values in the CXL eye, post-CXL, from baseline (median, 56.8 diopters [D]; 95% confidence interval [CI], 50.4-60.3) to the second visit (55.7 D; 95% CI, 50.4-58.8; P < 0.001). Systemic DHEA-S levels were 5 to 6 orders of magnitude higher than estriol or estrone concentrations in plasma. Importantly, estriol levels, rather than DHEA-S or estrone levels, were more closely correlated with Kmax before CXL (Spearman's r = 0.55, P = 0.01). Post-CXL Kmax and CCtmin were not associated with DHEA-S, estrone, or estriol plasma levels at the same timepoint. Conclusions This study provides supporting evidence based on a KC clinical population that systemic estrogen levels may influence corneal parameters (curvature and thickness) pre-CXL. Further studies evaluating the interplay between the therapeutic benefits of CXL and systemic hormone distributions are needed to determine if perturbation of the local corneal microenvironment influences endocrine function. Financial Disclosures The authors have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Lyly Van
- Department of Ophthalmology, Dean McGee Eye Institute, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Sashia Bennett
- Department of Ophthalmology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Sarah E. Nicholas
- North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, Texas
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, Fort Worth, Texas
| | - Jesper Hjortdal
- Department of Ophthalmology, Aarhus University Hospital, 8200 Aarhus N, Denmark
| | - Tina B. McKay
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Dimitrios Karamichos
- North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, Texas
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, Fort Worth, Texas
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas
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Kelly DS, Sabharwal S, Ramsey DJ, Morkin MI. The effects of female sex hormones on the human cornea across a woman's life cycle. BMC Ophthalmol 2023; 23:358. [PMID: 37587412 PMCID: PMC10428535 DOI: 10.1186/s12886-023-03085-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 07/14/2023] [Indexed: 08/18/2023] Open
Abstract
The cornea is a hormone-responsive tissue that responds to changing levels of female sex hormones. This review focuses on the structural and functional changes in the human cornea associated with the hormonal milestones of menarche, pregnancy, and menopause, as well as consequences stemming from the use of exogenous sex hormones for fertility control and replacement. Articles were identified by searching PubMed without language or region restrictions. The primary outcomes evaluated were changes in central corneal thickness (CCT), intraocular pressure (IOP), and quality of the ocular tear film. The potential impact of hormone-associated changes on the diagnosis and surgical management of common eye diseases, as well as the potential use of sex hormones as therapeutic agents is also considered. Understanding the physiological effects of female sex hormones on the cornea is important because that knowledge can shape the management decisions physicians and women face about ocular health across their life stages.
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Affiliation(s)
- Donel S Kelly
- United States Naval Hospital Okinawa, Ginowan, Japan
| | | | - David J Ramsey
- Department of Ophthalmology, Lahey Hospital & Medical Center, Burlington, MA, 01805, USA
- Department of Ophthalmology, Tufts University School of Medicine, 800 Washington St, Boston, MA, 02111, USA
| | - Melina I Morkin
- Department of Ophthalmology, Tufts University School of Medicine, 800 Washington St, Boston, MA, 02111, USA.
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Hashemi H, Khabazkhoob M, Fayaz M, Emamian MH, Yekta A, Iribarren R, Fotouhi A. Refractive Errors and Their Associated Factors in Schoolchildren: A Structural Equation Modeling. Ophthalmic Epidemiol 2023; 30:46-56. [PMID: 35333680 DOI: 10.1080/09286586.2022.2048397] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To determine the prevalence of myopia and hyperopia in Shahroud schoolchildren and their risk factors. METHODS Optometric examinations including the measurement of uncorrected and corrected visual acuity as well as non-cycloplegic and cycloplegic refraction using retinoscopy were done for students. Generalized Structural Equation Modeling (GSEM) was used to determine direct and indirect effects of independent variables on myopia and hyperopia. RESULTS The data of 5581 students with a mean age of 9.24 ± 1.7 years were used in this study. The prevalence of myopia was 5.0% (95%CI: 4.3-5.7) and the prevalence of hyperopia was 4.8% (95%CI: 4.0 - 5.5) in all schoolchildren. According to the GSEM results, the odds of myopia in rural areas were 0.55 compared to urban areas. A one-unit increase in the ocular AL increased the odds of myopia by 4.91 times. The interaction of sex and age on myopia was significant such that in girls, the odds of myopia increased by 20% for every one-year increase in age while no significant change was seen in boys. A one-unit increase in the ocular AL decreased the odds of hyperopia by 0.49 times. Moreover, the interaction of outdoor activity hours and sex on the prevalence of hyperopia was significant such that increased outdoor activity reduced the odds of hyperopia in girls while no significant correlation was found in boys. CONCLUSION Myopia and hyperopia had moderate prevalence. Axial Length had the largest direct association on myopia and hyperopia. Age and outdoor activity had weak associations on refractive errors.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Fayaz
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Balıkçı AT, Ulutaş HG, Özgen GA. Evaluation of meibomian gland morphology and anterior segment parameters by Sirius topography systems in polycystic ovary syndrome. Indian J Ophthalmol 2022; 70:2922-2928. [PMID: 35918944 DOI: 10.4103/ijo.ijo_6_22] [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] [Indexed: 12/15/2022] Open
Abstract
Purpose To compare findings in specular microscopy, corneal topography, and noncontact meibography in polycystic ovary syndrome (PCOS) patients with healthy controls. Methods A total of 40 women with PCOS and 32 healthy controls were enrolled in the study. Schirmer's test, Ocular Surface Disease Index (OSDI), noninvasive tear break-up time (NITBUT), the mean keratometry (Km), maximum keratometry (Kmax), central (CCT), thinnest (TCT) and apical (ACT) corneal thicknesses, meibomian gland (MG) loss, meiboscores, morphology of MGs, endothelial cell density (ECD), coefficient of variation (CV), and percentage of hexagonal cells (PHEX) were analyzed. Correlations between anti-Mullerian hormone (AMH) and sex hormones and the findings of PCOS patients were evaluated. Results Mean OSDI score, intraocular pressure, Km and Kmax values, the mean MG loss of upper and lower eyelids, lower eyelid meiboscore, and degree of morphological abnormalities of MGs were higher in cases with PCOS than healthy controls. There were no significant differences between groups in Schirmer results, first and average NITBUT, mean values of TCT, ACT, CCT, ECD, CV, and PHEX (P > 0.05, for all). There were correlations between plasma AMH level and Kmax, back Km and PHEX, and between estradiol (E2) and PHEX; there were negative correlations between E2 and total MG loss and CV and between total testosterone and ACT. Conclusion Loss and morphological deterioration of the MGs are observed in PCOS patients, even if the tear parameters are not impaired yet. In eyes with PCOS, keratometry values become steeper in proportion to AMH levels. The PCOS patients should be followed carefully for the development of corneal ectasia.
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Affiliation(s)
- Ayşe Tüfekçi Balıkçı
- Department of Ophthalmology, University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey
| | - Hafize Gökben Ulutaş
- Department of Ophthalmology, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Gülten Aslan Özgen
- Department of Gynecology and Obstetrics, University of Health Sciences, Bursa Yüksek Ihtisas Training and Research Hospital, Bursa, Turkey
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McKay TB, Priyadarsini S, Karamichos D. Sex Hormones, Growth Hormone, and the Cornea. Cells 2022; 11:cells11020224. [PMID: 35053340 PMCID: PMC8773647 DOI: 10.3390/cells11020224] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/03/2022] [Accepted: 01/07/2022] [Indexed: 12/31/2022] Open
Abstract
The growth and maintenance of nearly every tissue in the body is influenced by systemic hormones during embryonic development through puberty and into adulthood. Of the ~130 different hormones expressed in the human body, steroid hormones and peptide hormones are highly abundant in circulation and are known to regulate anabolic processes and wound healing in a tissue-dependent manner. Of interest, differential levels of sex hormones have been associated with ocular pathologies, including dry eye disease and keratoconus. In this review, we discuss key studies that have revealed a role for androgens and estrogens in the cornea with focus on ocular surface homeostasis, wound healing, and stromal thickness. We also review studies of human growth hormone and insulin growth factor-1 in influencing ocular growth and epithelial regeneration. While it is unclear if endogenous hormones contribute to differential corneal wound healing in common animal models, the abundance of evidence suggests that systemic hormone levels, as a function of age, should be considered as an experimental variable in studies of corneal health and disease.
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Affiliation(s)
- Tina B. McKay
- Department of Cell Biology, University of Oklahoma Health Sciences, Oklahoma City, OK 73104, USA;
| | | | - Dimitrios Karamichos
- North Texas Eye Research Institute, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- Department of Pharmaceutical Sciences, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
- Correspondence: ; Tel.: +1-817-735-2101
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