1
|
Dogan L, Arslan GD. Evaluation of the Tear Meniscus Using Optical Coherence Tomography in Meibomian Gland Dysfunction. Ocul Immunol Inflamm 2023; 31:1785-1791. [PMID: 36043889 DOI: 10.1080/09273948.2022.2113802] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 08/11/2022] [Indexed: 10/14/2022]
Abstract
INTRODUCTION This study aimed to evaluate tear meniscus parameters in meibomian gland dysfunction (MGD) using optical coherence tomography and ImageJ software. METHODS We enrolled 66 eyes of 66 participants and measured tear meniscus parameters, including height, depth, turbidity, and percentage area occupied by particles (PAOP) in the meniscus in the MGD and control groups. RESULTS Tear meniscus turbidity and PAOP were significantly higher in the MGD group, but tear meniscus height (TMH) and depth (TMD) did not differ significantly between groups. Tear meniscus turbidity and PAOP were positively correlated with each other and ocular surface parameters, including OSDI and ocular surface staining scores. CONCLUSION Tear meniscus turbidity and PAOP were higher in the MGD group than in the control group; therefore, they can be used as significant non-invasive parameters in the prediction of MGD. TMH and TMD did not differ significantly between groups.
Collapse
Affiliation(s)
- Levent Dogan
- Department of Ophthalmology, Tatvan State Hospital, Bitlis, Turkey
| | | |
Collapse
|
2
|
Amano S, Shimazaki J, Yokoi N, Hori Y, Arita R. Meibomian Gland Dysfunction Clinical Practice Guidelines. Jpn J Ophthalmol 2023; 67:448-539. [PMID: 37351738 DOI: 10.1007/s10384-023-00995-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 12/21/2022] [Indexed: 06/24/2023]
Affiliation(s)
- Shiro Amano
- Ochanomizu Inoue Eye Clinic, 4-3 Kandasurugadai, Chiyoda-ku, Tokyo, 101-0062, Japan.
| | - Jun Shimazaki
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Japan
| | - Norihiko Yokoi
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuichi Hori
- Department of Ophthalmology, Toho University Omori Medical Center, Tokyo, Japan
| | | |
Collapse
|
3
|
Asghari B, Brocks D, Carrasquillo KG, Crowley E. OSDI Outcomes Based on Patient Demographic and Wear Patterns in Prosthetic Replacement of the Ocular Surface Ecosystem. CLINICAL OPTOMETRY 2022; 14:1-12. [PMID: 35046743 PMCID: PMC8760101 DOI: 10.2147/opto.s337920] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/18/2021] [Indexed: 05/26/2023]
Abstract
PURPOSE To evaluate the impact of prosthetic replacement of the ocular surface ecosystem (BostonSight PROSE) treatment on symptom outcomes based on the Ocular Surface Disease Index (OSDI). PATIENTS AND METHODS This was a single-center, retrospective analysis of consecutive patients who initiated PROSE treatment between September 2017 and December 2019 by the same clinician. The primary outcome measure was to compare OSDI survey scores at baseline prior to PROSE treatment and at follow-up, after PROSE treatment. Indication for treatment, sex, age, device diameter, average wear time, preexisting mental illness, duration of PROSE wear, and status of PROSE wear at follow-up were also studied. RESULTS A total of 134 patients underwent PROSE treatment and completed a baseline OSDI survey during the study period. Forty-three patients completed a follow-up OSDI survey and were included in the study analysis. The most common treatment indications were keratoconjunctivitis sicca (n=27) and corneal ectasia (n=16). Baseline average OSDI score was 56.9±23.7 for the 43 subjects who completed a subsequent OSDI survey. The last documented average follow-up OSDI for those 43 subjects was 23.8±15.6, median (IQR) of 22.9 (10.4 to 32.3), and a statistically significant 54.7±27.6% average improvement from baseline (p<0.01). All patients, except for two, showed improvement in OSDI score. Statistically significant improvement occurred regardless of underlying diagnosis with no statistically significant difference based on age, sex, mental illness, or device diameter and no statistical correlation with average wear time, or duration of PROSE wear. CONCLUSION PROSE treatment improves visual function and symptom relief as demonstrated by the OSDI survey. Sex, age, preexisting mental illness, device diameter, average wear time, and duration of wear had no statistically significant impact on OSDI outcomes.
Collapse
|
4
|
Rodríguez-Fernández S, Álvarez-Portela M, Rendal-Vázquez E, Piñeiro-Ramil M, Sanjurjo-Rodríguez C, Castro-Viñuelas R, Sánchez-Ibáñez J, Fuentes-Boquete I, Díaz-Prado S. Analysis of Cryopreservation Protocols and Their Harmful Effects on the Endothelial Integrity of Human Corneas. Int J Mol Sci 2021; 22:ijms222212564. [PMID: 34830446 PMCID: PMC8620027 DOI: 10.3390/ijms222212564] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/08/2021] [Accepted: 11/15/2021] [Indexed: 11/30/2022] Open
Abstract
Corneal cryopreservation can partially solve the worldwide concern regarding donor cornea shortage for keratoplasties. In this study, human corneas were cryopreserved using two standard cryopreservation protocols that are employed in the Tissue Bank of the Teresa Herrera Hospital (Spain) to store corneas for tectonic keratoplasties (TK protocol) and aortic valves (AV protocol), and two vitrification protocols, VS55 and DP6. Endothelial viability and general corneal state were evaluated to determine the protocol that provides the best results. The potential corneal cryopreservation protocol was studied in detail taking into consideration some cryopreservation-related variables and the endothelial integrity and stroma arrangement of the resulting cryopreserved corneas. TK corneas showed mostly viable endothelial cells, while the others showed few (AV) or none (DP6 and VS55). The corneal structure was well maintained in TK and AV corneas. TK corneas showed endothelial acellular areas surrounded by injured cells and a normal-like stromal fiber arrangement. Cryoprotectant solutions of the TK protocol presented an increasing osmolality and a physiological pH value. Cooling temperature rate of TK protocol was of 1 °C/min to −40 °C and 3 °C/min to −120 °C, and almost all of dimethyl sulfoxide left the tissue after washing. Future studies should be done changing cryopreservation-related variables of the TK protocol to store corneas of optical grade.
Collapse
Affiliation(s)
- Silvia Rodríguez-Fernández
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Departamento de Fisioterapia, Medicina e Ciencias Biomédicas, Facultade de Ciencias da Saúde, Universidade da Coruña (UDC), Campus de Oza, 15006 A Coruña, Spain; (S.R.-F.); (M.P.-R.); (C.S.-R.); (R.C.-V.); (I.F.-B.)
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Centro de Investigacións Científicas Avanzadas (CICA), Universidade da Coruña (UDC), 15071 A Coruña, Spain
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), 15006 A Coruña, Spain
| | - Marcelino Álvarez-Portela
- Servizo de Oftalmoloxía, Complexo Hospitalario Universitario A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), 15002 A Coruña, Spain;
| | - Esther Rendal-Vázquez
- Unidade de Criobioloxía-Banco de Tecidos, Complexo Hospitalario Universitario A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), 15006 A Coruña, Spain; (E.R.-V.); (J.S.-I.)
| | - María Piñeiro-Ramil
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Departamento de Fisioterapia, Medicina e Ciencias Biomédicas, Facultade de Ciencias da Saúde, Universidade da Coruña (UDC), Campus de Oza, 15006 A Coruña, Spain; (S.R.-F.); (M.P.-R.); (C.S.-R.); (R.C.-V.); (I.F.-B.)
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Centro de Investigacións Científicas Avanzadas (CICA), Universidade da Coruña (UDC), 15071 A Coruña, Spain
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), 15006 A Coruña, Spain
| | - Clara Sanjurjo-Rodríguez
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Departamento de Fisioterapia, Medicina e Ciencias Biomédicas, Facultade de Ciencias da Saúde, Universidade da Coruña (UDC), Campus de Oza, 15006 A Coruña, Spain; (S.R.-F.); (M.P.-R.); (C.S.-R.); (R.C.-V.); (I.F.-B.)
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Centro de Investigacións Científicas Avanzadas (CICA), Universidade da Coruña (UDC), 15071 A Coruña, Spain
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), 15006 A Coruña, Spain
| | - Rocío Castro-Viñuelas
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Departamento de Fisioterapia, Medicina e Ciencias Biomédicas, Facultade de Ciencias da Saúde, Universidade da Coruña (UDC), Campus de Oza, 15006 A Coruña, Spain; (S.R.-F.); (M.P.-R.); (C.S.-R.); (R.C.-V.); (I.F.-B.)
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Centro de Investigacións Científicas Avanzadas (CICA), Universidade da Coruña (UDC), 15071 A Coruña, Spain
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), 15006 A Coruña, Spain
| | - Jacinto Sánchez-Ibáñez
- Unidade de Criobioloxía-Banco de Tecidos, Complexo Hospitalario Universitario A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), 15006 A Coruña, Spain; (E.R.-V.); (J.S.-I.)
| | - Isaac Fuentes-Boquete
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Departamento de Fisioterapia, Medicina e Ciencias Biomédicas, Facultade de Ciencias da Saúde, Universidade da Coruña (UDC), Campus de Oza, 15006 A Coruña, Spain; (S.R.-F.); (M.P.-R.); (C.S.-R.); (R.C.-V.); (I.F.-B.)
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Centro de Investigacións Científicas Avanzadas (CICA), Universidade da Coruña (UDC), 15071 A Coruña, Spain
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), 15006 A Coruña, Spain
| | - Silvia Díaz-Prado
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Departamento de Fisioterapia, Medicina e Ciencias Biomédicas, Facultade de Ciencias da Saúde, Universidade da Coruña (UDC), Campus de Oza, 15006 A Coruña, Spain; (S.R.-F.); (M.P.-R.); (C.S.-R.); (R.C.-V.); (I.F.-B.)
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Centro de Investigacións Científicas Avanzadas (CICA), Universidade da Coruña (UDC), 15071 A Coruña, Spain
- Grupo de Investigación en Terapia Celular e Medicina Rexenerativa, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), Universidade da Coruña (UDC), 15006 A Coruña, Spain
- Correspondence:
| |
Collapse
|
5
|
A Systematic Review on the Association Between Tear Film Metrics and Higher Order Aberrations in Dry Eye Disease and Treatment. Ophthalmol Ther 2021; 11:35-67. [PMID: 34762259 PMCID: PMC8770783 DOI: 10.1007/s40123-021-00419-1] [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: 07/29/2021] [Accepted: 10/29/2021] [Indexed: 12/05/2022] Open
Abstract
We systematically reviewed published research on dry eye disease and its association with higher order aberrations (HOAs). The purpose of this review was to first determine if an association between tear film metrics and HOAs exists and second to determine if the treatment of dry eyes can improve tear film metrics and HOAs together. A search was conducted in Entrez PubMed on 25 April 2021 using the keywords “higher order aberrations” and “dry eye”. The initial search yielded 61 articles. After publications were restricted to only original articles measuring HOA outcomes in patients with dry eye, the final yield was 27 relevant articles. Of these 27 papers, 12 directly looked at associations and correlations between dry eyes and HOA parameters. The remaining 15 studies looked at dry eye interventions and HOA outcomes and parameters. There is clear evidence demonstrating that dry eyes and HOAs have an association, and that the tear film is one of the most important factors in this relationship. There is also a direct correlation between tear film metrics and HOAs. Improvements in HOAs with dry eye interventions provide further evidence to support the intricate relationship between the two. Despite the clear association between HOAs and dry eye disease, further research is still required in the realm of clinical application as dry eye interventions vary depending on many factors, including patient severity and eye drop viscosity.
Collapse
|
6
|
Time-Dependent Serial Changes of Antigen-Presenting Cell Subsets in the Ocular Surface Are Distinct between Corneal Sterile Inflammation and Allosensitization in a Murine Model. Cells 2021; 10:cells10092210. [PMID: 34571859 PMCID: PMC8467177 DOI: 10.3390/cells10092210] [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] [Received: 07/21/2021] [Revised: 08/22/2021] [Accepted: 08/23/2021] [Indexed: 11/30/2022] Open
Abstract
The kinetics of antigen-presenting cells (APCs) vary depending on their resident tissues and the manner of immunization. We investigated the long-term changes in mature APC and T-cell subsets over 4 weeks in the ocular surface in murine models of corneal quiescent or potent sterile inflammation, and allosensitization using partial (PT), syngeneic (Syn), and allogeneic (Allo) corneal transplantation. In PT, CD11bintCD11chiMHCIIhiCD86hi cells increased until 4 weeks with an increase in IFNγhi T cells. In Syn, both CD11bintCD11chiMHCIIhiCD86hi and CD11bhiCD11chiMHCIIhiCD86hi APC subsets increased until 4 weeks with a brief increase in CD69hi T cells at 2 weeks. In Allo, CD11bintCD11chiMHCIIhiCD86hi and CD11bhiCD11chiMHCIIhiCD86hi APC subsets increased until 4 weeks, and an early increase in CD69hi T cells was observed at 2 weeks followed by a late increase in IFNγhi T cells at 4 weeks. The frequency of the IFNγhi T cell subset was positively correlated with the frequency of the CD11bintCD11chiMHCIIhiCD86hi subset, indicating the existence of APC–T cell interaction in the ocular surface. Together, the results indicate that allosensitization in mature APCs leads to T-cell activation in the ocular surface, whereas sterile inflammation merely induces a brief and non-specific T-cell activation in the ocular surface.
Collapse
|
7
|
Abusharha A. Assessment of a Cationic Emulsion to Control the Tear Film Evaporation Rate. CLINICAL OPTOMETRY 2021; 13:243-248. [PMID: 34408523 PMCID: PMC8364913 DOI: 10.2147/opto.s328787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 07/30/2021] [Indexed: 06/13/2023]
Abstract
PURPOSE To investigate the effect of a single application of cationic emulsion in controlling tear film evaporation and improving tear quality and quantity. MATERIALS A METHODS Twenty male subjects diagnosed with DE were enrolled in the study with an average age of 45.8 ± 6.37 years. The tear film parameters were observed at several time points post-instillation of the cationic emulsion (10, 20, 30, and 60 min). The tear evaporation rate (TER) was measured with a VapoMeter. Noninvasive tear break-up time and meniscus height were assessed using OCULUS Keratograph. RESULTS TER decreased by more than 20% at 20, 30, and 60 minutes time points after instillation of single drop of cationic emulsion. Also, a significant improvement in tear film stability was found at all time points following the instillation of cationic emulsion eye drops. The mean tear break-up time increased from 5.55 ± 2.87 to 6.6 ± 4.2 sec at 60 minutes. The maximum increase in tear break-up time occurred at 30 minutes time point. The TMH was also significantly higher post-instillation of oil emulsion eye drops. There was a significant increase in the TMH post-therapy with oil drop at all time points. CONCLUSION The overall study findings of this study illustrate that the single application of a cationic emulsion effectively controls tear film evaporation in patients with mild to moderate DEs. The cationic emulsion efficiently enhanced both the tear film stability and the tear meniscus volume.
Collapse
Affiliation(s)
- Ali Abusharha
- Cornea Research Chair, Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, 11433, Saudi Arabia
| |
Collapse
|
8
|
Napoli PE, Nioi M, Fossarello M. The "Quarantine Dry Eye": The Lockdown for Coronavirus Disease 2019 and Its Implications for Ocular Surface Health. Risk Manag Healthc Policy 2021; 14:1629-1636. [PMID: 33907480 PMCID: PMC8064711 DOI: 10.2147/rmhp.s277067] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/01/2020] [Indexed: 12/12/2022] Open
Abstract
The pandemic of coronavirus disease 2019 (COVID-19) has led many countries of the world to impose a series of containment measures such as lockdowns (mass quarantines), curfews or similar restrictions (eg, stay-at-home orders, or shelter-in-place orders). All these restrictions were established in order to limit spread of COVID-19. Thus, approximately 3.9 billion people worldwide were under lockdown by early April 2020. During this time (home confinement), some solutions have been proposed by experts to improve work and school productivity, including smart working and online school lessons. However, many of the restrictive measures are likely to act as predisposing factors for dry eye disease (DED), directly or related to sick building syndrome (SBS). Herein, we discuss the implications of quarantine measures on eye health, in particular on DED associated with SBS, and introduce some potential preventive strategies for lockdown-related ocular surface disorders. Several risk factors are implicated in their pathogenesis, including environmental changes (eg, air quality) and modifications in personal behaviors (eg, the abuse of digital devices, malnutrition, and sleep/psychiatric disorders). Considering a number of predisposing factors for DED, it is possible to state that patients under lockdown are at risk of ocular surface alterations. Accordingly, the COVID-19 pandemic era is expected to determine an increase in dry eye patients all around the world (a new phenomenon that we propose to name the "quarantine dry eye") in the event that the restrictive measures will be recursively extended over time.
Collapse
Affiliation(s)
| | - Matteo Nioi
- Department of Clinical Sciences and Public Health, University of Cagliari, Forensic Medicine Unit, Cagliari, Italy
| | - Maurizio Fossarello
- Department of Surgical Science, University of Cagliari, Eye Clinic, Cagliari, Italy
- Clinica Oculistica, San Giovanni di Dio Hospital, Azienda Ospedaliera Universitaria di Cagliari, Cagliari, Italy
| |
Collapse
|
9
|
Anatomical and physiological considerations in scleral lens wear: Eyelids and tear film. Cont Lens Anterior Eye 2021; 44:101407. [PMID: 33468392 DOI: 10.1016/j.clae.2021.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/31/2020] [Accepted: 01/07/2021] [Indexed: 12/19/2022]
Abstract
Scleral lenses can affect a range of anterior segment structures including the eyelids and the tears. The eyelids, consisting of the outer skin layer, the middle tarsal plate, and the posterior palpebral conjunctiva, provide physical protection and house the meibomian glands and cilia which have important and unique functions. Tears consist of a mix of aqueous, mucus, and lipidomic components that serve vital functions of lubricity, protection, and nourishment to the ocular surface. Both the eyelids and the tear film interact directly with scleral lenses on the eye and can affect but also be impacted by scleral lens wear. The purpose of this paper is to review the anatomy and physiology of the eyelids and tear film, discuss the effects and impacts of the scleral lenses on these structures, and identify areas that require further research.
Collapse
|
10
|
Maki KL, Braun RJ, Barron GA. The influence of a lipid reservoir on the tear film formation. MATHEMATICAL MEDICINE AND BIOLOGY-A JOURNAL OF THE IMA 2020; 37:363-388. [PMID: 31990037 DOI: 10.1093/imammb/dqz018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 11/15/2019] [Accepted: 11/24/2019] [Indexed: 12/23/2022]
Abstract
We present a mathematical model to study the influence of a lipid reservoir, seen experimentally, at the lid margin on the formation and relaxation of the tear film during a partial blink. Applying the lubrication limit, we derive two coupled non-linear partial differential equations characterizing the evolution of the aqueous tear fluid and the covering insoluble lipid concentration. Departing from prior works, we explore a new set of boundary conditions (BCs) enforcing hypothesized lipid concentration dynamics at the lid margins. Using both numerical and analytical approaches, we find that the lipid-focused BCs strongly impact tear film formation and thinning rates. Specifically, during the upstroke of the eyelid, we find specifying the lipid concentration at the lid margin accelerates thinning. Parameter regimes that cause tear film formation success or failure are identified. More importantly, this work expands our understanding of the consequences of lipid dynamics near the lid margins for tear film formation.
Collapse
Affiliation(s)
- Kara L Maki
- School of Mathematical Sciences, Rochester Institute of Technology, 85 Lomb Memorial Drive, Rochester, NY 14625, USA
| | - Richard J Braun
- Department of Mathematical Sciences, University of Delaware, 15 Orchard Road, Newark, DE 19716, USA
| | - Gregory A Barron
- School of Mathematical Sciences, Rochester Institute of Technology, 85 Lomb Memorial Drive, Rochester, NY 14625, USA
| |
Collapse
|
11
|
Napoli PE, Mangoni L, Gentile P, Braghiroli M, Fossarello M. A Panel of Broad-Spectrum Antivirals in Topical Ophthalmic Medications from the Drug Repurposing Approach during and after the Coronavirus Disease 2019 Era. J Clin Med 2020; 9:E2441. [PMID: 32751615 PMCID: PMC7463888 DOI: 10.3390/jcm9082441] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/15/2020] [Accepted: 07/27/2020] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) represents a global concern of public health caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Its clinical manifestations are characterized by a heterogeneous group of symptoms and pictures (ranging from asymptomatic to lethal courses). The prevalence of conjunctivitis in patients with COVID-19 is at present controversial. Although it has been reported that only 0.9% developed signs of conjunctivitis, other report indicates that up to 31.6% of hospitalized patients had conjunctivitis. Considering the widespread use of topical ophthalmic medications (e.g., eye drops) by the general population, for various reasons (e.g., artificial tears, anti-glaucoma medications, topical antibiotics, etc.), the existence of their side effects as antiviral action should be investigated in-depth because it could possibly explain the aforementioned controversial data and represent a potential antiviral treatment for SARS-CoV-2 replication/diffusion on the ocular surface. Here, we discuss and elucidate the antiviral side effect of many eye drops and ophthalmic ointments commonly used for others purposes, thus showing that these secondary effects (not to be confused with the 'adverse effects') might be of primary importance in a number of viral infections (e.g., those for which there is no validated treatment protocol), according to a drug repurposing approach. Some active ingredients or excipients described here have activity against other types of viruses, thus suggesting potential broad-spectrum applications.
Collapse
Affiliation(s)
- Pietro Emanuele Napoli
- Clinica Oculistica, San Giovanni di Dio Hospital, Azienda Ospedaliera Universitaria di Cagliari, 09124 Cagliari, Italy; (L.M.); (P.G.); (M.B.); (M.F.)
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
| | - Lorenzo Mangoni
- Clinica Oculistica, San Giovanni di Dio Hospital, Azienda Ospedaliera Universitaria di Cagliari, 09124 Cagliari, Italy; (L.M.); (P.G.); (M.B.); (M.F.)
| | - Pietro Gentile
- Clinica Oculistica, San Giovanni di Dio Hospital, Azienda Ospedaliera Universitaria di Cagliari, 09124 Cagliari, Italy; (L.M.); (P.G.); (M.B.); (M.F.)
| | - Mirco Braghiroli
- Clinica Oculistica, San Giovanni di Dio Hospital, Azienda Ospedaliera Universitaria di Cagliari, 09124 Cagliari, Italy; (L.M.); (P.G.); (M.B.); (M.F.)
| | - Maurizio Fossarello
- Clinica Oculistica, San Giovanni di Dio Hospital, Azienda Ospedaliera Universitaria di Cagliari, 09124 Cagliari, Italy; (L.M.); (P.G.); (M.B.); (M.F.)
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, 09124 Cagliari, Italy
| |
Collapse
|
12
|
Fourier-Domain OCT Imaging of the Ocular Surface and Tear Film Dynamics: A Review of the State of the Art and an Integrative Model of the Tear Behavior During the Inter-Blink Period and Visual Fixation. J Clin Med 2020; 9:jcm9030668. [PMID: 32131486 PMCID: PMC7141198 DOI: 10.3390/jcm9030668] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 12/26/2022] Open
Abstract
In the last few decades, the ocular surface and the tear film have been noninvasively investigated in vivo, in a three-dimensional, high resolution, and real-time mode, by optical coherence tomography (OCT). Recently, OCT technology has made great strides in improving the acquisition speed and image resolution, thus increasing its impact in daily clinical practice and in the research setting. All these results have been achieved because of a transition from traditional time-domain (TD) to Fourier-domain (FD) technology. FD-OCT devices include a spectrometer in the receiver that analyzes the spectrum of reflected light on the retina or ocular surface and transforms it into information about the depth of the structures according to the Fourier principle. In this review, we summarize and provide the state-of-the-art in FD-OCT imaging of the ocular surface system, addressing specific aspects such as tear film dynamics and epithelial changes under physiologic and pathologic conditions. A theory on the dynamic nature of the tear film has been developed to explain the variations within the individual compartments. Moreover, an integrative model of tear film behavior during the inter-blink period and visual fixation is proposed.
Collapse
|
13
|
Gottschalk HM, Wecker T, Khattab MH, Fischer CV, Callizo J, Rehfeldt F, Lubjuhn R, Russmann C, Hoerauf H, van Oterendorp C. Lipid Emulsion-Based OCT Angiography for Ex Vivo Imaging of the Aqueous Outflow Tract. Invest Ophthalmol Vis Sci 2019; 60:397-406. [PMID: 30682210 DOI: 10.1167/iovs.18-25223] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Contrast agents applicable for optical coherence tomography (OCT) imaging are rare. The intrascleral aqueous drainage system would be a potential application for a contrast agent, because the aqueous veins are of small diameter and located deep inside the highly scattering sclera. We tested lipid emulsions (LEs) as candidate OCT contrast agents in vitro and ex vivo, including milk and the anesthetic substance Propofol. Methods Commercial OCT and OCT angiography (OCTA) devices were used. Maximum reflectivity and signal transmission of LE were determined in tube phantoms. Absorption spectra and light scattering was analyzed. The anterior chamber of enucleated porcine eyes was perfused with LEs, and OCTA imaging of the LEs drained via the aqueous outflow tract was performed. Results All LEs showed a significantly higher reflectivity than water (P < 0.001). Higher milk lipid content was positively correlated with maximum reflectivity and negatively with signal transmission. Propofol exhibited the best overall performance. Due to a high degree of signal fluctuation, OCTA could be applied for detection of LE. Compared with blood, the OCTA signal of Propofol was significantly stronger (P = 0.001). As a proof of concept, time-resolved aqueous angiography of porcine eyes was performed. The three-dimensional (3D) structure and dynamics of the aqueous outflow were significantly different from humans. Conclusions LEs induced a strong signal in OCT and OCTA. LE-based OCTA allowed the ability to obtain time-resolved 3D datasets of aqueous outflow. Possible interactions of LE with inner eye's structures need to be further investigated before in vivo application.
Collapse
Affiliation(s)
- Hanna M Gottschalk
- Department of Ophthalmology, University Medical Center, Göttingen, Germany
| | | | - Mohammed H Khattab
- Department of Ophthalmology, University Medical Center, Göttingen, Germany
| | | | - Josep Callizo
- Department of Ophthalmology, University Medical Center, Göttingen, Germany
| | - Florian Rehfeldt
- Third Institute of Physics, Biophysics, Georg-August-University, Göttingen, Germany
| | - Roswitha Lubjuhn
- Department of Anaesthesiology, University Medical Center, Göttingen, Germany
| | - Christoph Russmann
- Faculty of Natural Science and Technology, University of Applied Sciences and Arts, Göttingen, Germany.,Molecular Biomarkers Nano-Imaging Laboratory, Brigham and Women's Hospital, and Department of Radiology, Harvard Medical School, Boston, Massachusetts, United States
| | - Hans Hoerauf
- Department of Ophthalmology, University Medical Center, Göttingen, Germany
| | | |
Collapse
|
14
|
Anterior Segment Optical Coherence Tomography (AS-OCT) in the Management of Dry Eye. Int Ophthalmol Clin 2018; 57:13-22. [PMID: 28282311 DOI: 10.1097/iio.0000000000000164] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
15
|
Ang M, Baskaran M, Werkmeister RM, Chua J, Schmidl D, Aranha dos Santos V, Garhöfer G, Mehta JS, Schmetterer L. Anterior segment optical coherence tomography. Prog Retin Eye Res 2018; 66:132-156. [DOI: 10.1016/j.preteyeres.2018.04.002] [Citation(s) in RCA: 216] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 02/20/2018] [Accepted: 04/04/2018] [Indexed: 02/03/2023]
|
16
|
Garaszczuk IK, Montes Mico R, Iskander DR, Expósito AC. The tear turnover and tear clearance tests – a review. Expert Rev Med Devices 2018; 15:219-229. [DOI: 10.1080/17434440.2018.1435271] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Izabela K. Garaszczuk
- Department of Optics, Optometry and Vision Sciences, University of Valencia, Valencia, Spain
| | - Robert Montes Mico
- Department of Optics, Optometry and Vision Sciences, University of Valencia, Valencia, Spain
| | - D. Robert Iskander
- Department of Biomedical Engineering, Wroclaw University of Science and Technology, Wroclaw, Poland
| | | |
Collapse
|
17
|
Gagliano C, Papa V, Amato R, Malaguarnera G, Avitabile T. Measurement of the Retention Time of Different Ophthalmic Formulations with Ultrahigh-Resolution Optical Coherence Tomography. Curr Eye Res 2017; 43:499-502. [DOI: 10.1080/02713683.2017.1418893] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Caterina Gagliano
- Neurovisual Science Technology (NEST), Catania, Italy
- Department of Ophthalmology, University of Catania, Catania, Italy
- Eye Clinic S.Marta Hospital, Catania, Italy
| | | | - Roberta Amato
- Neurovisual Science Technology (NEST), Catania, Italy
| | - Giulia Malaguarnera
- Neurovisual Science Technology (NEST), Catania, Italy
- Department of Ophthalmology, University of Catania, Catania, Italy
| | | |
Collapse
|
18
|
Galantuomo MS, Fossarello M, Cuccu A, Farci R, Preising MN, Lorenz B, Napoli PE. Rebound macular edema following oral acetazolamide therapy for juvenile X-linked retinoschisis in an Italian family. Clin Ophthalmol 2016; 10:2377-2382. [PMID: 27932860 PMCID: PMC5135400 DOI: 10.2147/opth.s114568] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Juvenile X-linked retinoschisis (RS1, OMIM: 312700) is a hereditary vitreoretinal dystrophy characterized by bilateral foveal schisis and, in half of the patients, splitting through the nerve fiber layer in the peripheral retina. In the first decade of life, patients usually develop a decrease in visual acuity. Long-term visual outcomes can be poor due to the limited number of known successful treatments. Purpose The purposes of this study were to present, for the first time, a p.Arg197Cys missense mutation in the RS1 gene (OMIM: 300839) in a four-generation Italian family with RS1 and to examine the clinical response to the treatment with acetazolamide tablets alone or in combination with dorzolamide eye drops as assessed by spectral-domain optical coherence tomography (SD-OCT). Methods Eleven individuals, including two brothers with RS1 (patients 1 and 2), underwent a full medical history examination and a comprehensive ocular assessment that involved SD-OCT, fluorescein angiography, electroretinography and DNA analysis. Each RS1 patient received oral acetazolamide (375 mg daily) during the first three months. Thereafter, patient 1 continued only with dorzolamide eyedrops three times a day for a period of three months, while patient 2 spontaneously stopped both medications. Results Sequence analysis of the RS1 gene identified a hemizygous c.589C>T (p.Arg197Cys) missense mutation in exon 6, which has not been previously reported in an Italian family. A different response to the medical therapy was observed in the four eyes of the two affected brothers hemizygous for this abnormality. Of note, after acetazolamide interruption, a rebound effect on cystoid macular edema reduced the beneficial effects of the initial therapy for RS1 from p.Arg197Cys mutation. Indeed, a minimal rebound effect on cystoid macular edema, and an improvement in visual acuity, was observed in patient 1 during the six months of treatment. Conversely, in patient 2, an initial improvement in cystoid macular edema was not associated with visual acuity changes, followed by a marked rebound effect. Conclusion This study showed that the sequential use of acetazolamide tablets and dorzolamide eye drops should be considered and studied further as a possible treatment for macular edema and visual impairment in patients with RS1 from a hemizygous p.Arg197Cys mutation.
Collapse
Affiliation(s)
| | - Maurizio Fossarello
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Alberto Cuccu
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Roberta Farci
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Markus N Preising
- Department of Ophthalmology, Faculty of Medicine, Justus-Liebig-University, Giessen, Germany
| | - Birgit Lorenz
- Department of Ophthalmology, Faculty of Medicine, Justus-Liebig-University, Giessen, Germany
| | | |
Collapse
|
19
|
Napoli PE, Coronella F, Satta GM, Iovino C, Sanna R, Fossarello M. A Simple Novel Technique of Infrared Meibography by Means of Spectral-Domain Optical Coherence Tomography: A Cross-Sectional Clinical Study. PLoS One 2016; 11:e0165558. [PMID: 27798696 PMCID: PMC5087862 DOI: 10.1371/journal.pone.0165558] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 10/13/2016] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To compare a novel spectral-domain optical coherence tomography (SD-OCT) technique with traditional lid transillumination for evaluation of meibomian glands (MGs) and to assess the relation of MG morphologic changes to the glandular atrophy. DESIGN Evaluation of diagnostic technology. PARTICIPANTS Sixty-one patients with obstructive MGD (30 men, 31 women; age [mean ± standard deviation] 45.1 ± 12.1 years), and 75 control subjects (32 men, 43 women; 44.1 ± 12.5 years) were recruited in order to have a balanced distribution of glandular features. METHODS Agreement between SD-OCT and lid transillumination examination for the detection of drop-out (partial or complete loss of MGs) and microscopic changes (i.e. shortening, distortion, segmentation and entanglement), as well as the relationship between morphological features and MG atrophy were evaluated. MAIN OUTCOME MEASURES Agreement between the two meibographic techniques, bias in symmetry of classification, and association analysis between microscopic changes and MG dropout. RESULTS Overall agreement for all morphological features was substantial (Cohen kappa coefficient = 0.77; p<0.001), even if, the majority of disagreement occurred for cases with segmentation, where agreement was present in only 108 (81.82%) of 132 eyes with adequate images for interpretation, and where SD-OCT tended to diagnose more cases not detected by traditional lid transillumination (McNemar test, p<0.001). Moreover, segmentation and distortion pattern negatively correlated with the degree of drop-out, whereas shortening and entanglement pattern demonstrated only a weak correlation (Spearman's ρ was -0.691, -0.491, -0.359, -0.385, respectively). CONCLUSIONS Each method has its advantages but in general there was close agreement between these meibographic techniques, particularly for MG dropout, which supports the reliability of our novel, simple and patient-friendly SD-OCT approach.
Collapse
Affiliation(s)
- Pietro Emanuele Napoli
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
- * E-mail:
| | - Franco Coronella
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Giovanni Maria Satta
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Claudio Iovino
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Raffaele Sanna
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Maurizio Fossarello
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| |
Collapse
|
20
|
Napoli PE, Cuccu A, Farci R, Fossarello M. Simultaneous occlusion of three cilioretinal arteries following scleral buckling surgery under local anesthesia. Int Med Case Rep J 2016; 9:285-290. [PMID: 27695367 PMCID: PMC5028177 DOI: 10.2147/imcrj.s111682] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Cilioretinal artery (CRA) occlusions are rare in young patients. In these cases, the most commonly associated causes are considered to be the same as those implicated in central retina artery occlusions, such as vasculitic processes, migraine, cardiac disorder, and coagulation abnormality. The aim of this article was to report for the first time the medical records and investigational results of an unusual case of simultaneous occlusion of three CRAs after scleral buckling surgery under local anesthesia. Methods A complete ophthalmic examination, including color fundus image, fundus fluorescein angiography, optical coherence tomography, visual field, as well as systemic and laboratory assessments, was performed. Results A case of contemporaneous blockage of three CRAs after ab externo surgery for retinal detachment in a 29-year-old Caucasian woman was reported. The interdisciplinary approach and the imaging results have allowed us the clinical definition of such a very rare case. Conclusion Here, we reported that optical coherence tomography is an indispensable tool to better delineate the pathological process and follow atrophic changes in the macula, especially in cases in which fundus fluorescein angiography and systemic tests may be poorly informative.
Collapse
Affiliation(s)
| | - Alberto Cuccu
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Roberta Farci
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Maurizio Fossarello
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| |
Collapse
|
21
|
Matet A, Amar N, Mohand-Said S, Sahel JA, Barale PO. Argus II retinal prosthesis implantation with scleral flap and autogenous temporalis fascia as alternative patch graft material: a 4-year follow-up. Clin Ophthalmol 2016; 10:1565-71. [PMID: 27574397 PMCID: PMC4993412 DOI: 10.2147/opth.s112403] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction The Argus II retinal prosthesis is composed of an epiretinal electrode array positioned over the macula and connected to an extrascleral electronics case via a silicone cable, running through a sclerotomy. During implantation, the manufacturer recommends to cover the sclerotomy site with a patch of processed human pericardium to prevent postoperative hypotony and conjunctival erosion by the underlying electronics case. Due to biomedical regulations prohibiting the use of this material in France, we developed an alternative technique combining a scleral flap protecting the sclerotomy and an autogenous graft of superior temporalis fascia overlying the electronics case. Methods The purpose of this study is to describe the 4-year outcomes of this modified procedure in three subjects who underwent Argus II Retinal Prosthesis System implantation. Clinical data consisting of intraocular pressure measurements and tolerance in terms of conjunctival erosion or inflammation were retrospectively assessed over a 4-year postoperative follow-up. Results None of the three patients implanted with the modified technique developed ocular hypotony over 4 years. A normal, transient conjunctival inflammation occurred during the first postoperative month but conjunctival erosion was not observed in any of the three patients over 4 years. Four years after implantation, the autogenous temporalis fascia graft remained well tolerated and the retinal prosthesis was functional in all three patients. Conclusion The combination of an autograft of superficial temporalis fascia and a scleral flap efficiently prevented leakage through the sclerotomy site, ocular hypotony, and conjunctival erosion by the extrascleral electronics case. This modified technique is suitable for the implantation of existing and forthcoming retinal prostheses. Superficial temporalis fascia may also be used as alternative to commercial tectonic tissues for scleral wound repair in clinical settings where they are not available.
Collapse
Affiliation(s)
- Alexandre Matet
- INSERM and DHOS, CHNO des Quinze-Vingts; Sorbonne Universités, UPMC Univ Paris 6, Institut de la Vision
| | - Nawel Amar
- INSERM and DHOS, CHNO des Quinze-Vingts; Sorbonne Universités, UPMC Univ Paris 6, Institut de la Vision
| | - Saddek Mohand-Said
- INSERM and DHOS, CHNO des Quinze-Vingts; Sorbonne Universités, UPMC Univ Paris 6, Institut de la Vision; INSERM; CNRS, Paris, France
| | - José-Alain Sahel
- INSERM and DHOS, CHNO des Quinze-Vingts; Sorbonne Universités, UPMC Univ Paris 6, Institut de la Vision; INSERM; CNRS, Paris, France; Institute of Ophthalmology, University College London, London, UK; Fondation Ophtalmologique Adolphe de Rothschild; Académie des Sciences, Institut de France, Paris, France
| | - Pierre-Olivier Barale
- INSERM and DHOS, CHNO des Quinze-Vingts; Sorbonne Universités, UPMC Univ Paris 6, Institut de la Vision
| |
Collapse
|
22
|
Napoli PE, Nioi M, d'Aloja E, Fossarello M. Post-Mortem Corneal Thickness Measurements with a Portable Optical Coherence Tomography System: a Reliability Study. Sci Rep 2016; 6:30428. [PMID: 27457021 PMCID: PMC4960653 DOI: 10.1038/srep30428] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/01/2016] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to determine the repeatability and reproducibility of post-mortem central corneal thickness (CCT) measurements by using a real-time, portable optical coherence tomography (OCT) system on an animal model, and to prospectively evaluate the time-course of post-mortem changes in CCT. Forty-six ocular globes of sheep (Ovis aries) were analyzed with a portable spectral-domain OCT device by two operators at different postmortem intervals (PMIs) as follows: immediately (i.e. within 10 minutes), at the 30th minute, at the 1st, 6th, 12th, 24th and 48th hour, and later (up to the 96th hour). The coefficient of repeatability ranged from 0.3% to 3.5%, and coefficients of reproducibility ranged from 0.2% to 3.7% in the central region of the cornea. The intraclass correlation coefficients were particularly high at different PMIs, thus confirming good measurement reliability with the portable OCT. The average CCT decreased immediately and then increased thereafter, with two peaks at 6 and 24 hours after death. Our results suggest that portable OCT is a reliable tool for monitoring CCT variations after death and may be useful in characterizing corneas before explantation, detecting quantitative variations during post-mortem corneal degeneration or assessing changes in CCT for forensic implications.
Collapse
Affiliation(s)
| | - Matteo Nioi
- Department of Public Health, Clinical and Molecular Medicine-Forensic Science Unit-University of Cagliari, Cagliari, Italy
| | - Ernesto d'Aloja
- Department of Public Health, Clinical and Molecular Medicine-Forensic Science Unit-University of Cagliari, Cagliari, Italy
| | - Maurizio Fossarello
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| |
Collapse
|
23
|
dos Santos VA, Schmetterer L, Triggs GJ, Leitgeb RA, Gröschl M, Messner A, Schmidl D, Garhofer G, Aschinger G, Werkmeister RM. Super-resolved thickness maps of thin film phantoms and in vivo visualization of tear film lipid layer using OCT. BIOMEDICAL OPTICS EXPRESS 2016; 7:2650-70. [PMID: 27446696 PMCID: PMC4948620 DOI: 10.1364/boe.7.002650] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Revised: 05/06/2016] [Accepted: 05/09/2016] [Indexed: 05/06/2023]
Abstract
In optical coherence tomography (OCT), the axial resolution is directly linked to the coherence length of the employed light source. It is currently unclear if OCT allows measuring thicknesses below its axial resolution value. To investigate spectral-domain OCT imaging in the super-resolution regime, we derived a signal model and compared it with the experiment. Several island thin film samples of known refractive indices and thicknesses in the range 46 - 163 nm were fabricated and imaged. Reference thickness measurements were performed using a commercial atomic force microscope. In vivo measurements of the tear film were performed in 4 healthy subjects. Our results show that quantitative super-resolved thickness measurement can be performed using OCT. In addition, we report repeatable tear film lipid layer visualization. Our results provide a novel interpretation of the OCT axial resolution limit and open a perspective to deeper extraction of the information hidden in the coherence volume.
Collapse
Affiliation(s)
- Valentin Aranha dos Santos
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20/4L, 1090 Vienna,
Austria
- Institute of Applied Physics, Vienna University of Technology, Wiedner Hauptstr. 8-10, 1040 Vienna,
Austria
| | - Leopold Schmetterer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20/4L, 1090 Vienna,
Austria
- Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20/6L, 1090 Vienna,
Austria
- Christian Doppler Laboratory for Ocular Effects of Thiomers, Medical University of Vienna, Währinger Gürtel 18-20/4L, 1090 Vienna,
Austria
| | - Graham J. Triggs
- Photonics Group, Department of Physics, University of York, York YO10 5DD,
UK
| | - Rainer A. Leitgeb
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20/4L, 1090 Vienna,
Austria
| | - Martin Gröschl
- Institute of Applied Physics, Vienna University of Technology, Wiedner Hauptstr. 8-10, 1040 Vienna,
Austria
| | - Alina Messner
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20/4L, 1090 Vienna,
Austria
| | - Doreen Schmidl
- Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20/6L, 1090 Vienna,
Austria
- Christian Doppler Laboratory for Ocular Effects of Thiomers, Medical University of Vienna, Währinger Gürtel 18-20/4L, 1090 Vienna,
Austria
| | - Gerhard Garhofer
- Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20/6L, 1090 Vienna,
Austria
- Christian Doppler Laboratory for Ocular Effects of Thiomers, Medical University of Vienna, Währinger Gürtel 18-20/4L, 1090 Vienna,
Austria
| | - Gerold Aschinger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20/4L, 1090 Vienna,
Austria
- Institute of Applied Physics, Vienna University of Technology, Wiedner Hauptstr. 8-10, 1040 Vienna,
Austria
| | - René M. Werkmeister
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Währinger Gürtel 18-20/4L, 1090 Vienna,
Austria
- Christian Doppler Laboratory for Ocular Effects of Thiomers, Medical University of Vienna, Währinger Gürtel 18-20/4L, 1090 Vienna,
Austria
| |
Collapse
|
24
|
Simmons PA, Liu H, Carlisle-Wilcox C, Vehige JG. Efficacy and safety of two new formulations of artificial tears in subjects with dry eye disease: a 3-month, multicenter, active-controlled, randomized trial. Clin Ophthalmol 2015; 9:665-75. [PMID: 25931807 PMCID: PMC4404880 DOI: 10.2147/opth.s78184] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose To evaluate and compare the efficacy and safety of two investigational artificial tear formulations (CHO-1 and CHO-2) containing carmellose sodium, hyaluronic acid at different concentrations, and osmoprotectants, with a standard carmellose sodium-containing formulation (Refresh Tears [RT]) in the treatment of dry eye disease. Subjects and methods In this 3-month, double-masked, multicenter study, subjects (n=305) were randomized 1:1:1 to receive CHO-1, CHO-2, or RT, used as needed but at least twice daily. The primary endpoint was change in ocular surface disease index (OSDI) score from baseline to day 90. Other key outcomes included symptoms evaluated on a visual analog scale, corneal and conjunctival staining, and adverse events. Results OSDI scores and dry eye symptoms showed a rapid and sustained reduction from baseline in each group. Both CHO-1 and CHO-2 met the primary efficacy endpoint of noninferiority to RT in day 90 OSDI score change from baseline. OSDI ocular symptoms subscale improved more with CHO-1 than CHO-2 (P=0.048). In subjects with clinically relevant baseline ocular surface staining (>14 total score of a maximum of 55), day 90 improvements were greater with CHO-1 and CHO-2 than RT (P≤0.044). Day 90 improvements in OSDI ocular symptoms subscale scores were also greater with CHO-1 than RT (P<0.007) in subjects with clinically relevant ocular staining. All treatments were well tolerated. Conclusion Both combination artificial tear formulations were efficacious and well tolerated in subjects with dry eye. CHO-1 demonstrated the best performance in improving ocular symptoms and reducing ocular staining in this heterogeneous study population.
Collapse
Affiliation(s)
| | - Haixia Liu
- Allergan Clinical Research, Allergan, Inc., Irvine, CA, USA
| | | | | |
Collapse
|
25
|
Napoli PE, Coronella F, Satta GM, Galantuomo MS, Fossarello M. Evaluation of the adhesive properties of the cornea by means of optical coherence tomography in patients with meibomian gland dysfunction and lacrimal tear deficiency. PLoS One 2014; 9:e115762. [PMID: 25536051 PMCID: PMC4275270 DOI: 10.1371/journal.pone.0115762] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 11/27/2014] [Indexed: 11/22/2022] Open
Abstract
Objective The aim was to determine the influence of meibomian gland dysfunction (MGD) and aqueous tear deficiency dry eye (ADDE) on the adhesive properties of the central cornea by means of optical coherence tomography (OCT), and to investigate the relationship between corneal adhesiveness and classical tear tests, as well as the reliability of results, in these lacrimal functional unit disorders. Design Prospective, case-control study. Methods Twenty-eight patients with MGD and 27 patients with ADDE were studied. A group of 32 healthy subjects of similar age and gender distribution served as a control group. The adhesive properties of the anterior corneal surface were measured by OCT, based on the retention time of adhesion marker above it, in all participants. Results An excellent (≥5 minutes), borderline (within 3–5 minutes), fair (within 1–3 minutes) and poor (<1 minute) values of corneal adhesiveness were found, respectively, in 0%, 7.1%, 64.3% and 28.6% of MGD, in 0%, 7.4%, 63% and 29.6% of ADDE, and in 31.3%, 65.6%, 3.1% and 0% of healthy patients. The differences in time of corneal adhesiveness between MGD and healthy patients, as well as between ADDE and healthy patients, were found to be statistically significant (p<0.001; p<0.001; respectively). Conversely, no statistical significant differences between MGD and ADDE were found (p = 0.952). Data analysis revealed a statistically significant correlation between corneal adhesiveness and clinical tests of dry eye, as well as an excellent degree of inter-rater reliability and reproducibility for OCT measurements (p<0.001). Conclusion ADDE and MGD share similar abnormalities on OCT imaging. Decreased adhesive properties of the anterior cornea were identified as a common feature of MGD and ADDE. This simple OCT approach may provide new clues into the mechanism and evaluation of dry eye syndrome.
Collapse
Affiliation(s)
- Pietro Emanuele Napoli
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
- * E-mail:
| | - Franco Coronella
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Giovanni Maria Satta
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | | | - Maurizio Fossarello
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| |
Collapse
|