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Cheng T, Zhao H, Chen Q, Wang S, Jiang C. Efficiency of different imaging methods in detecting ocular foreign bodies. Med Phys 2024; 51:3124-3129. [PMID: 38055556 DOI: 10.1002/mp.16818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/08/2023] [Accepted: 08/20/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Ocular foreign bodies (OFBs) are a relatively common occurrence in ocular injuries, and a severe risk factor for vision disorders. They are notoriously challenging to identify and localize precisely to allow surgical removal, even with the most recent technological advancements. PURPOSE To compare the efficiency of different imaging methods in detecting and localizing OFBs. METHODS We conducted a retrospective analysis of the medical records of patients with OFBs, detected by ultrasound biomicroscopy (UBM) and confirmed during surgery. Patients who presented to our medical center between January 2016 and January 2022 and also underwent computed tomography (CT), X ray, and/or ocular B-scan ultrasonography (B-scans) were selected. RESULTS This study included 134 patients with a history of ocular trauma and OFBs (mean age: 47.25 years, range: 8-78). The mean time interval from injury to UBM examination was 36.31 months (range: 0.2-120 months). Most OFBs were metallic (51.82%) or plant-based (25.37%); 22.39% of them were located in the sclera, 26.87% in the anterior chamber, and 23.88% in the ciliary body and iris. OFBs ranged in size from 0.10 to 6.67 mm (mean: 1.15 ± 1.10 mm). B-scans identified OFBs in 37 of the 119 patients examined (31.09%); CT in 52 of 84 patients (61.90%); and radiography in 29 of 50 patients (58.00%). Univariate and multivariate analyses determined that both CT and radiography showed low detection rates for plant-based versus non-plant-based OFBs (CT: p < 0.001; radiography: p = 0.007), small particles (<1.00 mm vs. >1.00 mm; CT: p = 0.001, radiography: p = 0.024), and with eyeball wall locations (vs. intraocular; CT: p < 0.001, radiography: p = 0.021). Similarly, B-scans were less efficient for plant-based and eyeball wall-located OFBs (both p = 0.001), whereas the difference based on dimensions was not significant (p = 0.118). CONCLUSIONS CT, radiography, and B-scans showed lower detection rates for plant-based, small, and eyeball wall-located OFBs. Our findings strongly suggest that UBM could be a more adequate imaging modality when such OFBs are suspected.
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Affiliation(s)
- Tongjie Cheng
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, NHC Key Laboratory of Myopia (Fudan University), Shanghai, People's Republic of China
| | - Hongmei Zhao
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, NHC Key Laboratory of Myopia (Fudan University), Shanghai, People's Republic of China
| | - Qian Chen
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, NHC Key Laboratory of Myopia (Fudan University), Shanghai, People's Republic of China
| | - Shenjiang Wang
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, NHC Key Laboratory of Myopia (Fudan University), Shanghai, People's Republic of China
| | - Chunhui Jiang
- Department of Ophthalmology and Visual Science, Eye, Ear, Nose and Throat Hospital, Fudan University, Shanghai, People's Republic of China
- Key Laboratory of Myopia of State Health Ministry, and Key Laboratory of Visual Impairment and Restoration of Shanghai, Shanghai, People's Republic of China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, NHC Key Laboratory of Myopia (Fudan University), Shanghai, People's Republic of China
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Barrio AR, Antona B, Morago-Villanueva S, Martínez-Arribas V, González-Pérez M. Intrasession repeatability and agreement of the anterior corneal assessment provided by a multidiagnostic device. Clin Exp Optom 2024:1-7. [PMID: 38494447 DOI: 10.1080/08164622.2024.2324978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 02/23/2024] [Indexed: 03/19/2024] Open
Abstract
CLINICAL RELEVANCE Multidiagnostic systems have recently appeared on the market. Knowledge of the repeatability and validity of any instrument is mandatory before its introduction in clinical practice. BACKGROUND The aim of this work is to examine the intrasession repeatability of anterior pole measurements provided by the multidiagnostic device Wave Analyzer Medica 700 (WAM700) and agreement with Pentacam measurements in normal eyes. METHODS In the right eyes of 113 participants, three repeat measurements of central keratometry, central corneal thickness, anterior chamber depth and corneal eccentricity were made with the WAM700 and Pentacam in random order. Intrasession repeatability and agreement were determined. RESULTS Employing WAM700, intrasession repeatability for keratometry, central corneal thickness and anterior chamber depth was good (ICCs ≥ 0.992; CV 0.48-0.98%), yet worse than the values obtained for the Pentacam (ICCs ≥ 0.998; CV 0-0.33%). WAM700 showed excellent intrasession repeatability when used to measure the anterior chamber depth (Sw 0.03 mm). However, the repeatability of this device was inferior for central corneal thickness (Sw 4.24 μm) and keratometry measurements (Sw < 0.21 D) and was poor for corneal eccentricity (Sw 0.07; ICC 0.908; CV 14.58%). Agreement between WAM700 and Pentacam showed a high ICC for the keratometry measurements, central corneal thickness and anterior chamber depth (>0.972) but lower for corneal eccentricity (ICC 0.762). CONCLUSIONS In healthy eyes, the WAM700 multidiagnostic device showed good intrasession repeatability for keratometry, central corneal thickness and anterior chamber depth measurements. Agreement between WAM700 and Pentacam was good for the anterior chamber depth measurement. However, these instruments cannot be considered interchangeable for keratometry, central corneal thickness and eccentricity readings.
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Affiliation(s)
- Ana Rosa Barrio
- Applied Vision Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| | - Beatriz Antona
- Applied Vision Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| | | | | | - Mariano González-Pérez
- Clinical and Experimental Eye Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
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Schneider S, Kallab M, Murauer O, Reisinger AS, Strohmaier S, Huang AS, Bolz M, Strohmaier CA. Bleb vessel density as a predictive factor for surgical revisions after Preserflo Microshunt implantation. Acta Ophthalmol 2024. [PMID: 38306110 DOI: 10.1111/aos.16642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/20/2023] [Accepted: 01/15/2024] [Indexed: 02/03/2024]
Abstract
PURPOSE Bleb failure is a common complication after glaucoma filtration surgery. Different bleb classification schemes incorporating filtration bleb vascularization have been proposed, but the reported correlation with intraocular pressure (IOP) has been variable, possibly because of subjective vascularization grading. The purpose of the present study was to evaluate bleb vascularization after Preserflo Microshunt (PM) implantation using anterior segment OCT-angiography (AS-OCTA) as a biomarker for bleb failure. METHODS Twenty-three eyes of twenty-three patients underwent PM implantation. Up to 12 months after surgery PM scleral passage-centred AS-OCTA measurements (PLEX Elite 9000) for bleb-vessel density (BVD) determination were performed and IOP as well as necessity for surgical revisions (needling and open revision) were documented. After multi-step image analysis (region of interest definition, artefact removal, binarization, BVD calculation), the predictive value of early postoperative BVD for surgical revisions was assessed using logistic regression modelling. RESULTS Baseline IOP (23.57 ± 7.75 mmHg) decreased significantly to 8.30 ± 2.12, 9.17 ± 2.33 and 11.70 ± 4.40 mmHg after 1, 2 and 4 week(s), and 13.48 ± 5.83, 11.87 ± 4.49, 12.30 ± 6.65, 11.87 ± 3.11 and 13.05 ± 4.12 mmHg after 2, 3, 6, 9 and 12 month(s), respectively (p < 0.001). Nine patients (39%) needed surgical revisions after a median time of 2 months. Bleb vessel densities at 2 and 4 weeks were significantly associated with future surgical revisions upon logistic regression analysis (2 W/4 W likelihood-ratio test p-value: 0.0244/0.0098; 2 W/4 W area under the receiver operating characteristics curve: 0.796/0.909). CONCLUSION Filtration bleb vessel density can be determined using AS-OCTA in the early postoperative period and is predictive for bleb failure after PM implantation.
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Affiliation(s)
- Sophie Schneider
- Department of Ophthalmology and Optometry, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Martin Kallab
- Department of Ophthalmology and Optometry, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Olivia Murauer
- Department of Ophthalmology and Optometry, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Anna-Sophie Reisinger
- Department of Ophthalmology and Optometry, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Alex S Huang
- Hamilton Glaucoma Center, The Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, California, USA
| | - Matthias Bolz
- Department of Ophthalmology and Optometry, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Clemens A Strohmaier
- Department of Ophthalmology and Optometry, Kepler University Hospital, Johannes Kepler University, Linz, Austria
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Chong YJ, Azzopardi M, Hussain G, Recchioni A, Gandhewar J, Loizou C, Giachos I, Barua A, Ting DSJ. Clinical Applications of Anterior Segment Optical Coherence Tomography: An Updated Review. Diagnostics (Basel) 2024; 14:122. [PMID: 38248000 PMCID: PMC10814678 DOI: 10.3390/diagnostics14020122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
Since its introduction, optical coherence tomography (OCT) has revolutionized the field of ophthalmology and has now become an indispensable, noninvasive tool in daily practice. Most ophthalmologists are familiar with its use in the assessment and monitoring of retinal and optic nerve diseases. However, it also has important applications in the assessment of anterior segment structures, including the cornea, conjunctiva, sclera, anterior chamber, and iris, and has the potential to transform the clinical examination of these structures. In this review, we aim to provide a comprehensive overview of the potential clinical utility of anterior segment OCT (AS-OCT) for a wide range of anterior segment pathologies, such as conjunctival neoplasia, pterygium, scleritis, keratoconus, corneal dystrophies, and infectious/noninfectious keratitis. In addition, the clinical applications of AS-OCT (including epithelial mapping) in preoperative planning and postoperative monitoring for corneal and refractive surgeries are discussed.
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Affiliation(s)
- Yu Jeat Chong
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Modality Ophthalmology, Modality Partnership, Birmingham B19 1BP, UK;
| | - Matthew Azzopardi
- Department of Ophthalmology, Royal Free Hospital, London NW3 2QG, UK;
| | - Gulmeena Hussain
- University Hospitals Birmingham NHS Foundation Trust, Birmingham B15 2GW, UK;
| | - Alberto Recchioni
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
| | - Jaishree Gandhewar
- New Cross Hospital, Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK;
| | | | - Ioannis Giachos
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
| | - Ankur Barua
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
| | - Darren S. J. Ting
- Birmingham and Midland Eye Centre, Birmingham B18 7QH, UK; (A.R.); (I.G.); (A.B.)
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK
- Academic Ophthalmology, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
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Teeuw GJ, Vergouwen DPC, Ramdas WD, Sanchez-Brea L, Andrade De Jesus D, Rothova A, Vingerling JR, Ten Berge JC. Assessment of conjunctival, episcleral and scleral thickness in healthy individuals using anterior segment optical coherence tomography. Acta Ophthalmol 2023. [PMID: 38140822 DOI: 10.1111/aos.16606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 11/07/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023]
Abstract
PURPOSE To determine the thickness of the conjunctiva, episclera and sclera in healthy individuals using anterior segment optical coherence tomography (AS-OCT). METHODS We prospectively included 107 healthy individuals of different age groups (18-39 years, 40-54 years, 55-69 years and ≥70 years). For each eye, AS-OCT scans of four quadrants (temporal, nasal, superior and inferior) were acquired. The thickness of the conjunctiva, episclera and sclera was measured for each scan. In addition, the axial length of both eyes was measured, and general characteristics, including smoking, allergies and contact lens use, were collected. RESULTS The mean conjunctival thickness was significantly different between the nasal and superior quadrants (87 ± 30 μm vs. 77 ± 16 μm; p < 0.001), as well as the superior and inferior quadrants (77 ± 16 μm vs. 86 ± 19 μm; p = 0.001). The mean episcleral thickness was larger in the superior (174 ± 54 μm) and inferior (141 ± 43 μm) quadrants, compared to the nasal (83 ± 38 μm) and temporal quadrants (90 ± 44 μm). The mean scleral thickness of the inferior quadrant was the largest (596 ± 64 μm), followed by the nasal (567 ± 76 μm), temporal (516 ± 67 μm) and superior (467 ± 52 μm) quadrants (all p < 0.001). The averaged scleral thickness increased 0.96 μm per age year (0.41-1.47 μm, p < 0.001). CONCLUSIONS This study provides an assessment of the thickness of scleral and adjacent superficial layers in healthy individuals determined on AS-OCT, which could enable future research into the use of AS-OCT in diseases affecting the anterior eye wall.
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Affiliation(s)
- G J Teeuw
- Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - D P C Vergouwen
- Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Immunology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - W D Ramdas
- Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - L Sanchez-Brea
- Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - D Andrade De Jesus
- Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - A Rothova
- Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J R Vingerling
- Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J C Ten Berge
- Department of Ophthalmology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Huang JJ, Locatelli EV, Huang JJ, De Arrigunaga S, Rao P, Dubovy S, Karp CL, Galor A. It Is All About the Angle: A Clinical and Optical Coherence Tomography Comparison of Corneal Ocular Surface Squamous Neoplasia and Corneal Pannus. Cornea 2023:00003226-990000000-00395. [PMID: 37889526 PMCID: PMC11045663 DOI: 10.1097/ico.0000000000003407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 09/13/2023] [Indexed: 10/28/2023]
Abstract
PURPOSE The aim of this study was to compare clinical characteristics and high-resolution optical coherence tomography (HR-OCT) findings between corneal ocular surface squamous neoplasia (OSSN) and corneal pannus. METHODS Retrospective study of 9 individuals, 3 with lesions histologically confirmed to be OSSN, 3 with lesions histologically confirmed to be pannus, 1 with lesions histologically confirmed to be OSSN followed by pannus, and 2 with long-standing, nonchanging lesions clinically diagnosed as pannus. All individuals presented to the Miami Veterans Affairs Medical Center eye clinic or Bascom Palmer Eye Institute between 2015 and 2023. Clinical characteristics and HR-OCT findings were evaluated and compared. RESULTS Mean age of the population was 72.8 ± 5.1 years, 100% self-identified as male, 100% as White, and 11.1% as Hispanic. Clinically, all lesions appeared as whitish, opalescent, variably vascularized opacities extending from the limbus. None of the OSSN cases had vessels that extended to the border, whereas 4 cases of pannus (67%) had at least 1 vessel that reached the border. On HR-OCT, epithelial hyperreflectivity was observed in all cases of OSSN and pannus. Epithelial thickening was observed in all cases of OSSN, but in none of the cases of pannus. An important distinction between the 2 groups was the transition between normal and abnormal epithelium. All cases of OSSN had a vertical transition, whereas all cases of pannus had an angled transition. CONCLUSIONS Corneal OSSN and corneal pannus can both present with clinical findings of an opalescent lesion and may have overlapping findings on HR-OCT. Although both entities may show epithelial hyperreflectivity on HR-OCT, OSSN demonstrates an abrupt transition at a vertical, 90 degrees angle perpendicular to the Bowman layer, whereas pannus appears as an angled transition around 45 degrees. Therefore, the angle of transition between normal and abnormal epithelium can be useful in distinguishing between the 2 entities.
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Affiliation(s)
- Jaxon J. Huang
- Surgical and Research Services, Miami Veterans Administration Medical Center, Miami, FL, 33125, United States
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, 33136, United States
| | - Elyana V.T. Locatelli
- Surgical and Research Services, Miami Veterans Administration Medical Center, Miami, FL, 33125, United States
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, 33136, United States
| | - Jordan J. Huang
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, 33136, United States
| | - Sofia De Arrigunaga
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, 33136, United States
| | - Pragnya Rao
- LV Prasad Eye Institute, Cornea and Anterior Segment Services, Hyderabad, TG, 500034, India
| | - Sander Dubovy
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, 33136, United States
| | - Carol L. Karp
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, 33136, United States
| | - Anat Galor
- Surgical and Research Services, Miami Veterans Administration Medical Center, Miami, FL, 33125, United States
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, FL, 33136, United States
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Locatelli EVT, Huang JJ, Mangwani-Mordani S, Tovar Vetencourt AA, Galor A. Individuals with Diabetes Mellitus Have a Dry Eye Phenotype Driven by Low Symptom Burden and Anatomic Abnormalities. J Clin Med 2023; 12:6535. [PMID: 37892672 PMCID: PMC10607897 DOI: 10.3390/jcm12206535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 09/29/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Dry eye disease is an umbrella term that includes a variety of symptoms and signs. A link between diabetes mellitus and dry eye disease exists, but the associated phenotype needs further examination. Thus, our aim was to determine how diabetes mellitus relates to the dry eye disease phenotype. A prospective, cross-sectional study was conducted at the Miami Veteran Affairs Medical Center ophthalmology clinic between October 2013 and September 2019. Participants included a volunteer sample of 366 South Florida veterans with one or more symptoms or signs of dry eye disease [Dry Eye Questionnaire-5 ≥ 6 OR tear break-up time ≤ 5 OR Schirmer's test score ≤ 5 OR corneal fluorescein staining ≥ 2]. Participants were divided into three groups: (1) individuals without diabetes mellitus (controls); (2) individuals with diabetes mellitus but without end-organ complications; and (3) individuals with diabetes mellitus and end-organ complications. Dry eye metrics were compared across groups. The main outcome measures included ocular symptom questionnaires [e.g., 5-item Dry Eye Questionnaire, Ocular Surface Disease Index, and ocular pain assessment] and clinical parameters obtained from an ocular surface evaluation. A total of 366 individuals were included (mean age 59 ± 6 years; 89% males; 39% White; 11% diabetes mellitus and end-organ complications; 15% diabetes mellitus but without end-organ complications). Individuals with diabetes mellitus and end-organ complications had lower symptom scores on the dry eye disease and pain-specific questionnaires compared to individuals with diabetes mellitus but without end-organ complications and controls (Ocular Surface Disease Index: 42.1 ± 24.5 vs. 38.9 ± 25.1 vs. 23.6 ± 16.2; p < 0.001; numerical rating scale of ocular pain intensity: 4.9 ± 3.2 vs. 4.3 ± 2.7 vs. 3.5 ± 2.7; p = 0.02). Eyelid laxity was also more severe in the group with diabetes mellitus and end-organ complications (0.69 ± 0.64 vs. 0.73 ± 0.72 vs. 1.08 ± 0.77; p = 0.004) compared to the two other groups. The diabetic dry eye disease phenotype is driven by signs more so than by symptoms, with anatomic eyelid abnormalities being more frequent in individuals with diabetes mellitus and end-organ complications. Given this, ocular surface abnormalities in individuals with DM may be missed if screened by symptoms alone. As such, individuals with DM should undergo a slit lamp examination for signs of ocular surface disease, including anatomic abnormalities.
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Affiliation(s)
- Elyana V. T. Locatelli
- Surgical and Research Services, Miami Veterans Affairs Medical Center, Miami, FL 33125, USA; (E.V.T.L.); (J.J.H.); (S.M.-M.)
- Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA;
| | - Jaxon J. Huang
- Surgical and Research Services, Miami Veterans Affairs Medical Center, Miami, FL 33125, USA; (E.V.T.L.); (J.J.H.); (S.M.-M.)
- Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA;
| | - Simran Mangwani-Mordani
- Surgical and Research Services, Miami Veterans Affairs Medical Center, Miami, FL 33125, USA; (E.V.T.L.); (J.J.H.); (S.M.-M.)
- Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA;
| | | | - Anat Galor
- Surgical and Research Services, Miami Veterans Affairs Medical Center, Miami, FL 33125, USA; (E.V.T.L.); (J.J.H.); (S.M.-M.)
- Bascom Palmer Eye Institute, University of Miami, Miami, FL 33136, USA;
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Noorani S, Kim DB. Tape-splint tarsorrhaphy technique to manage exposure keratopathy in a patient refusing surgical intervention. Clin Case Rep 2023; 11:e7797. [PMID: 37575457 PMCID: PMC10421974 DOI: 10.1002/ccr3.7797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/15/2023] [Accepted: 07/25/2023] [Indexed: 08/15/2023] Open
Abstract
This case report describes the benefits of a unique tape-splinting technique to serve as a nonsurgical tarsorrhaphy in the management of exposure keratopathy in a patient who refuses surgical intervention.
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Affiliation(s)
- Soha Noorani
- Philadelphia College of Osteopathic MedicineSuwaneeGeorgiaUSA
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Gobeka HH, Gülyeşil FF, Sabaner MC. Acute Effects of Neodymium-Doped Yttrium Aluminum Garnet Laser Capsulotomy on Anterior Segment Parameters in Capsular Bag Distension Syndrome. Photobiomodul Photomed Laser Surg 2023; 41:429-434. [PMID: 37579135 DOI: 10.1089/photob.2022.0151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023] Open
Abstract
Background: Capsular bag distension syndrome (CBDS) can be effectively treated using either Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) laser capsulotomy or surgery. Assessing anterior segment, particularly immediately after Nd:YAG laser capsulotomy, could provide clinically relevant information on ocular dynamics, refractive changes, and complication mechanisms, especially in late postoperative CBDS. Objective: To explore the acute effects of Nd:YAG laser posterior capsulotomy on anterior segment parameters in late postoperative CBDS. Methods and results: In this study, 20 patients underwent Nd:YAG laser posterior capsulotomy after cycloplegia, during which milky-white fluid material migrated into the anterior vitreous. Anterior segment parameters were assessed before and immediately after laser using Scheimpflug-Placido topographer. The main outcome measures were differences in best-corrected visual acuity (BCVA), aqueous depth (AqD), anterior chamber volume (ACV), iridocorneal angle (ICA), corneal volume (CV), and central corneal thickness (CCT) at the baseline versus at immediately after laser. The mean age and duration since surgery for CBDS presentation were 70.25 ± 6.21 and 6.15 ± 1.31 years, respectively. The AqD, ACV, ICA, and spherical equivalent increased significantly compared with baseline (4.18 vs. 4.02 mm, p = 0.001; 177 vs. 173.55 mm3, p = 0.004; 51.15° vs. 50.15°, p = 0.023; -1.00 vs. -2.00 D, p = 0.003, respectively). These changes were also associated with significantly improved BCVA an hour after capsulotomy [0.2 (0.05-0.2)] relative to baseline [0.3 (0.2-0.5)], (p = 0.001). CCT and CV decreased nonsignificantly; horizontal AC diameter and K1 and K2 increased nonsignificantly (p > 0.05). Conclusions: Nd:YAG laser posterior capsulotomy appears to be an effective CBDS treatment for acutely improving vision, potentially due to immediate refractive changes caused by altered anterior segment parameters.
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Affiliation(s)
- Hamidu Hamisi Gobeka
- Department of Ophthalmology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | | | - Mehmet Cem Sabaner
- Department of Ophthalmology, Samsun Bafra State Hospital, Samsun, Turkey
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Sakallioğlu AK, Alacamli G, Sattarpanah S, Guclu H. Evaluation of the structural changes of uveitis patients by optical biometry. Rom J Ophthalmol 2023; 67:238-243. [PMID: 37876515 PMCID: PMC10591429 DOI: 10.22336/rjo.2023.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/26/2023] Open
Abstract
Objective (Aim): To observe the ocular structural changes in active and inactive uveitis patients. Methods: This retrospective study involved 30 patients (32 eyes) with anterior and intermediate uveitis cases and 54 eyes of 54 cases in a control group, who were admitted to the Ophthalmology Department at Trakya University. In the study group, 14 patients were females, 16 patients were males and in the control group 26 volunteers were females, and 28 volunteers were male of the 54 volunteers. Anterior chamber depth, axial length, intraocular pressure, lens thickness, central corneal thickness, steep and flat values in keratometry, corrected visual acuity in both eyes, anterior chamber cells, and vitreous cells were measured and compared between three groups (two uveitis groups - active and inactive - and control group). Results: In the comparison of the median values of axial length, central corneal thickness, and steep and flat values of keratometry, the values of the patients with active uveitis were higher than the ones in the control group in each parameter, but no significant difference was observed. The anterior chamber depth parameter value was higher, the lens thickness value was lower in patients with active uveitis than the values in the control group and the differences were statistically significant (p<0,05). No significant structural differences in the values of the active and inactive group patients (p>0,05) were observed. Conclusions: Only lens thickness and anterior chamber depth parameters were statistically significant in patients with active uveitis, compared with the inactive uveitis group. Anterior chamber depth measurement values were higher and lens thickness measurement values were lower in patients with active uveitis when compared with the control group. Abbreviations: AAU = Acute anterior uveitis, CAU = Chronic Anterior Uveitis, AC = Anterior Chamber, IOP = Intraocular Pressure, IVCM = in vivo Confocal Microscopy, AS-OCT = Anterior Segment Optical Coherence Tomography, UBM = Ultrasound Biomicroscopy, LFP = Laser Flare Photometry, KP = Keratic Precipitates, OCT = Optical Coherence Tomography, AL = Axial Length, ACD = Anterior Chamber Depth, LT = Lens Thickness, CCT = Central Corneal Thickness, Ks = Steep Value of Keratometry, Kf = Flat Value of Keratometry, AUP = Active Uveitis Patients, IUP = Inactive Uveitis Patients, SUN = Standardization of Uveitis Nomenclature.
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Affiliation(s)
| | - Goksu Alacamli
- Department of Ophthalmology, Clinical County Emergency Hospital, Brăila, Romania
| | - Samira Sattarpanah
- Department of Ophthalmology, “Grigore T. Popa” University of Medicine and Pharmacy, Iaşi, Romania
| | - Hande Guclu
- Department of Ophthalmology, Clinical County Emergency Hospital, Brăila, Romania
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11
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Vöcking O, Famulski JK. Single cell transcriptome analyses of the developing zebrafish eye- perspectives and applications. Front Cell Dev Biol 2023; 11:1213382. [PMID: 37457291 PMCID: PMC10346855 DOI: 10.3389/fcell.2023.1213382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Within a relatively short period of time, single cell transcriptome analyses (SCT) have become increasingly ubiquitous with transcriptomic research, uncovering plentiful details that boost our molecular understanding of various biological processes. Stemming from SCT analyses, the ever-growing number of newly assigned genetic markers increases our understanding of general function and development, while providing opportunities for identifying genes associated with disease. SCT analyses have been carried out using tissue from numerous organisms. However, despite the great potential of zebrafish as a model organism, other models are still preferably used. In this mini review, we focus on eye research as an example of the advantages in using zebrafish, particularly its usefulness for single cell transcriptome analyses of developmental processes. As studies have already shown, the unique opportunities offered by zebrafish, including similarities to the human eye, in combination with the possibility to analyze and extract specific cells at distinct developmental time points makes the model a uniquely powerful one. Particularly the practicality of collecting large numbers of embryos and therefore isolation of sufficient numbers of developing cells is a distinct advantage compared to other model organisms. Lastly, the advent of highly efficient genetic knockouts methods offers opportunities to characterize target gene function in a more cost-efficient way. In conclusion, we argue that the use of zebrafish for SCT approaches has great potential to further deepen our molecular understanding of not only eye development, but also many other organ systems.
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12
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Mandell JT, de Rivero Vaccari JP, Sabater AL, Galor A. The inflammasome pathway: A key player in ocular surface and anterior segment diseases. Surv Ophthalmol 2023; 68:280-289. [PMID: 35798189 DOI: 10.1016/j.survophthal.2022.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 06/29/2022] [Accepted: 06/30/2022] [Indexed: 01/06/2023]
Abstract
Inflammasomes are multicomplex molecular regulators with an emerging importance in regulating ocular surface and anterior segment health and disease. Key components found in the eye include NF-κB, NLRP3, NLRC4, NLRP6, ASC, IL-1β, IL-18, and caspase-1. The role of NLRP1, NLRC4, AIM2, and NLRP3 inflammasomes in the pathogenesis of infectious ulcers, DED, uveitis, glaucoma, corneal edema, and other diseases is being studied with many developments. Attenuation of these diseases has been explored by blocking various molecules along the inflammasome pathway with agents like NAC, polydatin, calcitriol, glyburide, YVAD, and disulfiram. We provide a background on the inflammasome pathway as it relates to the ocular surface and anterior segment of the eye, discuss the role of inflammasomes in the above diseases in animals and humans, investigate new therapeutic targets, and explore the efficacy of new anti-inflammasome therapies.
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Affiliation(s)
| | - Juan Pablo de Rivero Vaccari
- Department of Neurological Surgery, The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, FL, USA
| | | | - Anat Galor
- Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA; Ophthalmology, Miami Veterans Affairs (VA) Medical Center, Miami, FL, USA.
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13
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Başkan C, Kılıcarslan A. How Can We Diagnose Ocular Surface Squamous Neoplasia With Optical Coherence Tomography? Cureus 2023; 15:e36320. [PMID: 36941905 PMCID: PMC10023871 DOI: 10.7759/cureus.36320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 03/19/2023] Open
Abstract
AIM We aimed to evaluate the effectiveness of optical coherence tomography (OCT) in the differential diagnosis of anterior segment diseases such as ocular surface squamous neoplasia (OSSN) and pterygium. METHODS Patients who were pre-diagnosed with either OSSN (21) or pterygium (19) between January 2020 and November 2022 were included in this retrospective study. Anterior segment photographs and anterior segment optical coherence tomography (AS-OCT) measurements were obtained from each patient. Excisional or incisional biopsy materials underwent pathological evaluation. RESULTS Preoperative AS-OCT images of the patients with OSSN showed similarities with histopathological specimens. Both ocular and pathological specimens appeared to have a thicker epithelial layer with a distinct change from healthy to neoplastic epithelium. Preoperative AS-OCT images of individuals with pterygium were also comparable with histopathological samples. Both pathological and AS-OCT images of the pterygium patients showed a normal thickness epithelium and a thickened subepithelial layer under the epithelium. The mean epithelial thickness measured with AS-OCT in OSSN patients was found to be 295.3 ± 111.3 µm, while it was 80.7 ± 43.4 µm in pterygium patients. The difference was statistically significant (P<0.001). The receiver operating characteristic (ROC) curve analysis revealed a cut-off value of 97 µm for the differential diagnosis of OSSN from pterygium, with a sensitivity of 100% and specificity of 94.7%. CONCLUSIONS AS-OCT can be used as a noninvasive diagnostic tool for the evaluation of ocular surface lesions. Its ability to distinguish between OSSN and pterygium is demonstrated by the statistically significant difference in epithelial thickness and the significant morphological association with histopathological findings.
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Affiliation(s)
- Ceyda Başkan
- Ophthalmology, Ankara Bilkent City Hospital, Ankara, TUR
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14
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Sung MS, Kim HJ, Park SW. Predictors of long-term visual field outcome after an episode of acute primary angle closure. Clin Exp Ophthalmol 2023. [PMID: 36641235 DOI: 10.1111/ceo.14206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 12/14/2022] [Accepted: 01/07/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND To investigate the long-term visual field (VF) outcome and baseline factors associated with functional sequelae in patients who experienced an episode of acute primary angle closure (APAC) and underwent subsequent lens extraction. METHODS Fifty patients (50 eyes) who experienced an APAC episode and underwent subsequent lens extraction at Chonnam National University Hospital were enrolled in this retrospective study. Patients underwent VF examinations after 1 year of an acute episode. They were classified into two groups based on whether they had significant VF defects or not. Demographic data were recorded, and baseline anterior-segment OCT (AS-OCT) images were analysed. Multivariate logistic regression analysis was performed to assess baseline risk factors for presence of VF defects. RESULTS Twenty-five (50%) eyes were found to have varied degree of VF defects after 1 year of an acute episode. Longer duration between the symptom onset and IOP lowering (p = 0.005), a higher presenting IOP (p = 0.014), and flat iris curvature (p = 0.037) at baseline AS-OCT measurement were significant predictors of VF loss. The area under the receiver operating characteristic curve (AUC) revealed that combination of these three potential baseline factors could predict the long-term VF outcome (AUC = 0.921). CONCLUSIONS Patients exhibiting a long duration between symptom onset and IOP lowering, a high presenting IOP, and flat iris curvature were at a higher risk of visual impairment after an episode of APAC. The eyes with such features may require more careful follow-up after an episode of APAC.
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Affiliation(s)
- Mi Sun Sung
- Chonnam National University, College of Medicine, Gwangju, South Korea.,Chonnam National University Hospital, Department of Ophthalmology, Gwangju, South Korea
| | - Hyun Jee Kim
- Chonnam National University Hospital, Department of Ophthalmology, Gwangju, South Korea
| | - Sang Woo Park
- Chonnam National University, College of Medicine, Gwangju, South Korea.,Chonnam National University Hospital, Department of Ophthalmology, Gwangju, South Korea
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15
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Chen X, Yang R, Shen J, Huang Q, Wu Z. Research Progress of Bioinspired Nanostructured Systems for the Treatment of Ocular Disorders. Pharmaceuticals (Basel) 2023; 16:ph16010096. [PMID: 36678597 PMCID: PMC9865244 DOI: 10.3390/ph16010096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 12/30/2022] [Accepted: 01/06/2023] [Indexed: 01/12/2023] Open
Abstract
How to enhance the bioavailability and prolong the residence time of drugs in the eye present the major barriers to traditional eye delivery. Nanotechnology has been widely used in ocular drug delivery systems because of its advantages of minimizing adverse reactions, decreasing the frequency of administration, prolonging the release time, and improving the bioavailability of the drug in the eye. As natural product-based nanostructured systems, bioinspired nanostructured systems have presented as less toxic, easy to prepare, and cost-effective and have potential application value in the field of nanotechnology. A systematic classification of bioinspired nanostructured systems based on their inspiration source and formulation and their brief applications in disease are presented here. A review of recent research progress of the bioinspired nanostructured systems for the treatment of the anterior and posterior segment of ocular disorders is then presented in detail. Finally, current challenges and future directions with regard to manufacturing bioinspired nanomaterials are provided.
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Affiliation(s)
- Xuan Chen
- Department of Ophthalmology, Wuxi Second People’s Hospital, Nanjing Medical University, Wuxi 214002, China
| | - Rui Yang
- Research Institute for Reproductive Health and Genetic Diseases, Wuxi Maternity and Child Health Care Hospital, Wuxi School of Medicine, Jiangnan University, Wuxi 214002, China
- Correspondence: (R.Y.); (Z.W.)
| | - Jinyan Shen
- Department of Ophthalmology, Wuxi Second People’s Hospital, Nanjing Medical University, Wuxi 214002, China
| | - Qingyu Huang
- Department of Ophthalmology, Wuxi Second People’s Hospital, Nanjing Medical University, Wuxi 214002, China
| | - Zhifeng Wu
- Department of Ophthalmology, Wuxi Second People’s Hospital, Nanjing Medical University, Wuxi 214002, China
- Department of Ophthalmology, Affiliated Wuxi Clinical College of Nantong University, Wuxi 214002, China
- Correspondence: (R.Y.); (Z.W.)
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16
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Abstract
Since the introduction of artificial intelligence (AI) in 1956 by John McCarthy, the field has propelled medicine, optimized efficiency, and led to technological breakthroughs in clinical care. As an important frontier in healthcare, AI has implications on every subspecialty within medicine. This review highlights the applications of AI in ophthalmology: a specialty that lends itself well to the integration of computer algorithms due to the high volume of digital imaging, data, and objective metrics such as central retinal thickness. The focus of this review is the use of AI in retina, cornea, anterior segment, and pediatrics.
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Affiliation(s)
- Ojas Srivastava
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alta, Canada
| | - Matthew Tennant
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alta, Canada
| | - Parampal Grewal
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alta; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ont, Canada
| | - Uriel Rubin
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alta, Canada
| | - Mark Seamone
- Department of Ophthalmology and Visual Sciences, University of Alberta, Edmonton, Alta, Canada
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17
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McLintock C, Niyazmand H, Seo S, Barrett G, Kumar Nilagiri V, Karimian S, McKelvie J. Agreement between a new swept-source ocular coherence tomography and a Placido disc-dual Scheimpflug ocular biometric devices. Eur J Ophthalmol 2022; 33:11206721221143160. [PMID: 36475915 DOI: 10.1177/11206721221143160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
PURPOSE To evaluate the agreement between two biometry devices, the Heidelberg Anterion and the Galilei G6 Lens Professional. METHODS Eyes were scanned with both biometry devices. Analysis of inter-device agreement was conducted for the following metrics: flat (K1), steep (K2) and mean K (Km) for anterior, posterior and total cornea, lens thickness (LT), central corneal thickness (CCT), anterior chamber depth (ACD), white to white (WTW) and axial length (AL). Generalised Estimating Equations were used to account for inter-eye correlation. Bland-Altman analysis was conducted to derive the mean difference (MD) and limits of agreement (LoA) between devices. Differences were deemed clinically significant if they would result in a change in post-operative refraction of 0.25D or more. RESULTS 159 eyes of 91 patients were included. For the anterior cornea, no significant MD was found for K1 (-0.11D) and K2 (-0.10D), although a significant MD was found for Km (-0.10D). For posterior cornea, while there were no significant MDs between devices, the LoAs were wide for both posterior K1(-0.70, 0.68) and posterior K2 (-1.01, 1.29). For total corneal power, significant MDs were found in K1 (0.36D), and Km (0.26D) but not for K2 (0.17D). Significant MDs were found for LT (0.179mm), CCT (-0.005mm), ACD (-0.111mm) and WTW (-0.158mm), but not for AL (-0.021mm, p > 0.05).Conclusion: There are statistically but not clinically significant differences between Anterion and Galilei G6 Lens Professional in anterior Km, LT, CCT, ACD and WTW. Measurements of the posterior and total cornea are not interchangeable between devices.
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Affiliation(s)
- Cameron McLintock
- Department of Ophthalmology, 1966Princess Alexandra hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD 4102, Australia
- School of Medicine, University of Queensland, Brisbane, Australia
| | - Hamed Niyazmand
- Division of Optometry, School of Allied Health, Faculty of Health and Medical Sciences, 2720The University of Western Australia, QEII Health Campus, Nedlands, 6009, Western Australia, Australia
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Shiney Seo
- Department of Ophthalmology, 1966Princess Alexandra hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD 4102, Australia
| | - Graham Barrett
- 10111Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia
- Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | | | - Sahar Karimian
- Rockingham Medical Research Centre, Rockingham, Perth, Australia
| | - James McKelvie
- Department of Ophthalmology, 1415University of Auckland, Auckland, New Zealand
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18
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Straßer T, Wagner S. Performance of the Deep Neural Network Ciloctunet, Integrated with Open-Source Software for Ciliary Muscle Segmentation in Anterior Segment OCT Images, Is on Par with Experienced Examiners. Diagnostics (Basel) 2022; 12:diagnostics12123055. [PMID: 36553062 PMCID: PMC9777151 DOI: 10.3390/diagnostics12123055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/24/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022] Open
Abstract
Anterior segment optical coherence tomography (AS-OCT), being non-invasive and well-tolerated, is the method of choice for an in vivo investigation of ciliary muscle morphology and function. The analysis requires the segmentation of the ciliary muscle, which is, when performed manually, both time-consuming and prone to examiner bias. Here, we present a convolutional neural network trained for the automatic segmentation of the ciliary muscle in AS-OCT images. Ciloctunet is based on the Freiburg U-net and was trained and validated using 1244 manually segmented OCT images from two previous studies. An accuracy of 97.5% for the validation dataset was achieved. Ciloctunet's performance was evaluated by replicating the findings of a third study with 180 images as the test data. The replication demonstrated that Ciloctunet performed on par with two experienced examiners. The intersection-over-union index (0.84) of the ciliary muscle thickness profiles between Ciloctunet and an experienced examiner was the same as between the two examiners. The mean absolute error between the ciliary muscle thickness profiles of Ciloctunet and the two examiners (35.16 µm and 45.86 µm) was comparable to the one between the examiners (34.99 µm). A statistically significant effect of the segmentation type on the derived biometric parameters was found for the ciliary muscle area but not for the selective thickness reading ("perpendicular axis"). Both the inter-rater and the intra-rater reliability of Ciloctunet were good to excellent. Ciloctunet avoids time-consuming manual segmentation, thus enabling the analysis of large numbers of images of ample study cohorts while avoiding possible examiner biases. Ciloctunet is available as open-source.
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Affiliation(s)
- Torsten Straßer
- Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany
- University Eye Hospital Tuebingen, 72076 Tuebingen, Germany
- Correspondence:
| | - Sandra Wagner
- Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany
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Williams AL, Bohnsack BL. Zebrafish Model of Stickler Syndrome Suggests a Role for Col2a1a in the Neural Crest during Early Eye Development. J Dev Biol 2022; 10:jdb10040042. [PMID: 36278547 PMCID: PMC9589970 DOI: 10.3390/jdb10040042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/21/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
Most cases of Stickler syndrome are due to autosomal-dominant COL2A1 gene mutations leading to abnormal type II collagen. Ocular findings include axial eye lengthening with vitreal degeneration and early-onset glaucoma, which can result in vision loss. Although COL2A1 is a major player in cartilage and bone formation, its specific role in eye development remains elusive. We investigated the role of Col2a1a in neural crest migration and differentiation during early zebrafish eye development. In situ hybridization, immunofluorescence, live imaging, exogenous treatments [10 μM diethylaminobenzaldehyde (DEAB), 100 nM all-trans retinoic acid (RA) and 1-3% ethanol (ETOH)] and morpholino oligonucleotide (MO) injections were used to analyze wildtype Casper (roy-/-;nacre-/-), TgBAC(col2a1a::EGFP), Tg(sox10::EGFP) and Tg(foxd3::EGFP) embryos. Col2a1a colocalized with Foxd3- and Sox10-positive cells in the anterior segment and neural crest-derived jaw. Col2a1a expression was regulated by RA and inhibited by 3% ETOH. Furthermore, MO knockdown of Col2a1a delayed jaw formation and disrupted the ocular anterior segment neural crest migration of Sox10-positive cells. Interestingly, human COL2A1 protein rescued the MO effects. Altogether, these results suggest that Col2a1a is a downstream target of RA in the cranial neural crest and is required for both craniofacial and eye development.
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Affiliation(s)
- Antionette L. Williams
- Division of Ophthalmology, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave., Chicago, IL 60611, USA
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, 645 N. Michigan Ave., Chicago, IL 60611, USA
- Correspondence: (A.L.W.); (B.L.B.); Tel.: +1-312-503-4706 (A.L.W.); +1-312-227-6180 (B.L.B.)
| | - Brenda L. Bohnsack
- Division of Ophthalmology, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E. Chicago Ave., Chicago, IL 60611, USA
- Department of Ophthalmology, Northwestern University Feinberg School of Medicine, 645 N. Michigan Ave., Chicago, IL 60611, USA
- Correspondence: (A.L.W.); (B.L.B.); Tel.: +1-312-503-4706 (A.L.W.); +1-312-227-6180 (B.L.B.)
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20
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Fuellen G, Jünemann A. Gene Expression Data for Investigating Glaucoma Treatment Options and Pharmacology in the Anterior Segment, State-of-the-Art and Future Directions. Front Neurosci 2022; 16:912043. [PMID: 35757536 PMCID: PMC9213806 DOI: 10.3389/fnins.2022.912043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 05/20/2022] [Indexed: 11/30/2022] Open
Abstract
Glaucoma treatment options as well as its etiology are far from understood. Gene expression (transcriptomics) data of the anterior segment of the eye can help by elucidating the molecular-mechanistic underpinnings, and we present an up-to-date description and discussion of what gene expression data are publicly available, and for which purposes these can be used. We feature the few resources covering all segments of the eye, and we then specifically focus on the anterior segment, and provide an extensive list of the Gene Expression Omnibus data that may be useful. We also feature single-cell data of relevance, particularly three datasets from tissues of relevance to aqueous humor outflow. We describe how the data have been used by researchers, by following up resource citations and data re-analyses. We discuss datasets and analyses pertaining to fibrosis following glaucoma surgery, and to glaucoma resulting from the use of steroids. We conclude by pointing out the current lack and underutilization of ocular gene expression data, and how the state of the art is expected to improve in the future.
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Affiliation(s)
- Georg Fuellen
- Institute for Biostatistics and Informatics in Medicine and Aging Research, Rostock University Medical Center, Rostock, Germany
| | - Anselm Jünemann
- Institute for Biostatistics and Informatics in Medicine and Aging Research, Rostock University Medical Center, Rostock, Germany
- Department of Ophthalmology, Rostock University Medical Center, Rostock, Germany
- Department of General Ophthalmology and Pediatric Ophthalmology Service, Medical University of Lublin, Lublin, Poland
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21
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Oren B, Kocabas DO. Assessment of corneal endothelial cell morphology and anterior segment parameters in COVID-19. Ther Adv Ophthalmol 2022; 14:25158414221096057. [PMID: 35574183 PMCID: PMC9092573 DOI: 10.1177/25158414221096057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/05/2022] [Indexed: 12/16/2022] Open
Abstract
Background The ocular manifestations of the 2019 novel coronavirus disease (COVID-19) vary from acute follicular, pseudomembranous, and hemorrhagic conjunctivitis to keratoconjunctivitis with subepithelial infiltrates and dendritic lesions. Similar to other respiratory viruses, such as adenoviruses, it is thought that COVID-19 may impact the cornea. However, its impact on the cornea and anterior segment parameters are currently poorly understood. Objective This study aims to assess the corneal endothelial cell morphology and anterior segment parameters in patients who have recovered from COVID-19. Methods In this cross-sectional study, the COVID-19 group comprised 34 patients who had been diagnosed with and recovered from COVID-19, while the control group comprised age- and sex-matched individuals without any systemic or ocular diseases. The endothelial cell density (ECD), coefficient of variation (CV) of cell area, hexagonal cell percentage (HEX), anterior chamber depth (ACD), central corneal thickness (CCT), horizontal anterior chamber diameter (HACD), iridocorneal angle (ICA), horizontal visible iris diameter (HVID), pupillary diameter (PD), and keratometry values (K1 and K2) were analyzed for each participant. The differences in each of these between the groups were analyzed using either an independent samples t test or a Mann-Whitney U test based on the normality of the data. Results Regarding corneal endothelial cell morphology, the ECDs for the COVID-19 and control groups were 2278.50 ± 186.78 cells/mm2 and 2420.15 ± 222.25 cells/mm2, respectively (p = 0.002). A significant increase was noted in CV values in the COVID-19 group compared with the control group (p < 0.001). The HEX values for the COVID-19 and control groups were 56.26 ± 5.75 and 61.50 ± 3.63, respectively (p < 0.001). Regarding the anterior segment parameters, no significant differences were observed between the groups (p > 0.05). Conclusions It was hypothesized that individuals who had recovered from COVID-19 would demonstrate a reduction in their endothelial functional preserves. A decrease in ECD and HEX and an increase in CV were observed in the individuals during their early post-recovery period from COVID-19.
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Affiliation(s)
- Burak Oren
- Department of Ophthalmology, Adıyaman
University Training and Research Hospital, Adıyaman, Turkey
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22
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Szpernal J, Bachman Groth JA, Wynne N, Williams V, Spellecy R, Thuruthumaly C, Carroll J. Pupillary Dilation in Research: More than Meets the Eye. Curr Eye Res 2022; 47:965-977. [PMID: 35499263 DOI: 10.1080/02713683.2022.2053723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Purpose: Pupil dilation is a commonly used procedure in vision research. While often considered a minimal risk procedure, there is the potential for significant adverse effects. Methods: Currently, there is variance in practices and protocols among researchers and institutions, perhaps due to a lack of guidelines for safe pupil dilation practices in research settings. In this perspective, we explore variables that can increase the potential for adverse effects and provide suggestions to limit their impact. Prior to dilation, an investigator can assess an individual's medical status and drug regimen when deciding upon a mydriatic agent to be used. Results: Assessing the angle through a variety of methods (i.e. penlight test, van Herick slit lamp, optical coherence tomography, gonioscopy) can also prevent inappropriate dilation of pupils with concerning anatomical features. During dilation, an investigator should look to limit the potential of infection and use caution in repeat dosing of dilation-resistant pupils. Conclusions: Post-dilation, an investigator should closely monitor eyes with elevated risk factors and improve an individual's health literacy on angle closure complications. When combined with proper informed consent processes regarding adverse effects, the aforementioned can allow for risk mitigation in studies using pupil dilation.
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Affiliation(s)
- Jacob Szpernal
- School of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jane A Bachman Groth
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Niamh Wynne
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Vesper Williams
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ryan Spellecy
- Center for Bioethics and Medical Humanities, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Catherine Thuruthumaly
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Joseph Carroll
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.,Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA.,Department of Biomedical Engineering, Medical College of Wisconsin, Milwaukee, WI, USA
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Luo M, Zhu Y, Xiao H, Huang J, Ling J, Huang H, Li Y, Zhuo Y. Characteristic Assessment of Angiographies at Different Depths with AS-OCTA: Implication for Functions of Post-Trabeculectomy Filtering Bleb. J Clin Med 2022; 11:jcm11061661. [PMID: 35329987 PMCID: PMC8949979 DOI: 10.3390/jcm11061661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/23/2022] [Accepted: 03/09/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to analyze the quantitative vascular biomarkers of filtering bleb function at different depths using anterior segment optical coherence tomography angiography (AS-OCTA). This cross-sectional study is registered on Clinicaltrails.gov (NCT 04515017). Forty-six eyes with primary open-angle glaucoma that had undergone trabeculectomy with mitomycin-C for more than six months were included. Vessel density (VD) and vessel diameter index (VDI) in the superficial layer (SL), Tenon’s layer (TL), and deep layer (DL) of the bleb were obtained. The VD and VDI were higher in the failure group (both p = 0.000). Significant correlations were found between the SL, TL, DL’s VDI, and IOP in the success group (p = 0.013, 0.016, 0.031, respectively). The VD of the TL and DL were related to IOP in the failure group (p = 0.012, 0.009). Tenon’s VD (TVD) and Tenon’s VDI (TVDI) correlated with IOP adjusting for TVD, TVDI, and the Indiana Bleb Appearance Grading Scale (IBAGS) (p = 0.009, 0.043) or Kenfeld grading system (KGS) (p = 0.011, 0.016). The area under curve (AUC) of the TVD, TVDI, IBAGS, and KGS to predict surgery failure were 0.960, 0.925, 0.770, and 0.850. AS-OCTA realized the quantitative evaluation of vessels, especially the invisible vascularity beneath the conjunctiva. TVD and TVDI as detected by AS-OCTA better reflected bleb function than conventional grading systems.
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Affiliation(s)
- Man Luo
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (M.L.); (Y.Z.); (H.X.); (J.H.); (J.L.); (H.H.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Yingting Zhu
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (M.L.); (Y.Z.); (H.X.); (J.H.); (J.L.); (H.H.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Hui Xiao
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (M.L.); (Y.Z.); (H.X.); (J.H.); (J.L.); (H.H.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Jingjing Huang
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (M.L.); (Y.Z.); (H.X.); (J.H.); (J.L.); (H.H.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Jin Ling
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (M.L.); (Y.Z.); (H.X.); (J.H.); (J.L.); (H.H.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Haishun Huang
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (M.L.); (Y.Z.); (H.X.); (J.H.); (J.L.); (H.H.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Yiqing Li
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (M.L.); (Y.Z.); (H.X.); (J.H.); (J.L.); (H.H.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
- Correspondence: (Y.L.); (Y.Z.)
| | - Yehong Zhuo
- State Key Laboratory of Ophthalmology, Guangzhou 510060, China; (M.L.); (Y.Z.); (H.X.); (J.H.); (J.L.); (H.H.)
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China
- Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou 510060, China
- Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
- Correspondence: (Y.L.); (Y.Z.)
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Romaus-Sanjurjo D, Regueiro U, López-López M, Vázquez-Vázquez L, Ouro A, Lema I, Sobrino T. Alzheimer's Disease Seen through the Eye: Ocular Alterations and Neurodegeneration. Int J Mol Sci 2022; 23:2486. [PMID: 35269629 DOI: 10.3390/ijms23052486] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 02/21/2022] [Accepted: 02/22/2022] [Indexed: 12/18/2022] Open
Abstract
Alzheimer’s Disease (AD) is one of the main neurodegenerative diseases worldwide. Unfortunately, AD shares many similarities with other dementias at early stages, which impedes an accurate premortem diagnosis. Therefore, it is urgent to find biomarkers to allow for early diagnosis of the disease. There is increasing scientific evidence highlighting the similarities between the eye and other structures of the CNS, suggesting that knowledge acquired in eye research could be useful for research and diagnosis of AD. For example, the retina and optic nerve are considered part of the central nervous system, and their damage can result in retrograde and anterograde axon degeneration, as well as abnormal protein aggregation. In the anterior eye segment, the aqueous humor and tear film may be comparable to the cerebrospinal fluid. Both fluids are enriched with molecules that can be potential neurodegenerative biomarkers. Indeed, the pathophysiology of AD, characterized by cerebral deposits of amyloid-beta (Aβ) and tau protein, is also present in the eyes of AD patients, besides numerous structural and functional changes observed in the structure of the eyes. Therefore, all this evidence suggests that ocular changes have the potential to be used as either predictive values for AD assessment or as diagnostic tools.
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Kudsieh B, Fernández‐Vigo JI, Canut Jordana MI, Vila‐Arteaga J, Urcola JA, Ruiz Moreno JM, García‐Feijóo J, Fernández‐Vigo JÁ. Updates on the utility of anterior segment optical coherence tomography in the assessment of filtration blebs after glaucoma surgery. Acta Ophthalmol 2022; 100:e29-e37. [PMID: 33942540 DOI: 10.1111/aos.14881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/24/2021] [Accepted: 04/04/2021] [Indexed: 02/03/2023]
Abstract
The formation of filtration blebs is the main drainage mechanism for reducing intraocular pressure after traditional incisional glaucoma surgery such as trabeculectomy and non-penetrating deep sclerotomy. Early and short-lasting blebs may also occur after canaloplasty. Bleb formation also plays an important role after the implantation of glaucoma drainage devices, including Minimally Invasive Glaucoma Surgery devices. Anterior segment optical coherence tomography (AS-OCT) is a rapid and non-invasive high-resolution imaging technique that has evolved in recent years to become a routine examination. Anterior segment optical coherence tomography (AS-OCT) provides key information in the assessment and follow-up of glaucoma surgery, especially in the assessment of filtration blebs. Thus, bleb morphology can be qualitatively classified into diffuse, cystic, encapsulated and flattened, and AS-OCT imaging can also provide several quantitative parameters of the bleb, such as total bleb height, bleb fluid-filled cavity height, bleb wall thickness, number of microcysts and trabeculectomy opening size. These parameters could have an impact on clinical management during follow-up because they may predict the success or failure of the surgery in the early and late postoperative periods. Additionally, they may also guide the procedures used to increase filtration and reduce intraocular pressure, such as bleb needling and laser suture lysis.
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Affiliation(s)
- Bachar Kudsieh
- Department of Ophthalmology Hospital Universitario Puerta de Hierro Majadahonda Madrid Spain
- Centro Internacional de Oftalmologia Avanzada Madrid Spain
| | - José Ignacio Fernández‐Vigo
- Centro Internacional de Oftalmologia Avanzada Madrid Spain
- Department of Ophthalmology Hospital Clínico San Carlos Instituto de Investigación Sanitaria (IdISSC) Madrid Spain
| | | | - Jorge Vila‐Arteaga
- Department of Ophthalmology Hospital Universitario La Fe Valencia Spain
- Innova Ocular Clinic Valencia Spain
| | - Javier Aritz Urcola
- Department of Ophthalmology Hospital Universitario de Álava Vitoria Spain
- Begitek Ophthalmological Clinic Begitek‐Miranza Donostia‐San Sebastián Spain
| | - Jose Maria Ruiz Moreno
- Department of Ophthalmology Hospital Universitario Puerta de Hierro Majadahonda Madrid Spain
| | - Julián García‐Feijóo
- Department of Ophthalmology Hospital Clínico San Carlos Instituto de Investigación Sanitaria (IdISSC) Madrid Spain
| | - José Ángel Fernández‐Vigo
- Centro Internacional de Oftalmologia Avanzada Madrid Spain
- Department of Ophthalmology Universidad de Extremadura Badajoz Spain
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26
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Knickelbein KE, Lassaline ME, Kim S, Scharbrough MS, Thomasy SM. Corneal thickness and anterior chamber depth of the normal adult horse as measured by ultrasound biomicroscopy. Vet Ophthalmol 2022; 25 Suppl 1:17-24. [PMID: 35084084 PMCID: PMC9246829 DOI: 10.1111/vop.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 01/10/2022] [Accepted: 01/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine corneal thickness (CT) and axial anterior chamber depth (ACD) using ultrasound biomicroscopy (UBM) in normal adult horses. To compare corneal thickness measurements between UBM and ultrasonic pachymetry. ANIMALS STUDIED Sixty eyes of 30 healthy adult horses aged 8-24 years. PROCEDURES Ultrasonic pachymetry (velocity of 1640 m/s) was utilized to obtain measurements of the central, superior, temporal, inferior, and nasal cornea. Triplicate images of the same corneal locations were acquired using UBM (50 MHz). Images of the axial anterior chamber were used to measure ACD. Intraocular pressure (IOP) was estimated using rebound tonometry, and axial globe length was measured using ultrasonographic biometry. RESULTS CT (mean ± SD µm) measured by UBM was 854 ± 61 (central), 994 ± 58 (superior), 930 ± 57 (temporal), 979 ± 55 (inferior), and 898 ± 48 (nasal). CT measured by UBM was greater than that measured by ultrasonic pachymetry at all locations and was statistically significant at all locations except inferior (p = 0.0006-0.048). No sex nor age effect was detected for CT at any location. The repeatability of ultrasonic pachymetry was superior to that of UBM. Mean ± SD ACD was 5.74 ± 0.41 mm. A weak positive correlation was identified between central CT and IOP and between central CT and axial globe length. CONCLUSIONS Normal data for CT and ACD of the adult horse obtained using UBM are provided. CT determined by UBM was greater relative to pachymetry at all corneal locations.
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Affiliation(s)
- Kelly E Knickelbein
- Veterinary Medical Teaching Hospital, University of California-Davis, Davis, California, USA
| | - Mary E Lassaline
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Soohyun Kim
- Veterinary Medical Teaching Hospital, University of California-Davis, Davis, California, USA
| | - Machal S Scharbrough
- School of Veterinary Medicine, University of California-Davis, Davis, California, USA
| | - Sara M Thomasy
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, California, USA.,Department of Ophthalmology and Vision Science, University of California-Davis, Davis, California, USA
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Zong Z, Kalyan S, Andres C, Akkor S, Prior JC, Patel MS. Prevalence of ocular anomalies is increased in women with polycystic ovary syndrome-exploration of association with PAX6 genotype. Ophthalmic Genet 2022; 43:340-343. [PMID: 35016586 DOI: 10.1080/13816810.2022.2025605] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Polycystic Ovarian Syndrome (PCOS), the most common reproductive endocrine disorder affecting premenopausal women, is frequently associated with central obesity and pancreatic β-cell dysfunction. Aniridia, a rare congenital eye disorder with haploinsufficiency of the PAX6 gene, was observed to co-occur with PCOS in a proband. This study investigates eye health and PAX6 genotypes of women with PCOS and controls. MATERIALS AND METHODS This is a cross-sectional study of 203 premenopausal women (100 healthy controls, 103 with PCOS) conducted at an academic medical center in Vancouver, Canada. Ophthalmological exams and detailed medical histories were obtained from each participant. DNA extracted from saliva was Sanger-sequenced for the exons, intron-exon boundaries, and untranslated regions of PAX6. RESULTS Women with PCOS had eye abnormalities, including abnormalities of the anterior segment, optic nerve, and retina, that were not observed in controls (p = 0.0002). Myopia prevalence was similar in both groups. Dry eye syndrome, by history, was markedly more prevalent in women with PCOS (22.3%) than controls (5%), p = 0.004. PAX6 genotype did not significantly differ between the two groups, nor was it associated with the greater prevalence of eye anomalies observed in women with PCOS. CONCLUSION This is the first study to systematically perform an ophthalmological examination in women with PCOS, who were found to have a higher prevalence of potentially serious eye health problems compared with controls. These data suggest that ophthalmological-metabolic-genetic connections in women with PCOS require further investigation. Confirmation of these data and increased attention to eye health in women with PCOS appears warranted.
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Affiliation(s)
- Zheyuan Zong
- Department of Medical Genetics, Faculty of Medicine and BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada
| | - Shirin Kalyan
- Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, Canada
| | - Cameron Andres
- Department of Medical Genetics, Faculty of Medicine and BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada
| | - Sueda Akkor
- Department of Ophthalmology, University of British Columbia, Vancouver, Canada
| | - Jerilynn C Prior
- Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, Canada.,Centre for Menstrual Cycle and Ovulation Research, University of British Columbia, Vancouver, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada.,Women's Health Research Institute, Vancouver, BC, Canada
| | - Millan S Patel
- Department of Medical Genetics, Faculty of Medicine and BC Children's Hospital Research Institute, University of British Columbia, Vancouver, Canada
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Jasien JV, Read AT, van Batenburg-Sherwood J, Perkumas KM, Ethier CR, Stamer WD, Samuels BC. Anterior Segment Anatomy and Conventional Outflow Physiology of the Tree Shrew (Tupaia belangeri). Invest Ophthalmol Vis Sci 2022; 63:21. [PMID: 35040876 PMCID: PMC8764208 DOI: 10.1167/iovs.63.1.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 10/26/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose Rodent and primate models are commonly used in glaucoma research; however, both have their limitations. The tree shrew (Tupaia belangeri) is an emerging animal model for glaucoma research owing in part to having a human-like optic nerve head anatomy, specifically a collagenous load-bearing lamina. However, the anterior segment anatomy and function have not been extensively studied in the tree shrew. Thus, the purpose of this study was to provide the first detailed examination of the anterior segment anatomy and aqueous outflow facility in the tree shrew. Methods Aqueous outflow dynamics were measured in five ostensibly normal eyes from three tree shrews using the iPerfusion system over a range of pressures. Gross histological assessment and immunohistochemistry were performed to characterize anterior segment anatomy and to localize several key molecules related to aqueous outflow. Results Anterior segment anatomy in tree shrews is similar to humans, demonstrating a scleral spur, a multilayered trabecular meshwork and a circular Schlemm's canal with a single lumen. Average outflow facility was 0.193 µL/min/mm Hg (95% confidence interval, 0.153-0.244), and was stable over time. Outflow facility was more similar between contralateral eyes (approximately 5% average difference) than between eyes of different animals. No significant dependence of outflow facility on time or pressure was detected (pressure-flow nonlinearity parameter of 0.01 (95% % confidence interval, -0.29 to 0.31 CI µL/min/mm Hg). Conclusions These studies lend support to the usefulness of the tree shrew as a novel animal model in anterior segment glaucoma and pharmacology research. The tree shrew's cost, load-bearing collagenous lamina cribrosa, and lack of washout or anterior chamber deepening provides a distinct experimental and anatomic advantage over the current rodent and nonhuman primate models used for translational research.
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Affiliation(s)
- Jessica V. Jasien
- Vision Science Graduate Program, School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - A. Thomas Read
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, United States
| | | | - Kristin M. Perkumas
- Department of Ophthalmology, Duke University, Durham, North Carolina, United States
| | - C. Ross Ethier
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, United States
| | - W. Daniel Stamer
- Department of Ophthalmology, Duke University, Durham, North Carolina, United States
| | - Brian C. Samuels
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
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Janssens R, van Rijn LJ, Eggink CA, Jansonius NM, Janssen SF. Ultrasound biomicroscopy of the anterior segment in patients with primary congenital glaucoma: a review of the literature. Acta Ophthalmol 2021; 100:605-613. [PMID: 34939345 DOI: 10.1111/aos.15082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 12/07/2021] [Indexed: 01/25/2023]
Abstract
PURPOSE Primary congenital glaucoma (PCG) is a form of childhood glaucoma caused by maldevelopment of the anterior chamber. Disease severity differs greatly amongst patients. Ultrasound biomicroscopy (UBM) is a non-invasive technique that can visualize the anterior segment in infants in vivo. The purpose of this narrative review is to make an overview of the UBM data in PCG and study the applicability of UBM in characterizing the disease. METHODS An online search was performed on PubMed in December 2020. After a critical appraisal of the included articles, study and patient characteristics were summarized. The UBM measurements of the anterior segment in PCG of the different studies were analysed. RESULTS Six studies were included in this review. All were cross-sectional prospective studies. A total of 221 PCG eyes were examined. PCG eyes showed a larger trabecular iris angle, decreased iris thickness, narrower or absent Schlemm's canal and an increased zonular length compared to controls. Abnormal tissue membrane covering the trabecular meshwork and abnormal insertion of the iris and ciliary process were frequently found. The success rate of glaucoma surgery depended on the severity of anterior segment malformations found with UBM. CONCLUSION Malformations of the anterior segment in PCG can be demonstrated by UBM in vivo. This imaging can help to characterize disease severity and might support surgical treatment decisions.
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Affiliation(s)
- Robin Janssens
- Department of Ophthalmology Amsterdam University Medical Center location VUmc Amsterdam The Netherlands
| | - Laurentius J. van Rijn
- Department of Ophthalmology Amsterdam University Medical Center location VUmc Amsterdam The Netherlands
- Department of Ophthalmology OLVG Hospital Amsterdam The Netherlands
| | - Cathrien A. Eggink
- Department of Ophthalmology Radboud University Medical Center Nijmegen The Netherlands
| | - Nomdo M. Jansonius
- Department of Ophthalmology University Medical Center Groningen Groningen The Netherlands
| | - Sarah F. Janssen
- Department of Ophthalmology Amsterdam University Medical Center location VUmc Amsterdam The Netherlands
- Department of Ophthalmology Dijklander Hospital Hoorn The Netherlands
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30
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Liu G, Rong H, Zhang P, Xue Y, Du B, Wang B, Hu J, Chen Z, Wei R. The Effect of Axial Length Elongation on Corneal Biomechanical Property. Front Bioeng Biotechnol 2021; 9:777239. [PMID: 34926423 PMCID: PMC8677453 DOI: 10.3389/fbioe.2021.777239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/15/2021] [Indexed: 01/15/2023] Open
Abstract
Background: To investigate the correlation between the corneal biomechanical parameter stress-strain index (SSI) and axial length (AL) in moderately elongated eye (MEE) and severely elongated eye (SEE). Methods: This study included 117 eyes from 117 participants. Among them, 59 (50.4%) had MEE (AL<26 mm) and 58 (49.6%) had SEE (AL≥26 mm). AL was measured using Lenstar LS-900, and central corneal thickness (CCT) and anterior chamber volume (ACV) were measured using Pentacam. SSI was measured via corneal visualisation Scheimpflug technology (Corvis ST). Kolmogorov-Smirnov test, Student’s t-test, and Pearson and partial correlation analyses were used for statistical analyses. Results: The mean (±SD) SSI was 1.08 ± 0.15 in the MEE group and 0.92 ± 0.13 in the SEE group (p < 0.01). SSI was positively correlated with age (MEE: r = 0.326, p < 0.05; SEE: r = 0.298, p < 0.05) in both groups; it was negatively correlated with AL (r = −0.476, p < 0.001) in the MEE group but not in the SEE group (p > 0.05). CCT was negatively correlated with AL (r = −0.289, p < 0.05) and ACV positively correlated with AL (r = 0.444, p < 0.001) in the MEE group. Neither CCT nor ACV was correlated with AL (p > 0.05) in the SEE group. Conclusion: Corneal biomechanical parameter SSI, which represents the stiffness of corneal tissue, was lower in the SEE group than in the MEE group. When analyzed separately, SSI was negatively correlated with AL in the MEE group, but not in the SEE group, which may provide insight into different ocular growth patterns between lower myopia and higher myopia.
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Affiliation(s)
- Guihua Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Hua Rong
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ping Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yu Xue
- NHC Key Laboratory of Myopia, Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Shanghai Research Center of Ophthalmology and Optometry, Chinese Academy of Medical Sciences, Shanghai, China
| | - Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Biying Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Jiamei Hu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Zhi Chen
- NHC Key Laboratory of Myopia, Eye Institute and Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China.,Key Laboratory of Myopia, Shanghai Research Center of Ophthalmology and Optometry, Chinese Academy of Medical Sciences, Shanghai, China
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
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Luo M, Li Y, Zhuo Y. Advances and Current Clinical Applications of Anterior Segment Optical Coherence Tomography Angiography. Front Med (Lausanne) 2021; 8:721442. [PMID: 34888319 PMCID: PMC8649770 DOI: 10.3389/fmed.2021.721442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 11/01/2021] [Indexed: 12/04/2022] Open
Abstract
Optical coherence tomography angiography (OCTA) is the most relevant evolution based on optical coherence tomography (OCT). OCTA can present ocular vasculature, show detailed morphology for assessment, and quantify vessel parameters without intravenous dye agent. Research on the anterior segment OCTA (AS-OCTA) is only in its initial phase, and its advances in clinical diagnosis and treatment efficacy evaluations require a detailed comparison to traditional imaging methods. In this review of AS-OCTA, we summarize its technical features, imaging advances, current clinical applications in various eye diseases, as well as its limitations and potential future directions. AS-OCTA offers potential advantages in ophthalmic imaging, and with further development it could become a common tool in the near future.
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Affiliation(s)
- Man Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yiqing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yehong Zhuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
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Alhoutan K, Alarfaj K. Exposure Keratopathy: An Idiopathic Lagophthalmos Case Report. Cureus 2021; 13:e18945. [PMID: 34812323 PMCID: PMC8604430 DOI: 10.7759/cureus.18945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2021] [Indexed: 11/30/2022] Open
Abstract
Exposure keratopathy refers to corneal damage that results primarily from prolonged exposure of the ocular surface to the outside environment. Herein, we describe a case of exposure keratopathy with bilateral idiopathic lagophthalmos and discuss factors pertaining to prompt diagnosis and treatment. A 21-year-old woman presented with bilateral nocturnal lagophthalmos, blurred vision, and whitish spots in both eyes. She had no remarkable history of medication use, trauma, surgery, cranial nerve abnormality, critical illness, or other ocular problems. Examination revealed bilateral lagophthalmos, good Bell’s phenomenon, bilateral inferior corneal scars, and vision loss. Laboratory results were normal; there was an absence of proptosis, and no epithelial defects were apparent. Based on these findings, she was diagnosed with exposure keratopathy resulting from idiopathic bilateral lagophthalmos and treated with lubricants. This was a rare case of exposure keratopathy with bilateral lagophthalmos of idiopathic origin, and a challenging one, which prompted the researchers to formulate an appropriate treatment plan.
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Affiliation(s)
| | - Khalid Alarfaj
- Ophthalmology, King Fahd University Hospital, Dammam, SAU
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Alba‐Linero C, Rocha‐de‐Lossada C, Rachwani‐Anil R, Sainz‐de‐la‐Maza M, Sena‐Corrales G, Romano V, Rodríguez‐Calvo‐de‐Mora M. Anterior segment involvement in Epstein-Barr virus: a review. Acta Ophthalmol 2021; 100:e1052-e1060. [PMID: 34766457 DOI: 10.1111/aos.15061] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 10/12/2021] [Accepted: 10/25/2021] [Indexed: 11/28/2022]
Abstract
The aim of this study is to describe the involvement of Epstein-Barr Virus (EBV) in the diseases of the ocular anterior segment. This is a narrative review designed using the PUBMED, SCOPE and Web of Science databases, searching for reported literature on findings in the anterior ocular segment related to EBV between 1990 and 2020. Epstein-Barr Virus (EBV) is implicated in the development of salmon-coloured conjunctival masses in the context of acute mononucleosis and lymphoproliferative disorders. Moreover, EBV can cause haemorrhagic conjunctivitis and its corneal implications appear as different types of keratitis patterns. The involvement of EBV in the pathogenesis of anterior segment inflammation is not well-defined. Current evidence regarding anterior segment disease caused by EBV infection has been proved by positive viral detection through polymerase chain reaction test in eyes with lymphoproliferative disorders known to be caused by EBV, as B- and NK/T-cell lymphoid tumours. Antiviral treatment (oral Aciclovir or Valaciclovir) in anterior segment disease caused by EBV remains controversial.
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Affiliation(s)
- Carmen Alba‐Linero
- Hospital Clínico Universitario Málaga Málaga Spain
- Departamento Oftalmología Facultad de Medicina Universidad de Málaga Málaga Spain
| | - Carlos Rocha‐de‐Lossada
- Hospital Universitario Virgen de las Nieves Granada Spain
- Department of Ophthalmology (Qvision) Vithas Virgen del Mar Hospital Almería Spain
- Ceuta Medical Center Ceuta Spain
| | | | | | | | - Vito Romano
- Eye Clinic, Department of Neurological and Vision Sciences University of Brescia Brescia Italy
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences University of Liverpool Liverpool UK
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Lin S, Zuo C, Liu Y, Xiao H, Fang L, Su Y, Chen L, Lin M, Ling Y, Liu X. Ocular Biometry of Primary Angle-Closure Disease in Younger Patients. Front Med (Lausanne) 2021; 8:772578. [PMID: 34805232 PMCID: PMC8595477 DOI: 10.3389/fmed.2021.772578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The purpose of this study was to analyze the ocular biometric parameters of primary angle-closure disease (PACD) in younger patients and compare them with those of elderly patients. Methods: This clinic-based, cross-sectional study included 154 eyes of 154 patients with PACD, consisting of 77 eyes of patients aged 40 years or younger and 77 eyes of patients older than 40. The PACD case definition was compatible with the ISGEO definition. Anterior segment parameters were measured by ultrasound biomicroscopy, axial length (AL) and lens thickness (LT) were measured by A-scan ultrasonography measurements, and the thickness of the retina and choroid were measured by optical coherence tomography. The differences in ocular biometric parameters between different age groups were compared by independent sample t-tests or Mann-Whitney U tests, and the correlation between the parameters and age was analyzed. Results: Compared to older PACD patients, the lens vault(LV),LV/LT and subfoveal choroidal thickness (SFCT) of younger patients were larger, while the peripheral and mean iris thickness (IT), trabecular-ciliary angle (TCA), ciliary body thickness (CBT), AL and LT were smaller (all P < 0.01). There was no significant difference in anterior chamber depth, anterior chamber width, pupil diameter, angle opening distance at 500 μm from the scleral spur, anterior chamber angle and iris convexity between the two groups (all P > 0.05). AL, LT, IT, TCA and CBT were positively associated with age (all P < 0.001), while LV and SFCT were negatively associated with age (P = 0.027 and P < 0.001, respectively). Conclusions: Compared with elderly patients, younger PACD patients had more anteriorly positioned lenses, thinner and more anteriorly rotated ciliary bodies, thicker choroids, and shorter axial length. These characteristics might be important anatomical bases for the earlier onset of PACD and the higher risk of malignant glaucoma after filtering surgery.
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Affiliation(s)
- Shufen Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Chengguo Zuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yuan Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Hui Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lei Fang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yihua Su
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Liming Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mingkai Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yunlan Ling
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xing Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Wang B, Cao K, Wang Z, Zhang Y, Congdon N, Wang T. Analyzing Anatomical Factors Contributing to Angle Closure Based on Anterior Segment Optical Coherence Tomography Imaging. Curr Eye Res 2021; 47:256-261. [PMID: 34569390 DOI: 10.1080/02713683.2021.1978098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To analyze anatomical factors contributing to angle closure based on anterior segment optical coherence tomography (AS-OCT) imaging. METHODS A total of 238 patients with angle closure and 1122 normal controls were consecutively recruited for this study. Participants' eyes were imaged using AS-OCT under the same darkened ambient light conditions. The following parameters were analyzed: central anterior chamber depth (ACD); anterior chamber area (ACA); anterior chamber volume (ACV), anterior chamber width (ACW); corneal diameter (CD); posterior cornea curvature (PCC); anterior cornea curvature (ACC); maximum iris thickness (ITM); iris thickness at 750 um (IT750) and 2000 um (IT2000) from the scleral spur; iris curvature (IC); iris area (IA); lens vault (LV); angle opening distance (AOD); trabecular iris space area at 500 um (TISA500) and 750 um (TISA750) from the scleral spur; angle recess area (ARA). Lasso regression models were used to detect the collinearity of parameters. The multivariable logistic regression was performed to determine the independent association between angle closure and those parameters included in Lasso regression model. Also Factor analysis was performed to extract a few underlying factors (components) from these parameters. RESULTS Lasso regression showed that ACD, ACV, PCC, IT750, IT2000 and LV were screened in the model. The multivariable logistic regression indicated that ACV, PCC, IT750 and LV were significantly associated with angle closure. Factor analyses revealed that 4 factors, each with its closely associated clusters of variables, produced the best results: ACA, ACV and ACD (Factor 1); LV, tIC and nIC, (Factor 2); ACW, CD and PCC (Factor 3); and tITM, tIT2000, tIT750, nIT2000 and nIT750 (Factor 4). CONCLUSIONS Four separate mechanisms were showed to be involved in the pathogenesis of angle closure, from anterior chamber dimensions, lens, iris and cornea respectively. The parameters ACV, PCC, IT750, and LV are more predominant in determining angle closure.
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Affiliation(s)
- Bingsong Wang
- Beijing Tongren Eye Center, Beijnng Tongren Hospital, Capital Medical University, Beijing, China
| | - Kai Cao
- Beijing Institute of Opthalmology, Beijnng Tongren Hospital, Capital Medical University, Beijing, China
| | - Zhiheng Wang
- School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, China
| | - Ye Zhang
- Beijing Tongren Eye Center, Beijnng Tongren Hospital, Capital Medical University, Beijing, China
| | - Nathan Congdon
- Centre for Public Health, Queen's University, Belfast, UK
| | - Tao Wang
- Beijing Tongren Eye Center, Beijnng Tongren Hospital, Capital Medical University, Beijing, China
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French CR. Mechanistic Insights into Axenfeld-Rieger Syndrome from Zebrafish foxc1 and pitx2 Mutants. Int J Mol Sci 2021; 22:ijms221810001. [PMID: 34576164 PMCID: PMC8472202 DOI: 10.3390/ijms221810001] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/03/2021] [Accepted: 09/05/2021] [Indexed: 12/11/2022] Open
Abstract
Axenfeld-Rieger syndrome (ARS) encompasses a group of developmental disorders that affect the anterior segment of the eye, as well as systemic developmental defects in some patients. Malformation of the ocular anterior segment often leads to secondary glaucoma, while some patients also present with cardiovascular malformations, craniofacial and dental abnormalities and additional periumbilical skin. Genes that encode two transcription factors, FOXC1 and PITX2, account for almost half of known cases, while the genetic lesions in the remaining cases remain unresolved. Given the genetic similarity between zebrafish and humans, as well as robust antisense inhibition and gene editing technologies available for use in these animals, loss of function zebrafish models for ARS have been created and shed light on the mechanism(s) whereby mutations in these two transcription factors cause such a wide array of developmental phenotypes. This review summarizes the published phenotypes in zebrafish foxc1 and pitx2 loss of function models and discusses possible mechanisms that may be used to target pharmaceutical development and therapeutic interventions.
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Affiliation(s)
- Curtis R French
- Division of Biomedical Sciences, Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John's, NL A1B 3V6, Canada
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Mahmood AH, Alharbi AS, Almanea BA, Alsaati AF. Sutureless Amniotic Membrane (ProKera®) and Intravenous Immunoglobulin in the Management of Ocular Complications of Stevens-Johnson Syndrome-Toxic Epidermal Necrolysis Overlap. Cureus 2021; 13:e16989. [PMID: 34540392 PMCID: PMC8422256 DOI: 10.7759/cureus.16989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2021] [Indexed: 11/05/2022] Open
Abstract
PURPOSE To report a case of Stevens-Johnson syndrome-toxic epidermal necrolysis (SJS-TEN) overlap, with severe acute ocular manifestations successfully managed with sutureless Amniotic Membrane device ProKera® (Bio-Tissue, Inc., Miami, FL) and topical steroids, followed by late complications that were successfully managed with intravenous immunoglobulin (IVIG) therapy. OBSERVATIONS A 24-year-old lady, known case of epilepsy, admitted to the burn unit with SJS-TEN overlap attributed to a recent change of her anti-convulsant therapy, with severe ocular manifestations, inability to open both eyes, and poor visual acuity. Early management included intensive topical steroids and lubrication, in addition to the application of a ProKera® device. Despite achieving full epithelialization within two weeks with the improvement of ocular manifestations, the patient presented three weeks later with recurrence of conjunctival epithelial defects, partial ankyloblepharon, and severely dry corneas. These late sequelae were managed with bandage contact lens (BCL) application, intensive topical steroid, and lubrication in addition to IVIG therapy. After six cycles of IVIG therapy, ocular manifestations improved significantly and the patient achieved uncorrected visual acuity of 6/9 in both eyes. Conclusion and importance: Existing evidence suggests that the use of IVIG in combination with systemic steroids in the early phase of SJS-TEN can reduce mortality, without affecting the final visual outcome in patients with ocular manifestations. This case highlights the possible role of IVIG therapy alone - without systemic steroids - in managing and preventing long-term ocular complications of SJS-TEN.
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Affiliation(s)
- Abdulhameed H Mahmood
- Ophthalmology, Salmaniya Medical Complex, Manama, BHR
- Ophthalmology, Anterior Segment Division, Prince Sultan Military Medical City, Riyadh, SAU
| | | | | | - Anoud F Alsaati
- Ophthalmology, Anterior Segment Division, Prince Sultan Military Medical City, Riyadh, SAU
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D'Oria F, Puzo P, Incandela C, Sborgia A, Gigliola S, Boscia F, Alessio G. Evaluation of Demarcation Line after Epithelium-Off Iontophoresis Corneal Collagen Cross-Linking for Progressive Keratoconus. J Clin Med 2021; 10:3295. [PMID: 34362077 DOI: 10.3390/jcm10153295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 11/29/2022] Open
Abstract
The aim of the study was to visualize and evaluate the characteristics and depth of the demarcation line with anterior segment optical coherence tomography (AS-OCT) after epithelium-off iontophoresis corneal collagen cross-linking (epi-off I-CXL). In this prospective, consecutive, single center study 18 eyes of 18 patients with keratoconus were involved. One month after epi-off I-CXL, all the patients underwent an AS-OCT scan to search for a demarcation line and its characteristics. The corneal stromal demarcation line was identified in all the eyes. Mean depth of the corneal stromal demarcation line was 261.8 ± 46.7 μm (range: 184 to 362 μm), at 56.7 ± 12% corneal depth. In conclusion, epi-off I-CXL determines a demarcation line that can be visualized with AS-OCT, which seems clearly distinguishable and similar to that created in standard CXL.
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Rampat R, Deshmukh R, Chen X, Ting DSW, Said DG, Dua HS, Ting DSJ. Artificial Intelligence in Cornea, Refractive Surgery, and Cataract: Basic Principles, Clinical Applications, and Future Directions. Asia Pac J Ophthalmol (Phila) 2021; 10:268-281. [PMID: 34224467 PMCID: PMC7611495 DOI: 10.1097/apo.0000000000000394] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
ABSTRACT Corneal diseases, uncorrected refractive errors, and cataract represent the major causes of blindness globally. The number of refractive surgeries, either cornea- or lens-based, is also on the rise as the demand for perfect vision continues to increase. With the recent advancement and potential promises of artificial intelligence (AI) technologies demonstrated in the realm of ophthalmology, particularly retinal diseases and glaucoma, AI researchers and clinicians are now channeling their focus toward the less explored ophthalmic areas related to the anterior segment of the eye. Conditions that rely on anterior segment imaging modalities, including slit-lamp photography, anterior segment optical coherence tomography, corneal tomography, in vivo confocal microscopy and/or optical biometers, are the most commonly explored areas. These include infectious keratitis, keratoconus, corneal grafts, ocular surface pathologies, preoperative screening before refractive surgery, intraocular lens calculation, and automated refraction, among others. In this review, we aimed to provide a comprehensive update on the utilization of AI in anterior segment diseases, with particular emphasis on the recent advancement in the past few years. In addition, we demystify some of the basic principles and terminologies related to AI, particularly machine learning and deep learning, to help improve the understanding, research and clinical implementation of these AI technologies among the ophthalmologists and vision scientists. As we march toward the era of digital health, guidelines such as CONSORT-AI, SPIRIT-AI, and STARD-AI will play crucial roles in guiding and standardizing the conduct and reporting of AI-related trials, ultimately promoting their potential for clinical translation.
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Affiliation(s)
| | - Rashmi Deshmukh
- Department of Ophthalmology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Xin Chen
- School of Computer Science, University of Nottingham, Nottingham, UK
| | - Daniel S. W. Ting
- Duke-NUS Medical School, National University of Singapore, Singapore
- Singapore National Eye Centre / Singapore Eye Research Institute, Singapore
| | - Dalia G. Said
- Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Ophthalmology, Queen’s Medical Centre, Nottingham, UK
| | - Harminder S. Dua
- Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Ophthalmology, Queen’s Medical Centre, Nottingham, UK
| | - Darren S. J. Ting
- Singapore National Eye Centre / Singapore Eye Research Institute, Singapore
- Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Ophthalmology, Queen’s Medical Centre, Nottingham, UK
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Abdelghany AA, D’Oria F, Alio Del Barrio J, Alio JL. The Value of Anterior Segment Optical Coherence Tomography in Different Types of Corneal Infections: An Update. J Clin Med 2021; 10:jcm10132841. [PMID: 34199039 PMCID: PMC8267702 DOI: 10.3390/jcm10132841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 06/03/2021] [Accepted: 06/26/2021] [Indexed: 11/06/2022] Open
Abstract
Anterior segment optical coherence tomography (AS-OCT) is a modality that uses low-coherence interferometry to visualize and assess anterior segment ocular features, offering several advantages of being a sterile and noncontact modality that generates high-resolution cross-sectional images of the tissues. The qualitative and quantitative information provided by AS-OCT may be extremely useful for the clinician in the assessment of a wide spectrum of corneal infections, guiding in the management and follow-up of these patients. In clinical practice, infections are routinely evaluated with slit-lamp biomicroscopy, an examination and imaging modality that is limited by the physical characteristics of light. As a consequence, the depth of pathology and the eventually associated corneal edema cannot be accurately measured with the slit-lamp. Therefore, it represents a limit for the clinician, as in vivo information about corneal diseases and the response to treatment is limited. Resolution of corneal infection is characterized by an early reduction in corneal edema, followed by a later reduction in infiltration: both parameters can be routinely measured with standardized serial images by AS-OCT.
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Affiliation(s)
- Ahmed A. Abdelghany
- Ophthalmology Department, Faculty of Medicine, Minia University, Minia 61519, Egypt;
| | - Francesco D’Oria
- Section of Ophthalmology, Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, 70124 Bari, Italy;
| | | | - Jorge L. Alio
- Vissum Miranza, Miguel Hernandez University, c/Cabañal, 1, 03016 Alicante, Spain;
- Correspondence:
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Alexander JL, Maripudi S, Kannan K, Drechsler J, Levin MR, Saeedi OJ, Kaleem M, Bazemore M, Karwoski B, Martinez C, Jaafar M, Madigan WP. Semiautomated Assessment of Anterior Segment Structures in Pediatric Glaucoma Using Quantitative Ultrasound Biomicroscopy. J Glaucoma 2021; 30:e222-e226. [PMID: 33596011 PMCID: PMC8261835 DOI: 10.1097/ijg.0000000000001809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 01/14/2021] [Indexed: 11/26/2022]
Abstract
The study was a prospective observational study comparing semiautomated to manual quantitative ultrasound biomicroscopy image analysis among 82 images from 41 eyes of 32 subjects (21 controls and 11 glaucoma) enrolled in the Pediatric Anterior Segment Imaging Innovation Study. Intraclass correlation coefficients and correlation coefficients were >0.8 for all parameters, and comparison of respective analysis speed was 7 times faster for the semiautomated method compared with manual image quantification.
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Affiliation(s)
- Janet Leath Alexander
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, 419 West Redwood Street, Suite 479, Baltimore, MD 21201
| | - Snehaa Maripudi
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, 419 West Redwood Street, Suite 479, Baltimore, MD 21201
| | - Karun Kannan
- Johns Hopkins University, Department of Computer Science and Engineering, 3400 N. Charles St., Baltimore, MD 21218, USA
| | - Jennifer Drechsler
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, 419 West Redwood Street, Suite 479, Baltimore, MD 21201
| | - Moran R. Levin
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, 419 West Redwood Street, Suite 479, Baltimore, MD 21201
| | - Osamah J. Saeedi
- Department of Ophthalmology and Visual Sciences, University of Maryland School of Medicine, 419 West Redwood Street, Suite 479, Baltimore, MD 21201
| | - Mona Kaleem
- Wilmer Eye Institute, Johns Hopkins University, 3400 N. Charles St., Baltimore, MD 21218, USA
| | - Marlet Bazemore
- Department of Ophthalmology, Children’s National Health System, 111 Michigan Avenue, Washington, DC 20010, USA
| | - Bethany Karwoski
- Department of Ophthalmology, Children’s National Health System, 111 Michigan Avenue, Washington, DC 20010, USA
| | - Camilo Martinez
- Department of Ophthalmology, Children’s National Health System, 111 Michigan Avenue, Washington, DC 20010, USA
| | - Mohamad Jaafar
- Department of Ophthalmology, Children’s National Health System, 111 Michigan Avenue, Washington, DC 20010, USA
| | - William Patrick Madigan
- Department of Ophthalmology, Children’s National Health System, 111 Michigan Avenue, Washington, DC 20010, USA
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Zhong L, Zuo J, Jin Q, Xing J, Zhou X. Evaluation of phacoemulsification (ultrasound) cataract surgery on the dynamics of the anterior segment of primary angle closure by AS-OCT. Am J Transl Res 2021; 13:3156-3164. [PMID: 34017484 PMCID: PMC8129420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore the changes of anatomical biological parameters and dynamic parameters of the anterior segment (AS) before and after primary angle closure glaucoma (PACG) surgery. METHODS The clinical data of 82 patients (82 eyes) who underwent phacoemulsification in our hospital were retrospectively analyzed and divided into group A (angle closure, n = 38) and group B (normal open angle, n = 44). The anatomical biological parameters and dynamic parameters were compared between the two groups before and after surgery. RESULTS Compared with group B, group A had smaller anterior chamber depth, higher vaulting, greater iris curvature, and smaller TISA500. Compared with group B, group A had smaller ΔTISA500 and ΔI-area. Compared with group B, the TISA500 was smaller in group A preoperatively, at 1 week, and 1 month after surgery (P < 0.05). The iris curvature was larger in group A (P < 0.05). The ΔI-area was significantly reduced in group B at 1 week and 1 month after surgery. Group B exhibited smaller ΔI-curv than group A at 1 week and 1 month after surgery (P < 0.05). CONCLUSION Anterior segment optical coherence tomography (AS-OCT) can effectively monitor the dynamic changes (DC) of the AS caused by phacoemulsification in patients with primary angle closure (PAC). Phacoemulsification can open the primary of PAC patients. However, their iris area does not change significantly. The biological characteristics of the iris itself may be a risk factor leading to PAC.
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Affiliation(s)
- Lu Zhong
- Department of Ophthalmology, Jiangsu Province Hospital of Chinese Medicine Nanjing 210029, Jiangsu Province, China
| | - Jing Zuo
- Department of Ophthalmology, Jiangsu Province Hospital of Chinese Medicine Nanjing 210029, Jiangsu Province, China
| | - Qingzi Jin
- Department of Ophthalmology, Jiangsu Province Hospital of Chinese Medicine Nanjing 210029, Jiangsu Province, China
| | - Jing Xing
- Department of Ophthalmology, Jiangsu Province Hospital of Chinese Medicine Nanjing 210029, Jiangsu Province, China
| | - Xin Zhou
- Department of Ophthalmology, Jiangsu Province Hospital of Chinese Medicine Nanjing 210029, Jiangsu Province, China
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Tañá-Sanz P, Ruiz-Santos M, Rodríguez-Carrillo MD, Aguilar-Córcoles S, Montés-Micó R, Tañá-Rivero P. Agreement between intraoperative anterior segment spectral-domain OCT and 2 swept-source OCT biometers. Expert Rev Med Devices 2021; 18:387-393. [PMID: 33730515 DOI: 10.1080/17434440.2021.1905518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: To evaluate the agreement of different biometric parameters obtained using intraoperative spectral-domain optical coherence tomography (SD-OCT) and two swept-source optical coherence tomography (SS-OCT) based biometers.Methods: 102 eyes were assessed using the intraoperative SD-OCT integrated into the Catalys femtosecond-laser, and the IOLMaster 700 and Anterion SS-OCT-based-biometers. Central corneal thickness (CCT), anterior chamber depth (ACD), white-to-white (WTW), and lens thickness (LT) were measured.Results: There were statistically significant differences for CCT, ACD, WTW and LT between devices (p < 0.001). The mean difference for ACD ranged from -0.067 to -0.250 mm, with the largest mean difference being between the IOLMaster 700 and Catalys. CCT mean differences ranged from 7 to 32 µm, with the largest mean difference being between the Anterion and Catalys. For WTW, the comparison between the IOLMaster 700 vs Catalys showed the largest mean difference (0.38 mm). However, the mean differences for LT from all three devices were quite similar, ranging from -0.02 to -0.08 mm.Conclusions: SS-OCT biometers showed good agreement for ACD, CCT, WTW and LT. The SD-OCT showed ACD, CCT and WTW values that do not seem to be interchangeable with the SS-OCT biometers; however, this device did show excellent agreement in the case of LT.
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Affiliation(s)
| | | | | | | | - Robert Montés-Micó
- Oftalvist, Alicante, Spain.,Optics and Optometry & Vision Sciences Department, University of Valencia, Valencia, Spain
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Mulchandani D, Reiser BJ, Ho TC, Reid MW, Stewart C, Lee TC, Nallasamy S. Evaluation of digital slit-lamp videos for paediatric anterior segment telemedicine consultations. J Telemed Telecare 2021:1357633X21990991. [PMID: 33535917 DOI: 10.1177/1357633x21990991] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION This study aimed to assess the validity of telemedicine consultations using digital slit-lamp videos to detect anterior segment pathology in a paediatric population. METHODS A paediatric anterior segment specialist simultaneously performed and recorded anterior segment examinations using the Topcon digital-ready slit lamp. Components of the examination included the eyelids/eyelashes, conjunctiva/sclera, cornea, anterior chamber, iris and lens. Masked to clinical findings, a paediatric ophthalmologist reviewed and graded the live video feed transmitted at 4 Mbps. At least three months later, both ophthalmologists graded the stored videos. We compared the sensitivity, specificity, percent agreement and weighted kappa (κ) of diagnosing anterior segment pathologies via live-streamed and store-and-forward video clips compared to the in-person standard examination. RESULTS Examinations of 89 eyes from 45 children (5-17 years old) with known anterior segment pathology were included. Agreement between live-streamed and in-person standard examinations for conjunctiva/sclera, anterior chamber, iris and lens findings was almost perfect (sensitivity 89-96%, specificity 95-100%, κ = 0.87-0.97). Substantial agreement was found for cornea pathology (sensitivity 88%, specificity 90%, κ = 0.72), and moderate agreement was found for eyelids/eyelashes pathology (sensitivity 54%, specificity 92%, κ = 0.46). Store-and-forward results were similar, though slightly better for eyelids/eyelashes and slightly worse for conjunctiva/sclera. DISCUSSION Digital slit-lamp videos hold promise for synchronous and asynchronous telemedicine in diagnosing paediatric anterior segment pathologies.
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Affiliation(s)
| | - Bibiana J Reiser
- The Vision Center at Children's Hospital Los Angeles, USA.,USC Roski Eye Institute and Department of Ophthalmology, Keck School of Medicine of the University of Southern California, USA
| | - Tiffany C Ho
- The Vision Center at Children's Hospital Los Angeles, USA.,USC Roski Eye Institute and Department of Ophthalmology, Keck School of Medicine of the University of Southern California, USA
| | - Mark W Reid
- The Vision Center at Children's Hospital Los Angeles, USA
| | - Carly Stewart
- The Vision Center at Children's Hospital Los Angeles, USA
| | - Thomas C Lee
- The Vision Center at Children's Hospital Los Angeles, USA.,USC Roski Eye Institute and Department of Ophthalmology, Keck School of Medicine of the University of Southern California, USA
| | - Sudha Nallasamy
- The Vision Center at Children's Hospital Los Angeles, USA.,USC Roski Eye Institute and Department of Ophthalmology, Keck School of Medicine of the University of Southern California, USA
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Bausz M, Csidey M, Csákány B, Németh O, Nagy ZZ, Maka E. Axenfeld–Rieger syndrome: ophthalmological and dental diagnostic and therapeutic options. Orv Hetil 2021; 162:192-199. [PMID: 33517333 DOI: 10.1556/650.2021.31924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/13/2020] [Indexed: 11/19/2022]
Abstract
Összefoglaló. Az Axenfeld-Rieger-szindróma ritka betegség. A közlemény bemutatja a klinikai megjelenési formáit, a diagnosztikus és terápiás lehetőségeket. A szemgolyó elülső szegmentumát érintő fejlődési rendellenességek vizsgálata a hagyományos biomikroszkópos vizsgálat mellett digitális kamerával is történhet, mely a csarnokzugi képleteket nagy nagyításban, éles képet mutatva tudja megjeleníteni. Az elülső szegmentum leképezését segítő optikaikoherencia-tomográfia és ultrahang-biomikroszkópia a fejlődési rendellenességnek és a csarnokvíz-elvezető sönt tubusának vizsgálatára, megjelenítésére is alkalmas. A szemnyomást a gyermek kooperációjának függvényében többféle módon mérhetjük. A szabálytalan alakú, sokszor csak résnyi pupilla, valamint a szemnyomás-emelkedés miatt szemészeti beavatkozás lehet szükséges. A korai pupillaképzés az amblyopia megelőzését, az antiglaucomás műtétek (trabeculectomia, hosszú tubusú sönt implantációja) pedig a látási funkciók megőrzését szolgálják. A szemészeti műtéteket akár már néhány hónapos korban szükséges elvégezni altatásban. A maxillahypoplasia és a fogászati fejlődési anomáliák miatt kétirányú panoráma-röntgenfelvétel szükséges. Többlépcsős fogászati konzervatív és restoratív kezelés hozhat eredményt. A diagnózis felállítása és a kezelés is multidiszciplináris megközelítést igényel. Gyermekgyógyász, genetikus, kardiológus, fogász-szájsebész és gyermekszemész együttes munkája biztosíthat megfelelő eredményt. Orv Hetil. 2021; 162(5): 192-199. Summary. Axenfeld-Rieger syndrome is a rare disease. Our paper presents its clinical manifestations, diagnostic and therapeutic options. Due to maxillary hypoplasia and dental developmental anomalies, bidirectional panoramic radiography is required. Multi-stage dental conservative and restorative treatment can provide better results. In addition to traditional biomicroscopic examination, developmental abnormalities affecting the anterior segment of the eye can also be examined with a digital camera, which can display the angle of the anterior chamber at high magnification, with a sharp image. Anterior segment optical coherence tomography and ultrasound biomicroscopy are also suitable for the examination and display of developmental abnormalities and drainage shunt tubes. Intraocular pressure can be measured in several ways depending on the child's cooperation. Due to the irregular shape of the pupil, often with only a slit aperture, and an increase in intraocular pressure, ophthalmic intervention may be required. The pupilloplasty is important preventing amblyopia prevention and early glaucoma surgery (trabeculectomy, shunt implantation) helps to preserve visual function. Eye surgeries need to be performed under anaesthesia, sometimes at few months of age. Both diagnosis and treatment require a multidisciplinary approach. The joint work of a paediatrician, geneticist, cardiologist, dental-oral surgeon and paediatric ophthalmologist may provide a satisfactory result. Orv Hetil. 2021; 162(5): 192-199.
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Affiliation(s)
- Mária Bausz
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Szemészeti Klinika, Budapest, Mária u. 39., 1085
| | - Mária Csidey
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Szemészeti Klinika, Budapest, Mária u. 39., 1085
| | - Béla Csákány
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Szemészeti Klinika, Budapest, Mária u. 39., 1085
| | - Orsolya Németh
- 2 Semmelweis Egyetem, Fogorvostudományi Kar, Fogászati és Szájsebészeti Oktató Intézet, Budapest
| | - Zoltán Zsolt Nagy
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Szemészeti Klinika, Budapest, Mária u. 39., 1085
| | - Erika Maka
- 1 Semmelweis Egyetem, Általános Orvostudományi Kar, Szemészeti Klinika, Budapest, Mária u. 39., 1085
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Abstract
During vertebrate embryonic development, a population of dorsal neural tube-derived stem cells, termed the neural crest (NC), undergo a series of morphogenetic changes and extensive migration to become a diverse array of cell types. Around the developing eye, this multipotent ocular NC cell population, called the periocular mesenchyme (POM), comprises migratory mesenchymal cells that eventually give rise to many of the elements in the anterior of the eye, such as the cornea, sclera, trabecular meshwork, and iris. Molecular cell biology and genetic analyses of congenital eye diseases have provided important information on the regulation of NC contributions to this area of the eye. Nevertheless, a complete understanding of the NC as a contributor to ocular development remains elusive. In addition, positional information during ocular NC migration and the molecular pathways that regulate end tissue differentiation have yet to be fully elucidated. Further, the clinical challenges of ocular diseases, such as Axenfeld-Rieger syndrome (ARS), Peters anomaly (PA) and primary congenital glaucoma (PCG), strongly suggest the need for better treatments. While several aspects of NC evolution have recently been reviewed, this discussion will consolidate the most recent current knowledge on the specification, migration, and contributions of the NC to ocular development, highlighting the anterior segment and the knowledge obtained from the clinical manifestations of its associated diseases. Ultimately, this knowledge can inform translational discoveries with potential for sorely needed regenerative therapies.
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Affiliation(s)
- Antionette L Williams
- Division of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Brenda L Bohnsack
- Division of Ophthalmology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, United States.,Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Pang J, Le L, Zhou Y, Tu R, Hou Q, Tsuchiya D, Thomas N, Wang Y, Yu Z, Alexander R, Thexton M, Lewis B, Corbin T, Durnin M, Li H, Ashery-Padan R, Yan D, Xie T. NOTCH Signaling Controls Ciliary Body Morphogenesis and Secretion by Directly Regulating Nectin Protein Expression. Cell Rep 2021; 34:108603. [PMID: 33440163 DOI: 10.1016/j.celrep.2020.108603] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 11/20/2020] [Accepted: 12/14/2020] [Indexed: 11/29/2022] Open
Abstract
Anterior segment dysgenesis is often associated with cornea diseases, cataracts, and glaucoma. In the anterior segment, the ciliary body (CB) containing inner and outer ciliary epithelia (ICE and OCE) secretes aqueous humor that maintains intraocular pressure (IOP). However, CB development and function remain poorly understood. Here, this study shows that NOTCH signaling in the CB maintains the vitreous, IOP, and eye structures by regulating CB morphogenesis, aqueous humor secretion, and vitreous protein expression. Notch2 and Notch3 function via RBPJ in the CB to control ICE-OCE adhesion, CB morphogenesis, aqueous humor secretion, and protein expression, thus maintaining IOP and eye structures. Mechanistically, NOTCH signaling transcriptionally controls Nectin1 expression in the OCE to promote cell adhesion for driving CB morphogenesis and to directly stabilize Cx43 for controlling aqueous humor secretion. Finally, NOTCH signaling directly controls vitreous protein secretion in the ICE. Therefore, this study provides important insight into CB functions and involvement in eye diseases.
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Affiliation(s)
- Ji Pang
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA; School of Chemistry and Chemical Engineering, State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Liang Le
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA
| | - Yi Zhou
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA; Department of Anatomy and Cell Biology, University of Kansas School of Medicine, 3901 Rainbow Blvd, Kansas City, KS 66160, USA
| | - Renjun Tu
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA
| | - Qiang Hou
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA; State Key Laboratory and Key Laboratory of Vision Science, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Dai Tsuchiya
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA
| | - Nancy Thomas
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA
| | - Yongfu Wang
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA
| | - Zulin Yu
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA
| | - Richard Alexander
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA
| | - Marina Thexton
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA
| | - Brandy Lewis
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA
| | - Timothy Corbin
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA
| | - Michael Durnin
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA
| | - Hua Li
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA
| | - Ruth Ashery-Padan
- Department of Human Molecular Genetics and Biochemistry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Deyue Yan
- School of Chemistry and Chemical Engineering, State Key Laboratory of Metal Matrix Composites, Shanghai Jiao Tong University, 800 Dongchuan Road, Shanghai 200240, China
| | - Ting Xie
- Stowers Institute for Medical Research, 1000 East 50(th) Street, Kansas City, MO 64110, USA; Department of Anatomy and Cell Biology, University of Kansas School of Medicine, 3901 Rainbow Blvd, Kansas City, KS 66160, USA.
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Chen Y, Shen X. Compensatory Changes in the Anterior Segment and Vascular System of the Eye in Myopic Children After Orthokeratology. Front Pediatr 2021; 9:663644. [PMID: 34568237 PMCID: PMC8458806 DOI: 10.3389/fped.2021.663644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 08/09/2021] [Indexed: 12/05/2022] Open
Abstract
Purpose: To analyze changes in the anterior segment, retinal vessel density, and choroidal thickness (ChT) after orthokeratology (Ortho-K). Methods: Myopic children were enrolled from Ruijin Hospital, Shanghai, China. Ortho-K lenses and single-vision spectacles were fitted for myopia correction. Ocular measurements were taken at baseline and 6 months, including axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), white to white (WTW), ChT, macular vessel density (MVD), and optic disc vessel density (OVD). Results: Seventy-six patients were enrolled in this study, including 40 in the Ortho-K group and 36 in the control group. At baseline, no parameters between the two groups were statistically different. After 6 months, changes in CCT and ACD decreased in the Ortho-K group compared with those in the control group (p < 0.05); LT and ChT in the Ortho-K group were thicker than those in the control group (p < 0.05), while there was no difference in MVD and OVD compared with those in the control group (p > 0.05). There were moderate positive correlations between ChT and LT and between ChT and OVD in the Ortho-K group (p < 0.05). Conclusion: The changes in the anterior and posterior segments of the eye after Ortho-K lens wearing suggest that the human eye has a powerful compensatory effect on the imposed defocus.
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Affiliation(s)
- Yanwei Chen
- Department of Ophthalmology, School of Medicine, Ruijin Hospital Affiliated Shanghai Jiao Tong University, Shanghai, China
| | - Xi Shen
- Department of Ophthalmology, School of Medicine, Ruijin Hospital Affiliated Shanghai Jiao Tong University, Shanghai, China
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Abstract
Dichotomies are double-edged: they can simplify and enlighten as well as exaggerate and entangle. Seeing the eye as anterior segment vs. posterior segment simplifies the formidable task of dissecting the function of the eye. Yet this view creates artificial divisions in a coherent whole. Clearly, vision requires the convergence of the light refractive function of the front of the eye with the light sensing function of the back of the eye. The National Eye Institute has long aimed to foster research across the visual pathway. Finding the right balance is a constant work in progress. A recently held scientific meeting which we co-organized with the United States Army Medical Research Institute of Chemical Defense, offered an opportunity to take stock of what the anterior segment in general, and the ocular surface in particular, bring to our understanding of biology and disease of the eye. Multiple dichotomies surfaced: acute vs. chronic disease; epithelial vs. endothelial damage; fibrotic vs. vascular pathology; inflammation vs. resolution response; chemical exposure vs. countermeasure; monotherapy vs. combination therapy; mechanistic vs. exploratory research; human vs. animal model. Merging some of these dichotomies is the goal of this paper.
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Affiliation(s)
- Houmam Araj
- Department of Health and Human Services, National Eye Institute/National Institutes of Health, Bethesda, MD, USA
| | - Santa J Tumminia
- Department of Health and Human Services, National Eye Institute/National Institutes of Health, Office of the Director, Bethesda, MD, USA
| | - David T Yeung
- Department of Health and Human Services, National Institute of Allergy and Infectious Diseases/National Institutes of Health, Bethesda, MD, USA
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Montés-Micó R, Tañá-Rivero P, Aguilar-Córcoles S, Ruíz-Mesa R. Assessment of anterior segment measurements using a high-resolution imaging device. Expert Rev Med Devices 2020; 17:969-979. [PMID: 32847426 DOI: 10.1080/17434440.2020.1816463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To assess the repeatability of several anterior segment parameters obtained with swept-source optical coherence tomography (SS-OCT). METHODS We measured 5-times consequently several parameters in 69 eyes using the ANTERION SS-OCT. White-to-white (WTW), angle-to-angle (ATA), spur-to-spur (STS), and lens vault distances were measured in the horizontal- and vertical-meridian. Anterior-chamber-angle (ACA), scleral-spur-angle (SSA), angle-opening-distance (AOD), and trabecular-iris-space-area (TISA) were measured at 500 and 750 μm for the superior-, nasal-,inferior-, and temporal-quadrants. Intrasubject standard deviation (Sw),coefficient of variation (CoV), coefficient of repeatability (CoR), and intraclass-correlation-coefficient (ICC) were calculated for each parameter. Bland-Altman analysis was done. RESULTS We have not found statistically significant differences between repeated measurements (p > 0.05). Repeatability was good for the different parameters evaluated. Sw values in distances and areas were low and ranged from 0.01 to 0.07. CoR values showed a similar pattern being larger for those metrics measuring angles. The same happened with CoV values, being very small for WTW,ATA, and STS distances (0.16-0.57%). ICC values for all parameters analyzed were > 0.97. Bland-Altman plots evidenced the narrow limits of agreement for all parameters. CONCLUSIONS The ANTERION SS-OCT demonstrated high repeatability measuring different distances, angles, and areas of the anterior segment of the eye.
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Affiliation(s)
- Robert Montés-Micó
- Oftalvist Clinic , Alicante, Spain.,Optics and Optometry & Vision Sciences Department, University of Valencia , Valencia, Spain
| | - Pedro Tañá-Rivero
- Optics and Optometry & Vision Sciences Department, University of Valencia , Valencia, Spain
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