1
|
Giannaccare G, Coco G, Rossi C, Borselli M, Lucisano A, Vaccaro S, Verdiglione M, Scorcia V. Combined Use of Therapeutic Hyper-CL Soft Contact Lens and Insulin Eye Drops for the Treatment of Recalcitrant Neurotrophic Keratopathy. Cornea 2024; 43:120-124. [PMID: 37607273 PMCID: PMC10686274 DOI: 10.1097/ico.0000000000003361] [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] [Received: 04/28/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE The aim of this study was to report the successful clinical outcome of recalcitrant neurotrophic keratopathy (NK) treated with insulin eye drops associated with therapeutic Hyper-CL soft contact lens (CL) (EyeYon Medical, Ness Ziona, Israel). METHODS This study is a case report. RESULTS A 40-year-old man was referred to our clinic for the management of severe recalcitrant NK developed after surgical and adjuvant radiotherapy treatment of adenoid cystic carcinoma of the nasal cavity with basicranial involvement. The patient presented with severe conjunctival hyperemia, a large (7 × 4 mm) central epithelial defect, corneal opacity and thinning, and deep corneal neovascularization. Unpreserved tear substitutes, vitamin A ointment, punctal plug, bandage CL, and autologous serum had been used for the previous 3 months without success. Patient was prescribed insulin eye drops (1 unit per mL), and therapeutic Hyper-CL soft CL was applied to increase the contact time between insulin eye drops and the corneal surface. Follow-up visits were performed at day 10 (T1) and day 20 (T2). A marked reduction in the epithelial defect size was noted at T1 and complete healing was reached at T2. Simultaneously, conjunctival hyperemia and corneal opacity markedly reduced over time with treatment. CONCLUSIONS The combination of insulin eye drops and therapeutic Hyper-CL soft CL was effective in determining healing of recalcitrant NK not responsive to standard treatments and bandage CL. It is unclear whether the positive outcomes were determined by insulin eye drops, Hyper-CL, or the combination of both, and future randomized clinical trials are warranted to determine the contribution of each treatment.
Collapse
Affiliation(s)
- Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Giulia Coco
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy; and
| | - Costanza Rossi
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Massimiliano Borselli
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Andrea Lucisano
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - Sabrina Vaccaro
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | | | - Vincenzo Scorcia
- Department of Ophthalmology, University Magna Graecia of Catanzaro, Catanzaro, Italy
| |
Collapse
|
2
|
Crasta M, Arteaga K, Peña T, Leiva M. Topical 1% cyclosporine eyedrops for the treatment of crystalline corneal dystrophy in dogs. Open Vet J 2023; 13:1167-1174. [PMID: 37842116 PMCID: PMC10576588 DOI: 10.5455/ovj.2023.v13.i9.12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/28/2023] [Indexed: 10/17/2023] Open
Abstract
Background Crystalline corneal dystrophy (CCD) is the most common type of corneal lipidic deposition in dogs. CCD is a primary metabolic disorder of the corneal fibroblast featuring an accumulation of extracellular and intracellular lipid deposits. Corneal lipid deposits create a corneal opacity and modify the interfibrillar collagen distance, inducing light scattering. Corneal vascularization is not usually associated with the disease, but, in case of chronicity, cell death may produce inflammation, and new corneal vessels are developed. To the best of the authors' knowledge, this is the first report of a medical approach for CCD treatment in veterinary medicine. Aim To evaluate the efficacy of topical 1% cyclosporine eyedrops (1% CsA) for the treatment of CCD in dogs. Methods Medical records of dogs with CCD were retrospectively reviewed (2009-2020). Corneal opacification description (COD) [size (mm), depth, and opacification degree (0-3)] was evaluated at 0, 3, 6, 9, 12, and 15 months postinitial diagnosis. Dogs were classified into three groups: the control group (G0), the group receiving topical 1% CsA once per day (G1), and the group receiving topical 1% CsA twice daily (G2). Results Ninety-two client-owned dogs (163 eyes) of different breeds, ages, and gender fulfilled the inclusion criteria. When compared to G0, where the eyes significantly increased COD (p < 0.001), G1 and G2 significantly decreased COD (p < 0.001). In fact, the probability of reducing COD was about three times higher in G2 than in G1, being nearly the same for the right [odds ratio (OR) = 2.94; 95% confidence interval (95% CI) = 0.55-15.78] and left eye (OR = 2.92; 95% CI = 0.49-17.26). In addition, for each additional month of treatment in G2, the probability of reducing COD increased significantly (OR = 1.12; 95%CI = 1.00-1.26 for the right eye and OR = 1.16; 95%CI = 1.02-1.32 for the left eye). Conclusion Long-term treatment with topical 1% CsA eyedrops significantly improved CCD in dogs, being the probability of reducing COD higher when applying the treatment twice daily.
Collapse
Affiliation(s)
- Manuela Crasta
- AniCura Visionvet, Eye Clinic, San Giovanni in Persiceto, Bologna, Italy
- Both authors contributed equally to this work
| | - Kevin Arteaga
- AniCura Visionvet, Eye Clinic, San Giovanni in Persiceto, Bologna, Italy
- Both authors contributed equally to this work
| | - Teresa Peña
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Servei d’Oftalmologia, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Marta Leiva
- Departament de Medicina i Cirurgia Animals, Facultat de Veterinària, Universitat Autònoma de Barcelona, Bellaterra, Spain
- Servei d’Oftalmologia, Fundació Hospital Clínic Veterinari, Universitat Autònoma de Barcelona, Bellaterra, Spain
| |
Collapse
|
3
|
Amer MM, Arze K, Galor A, Sayegh Y, Dubovy SS, Karp CL. Recurrent Lisch Epithelial Corneal Dystrophy Treated With 5-Fluorouracil: A Case Report and Review of the Literature. Cornea 2023; 42:645-647. [PMID: 36533990 PMCID: PMC10065887 DOI: 10.1097/ico.0000000000003211] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/02/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE The aim of the study was to describe a case of Lisch epithelial corneal dystrophy (LECD), review its clinical and histopathological features and diagnostic imaging, and introduce a novel treatment approach using topical 5-fluorouracil (5-FU). METHODS A 65-year-old woman presented with a recurrent left-sided corneal lesion consistent with LECD. The lesion was evaluated clinically, with high-resolution optical coherence tomography (HR-OCT), and histologically. The lesion was successfully treated with two 1-week cycles of topical 5-FU. RESULTS Slit-lamp examination showed an opalescent, whorl-shaped corneal lesion. HR-OCT revealed a trapezoidal area of normal thickness epithelial hyperreflectivity. Histopathology demonstrated a mucosal epithelium with foamy cytoplasm and increased cell size consistent with LECD. Treatment with topical 5-FU resulted in marked clearance of the corneal lesion on slit-lamp examination and HR-OCT. CONCLUSIONS 5-FU may be considered as a treatment option for LECD.
Collapse
Affiliation(s)
- Mona M. Amer
- Bascom Palmer Eye Institute, Department of Ophthalmology University of Miami, Miami, FL, USA
| | - Karen Arze
- Bascom Palmer Eye Institute, Department of Ophthalmology University of Miami, Miami, FL, USA
| | - Anat Galor
- Bascom Palmer Eye Institute, Department of Ophthalmology University of Miami, Miami, FL, USA
- Department of Ophthalmology, Miami Veterans Administration Medical Center, Miami, FL, USA
| | - Yoseph Sayegh
- Bascom Palmer Eye Institute, Department of Ophthalmology University of Miami, Miami, FL, USA
| | - Sander S. Dubovy
- Bascom Palmer Eye Institute, Department of Ophthalmology University of Miami, Miami, FL, USA
| | - Carol L. Karp
- Bascom Palmer Eye Institute, Department of Ophthalmology University of Miami, Miami, FL, USA
| |
Collapse
|
4
|
Abstract
A 54-year-old man with noncontributory medical history presented to an ophthalmologist in January 2022 after 10 days of irritation in his right eye. The patient recounts having felt something get into his eye and under his contact lens (CL) while he was climbing into his car, but he was unsure what the foreign body may have been. Initial examination by the clinician found uncorrected distance visual acuity of 20/100-2 with a corneal abrasion, 4+ corneal edema, and 3+ conjunctival injection, for which he was placed on topical antibiotics (ocuflox and tobradex) with a bandage CL. 1 week later, visual acuity was 20/80, corneal edema had improved, and he was noted to have corneal scarring and an epithelial defect. Tobradex was continued while prednisolone drops and preservative-free artificial tears were started. 1 week later, the patient had worsening visual acuity to 20/250 and was referred to our tertiary center. On initial consultation, the patient had an uncorrected distance visual acuity of 20/500 and an uncorrected near visual acuity of >J10 in the right eye. Slitlamp examination of the right eye was significant for vortex keratopathy and mild corneal pannus with 360-degree subtle conjunctivalization of the limbus ( Figure 1JOURNAL/jcrs/04.03/02158034-202210000-00022/figure1/v/2022-10-03T121249Z/r/image-tiff ). The corneal topograph was obtained showing significant surface irregularity on the Placido image ( Figure 2JOURNAL/jcrs/04.03/02158034-202210000-00022/figure2/v/2022-10-03T121249Z/r/image-tiff ). Examination of the left eye was unremarkable. The ocular history is significant for myopia of -4.0 diopters and CL use for 20 years. The patient admits to regularly wearing soft CLs for several days straight and only removing them for a few hours. Antibiotics were discontinued, corticosteroid drops were reduced in frequency, and the patient was continued on preservative-free artificial tears. What imaging might you consider? What is your differential diagnosis at this point? What would be the most appropriate surgical and/or medical interventions? What would you counsel in prognosis for this patient?
Collapse
|
5
|
Hamrah P, Saricay LY, Ozmen MC. Cutting Edge: Topical Recombinant Nerve Growth Factor for the Treatment of Neurotrophic Keratopathy-Biologicals as a Novel Therapy for Neurotrophic Keratopathy. Cornea 2022; 41:673-679. [PMID: 35266655 PMCID: PMC9106815 DOI: 10.1097/ico.0000000000002974] [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: 08/27/2021] [Accepted: 11/23/2021] [Indexed: 11/27/2022]
Abstract
ABSTRACT Ophthalmologists find management of neurotrophic keratopathy (NK) challenging because conventional therapy lacks efficacy and may result in permanent loss of vision. Recombinant nerve growth factor (cenegermin) targets the underlying pathogenesis of NK by regenerating corneal nerves and healing the corneal epithelium through promotion of proliferation, maturing corneal epithelial cells. It has been approved as Food Drug Association-approved treatment of NK. In this article, the background, clinical trials, and impact of recombinant nerve growth factor as the first neurotrophic factor for the restoration of corneal integrity, homeostasis, and corneal nerve regeneration are discussed.
Collapse
Affiliation(s)
- Pedram Hamrah
- Cornea Service, New England Eye Center, Department of Ophthalmology, Tufts Medical School, Tufts University School of Medicine, Boston, MA, USA
- Center for Translational Ocular Immunology, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Leyla Yavuz Saricay
- Cornea Service, New England Eye Center, Department of Ophthalmology, Tufts Medical School, Tufts University School of Medicine, Boston, MA, USA
- Center for Translational Ocular Immunology, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - M. Cuneyt Ozmen
- Cornea Service, New England Eye Center, Department of Ophthalmology, Tufts Medical School, Tufts University School of Medicine, Boston, MA, USA
- Center for Translational Ocular Immunology, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| |
Collapse
|
6
|
Qureshi S, Ferguson TJ, Lim M, You JY, Goshe JM, Hood CT. Acute Calcific Band Keratopathy as an Adverse Effect of Recombinant Human Nerve Growth Factor (Cenegermin): A Multicenter Case Series. Cornea 2022; 41:52-59. [PMID: 34582138 DOI: 10.1097/ico.0000000000002767] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 03/29/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE Cenegermin, (OXERVATE) a recently Food and Drug Administration-approved topical formulation of recombinant human nerve growth factor, has been used for the treatment of neurotrophic keratopathy (NK). Corneal deposits have been previously reported as a potential adverse effect; however, the clinical characteristics, visual significance, and treatment options have not been fully described. The purpose of this article is to better characterize corneal deposits occurring during treatment with cenegermin for neurotrophic keratopathy. METHODS This was a retrospective, multicenter consecutive case series. RESULTS We identified 5 patients from 3 institutions who developed a white opacity in varying layers of the cornea, consistent with calcium deposition, during treatment with cenegermin. In all cases, the opacity occurred rapidly over the course of a few weeks after initiation of treatment. Histopathologic examination of the cornea from one corneal patient demonstrated extensive calcification of the stroma extending to 90% depth. Before treatment, all patients had stage 2 or 3 NK (Mackie classification). The deposits were visually significant in all patients and did not resolve after cessation of cenegermin. There were no differences in age, sex, etiology of the NK, corneal transplant status, or concurrent medications between the patients who developed a deposit and 15 other patients with stage 2 or 3 NK who did not. One patient was successfully treated with superficial keratectomy with ethylenediaminetetraacetic acid chelation, one patient underwent penetrating keratoplasty, and one patient received a Boston keratoprosthesis. CONCLUSIONS We report the rapid onset of a corneal opacity after initiation of treatment with cenegermin in patients with stage 2 or 3 NK, consistent with acute calcific band keratopathy. This visually significant adverse finding has not previously been described. We could not identify any risk factors for development. We recommend close monitoring of patients receiving cenegermin therapy because the opacity may be irreversible and may require keratoplasty for visual rehabilitation.
Collapse
Affiliation(s)
- Sana Qureshi
- Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI
| | | | - Mira Lim
- Department of Ophthalmology, California Pacific Medical Center, San Francisco, CA; and
| | - Jae Young You
- Department of Ophthalmology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA
| | | | - Christopher T Hood
- Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, MI
| |
Collapse
|
7
|
Narvaez J, Chang M, Ing J, De Chance D, Narvaez JJ. Simplified, Readily Available Method for the Treatment of Band Keratopathy With Ethylenediaminetetraacetic Acid. Cornea 2021; 40:1360-1362. [PMID: 34481414 PMCID: PMC8423137 DOI: 10.1097/ico.0000000000002635] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/13/2020] [Accepted: 11/02/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To compare 3 methods for creating ethylenediaminetetraacetic acid (EDTA) solution using readily available Vacutainer tubes for the treatment of band keratopathy. METHODS All 3 protocols used commercially available Vacutainer blood collection tubes coated with K2EDTA. An osmometer was used to measure and compare the concentration of EDTA created using 3 different protocols. The time required for preparation of the solution was measured and compared to evaluate its efficiency for everyday clinical use. In addition, volume of EDTA solution obtained was measured for method 1. The most promising protocol for clinical use was then used for treatment of a series of patients. RESULTS Average osmolarity was 532, 285, and 422 for methods 1, 2, and 3, respectively (ANOVA P < 0.01, all Tukey honestly significant difference P < 0.01). For the respective mixtures, average concentration was 65, 35, and 52 mg/mL, and average time to create solution was 189, 38, and 83 seconds (ANOVA P < 0.01, all Tukey honestly significant difference P < 0.01). The most promising, method 3, was found to be safe and effective in removing calcium from the corneal stroma in a series of 5 patients with 6 eyes treated. It also yielded 25% more solution for clinical use than method 1. CONCLUSIONS Method 3 using a single 10-mL Vacutainer tube with 18 mg of K2-EDTA had the best balance of effective concentration of EDTA, time to preparation, and simplicity of methodology, when compared with previously published methods 1 and 2. It also yielded a greater final volume of solution.
Collapse
Affiliation(s)
- Julio Narvaez
- Delta Eye Medical Group, Stockton, Lodi, and Tracy, CA
- Department of Ophthalmology, Loma Linda University, Loma Linda, CA
| | - Matthew Chang
- Loma Linda University School of Medicine, Loma Linda, CA; and
| | - Jeffrey Ing
- Department of Ophthalmology, Loma Linda University, Loma Linda, CA
| | | | | |
Collapse
|
8
|
Castiglia D, Fortugno P, Condorelli AG, Barresi S, De Luca N, Pizzi S, Neri I, Graziano C, Trojan D, Ponzin D, Rossi S, Zambruno G, Tartaglia M. A Novel Phenotype of Junctional Epidermolysis Bullosa with Transient Skin Fragility and Predominant Ocular Involvement Responsive to Human Amniotic Membrane Eyedrops. Genes (Basel) 2021; 12:716. [PMID: 34064633 PMCID: PMC8151857 DOI: 10.3390/genes12050716] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/07/2021] [Accepted: 05/08/2021] [Indexed: 02/06/2023] Open
Abstract
Junctional epidermolysis bullosa (JEB) is a clinically and genetically heterogeneous skin fragility disorder frequently caused by mutations in genes encoding the epithelial laminin isoform, laminin-332. JEB patients also present mucosal involvement, including painful corneal lesions. Recurrent corneal abrasions may lead to corneal opacities and visual impairment. Current treatments are merely supportive. We report a novel JEB phenotype distinguished by the complete resolution of skin fragility in infancy and persistent ocular involvement with unremitting and painful corneal abrasions. Biallelic LAMB3 mutations c.3052-5C>G and c.3492_3493delCG were identified as the molecular basis for this phenotype, with one mutation being a hypomorphic splice variant that allows residual wild-type laminin-332 production. The reduced laminin-332 level was associated with impaired keratinocyte adhesion. Then, we also investigated the therapeutic power of a human amniotic membrane (AM) eyedrop preparation for corneal lesions. AM were isolated from placenta donors, according to a procedure preserving the AM biological characteristics as a tissue, and confirmed to contain laminin-332. We found that AM eyedrop preparation could restore keratinocyte adhesion in an in vitro assay. Of note, AM eyedrop administration to the patient resulted in long-lasting remission of her ocular manifestations. Our findings suggest that AM eyedrops could represent an effective, non-invasive, simple-to-handle treatment for corneal lesions in patients with JEB and possibly other EB forms.
Collapse
Affiliation(s)
- Daniele Castiglia
- Laboratory of Molecular and Cell Biology, IDI-IRCCS, 00167 Rome, Italy; (P.F.); (N.D.L.)
| | - Paola Fortugno
- Laboratory of Molecular and Cell Biology, IDI-IRCCS, 00167 Rome, Italy; (P.F.); (N.D.L.)
| | - Angelo Giuseppe Condorelli
- Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.C.); (G.Z.)
| | - Sabina Barresi
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (S.B.); (S.P.); (M.T.)
| | - Naomi De Luca
- Laboratory of Molecular and Cell Biology, IDI-IRCCS, 00167 Rome, Italy; (P.F.); (N.D.L.)
| | - Simone Pizzi
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (S.B.); (S.P.); (M.T.)
| | - Iria Neri
- Department of Experimental, Diagnostic and Specialty Medicine, Division of Dermatology, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy;
| | - Claudio Graziano
- Medical Genetics, S. Orsola-Malpighi University Hospital, 40138 Bologna, Italy;
| | | | - Diego Ponzin
- The Veneto Eye Bank Foundation, 30174 Venice, Italy;
| | - Sabrina Rossi
- Pathology Unit, Department of Laboratories, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Giovanna Zambruno
- Genodermatosis Unit, Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy; (A.G.C.); (G.Z.)
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (S.B.); (S.P.); (M.T.)
| |
Collapse
|
9
|
Leonard BC, Kermanian CS, Michalak SR, Kass PH, Hollingsworth SR, Good KL, Maggs DJ, Thomasy SM. A Retrospective Study of Corneal Endothelial Dystrophy in Dogs (1991-2014). Cornea 2021; 40:578-583. [PMID: 32947393 PMCID: PMC7960559 DOI: 10.1097/ico.0000000000002488] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/25/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To retrospectively evaluate the clinical data, diagnostic tests, treatments, and outcomes for dogs with corneal endothelial dystrophy (CED) and determine risk factors for CED when compared with a canine reference population. METHODS Medical records of 99 dogs (1991-2014) diagnosed with CED at the University of California Davis Veterinary Medical Teaching Hospital were reviewed and compared with 458,680 dogs comprising the general hospital population during the study period. Retrieved data included signalment, examination findings, diagnoses, treatments, and outcomes associated with CED. The exact Pearson χ2 test or exact Kruskal-Wallis test was used to compare parameters between the groups. Progression of corneal edema was assessed using 3 independent Kaplan-Meier curves, identifying clinically significant changes in corneal opacity. RESULTS Boston terriers, German wirehaired pointers, and Dachshunds were overrepresented in the CED-affected group, whereas Labradors were underrepresented. Dogs older than 11 years were overrepresented in the CED-affected group, whereas intact dogs were underrepresented. Surgical intervention was performed (n = 11) based on the severity of disease and secondary complications from CED. Median time to progression of corneal edema was 1) 368 days when an at-risk eye initially without edema developed edema at a subsequent visit, 2) 701 days when there was progression from mild to marked corneal edema, and 3) 340 days when there was progression from focal to diffuse corneal edema. CONCLUSIONS Many CED-affected dogs progress over months to years without surgical intervention, making dogs with CED a useful model for studying genetic predispositions and development of novel therapeutics for Fuchs endothelial corneal dystrophy.
Collapse
Affiliation(s)
- Brian C. Leonard
- Departments of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - Celine S. Kermanian
- Departments of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - Sarah R. Michalak
- Departments of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - Philip H. Kass
- Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - Steven R. Hollingsworth
- Departments of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - Kathryn L. Good
- Departments of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - David J. Maggs
- Departments of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA
| | - Sara M. Thomasy
- Departments of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA
- Department of Ophthalmology & Vision Science, School of Medicine, University of California, Davis, Davis, CA
| |
Collapse
|
10
|
Sarosiak A, Oziębło D, Udziela M, Vermeer C, Malejczyk J, Szaflik JP, Ołdak M. High expression of Matrix Gla Protein in Schnyder corneal dystrophy patients points to an active role of vitamin K in corneal health. Acta Ophthalmol 2021; 99:e171-e177. [PMID: 32602245 DOI: 10.1111/aos.14533] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Revised: 05/28/2020] [Accepted: 06/02/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Schnyder corneal dystrophy (SCD) is a rare autosomal dominant disorder characterized by corneal lipid accumulation and caused by UBIAD1 pathogenic variants. UBIAD1 encodes a vitamin K (VK) biosynthetic enzyme. To assess the corneal and vascular VK status in SCD patients, we focused on matrix Gla protein (MGP), a VK-dependent protein. METHODS Conformation-specific immunostainings of different MGP maturation forms were performed on corneal sections and primary keratocytes from corneal buttons of two SCD patients with UBIAD1 p.Asp112Asn and p.Asn102Ser pathogenic variants and unrelated donors. Native or UBIAD1-transfected keratocytes were used for gene expression analysis. Plasma samples from SCD patients (n = 12) and control individuals (n = 117) were subjected for inactive desphospho-uncarboxylated MGP level measurements with an ELISA assay. RESULTS Substantial amounts of MGP were identified in human cornea and most of it in its fully matured and active form. The level of mature MGP did not differ between SCD and control corneas. In primary keratocytes from SCD patients, a highly increased MGP expression and presence of immature MGP forms were detected. Significantly elevated plasma concentration of inactive MGP was found in SCD patients. CONCLUSION High amount of MGP and the predominance of mature MGP forms in human cornea indicate that VK metabolism is active in the visual system. Availability of MGP seems of vital importance for a healthy cornea and may be related to protection against corneal calcification. Systemic MGP findings reveal a poor vascular VK status in SCD patients and indicate that SCD may lead to cardiovascular consequences.
Collapse
Affiliation(s)
- Anna Sarosiak
- Department of Histology and Embryology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
- Postgraduate School of Molecular Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Dominika Oziębło
- Department of Histology and Embryology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
- Postgraduate School of Molecular Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Monika Udziela
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
| | - Cees Vermeer
- R&D Group VitaK and Cardiovascular Research Institute CARIM, Maastricht University, Maastricht, The Netherlands
| | - Jacek Malejczyk
- Department of Histology and Embryology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| | - Jacek P Szaflik
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
| | - Monika Ołdak
- Department of Histology and Embryology, Center of Biostructure Research, Medical University of Warsaw, Warsaw, Poland
| |
Collapse
|
11
|
Choi SI, Lee E, Akuzum B, Jeong JB, Maeng YS, Kim TI, Kim EK. Melatonin reduces endoplasmic reticulum stress and corneal dystrophy-associated TGFBIp through activation of endoplasmic reticulum-associated protein degradation. J Pineal Res 2017; 63. [PMID: 28580641 DOI: 10.1111/jpi.12426] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 05/31/2017] [Indexed: 02/06/2023]
Abstract
Endoplasmic reticulum (ER) stress is emerging as a factor for the pathogenesis of granular corneal dystrophy type 2 (GCD2). This study was designed to investigate the molecular mechanisms underlying the protective effects of melatonin on ER stress in GCD2. Our results showed that GCD2 corneal fibroblasts were more susceptible to ER stress-induced death than were wild-type cells. Melatonin significantly inhibited GCD2 corneal cell death, caspase-3 activation, and poly (ADP-ribose) polymerase 1 cleavage caused by the ER stress inducer, tunicamycin. Under ER stress, melatonin significantly suppressed the induction of immunoglobulin heavy-chain-binding protein (BiP) and activation of inositol-requiring enzyme 1α (IRE1α), and their downstream target, alternative splicing of X-box binding protein 1(XBP1). Notably, the reduction in BiP and IRE1α by melatonin was suppressed by the ubiquitin-proteasome inhibitor, MG132, but not by the autophagy inhibitor, bafilomycin A1, indicating involvement of the ER-associated protein degradation (ERAD) system. Melatonin treatment reduced the levels of transforming growth factor-β-induced protein (TGFBIp) significantly, and this reduction was suppressed by MG132. We also found reduced mRNA expression of the ERAD system components HRD1 and SEL1L, and a reduced level of SEL1L protein in GCD2 cells. Interestingly, melatonin treatments enhanced SEL1L levels and suppressed the inhibition of SEL1L N-glycosylation caused by tunicamycin. In conclusion, this study provides new insights into the mechanisms by which melatonin confers its protective actions during ER stress. The results also indicate that melatonin might have potential as a therapeutic agent for ER stress-related diseases including GCD2.
Collapse
Affiliation(s)
- Seung-Il Choi
- Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Eunhee Lee
- Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Begum Akuzum
- Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jang Bin Jeong
- Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Yong-Sun Maeng
- Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Tae-Im Kim
- Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Korea
- Institute of Vision Research, Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Eung Kweon Kim
- Department of Ophthalmology, Corneal Dystrophy Research Institute, Yonsei University College of Medicine, Seoul, Korea
- Institute of Vision Research, Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea
| |
Collapse
|
12
|
Celis Sánchez J, Mesa Varona DV, Avendaño Cantos E, López-Romero Moraleda S, Cebrian Rosado E, González Del Valle F. Keratolimbal autograft transplantation as a possible new treatment of Lisch epithelial corneal dystrophy. Arch Soc Esp Oftalmol 2016; 91:333-336. [PMID: 26928889 DOI: 10.1016/j.oftal.2016.01.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 01/18/2016] [Accepted: 01/19/2016] [Indexed: 06/05/2023]
Abstract
CASE REPORT The case concerns 64-year-old woman with visual acuity of 20/40 in the right eye. Slit-lamp examination revealed a grey, feathery corneal opacification with intraepithelial microcysts compatible with Lisch epithelial corneal dystrophy (LECD). It was treated with epithelial debridements, contact lenses and mitomycin C, but the opacification recurred within months. The removal of limbus sector and autologous limbal transplantation (KLAT) were used successfully without recurrence. CONCLUSIONS After removal of damaged limbus, KLAT should be considered as a treatment option for asymmetric LECD when other treatments have failed.
Collapse
Affiliation(s)
- J Celis Sánchez
- Servicio de Oftalmología, Hospital La Mancha Centro, Alcázar de San Juan, Ciudad Real, España
| | - D V Mesa Varona
- Servicio de Oftalmología, Hospital La Mancha Centro, Alcázar de San Juan, Ciudad Real, España.
| | - E Avendaño Cantos
- Servicio de Oftalmología, Hospital La Mancha Centro, Alcázar de San Juan, Ciudad Real, España
| | - S López-Romero Moraleda
- Servicio de Oftalmología, Hospital La Mancha Centro, Alcázar de San Juan, Ciudad Real, España
| | - E Cebrian Rosado
- Servicio de Oftalmología, Hospital de la Línea de la Concepción, La Línea de la Concepción, Cádiz, España
| | - F González Del Valle
- Jefatura de Servicio de Oftalmología, Hospital La Mancha Centro, Alcázar de San Juan, Ciudad Real, España
| |
Collapse
|
13
|
Spadea L, Maraone G, Cagini C. Sliding Keratoplasty Followed by Transepithelial Iontophoresis Collagen Cross-linking for Pellucid Marginal Degeneration. J Refract Surg 2016; 32:47-50. [PMID: 26812714 DOI: 10.3928/1081597x-20151119-02] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 11/10/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To describe the changes in visual acuity and topographic analysis in a patient affected by advanced pellucid marginal degeneration (PMD). METHODS A 59-year-old woman with bilateral PMD who was contact lens intolerant was treated by sliding keratoplasty before and 3 months after transepithelial (epi-on) iontophoresis collagen cross-linking (I-CXL) in one eye. Corrected distance visual acuity (CDVA), spherical equivalent and cylinder refraction, corneal topography, ultrasound pachymetry, and endothelial cell count were assessed at baseline and up to 12 months postoperatively. RESULTS After 1 year of follow-up, CDVA increased from 20/200 to 20/50 and the videokeratographic patterns significantly improved. Endothelial cell counts did not change significantly (P > .05). CONCLUSIONS Sliding keratoplasty combined with I-CXL was safe and effective in the treatment of advanced PMD.
Collapse
|
14
|
Semeraro F, Forbice E, Braga O, Bova A, Di Salvatore A, Azzolini C. Evaluation of the efficacy of 50% autologous serum eye drops in different ocular surface pathologies. Biomed Res Int 2014; 2014:826970. [PMID: 25136628 PMCID: PMC4130192 DOI: 10.1155/2014/826970] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 05/18/2014] [Indexed: 12/04/2022]
Abstract
PURPOSE This study evaluated the efficacy of 50% autologous serum eye drops in ocular surface diseases not improved by conventional therapy. METHODS We analyzed two groups: (1) acute eye pathologies (e.g., chemical burns) and (2) chronic eye pathologies (e.g., recurrent corneal erosion, neurotropic keratitis, and keratoconjunctivitis sicca). The patients were treated for surface instability after conventional therapy. The patients received therapy 5 times a day until stabilization of the framework; they then reduced therapy to 3 times a day for at least 3 months. We analyzed the best corrected visual acuity, epithelial defects, inflammation, corneal opacity, and corneal neovascularization. We also analyzed symptoms such as tearing, burning, sense of foreign body or sand, photophobia, blurred vision, and difficulty opening the eyelids. RESULTS We enrolled 15 eyes in group 1 and 11 eyes in group 2. The average therapy period was 16 ± 5.86 weeks in group 1 and 30.54 ± 20.33 weeks in group 2. The epithelial defects all resolved. Signs and symptoms improved in both groups. In group 2, the defect recurred after the suspension of therapy in 2 (18%) patients; in group 1, no defects recurred. CONCLUSIONS Autologous serum eye drops effectively stabilize and improve signs and symptoms in eyes previously treated with conventional therapy.
Collapse
Affiliation(s)
- Francesco Semeraro
- Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Piazzale Spedale Civili 1, 25123 Brescia, Italy
| | - Eliana Forbice
- Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Piazzale Spedale Civili 1, 25123 Brescia, Italy
| | - Osvaldo Braga
- Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Piazzale Spedale Civili 1, 25123 Brescia, Italy
| | - Alessandro Bova
- Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Piazzale Spedale Civili 1, 25123 Brescia, Italy
| | - Attilio Di Salvatore
- Eye Clinic, Department of Neurological and Vision Sciences, University of Brescia, Piazzale Spedale Civili 1, 25123 Brescia, Italy
| | - Claudio Azzolini
- Department of Surgical and Morphological Sciences, Section of Ophthalmology, University of Insubria, Ospedale di Circolo, Via F. Guicciardini 9, 21100 Varese, Italy
| |
Collapse
|
15
|
Hassan Z, Nemeth G, Modis L, Szalai E, Berta A. Collagen cross-linking in the treatment of pellucid marginal degeneration. Indian J Ophthalmol 2014; 62:367-70. [PMID: 23571261 PMCID: PMC4061688 DOI: 10.4103/0301-4738.109523] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [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: 08/04/2011] [Accepted: 03/14/2012] [Indexed: 11/18/2022] Open
Abstract
Pellucid marginal degeneration (PMD) is an uncommon cause of inferior peripheral corneal thinning disorder, characterized by irregular astigmatism. We analyzed a case of bilateral PMD patient and treated one eye with corneal collagen cross-linking (CXL) therapy. Corneal topography was characteristic for PMD. Visual acuity, slitlamp examinations, tonometry, and corneal thickness were observed. Simulated keratometric and topographic index values were detected with corneal topography. Uncorrected, LogMAR visual acuity has improved from +0.8 to +0.55 during the 6 months and +0.3 during the 8 months follow-up after CXL. Pachymetry values and intraocular pressure showed no changes. Keratometric values and topografic indexes disclosed no progression of the disease. CXL may postpone or eliminate the need of corneal transplantation in cases with PMD.
Collapse
Affiliation(s)
- Ziad Hassan
- Orbident Refractive Surgery and Medical Center, University of Debrecen, Debrecen, Hungary
| | - Gabor Nemeth
- Department of Ophthalmology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Laszlo Modis
- Department of Ophthalmology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Eszter Szalai
- Department of Ophthalmology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Andras Berta
- Department of Ophthalmology, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary
| |
Collapse
|
16
|
Mrukwa-Kominek E, Drzyzga Ł, Rogowska-Godela A, Porwik E. [The application of corneal collagen cross-linking in diseases other than keratoconus]. Klin Oczna 2013; 115:69-73. [PMID: 23882746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Corneal collagen cross-linking is a method of treatment using ultraviolet radiation UVA and photosensitizing substance riboflavin to strengthen the chemical connections between the collagen fibers of corneal stroma. This treatment is focused on halting the progression of the diasases, called ectasias, characterized by irregular curvature and diminished thickness of the cornea. The most common indication for corneal collagen cross-linking is keratoconus. However, this technique may be also applied to pathologies other than keratoconus. The aim of this paper is to review the applicilcability of corneal collagen cross-linking in other conditions than keratoconus. Specifically, the conditions such as pellucid marginal degeneration, post refractive surgery ectasia as well as combined corneal collagen cross-linking and topography-based photorefractive keratectomy for topographies indicating forme fruste keratoconus are discussed. In addition, the effects of-corneal collagen cross-linking-as an adjunctive therapy in keratitis, corneal ulcers and corneal edema in bullous keratopathy are considered. The authors highlight the importance of treatment in clinical practice and the potential application of the treatment and modification of the protocols in the treatment of corneal diseases other than keratoconus.
Collapse
Affiliation(s)
- Ewa Mrukwa-Kominek
- Klinika Okulistyki Katedry Okulistyki Slaskiego Uniwersytetu Medycznego w Katowicach. .
| | | | | | | |
Collapse
|
17
|
Choi SI, Dadakhujaev S, Ryu H, Im Kim T, Kim EK. Melatonin protects against oxidative stress in granular corneal dystrophy type 2 corneal fibroblasts by mechanisms that involve membrane melatonin receptors. J Pineal Res 2011; 51:94-103. [PMID: 21392093 DOI: 10.1111/j.1600-079x.2011.00866.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Considering that oxidative stress plays a role in corneal fibroblast degeneration during granular corneal dystrophy type 2 (GCD2) and melatonin is an effective antioxidant, we examined the ability of melatonin to protect against oxidative stress-induced cell death of primary cultured normal and GCD2-homozygous corneal fibroblasts. Melatonin treatment protected primary cultured normal and GCD2 corneal fibroblasts from paraquat (PQ)-induced oxidative stress and caused increased expression levels of Cu/Zn-superoxide dismutase (SOD1) and glutathione reductase (GR) in both types of cells. Interestingly, catalase expression increased in normal corneal fibroblasts, but decreased in GCD2 corneal fibroblasts after melatonin treatment. Melatonin also reduced the levels of intracellular reactive oxygen species and H(2)O(2) in both cell types. In addition, the selective melatonin receptor antagonist luzindole blocked melatonin-induced expression of SOD1 and GR. The expression levels of melatonin receptors 1A (MT1) and 1B (MT2) were significantly higher in GCD2 corneal fibroblasts than in normal cells. These results suggest that increased expression of melatonin receptors may be involved in the defense mechanisms against oxidative stress in GCD2 corneal fibroblasts, and melatonin may have potential therapeutic implications for GCD2 treatment.
Collapse
|
18
|
Abstract
PURPOSE This paper reviews current knowledge about the pathogenesis, clinical manifestations and treatment of lattice corneal dystrophy, gelsolin type (LCD2, Meretoja's syndrome). METHODS Material is derived from literature searches, a case study of a Finnish patient living in Sweden, and interviews in Helsinki with Professor Ahti Tarkkanen and Dr Sari Kiuru-Enari, both of whom have extensive first-hand experience in treating patients with the disease. RESULTS The disease is now reported from several countries in Europe, as well as Japan, the USA and Iran. Treatment is symptomatic and is based on eye lubrication combined with rigorous monitoring of intraocular pressure to reduce corneal haze and postpone the need for keratoplasty. When systemic symptoms occur, the ophthalmologist should consult other specialists. CONCLUSIONS The disease is probably under-reported and is almost certainly to be found in more countries, including Sweden. Every ophthalmologist should be vigilant and consider this diagnosis when discovering a corneal lattice dystrophy, especially because the disease is an inherited, lifelong chronic condition with systemic symptoms.
Collapse
Affiliation(s)
- Christian Carrwik
- Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Gothenburg, Sweden
| | | |
Collapse
|
19
|
Abstract
PURPOSE To report 4 patients with Avellino corneal dystrophy (ACD) who were treated with 0.02% mitomycin C (MMC) during phototherapeutic keratectomy (PTK). METHODS ACD was confirmed by polymorphism of the exon region in the BIGH3 gene using polymerase chain reaction followed by DNA sequencing analysis. Three patients with recurrent ACD and 1 patient with primary ACD underwent PTK. Intraoperative 0.02% MMC was applied topically with a soaked microsponge. RESULTS There was no recurrence of ACD in the heterozygotes, but there were recurrences with best-corrected visual acuity of 20/30 in the 2 homozygotes. CONCLUSION Intraoperative use of topical 0.02% MMC in conjunction with PTK may prevent or delay the recurrence of ACD for at least for 1 year.
Collapse
Affiliation(s)
- Tae-im Kim
- Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea
| | | | | | | | | |
Collapse
|
20
|
Abstract
PURPOSE To describe the clinical features, clinical course, and response to therapy of an atypical peripheral corneal opacification. METHODS Retrospective case series review. RESULTS Six patients are described with similar findings of bilateral, fairly symmetric, peripheral, hypertrophic, subepithelial corneal opacification. All patients were female and had no concurrent systemic conditions. All six patients complained of ocular irritation. Three patients complained of blurred vision, and one patient had monocular diplopia. In three patients followed up for more than 30 months, the corneal opacification remained stable in one patient and enlarged in the other two patients. The other three patients were examined once or twice, so the evaluation of disease progression was precluded. Two patients were treated surgically with superficial keratectomy followed by 2-minute intraoperative application of 0.02% mitomycin-C. Pathologic examination of bilateral keratectomy specimens from one patient showed subepithelial fibrosis without inflammation. CONCLUSIONS The clinical findings are reminiscent but atypical of Salzmann nodular degeneration.
Collapse
Affiliation(s)
- Heather A Maust
- Cornea Department,Wills Eye Hospital, Philadelphia, PA, USA.
| | | |
Collapse
|
21
|
Ziangirova GG, Antonova OV, Kasparov AA. [The role of the mast cells of the conjunctiva in the intercellular interactions in keratoconus and epithelial-endothelial corneal dystrophy]. Vestn Oftalmol 1998; 114:48-51. [PMID: 9865187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The aim of this study was assessment of the role of mast cells in inflammatory processes associated with keratoconus and corneal epithelial-endothelial dystrophy and clinical assessment of Lecrolin, a specially designed dosage form (eye drops) of potassium cromoglycate (intal) used as an antiallergic drug in asthma, rhinitis, etc. Examinations of 43 biopsy specimens of the conjunctiva from patients with keratoconus and epithelial-endothelial corneal dystrophy demonstrated the significance of immune inflammation in the pathogenesis of these diseases. Mast cells are a typical cell element participating in inflammation at all stages. The count of mast cells increases from 2.5 during the acute stage to 8.86 during the chronic stage, which is explained by absence of the leukocytic stage and proteolysis and stabilization of mature labrocyte degranulation associated with it. Reactions of mast cells with lymphocytes and monocytes/macrophages lead to proliferation of fibroblasts and chronic development of collagen formation. Close relationships between microvessels and mast cells promote stable spasms of the vessels, impairing the microcirculatory bed and leading to ischemia of the anterior segment of the eye. In such cases sodium cromolyne drugs (lecrolin) inhibiting histamine release and stabilizing mast cell membranes are recommended.
Collapse
|
22
|
Zolotarev AB. [Local use of retabolil in the treatment of corneal pathology in experimental animals and clinical practice]. Vestn Oftalmol 1994; 110:23-5. [PMID: 8191657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Experiments with 30 rabbits revealed enhanced corneal epithelium regeneration under the effect of local (epibulbar and subconjunctival) retabolil therapy. Clinically 15 patients with epithelial-endothelial corneal dystrophy were treated with retabolil, the treatment being effective in all the cases when the initial visual acuity was at least 0.1 diopters.
Collapse
|
23
|
Kobylarz J, Starzycka M. [Bullous degeneration of the cornea as a complication of cataract extraction]. Klin Oczna 1988; 90:339-40. [PMID: 3267027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
24
|
Wilson SE, Bourne WM, Brubaker RF. Effect of dexamethasone on corneal endothelial function in Fuchs' dystrophy. Invest Ophthalmol Vis Sci 1988; 29:357-61. [PMID: 3257749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Thirteen patients with Fuchs' endothelial dystrophy were studied to measure the potential effects of topically applied dexamethasone on endothelial function. Endothelial permeability in the Fuchs' dystrophy patients was not different from that found in normal controls. One eye, chosen at random, was treated topically four times a day for 7 days with 0.1% dexamethasone phosphate. The contralateral eye was treated with a placebo of identical appearance. Prior to treatment, there were no statistically significant differences in the means of the intraocular pressure, corneal thickness, endothelial permeability, or endothelial pump rate between the dexamethasone- and placebo-treated groups. In the placebo-treated eyes, a significant decrease was observed in both endothelial permeability and endothelial pump rate over the course of the study. No statistically significant changes occurred in the dexamethasone-treated eyes over the same period. When the dexamethasone group was compared with the placebo group, there was a significant difference in the change in endothelial pump rate between the two groups, attributable in large part to the decrease in pump rate observed in the placebo group over the course of treatment. We interpret our data as lacking support for the concept that topical steroids are beneficial for the treatment of stromal edema in patients with Fuchs' dystrophy.
Collapse
Affiliation(s)
- S E Wilson
- Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota 55905
| | | | | |
Collapse
|
25
|
Stuart JC, Linn JG. Dilute sodium hyaluronate (Healon) in the treatment of ocular surface disorders. Ann Ophthalmol 1985; 17:190-2. [PMID: 3873200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The use of dilute (1/10%) sodium hyaluronate (Healon) eyedrops has given definite subjective patient improvement in a variety of ocular surface disorders, especially keratitis sicca. No adverse effects of the sodium hyaluronate drops have been encountered in patients who have used the drops for as long as two years. Masked trials and objective improvement of corneal staining patterns have also confirmed its efficacy.
Collapse
|
26
|
Orculas E, Ionescu M. [Use of a collyrium with autoserum in trophic corneal diseases]. Rev Chir Oncol Radiol O R L Oftalmol Stomatol Ser Oftalmol 1980; 24:289-91. [PMID: 6454925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
|
27
|
Schrameyer B, Busse H, Schiffer HP. [Results of Nandrolone therapy (Keratyl) in lesions and diseases of the cornea (author's transl)]. Klin Monbl Augenheilkd 1978; 173:864-71. [PMID: 310493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The authors report on clinical experiences with the topical application of the synthetic hormone Nandrolon (Keratyl) in diseases of the cornea caused by exogenic, neurogenic, and combined exogenic-endogenic factors. In all cases a positive regenerative effect on epithelium and stroma of the cornea seemed to exist. The present results seem to allow the following range of indications: 1. injuries of the epithelial tissue; 2. ulcera of the cornea (combined with antibiotics); 3. dystrophic diseases of the cornea; 4. certain postoperative treatment after keratoplastic surgery.
Collapse
|
28
|
Abstract
Twenty patients with bullous keratopathy (Fuchs' endothelial dystrophy) were treated systemically with the antifibrinolytic drug tranexamic acid. The effect was evaluated by slit-lamp biomicroscopy, measurement of central corneal thickness and determination of visual acuity. The patients subjective complaints were also registered. The duration of the treatment varied from 3 to 16 months. In most cases the treatment was given over several periods with intervening free intervals. In all cases the central corneal thickness decreased and slit-lamp biomicroscopy revealed an improvement. The visual acuity improved and all patients became free of pain. A possible mechanism involving the complement system is discussed and preliminary studies on the composition of the aqueous humour in cases of bullous keratopathy are mentioned.
Collapse
|
29
|
Käfer O. [Additional observations of inferior, half-moon shaped, edematous dystrophy of the cornea (author's transl)]. Klin Monbl Augenheilkd 1976; 169:253-4. [PMID: 1086402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
30
|
Abstract
Altogether, 80 patients aged between 24 and 73 years with recurrent erosion of the cornea have been studied and compared with a control group of 200. The patients' erosions were divisible into macroform and microform types. The macroform occurred in 10%, the microform in 56%, and both types in the same patients in 31%. The macroform was more commonly related to trauma than the microform. However, many (40%) were spontaneous in origin. The most common cause of the initial trauma was a finger nail. The recurrences occurred at around the time of waking, either just before or just after. Difficulty in opening the eye occurred in 10%. There was little evidence of precipitating factors, but eye rubbing was admitted by 10% and barbiturates were implicated in 3%. The corneae were examined in the healed state, when a high incidence (59%) were found to have superficial corneal dystrophies of the fingerprint lines, bleb, and Bietti's lacunar (map-like) types. These are considered individually, particular attention being paid to the distinction between the various types of line resembling the fingerprint line. Epithelial microcysts were also a common finding (59%) and were sometimes of the Cogan type. In only 11% of patients were there no corneal signs in the healed state. The need for careful examination of the cornea by retroillumination, using both the iris and the fundus, is stressed. The control group, in contrast, showed a very low incidence of dystrophies and cysts. Treatment was given initially with either drops or ointment and no differences in healing were found. Debridement was performed in 12 eyes as an initial treatment and also in four eyes which were not healing on medical treatment. Debridement assisted healing, but did not prevent recurrence. One eye was treated with debridement and scarification and seven with carbolization. These procedures appeared to reduce the recurrence rate. Sodium chloride ointment 5% was found useful as a prophylactic taken at bedtime, and the recurrence rate increased when it was withdrawn.
Collapse
|
31
|
Levy JP, Py D, Humbert P. [Collagenase inhibitors in the treatment of some corneal diseases]. Bull Soc Ophtalmol Fr 1974; 74:661-75. [PMID: 4377550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
32
|
van Beuningen E. [Drug therapy of corneal dystrophy]. Klin Monbl Augenheilkd 1973; 162:518-20. [PMID: 4579456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
33
|
Nemetz U. [Therapy of external eye diseases using Tanderil eye ointment]. Klin Monbl Augenheilkd 1972; 160:618-23. [PMID: 4627661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
34
|
|
35
|
Christensen JS. [Polyvinyl alcohol (Liquifilm) in ophthalmological practice]. Ugeskr Laeger 1970; 132:1397-8. [PMID: 5311152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
36
|
Wolosker M. [Regression of the lipoidic corneal arch. Experience with CPIB (ethyl chlorophenoxyisobuyrate). Preliminary report]. Hospital (Rio J) 1969; 75:2131-3. [PMID: 5311470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|