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Esmail A, Ibrahim M, Nage S. Efficacy of topical insulin for recurrent epithelial corneal erosions. Ir J Med Sci 2023; 192:3117-3123. [PMID: 37140764 DOI: 10.1007/s11845-023-03373-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 04/11/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Topical insulin can promote and accelerate corneal regeneration, even in eyes with serious comorbidities, and offers several benefits over other treatment options. AIMS The aim of this study is to evaluate the effect of topical insulin in treatment of recurrent epithelial corneal erosion. METHODS Patients with recurrent epithelial erosions were included in a prospective non-randomized hospital-based study, divided into two groups, one of them received persistent epithelial defects (PEDs) conventional treatment and the other received the same treatment with insulin eye drops 4 times/day. All patients were examined carefully by slit lamp. Patients during the 1st, 2nd, 3rd, and 4th weeks as well as after 2 months. Demographics, etiology, therapy, comorbidities, and the healing time of PED were performed. RESULTS Area shows significant improvement after 2 weeks (p = 0.006), 2 months (p = 0.046), and 3 months (p = 0.002) in group II (cornetears gel and topical insulin) as compared to group I (cornetears gel). The recurrence was statistically significant decreased with cornetears gel and topical insulin (group II) by 0.0%, as compared to cornetears gel (group I) by 3 patients (21.4%). CONCLUSION Topical insulin can promote corneal reepithelization in recurrent epithelial erosion and decreases recurrence in these cases. Other advantages include excellent tolerance, availability, and cost-effectiveness.
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Affiliation(s)
- Ahmed Esmail
- Ophthalmology Department, Faculty of Medicine, Menoufia University, Menoufia, Shebin El Kom, Egypt.
| | - Mohamed Ibrahim
- Ophthalmology Department, Faculty of Medicine, Kafrelshiekh University Hospital, Kafrelshiekh, Egypt
| | - Sara Nage
- Ophthalmology Department, Faculty of Medicine, Menoufia University, Menoufia, Shebin El Kom, Egypt
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2
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Li L, Wang H, Pang S, Wang L, Fan Z, Ma C, Yang S, Banda J, Hui Q, Lv F, Fan H, Huang T, Zhang X, Wang X. rhFGF-21 accelerates corneal epithelial wound healing through the attenuation of oxidative stress and inflammatory mediators in diabetic mice. J Biol Chem 2023; 299:105127. [PMID: 37544647 PMCID: PMC10481360 DOI: 10.1016/j.jbc.2023.105127] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 07/14/2023] [Accepted: 07/23/2023] [Indexed: 08/08/2023] Open
Abstract
Diabetic keratopathy, commonly associated with a hyperactive inflammatory response, is one of the most common eye complications of diabetes. The peptide hormone fibroblast growth factor-21 (FGF-21) has been demonstrated to have anti-inflammatory and antioxidant properties. However, whether administration of recombinant human (rh) FGF-21 can potentially regulate diabetic keratopathy is still unknown. Therefore, in this work, we investigated the role of rhFGF-21 in the modulation of corneal epithelial wound healing, the inflammation response, and oxidative stress using type 1 diabetic mice and high glucose-treated human corneal epithelial cells. Our experimental results indicated that the application of rhFGF-21 contributed to the enhancement of epithelial wound healing. This treatment also led to advancements in tear production and reduction in corneal edema. Moreover, there was a notable reduction in the levels of proinflammatory cytokines such as TNF-α, IL-6, IL-1β, MCP-1, IFN-γ, MMP-2, and MMP-9 in both diabetic mouse corneal epithelium and human corneal epithelial cells treated with high glucose. Furthermore, we found rhFGF-21 treatment inhibited reactive oxygen species production and increased levels of anti-inflammatory molecules IL-10 and SOD-1, which suggests that FGF-21 has a protective role in diabetic corneal epithelial healing by increasing the antioxidant capacity and reducing the release of inflammatory mediators and matrix metalloproteinases. Therefore, we propose that administration of FGF-21 may represent a potential treatment for diabetic keratopathy.
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Affiliation(s)
- Le Li
- School of Pharmacological Sciences, Wenzhou Medical University, Chashan University Park, Wenzhou, China; Department of Pharmacy, The Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Huan Wang
- School of Pharmacological Sciences, Wenzhou Medical University, Chashan University Park, Wenzhou, China; Laboratory of Zhejiang Province for Pharmaceutical Engineering and Development of Growth Factors, Collaborative Biomedical Innovation Center of Wenzhou, Wenzhou, China
| | - Shucai Pang
- School of Pharmacological Sciences, Wenzhou Medical University, Chashan University Park, Wenzhou, China; Laboratory of Zhejiang Province for Pharmaceutical Engineering and Development of Growth Factors, Collaborative Biomedical Innovation Center of Wenzhou, Wenzhou, China
| | - Liangshun Wang
- School of Pharmacological Sciences, Wenzhou Medical University, Chashan University Park, Wenzhou, China
| | - Zhengkai Fan
- School of Pharmacological Sciences, Wenzhou Medical University, Chashan University Park, Wenzhou, China
| | - Chunyu Ma
- School of Pharmacological Sciences, Wenzhou Medical University, Chashan University Park, Wenzhou, China
| | - Shufen Yang
- School of Pharmacological Sciences, Wenzhou Medical University, Chashan University Park, Wenzhou, China
| | - Joshua Banda
- School of Pharmacological Sciences, Wenzhou Medical University, Chashan University Park, Wenzhou, China
| | - Qi Hui
- School of Pharmacological Sciences, Wenzhou Medical University, Chashan University Park, Wenzhou, China
| | - Fangyi Lv
- School of Pharmacological Sciences, Wenzhou Medical University, Chashan University Park, Wenzhou, China
| | - Haibing Fan
- School of Pharmacological Sciences, Wenzhou Medical University, Chashan University Park, Wenzhou, China
| | - Tongzhou Huang
- School of Pharmacological Sciences, Wenzhou Medical University, Chashan University Park, Wenzhou, China; Laboratory of Zhejiang Province for Pharmaceutical Engineering and Development of Growth Factors, Collaborative Biomedical Innovation Center of Wenzhou, Wenzhou, China
| | - Xiaobi Zhang
- Department of Pharmacy, The Eye Hospital of Wenzhou Medical University, Wenzhou, China.
| | - Xiaojie Wang
- School of Pharmacological Sciences, Wenzhou Medical University, Chashan University Park, Wenzhou, China; Department of Pharmacy, The Eye Hospital of Wenzhou Medical University, Wenzhou, China; Laboratory of Zhejiang Province for Pharmaceutical Engineering and Development of Growth Factors, Collaborative Biomedical Innovation Center of Wenzhou, Wenzhou, China; Research Units of Clinical Translation of Cell Growth Factors and Diseases, Chinese Academy of Medical Science, Wenzhou, China.
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3
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Kim H, Jang JH, Han W, Hwang HJ, Jang J, Kim JY, Cho DW. Extracellular matrix-based sticky sealants for scar-free corneal tissue reconstruction. Biomaterials 2023; 292:121941. [PMID: 36495802 DOI: 10.1016/j.biomaterials.2022.121941] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/05/2022]
Abstract
Regenerative medicine requires both tissue restoration and ease of compliance for clinical application. Considering this, sticky tissue sealants have been shown to have great potentials over surgical suturing and wound treatment. However, tissue sealants currently used pose challenges such as uncontrollable adhesion formation, mechanical mismatch, and lack of tissue restoration. A new sticky sealant based on gelatinized cornea-derived extracellular matrix (GelCodE) with a visible light-activating system is firstly being introduced in this study. De novo tissue regeneration relies on the matrisome in charge of tissue-organization and development within GelCodE while visible light-based photopolymerization with ruthenium/sodium persulfate rapidly induces covalent bonds with the adjacent tissues. The ease of not only in vivo application, biocompatibility, and biointegration, but also exceptional de novo tissue formation is demonstrated in this study. Interestingly, newly regenerated tissues were shown to have normal tissue-like matrices with little scar formation. Hence, this work presents a promising strategy to meet clinical demands for scar-free tissue recovery with superior ease of clinical application.
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Affiliation(s)
- Hyeonji Kim
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, 37673, Pohang, Kyungbuk, Republic of Korea
| | - Je-Hwan Jang
- Department of Veterinary Ophthalmology, College of Veterinary Medicine, Konkuk University, 120, Neungdong-ro, Gwangjin-gu, 05029, Seoul, Republic of Korea
| | - Wonil Han
- Division of Integrative Bioscience and Biotechnology, POSTECH, 77 Cheongam-ro, Nam-gu, 37673, Pohang, Kyungbuk, Republic of Korea
| | - Hyun-Jeong Hwang
- Department of Clinical Pathology, College of Veterinary Medicine, Konkuk University, Gwangjin-gu, Seoul, 05029, Republic of Korea
| | - Jinah Jang
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, 37673, Pohang, Kyungbuk, Republic of Korea; Institute of Convergence Science, Yonsei University, 50 Yonsei-ro, 03722, Seoul, Republic of Korea; Department of Convergence IT Engineering, 77 Cheongam-ro, Nam-gu, POSTECH, 37673, Pohang, Kyungbuk, Republic of Korea; School of Interdisciplinary Bioscience and Bioengineering, 77 Cheongam-ro, Nam-gu, POSTECH, 37673, Pohang, Kyungbuk, Republic of Korea.
| | - Joon Young Kim
- Department of Veterinary Ophthalmology, College of Veterinary Medicine, Konkuk University, 120, Neungdong-ro, Gwangjin-gu, 05029, Seoul, Republic of Korea; KU Center for Animal Blood Medical Science, Konkuk University, 120, Neungdong-ro, Gwangjin-gu, 05029, Seoul, Republic of Korea.
| | - Dong-Woo Cho
- Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), 77 Cheongam-ro, Nam-gu, 37673, Pohang, Kyungbuk, Republic of Korea; Institute of Convergence Science, Yonsei University, 50 Yonsei-ro, 03722, Seoul, Republic of Korea.
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Lin HY, Ho WT. Diffuse lamellar keratitis as a rare complication of diamond burr superficial keratectomy for recurrent corneal erosion: a case report. BMC Ophthalmol 2022; 22:362. [PMID: 36071403 PMCID: PMC9450270 DOI: 10.1186/s12886-022-02589-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/02/2022] [Indexed: 11/25/2022] Open
Abstract
Background To present a case with a history of laser in situ keratomileusis (LASIK) developing diffuse lamellar keratitis (DLK) after diamond burr superficial keratectomy (DBSK) for recurrent corneal erosion (RCE). Case presentation A 25-year-old man presented with multiple episodes of RCE one year after femtosecond-assisted LASIK for myopia correction. Because conservative treatments failed to halt the repetitive attack of RCE, he underwent epithelial debridement and DBSK. However, severe foreign body sensation and blurred vision developed on postoperative day one. The next day, slit lamp biomicroscopy revealed DLK manifested as diffuse granular infiltrates at the flap interface. After topical corticosteroid treatment, the inflammation resolved gradually, and his vision recovered to 20/20. Conclusions Diffuse lamellar keratitis is a rare post-LASIK complication that can be triggered by DBSK, which causes impairment of the corneal epithelial integrity and subsequent inflammation at the flap interface. For post-LASIK patients with RCE, alternative treatments, such as anterior stromal puncture, may be considered to avoid extensive disruption of corneal epithelium and DLK development depending on the size and the location of the lesions.
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Affiliation(s)
- Hung-Yu Lin
- Department of Ophthalmology, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan
| | - Wei-Ting Ho
- Department of Ophthalmology, Far Eastern Memorial Hospital, No.21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 220, Taiwan. .,School of Medicine, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.
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Jan RL, Ho CH, Wang JJ, Tseng SH, Chang YS. A Population-Based Study of Social Demographic Factors, Associated Diseases and Recurrent Corneal Erosion in Taiwan. Front Public Health 2022; 10:832333. [PMID: 35419341 PMCID: PMC8995765 DOI: 10.3389/fpubh.2022.832333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To investigate the association of recurrent corneal erosion (RCE) with sociodemographic factors and associated ocular conditions or systemic diseases. Methods This nationwide, population-based, retrospective, matched case-controlled study included 98,895 RCE patients, identified by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 371.42, were selected from the Taiwan National Health Insurance Research Database. The age-, sex-, and index date- matched control group included 98,895 non-RCE control group also selected from the Taiwan Longitudinal Health Insurance Database 2000. Sociodemographic factors and associated ocular conditions or systemic diseases were examined using univariate logistic regression analyses, and continuous variables were analyzed using paired t-test. The odds ratio (OR) of developing RCE were compared using adjusted logistic regression analysis. Results Patients with ocular conditions including corneal abrasion, ocular allergic conditions, and corneal dystrophy were more likely to have RCE than the control group (adjusted OR = 63.56, 95% CI = 42.06-96.06, p < 0.0001; adjusted OR = 24.27, 95% CI = 20.51-28.72, p < 0.0001; adjusted OR = 17.10, 95% CI = 5.14-59.93, p < 0.0001, respectively). Patients with systemic diseases such as diabetes mellitus, hyperlipidaemia, and atopy trait have significantly higher ORs for RCE development. Patients residing in either Northern Taiwan or a metropolis city had higher odds of developing RCE; however, there were no significant differences in income or occupation on the probability to develop RCE. Conclusion RCE is strongly associated with corneal abrasion, ocular allergic conditions, corneal dystrophy, diabetes mellitus, hyperlipidaemia, and atopy trait.
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Affiliation(s)
- Ren-Long Jan
- College of Health Sciences, Graduate Institute of Medical Sciences, Chang Jung Christian University, Tainan, Taiwan.,Department of Pediatrics, Chi Mei Medical Center, Liouying, Tainan, Taiwan
| | - Chung-Han Ho
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.,Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.,Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.,AI Biomed Center, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Sung-Huei Tseng
- Department of Ophthalmology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.,Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan
| | - Yuh-Shin Chang
- College of Health Sciences, Graduate Institute of Medical Sciences, Chang Jung Christian University, Tainan, Taiwan.,Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan
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6
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Yang Y, Mimouni M, Trinh T, Sorkin N, Cohen E, Santaella G, Rootman DS, Chan CC, Slomovic AR. Phototherapeutic keratectomy versus epithelial debridement combined with anterior stromal puncture or diamond-dusted burr for treatment of recurrent corneal erosions. CANADIAN JOURNAL OF OPHTHALMOLOGY 2022; 58:198-203. [PMID: 35216957 DOI: 10.1016/j.jcjo.2022.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 11/11/2021] [Accepted: 01/26/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare outcomes of phototherapeutic keratectomy (PTK) versus epithelial debridement combined with anterior stromal puncture (ASP) or diamond burr for the treatment of recurrent corneal erosions (RCES) in a large tertiary centre. METHODS Patients with a diagnosis of RCES secondary to trauma or epithelial basement membrane dystrophy who underwent a surgical procedure between 2009 and 2019 were included in the study. The following data were collected: demographics, ocular history, prior medical treatment, ocular surgeries, intervention, complete epithelialization at postoperative week 1, recurrences, and complications. Recurrence was defined as either an objective finding of a corneal epithelial defect or symptoms suggestive of recurrent epithelial erosion on history. Recurrence rate and time to epithelialization were compared between groups. RESULTS A total of 97 eyes (73 patients) were included in the study. Mean patient age was 51 ± 16.1 years, and mean follow-up was 474 days. RCES was secondary to epithelial basement membrane dystrophy in 80% (n = 78 of 97), trauma (15%, n = 15 of 97), or idiopathic (4%, n = 4 of 97). Epithelial debridement with ASP was performed in 34 eyes (35%), diamond burr in 33 eyes (33%), and PTK in 30 eyes (31%). Compared with epithelial debridement with ASP (recurrence 29.4%), the recurrence rate was significantly lower for both the diamond burr (9.1%, p = 0.031) and PTK groups (10%, p = 0.048). The diamond burr and PTK groups also had a significantly higher rate of complete epithelialization at 1 week (p < 0.05). CONCLUSION Compared with epithelial debridement with ASP, diamond burr and PTK have significantly lower rates of recurrence and time to epithelialization and may be considered first for surgical management of RCES.
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Affiliation(s)
- Yelin Yang
- Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ont
| | - Michael Mimouni
- Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ont
| | - Tanya Trinh
- Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ont
| | - Nir Sorkin
- Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ont.; Ophthalmology Department, Assaf Harofeh Medical Centre, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Cohen
- Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ont
| | - Gisella Santaella
- Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ont
| | - David S Rootman
- Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ont
| | - Clara C Chan
- Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ont..
| | - Allan R Slomovic
- Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ont
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Kim M, Oh JY, Kim KW. Refractory Recurrent Corneal Erosion after Descemet’s Stripping Automated Endothelial Keratoplasty. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2022. [DOI: 10.3341/jkos.2022.63.1.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: To report a case of refractory recurrent corneal erosion that occurred after Descemet’s stripping automated endothelial keratoplasty (DSAEK) in iridocorneal endothelial syndrome.Case summary: A 62-year-old male patient with iridocorneal endothelial syndrome planned to undergo ultrathin DSAEK. At the surgery, corneal epithelial debridement was performed using a No. 15 blade to enhance the surgical field visibility. Three corneal venting incisions were made before graft insertion in the recipient eye. The corneal epithelium was healed at postoperative 1 week. However, the epithelium detached at 2 weeks postoperatively. The loosened epithelium was peeled off, and a therapeutic bandage contact lens was applied. Thereafter, the corneal epithelial detachment did not improve, despite repeated corneal epithelial debridement, prolonged therapeutic bandage contact lens wear, applications of 5% sodium chloride eyedrops and autoserum eyedrops, and intake of doxycycline, steroids, and valaciclovir. Anterior stromal puncture was performed three times, and the corneal epithelium eventually attached at postoperative 8 weeks. Although recurrent corneal erosion was not observed at postoperative 10 weeks, acute graft rejection occurred but improved with immunosuppressive treatment. The corrected visual acuity was 0.8 after cataract surgery, which was performed at 1 year after DSAEK.Conclusions: Refractory recurrent corneal erosion may occur after DSAEK surgery. In such a case, an aggressive treatment including the repeated anterior stromal puncture technique may be helpful.
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Recurrent corneal erosion. OPHTHALMOLOGY JOURNAL 2021. [DOI: 10.17816/ov90921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Recurrent corneal erosion (RCE) is a common recurrent disease caused by abnormal adhesion of the corneal epithelium to the basement membrane. Previous corneal trauma is the most common cause of this disease. Corneal dystrophies, such as dystrophy of the epithelial basement membrane, Meesmann dystrophy, ReisBcklers dystrophy, lattice dystrophy and granular dystrophies, are also involved in the pathogenesis of recurrent corneal erosion. The main diagnostic methods for recurrent corneal erosion are slit-lamp examination and taking of medical history. Detectable RCE changes range from small corneal irregularities (such as epithelial microcysts) to large areas of loose epithelium or epithelial defects detecting by fluorescein staining. Areas of irregular epithelium with grayish inclusions or microcysts and a fingerprint pattern or a map-like defects are also revealed. The main goal of treatment is to relieve pain, stimulate re-epithelialization, and fully restore the adhesion of the basement membrane and epithelium. Lubricants and matrix proteinase inhibitors are prescribed as first-line therapy, and blood derivatives can be used as second-line therapy. When conservative therapy fails, surgical procedures are used (excimer laser phototherapeutic keratectomy, Bowmans membrane polishing with diamond drill, anterior stromal puncture, corneal collagen cross-linking).
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Chang HL, Kuo BI, Wu JH, Huang WL, Su CC, Chen WL. Anti-glaucoma agents-induced pseudodendritic keratitis presumed to be herpetic simplex keratitis: a clinical case series. Sci Rep 2021; 11:21443. [PMID: 34728756 PMCID: PMC8563774 DOI: 10.1038/s41598-021-01073-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 10/20/2021] [Indexed: 01/26/2023] Open
Abstract
Anti-glaucoma agents-induced corneal toxicity may be misdiagnosed as herpetic simplex keratitis (HSK). In our study, nineteen glaucoma patients were presumed to have HSK before referral. Corneal lesions were classified into (I) linear pseudodendritic lesions formed by elevated opacified cells, (II) linear pseudodendritic lesions formed by grouped superficial punctate keratitis (SPK), (III) satellite full-thickness epithelial defects, (IV) satellite lesions formed by elevated opacified cells, and (V) geographic lesions formed by grouped SPK. We observed thirty-one events, with 15 in the lower and 16 in the central corneas. There were 21 (67.7%) type II, five (16.1%) type V, two (6.5%) of each for types III and IV, and one (3.2%) type I events. Among linear lesions (types I and II), 17 (77.3%) had horizontal and 5 (22.7%) had curvilinear orientations. Exposure duration to the last-added anti-glaucoma agent was three days to 14.5 years. About half of the events (16/31, 51.6%) used prostaglandin analogues, and 30/31 (96.8%) applied benzalkonium chloride (BAK)-containing agents. All lesions resolved within two months after decreasing offending medications or enhancing protection of ocular surface. In conclusion, anti-glaucoma agents-induced pseudodendritic keratitis presents majorly in central-lower cornea as horizontally linear lesions, and BAK-containing agents are observed in the most events.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Anti-Infective Agents, Local/administration & dosage
- Anti-Infective Agents, Local/adverse effects
- Antiglaucoma Agents/adverse effects
- Benzalkonium Compounds/administration & dosage
- Benzalkonium Compounds/adverse effects
- Diagnosis, Differential
- Female
- Follow-Up Studies
- Glaucoma/drug therapy
- Glaucoma/pathology
- Humans
- Keratitis, Dendritic/chemically induced
- Keratitis, Dendritic/diagnosis
- Keratitis, Dendritic/epidemiology
- Keratitis, Herpetic/chemically induced
- Keratitis, Herpetic/diagnosis
- Keratitis, Herpetic/epidemiology
- Male
- Middle Aged
- Prognosis
- Retrospective Studies
- Taiwan/epidemiology
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Affiliation(s)
- Huai-Lung Chang
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan
| | - Bo-I Kuo
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan
- Section of Ophthalmology, National Taiwan University Cancer Center, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jo-Hsuan Wu
- Shiley Eye Institute and Viterbi Family Department of Ophthalmology, Hamilton Glaucoma Center, University of California, San Diego, CA, USA
| | - Wei-Lun Huang
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan
| | - Chien-Chia Su
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan
| | - Wei-Li Chen
- Department of Ophthalmology, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan.
- Advanced Ocular Surface and Corneal Nerve Regeneration Center, National Taiwan University Hospital, Taipei, Taiwan.
- Department of Ophthalmology, National Taiwan University College of Medicine, Taipei, Taiwan.
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10
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Teh BL, Chua PYS, Reddy AR. Three-year outcomes of alcohol delamination of corneal epithelium for recurrent corneal erosions of traumatic etiology. Indian J Ophthalmol 2021; 69:2437-2440. [PMID: 34427239 PMCID: PMC8544076 DOI: 10.4103/ijo.ijo_3796_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose Alcohol delamination of the corneal epithelium (ADCE) is a therapeutic option for patients with recurrent corneal erosion (RCE) who do not respond to nonsurgical management of lubricants and extended wear contact lens. The aim of the study is to report on three-year efficacy and safety of ADCE for RCE of traumatic etiology. Methods This is a retrospective review of consecutive patients who underwent ADCE for traumatic RCE in a local hospital between January 2010 and January 2020. The outcomes at a 3-year follow-up review are included. Nonsurgical therapy used; intra- and postoperative complications were recorded. ADCE was only offered to those who remained symptomatic despite maximum topical lubrications and/or extended wear contact lens. Success was defined as the absence of recurrence of corneal erosion. Results Twenty-six eyes of 26 patients with RCE caused by trauma underwent ADCE. The mean age of patients was 39 years. The follow-up period was a minimum of 36 months. Three eyes (11.5%) had recurrence of corneal erosion after ADCE at the 3-year follow-up. Recurrence was noted at months 2, 23, and 36 postoperatively in these patients. All patients reported significant improvement in symptoms associated with recurrent erosion. Ten eyes (38.5%) stopped all topical lubricants postoperatively. No intra- or postoperative complications were noted in our study. Conclusion This study documents the long-term safety and efficacy of alcohol delamination of corneal epithelium at 3 years for patients with RCE of traumatic origin.
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Affiliation(s)
- Boon Lin Teh
- Eye Clinic, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, United Kingdom
| | - Paul Y S Chua
- Eye Clinic, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, United Kingdom
| | - Aravind R Reddy
- Eye Clinic, Aberdeen Royal Infirmary, Foresterhill, Aberdeen, United Kingdom
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11
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Preclinical Studies of a Novel Microfabricated Device to Treat Corneal Epithelial Disease. Cornea 2021; 40:48-53. [PMID: 32769679 DOI: 10.1097/ico.0000000000002444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Anterior stromal puncture is an inexpensive technique for treating recurrent corneal erosions but is often ineffective and cannot be used in the optical axis because of scarring. These studies tested a novel microfabricated imprinting instrument to assess its potential efficacy for the treatment of corneal epithelial disease in the optical axis. METHODS The device is made using glass rods, bundled and drawn through multiple iterative cycles, and then fused under high heat to generate a solid rod comprised of many parallel, aligned, cladded fibers. The rods are sliced into discs and then etched to yield designable spikes based on the borosilicate composition of the glass. RESULTS Imprinting the cornea yields a regular pattern of imprints. Histologic studies showed both nonpenetrating stable deformations of Bowman layer, with formation of stable epithelial attachments, and full thickness penetration, with superficial ingrowth of the basal epithelium. CONCLUSIONS Microimprinted corneal tissue shows focal subepithelial scarring without evidence of optically evident anterior stromal scarring, and may be an effective way of treating recurrent corneal erosions in the optical axis, which is not currently possible using standard anterior stromal puncture methods.
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12
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Mohan RR, Balne PK, Muayad MS, Tripathi R, Sinha NR, Gupta S, An JA, Sinha PR, Hesemann NP. Six-Month In Vivo Safety Profiling of Topical Ocular AVV5-Decorin Gene Transfer. Transl Vis Sci Technol 2021; 10:5. [PMID: 34383877 PMCID: PMC8362634 DOI: 10.1167/tvst.10.10.5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose A significant remission of corneal fibrosis and neovascularization in rabbit eye in vivo was observed from a tissue-selective localized adeno-associated virus (AAV)5–Decorin (Dcn) gene therapy. This study sought to investigate 6-month toxicity profiling of this gene therapy for the eye in vivo using a rabbit model. Methods A small epithelial scrape followed by corneal drying was performed unilaterally in 12 rabbit eyes and either AAV5–Dcn (n = 6) or naked vector (n = 6) was delivered topically using a cloning cylinder technique. Contralateral eyes served as naïve control (n = 6). Safety and tolerability measurements in live rabbits were performed periodically until month 6 using multimodel clinical ophthalmic imaging tools—a slit lamp, stereomicroscope, and HRT3-RCM in vivo confocal microscope. Thereafter, corneas were excised and subjected to hematoxylin and eosin staining, Mason trichome staining, propidium iodide nuclear staining, and quantitative real-time polymerase chain reaction analyses. Results Clinical eye examinations based on the modified Hackett–McDonald ocular scoring system, and in vivo confocal imaging of the cornea showed no signs of ocular toxicity in rabbit eyes given AAV5–Dcn gene transfer vs control eyes (P > 0.05) through 6 months after treatment. The histologic and molecular analyses showed no significant differences in AAV5–Dcn vs AAV naked or naïve control groups (P > 0.05) and were in accordance with the masked clinical ophthalmic observations showing no abnormalities. Conclusions Topical tissue-targeted localized AAV5–Dcn gene therapy seems to be safe and nontoxic to the rabbit eye in vivo. Translational Relevance AAV5–Dcn gene therapy has the potential to treat corneal fibrosis and neovascularization in vivo safely without significant ocular toxicity.
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Affiliation(s)
- Rajiv R Mohan
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri, USA.,One-Health Vision Research Program, Departments of Veterinary Medicine & Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA.,Mason Eye Institute, School of Medicine, University of Missouri, Columbia, Missouri, USA
| | - Praveen K Balne
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri, USA.,One-Health Vision Research Program, Departments of Veterinary Medicine & Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Maryam S Muayad
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri, USA.,One-Health Vision Research Program, Departments of Veterinary Medicine & Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Ratnakar Tripathi
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri, USA.,One-Health Vision Research Program, Departments of Veterinary Medicine & Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Nishant R Sinha
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri, USA.,One-Health Vision Research Program, Departments of Veterinary Medicine & Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Suneel Gupta
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri, USA.,One-Health Vision Research Program, Departments of Veterinary Medicine & Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Jella A An
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri, USA.,Mason Eye Institute, School of Medicine, University of Missouri, Columbia, Missouri, USA
| | - Prashant R Sinha
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri, USA.,One-Health Vision Research Program, Departments of Veterinary Medicine & Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Nathan P Hesemann
- Harry S. Truman Memorial Veterans' Hospital, Columbia, Missouri, USA.,One-Health Vision Research Program, Departments of Veterinary Medicine & Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
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13
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Jan RL, Weng SF, Wang JJ, Tseng SH, Chang YS. Association Between Atopic Keratoconjunctivitis and the Risk of Recurrent Corneal Erosion. Front Med (Lausanne) 2021; 8:688355. [PMID: 34150819 PMCID: PMC8210667 DOI: 10.3389/fmed.2021.688355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/12/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To investigate the risk of recurrent corneal erosion (RCE) in patients with atopic keratoconjunctivitis (AKC). Methods: This national, retrospective, matched cohort study enrolled 184,166 newly-diagnosed AKC patients, selected from the Taiwan National Health Insurance Research Database and identified by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 372.05. The control group comprised 184,166 non-AKC patients matched by age, sex, and potential comorbidities and they were selected from the Taiwan Longitudinal Health Insurance Database, 2000. Information from patients was gathered from 1 January 2004 to 31 December 2011, and both groups were traced from the index date until December 2013. The incidence and risk of RCE (ICD-9-CM code 361.42) was compared between the groups. The adjusted hazard ratio (HR) for RCE was obtained by a Cox proportional hazard regression analysis. The Kaplan–Meier analysis was performed to calculate the cumulative incidence of RCE. Results: In total, 564 AKC patients and 406 non-AKC controls developed RCE during the follow-up span. The incidence of RCE was 1.45 times higher in AKC patients than in controls (95% confidence interval [CI] = 1.27–1.64; P < 0.0001). After adjusting for potential confounders, including diabetes mellitus, keratoconjunctivitis sicca, corneal transplantation, ocular blunt trauma, corneal dystrophy, and band keratopathy, AKC patients were 1.36 times more likely to develop RCE than controls (adjusted HR, 1.36; 95% CI = 1.19–1.54; p < 0.05). Conclusions: AKC Patients had an increased risk of developing RCE and should be informed of this risk.
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Affiliation(s)
- Ren-Long Jan
- Department of Pediatrics, Chi Mei Medical Center, Liouying, Tainan, Taiwan.,Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan
| | - Shih-Feng Weng
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.,Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan.,AI Biomed Center, Southern Taiwan University of Science and Technology, Tainan, Taiwan
| | - Sung-Huei Tseng
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan
| | - Yuh-Shin Chang
- Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan.,Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan
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14
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Erdal NB, Adolfsson KH, De lima S, Hakkarainen M. In vitro and in vivo effects of ophthalmic solutions on silicone hydrogel bandage lens material Senofilcon A. Clin Exp Optom 2021; 101:354-362. [DOI: 10.1111/cxo.12652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 10/24/2017] [Accepted: 11/18/2017] [Indexed: 11/29/2022] Open
Affiliation(s)
- Nejla B Erdal
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, Sweden,
| | - Karin H Adolfsson
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, Sweden,
| | - Sara De lima
- Department of Clinical Neuroscience, Division of Ophthalmology and Vision, St. Erik Eye Hospital, Karolinska Institutet, Stockholm, Sweden,
| | - Minna Hakkarainen
- Department of Fibre and Polymer Technology, KTH Royal Institute of Technology, Stockholm, Sweden,
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15
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Wladis EJ, Arunachalam T, LaJoie JE, Lau KW, Adam AP. Myeloid differentiation factor 88 expression in eyelid specimens of rosacea. Orbit 2021; 41:329-334. [PMID: 33789561 DOI: 10.1080/01676830.2021.1905668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: Rosacea is a common cause of ocular surface disease. Specific immunologic features have been implicated in its pathogenesis, including toll-like receptors, mitogen-associated kinase, and nuclear factor kappa-B. Myeolid differentiation factor 88 (MYD88) has been associated with these elements, suggesting a role for this protein in rosacea. This study was designed to compare the expression of MYD88 in the eyelids of patients with and without this disease.Methods: Western blotting for MYD88 was performed in 14 control patients and 15 patients with rosacea. Bands were quantified and normalized to actin. Immunohistochemical staining for MYD88 was performed in a different cohort of 12 patients with rosacea and 12 controls, and positively-staining cells were counted across five consecutive 40x fields. Statistical analyses compared the differences between the two groups via a dedicated software package.Results: On western blotting, the mean ratios of MYD88 to actin were 13.8 (standard deviation = 14.1) and 44.3 (standard deviation = 39.6) in control and rosacea patients, respectively (p = .002). On immunohistochemistry, the mean numbers of positively-staining cells were 12.1/40x field (standard deviation = 9.61/40x field) and 27.4/40x (standard deviation = 18.7/40x field) in control and rosacea patients, respectively (p = .0438).Conclusions: MYD88 is enriched in eyelid specimens of rosacea. This finding further implicates the innate immune system in the pathogenesis of rosacea, and is consistent with previous reports regarding the role of this protein in ocular surface disease and the previously-implicated cellular features of the disease. Inhibition of MYD88 may be a successful treatment strategy to manage rosacea.
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Affiliation(s)
- Edward J Wladis
- Ophthalmic Plastic Surgery, Department of Ophthalmology, Albany Medical College, Lions Eye Institute, Albany, New York, USA
| | - Thilaka Arunachalam
- Ophthalmic Plastic Surgery, Department of Ophthalmology, Albany Medical College, Lions Eye Institute, Albany, New York, USA
| | - Juliann E LaJoie
- Ophthalmic Plastic Surgery, Department of Ophthalmology, Albany Medical College, Lions Eye Institute, Albany, New York, USA
| | - Kevin W Lau
- Ophthalmic Plastic Surgery, Department of Ophthalmology, Albany Medical College, Lions Eye Institute, Albany, New York, USA
| | - Alejandro P Adam
- Ophthalmic Plastic Surgery, Department of Ophthalmology, Albany Medical College, Lions Eye Institute, Albany, New York, USA.,Center for Molecular Physiology, Albany Medical College, Albany, New York, USA
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Abstract
Recurrent corneal erosion syndrome (RCES) is a common chronic disease associated with repeated episodes of epithelial disruption and is characterized by sudden onset of sharp pain in the eye, usually at night or upon waking, as well as redness, photophobia and lacrimation. The cause of the disease is considered to be impaired adhesion of the epithelial layer to the stroma, which is a consequence of abnormal regeneration of the basement membrane of corneal epithelium. A number of biological factors, including inflammatory mediators and proteinases in high concentrations, contribute to the destruction of the formed adhesion complexes. The basis of RCES diagnosis is characteristic medical history and biomicroscopy. An area of epithelium absence can be detected under direct illumination - more often in paracentral view - mainly in the lower third of the cornea, where an area of loose and irregular epithelium with microcysts or grayish inclusions can be seen. There may also be a card-like or «fingerprint» pattern. First of all, it is necessary to differentiate RCES from infectious lesions, which require a fundamentally different treatment regimen. It is believed that the first stage of treatment should include lubricants, drugs that promote epithelialization, inhibitors of matrix metalloproteinases and lipases. The «second line» of conservative treatment can include blood derivatives. If conservative therapy is ineffective, it is advised to use phototherapeutic keratectomy (PTK) or perform diamond burr polishing of Bowman's layer. The choice of a method for treating recurrent erosion should be based on the effectiveness of drug therapy, frequency of recurrence, duration of the disease, severity of clinical symptoms, availability of specific ophthalmic equipment and experience with it.
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Affiliation(s)
- S V Trufanov
- Research Institute of Eye Diseases, Moscow, Russia
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17
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Mahmoud DB, Afifi SA, El Sayed NS. Crown Ether Nanovesicles (Crownsomes) Repositioned Phenytoin for Healing of Corneal Ulcers. Mol Pharm 2020; 17:3952-3965. [PMID: 32845650 DOI: 10.1021/acs.molpharmaceut.0c00742] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Drug repositioning is an important drug development strategy as it saves the time and efforts exerted in drug discovery. Since reepithelization of the cornea is a critical problem, we envisioned that the anticonvulsant phenytoin sodium can promote reepithelization of corneal ulcers as it was repurposed for skin wound healing. Herein, our aim is to develop novel crown ether-based nanovesicles "Crownsomes" of phenytoin sodium for ocular delivery with minimal drug-induced irritation and enhanced efficacy owing to "host-guest" properties of crown ethers. Crownsomes were successfully fabricated using span-60 and 18-crown-6 and their size, morphology, polydispersity index, ζ potential, drug loading efficiency, conductivity, and drug release were characterized. Crownsomes exhibited favorable properties such as formation of spherical nanovesicles of 280 ± 18 nm and -26.10 ± 1.21 mV surface charges. Crownsomes depicted a high entrapment efficiency (77 ± 5%) with enhanced and controlled-release pattern of phenytoin sodium. The optimum crownsomes formulation ameliorated ex vivo corneal drug permeability (1.78-fold than drug suspension) through the corneal calcium extraction ability of 18-crown-6. In vivo study was conducted utilizing an alkali-induced corneal injury rabbit model. Clinical and histopathological examination confirmed that crownsomes exhibited better biocompatibility and minimal irritation due to complex formation and drug shielding. Further, they enhanced corneal healing, indicating their effectiveness as a novel drug delivery system for ocular diseases.
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Affiliation(s)
- Dina B Mahmoud
- Pharmaceutics Department, National Organization for Drug Control and Research, Giza 12654, Egypt
| | - Samar A Afifi
- Pharmaceutics Department, National Organization for Drug Control and Research, Giza 12654, Egypt
| | - Nesrine S El Sayed
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Cairo University, Cairo 11562, Egypt
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18
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Song MY, Chung JL, Kim KY, Hwang KY, Kwon YA, Song SW, Kim BY, Koh K. Combined Phototherapeutic Keratectomy and Peripheral Anterior Stromal Puncture for the Treatment of Recurrent Corneal Erosion Syndrome. KOREAN JOURNAL OF OPHTHALMOLOGY 2020; 34:297-303. [PMID: 32783422 PMCID: PMC7419241 DOI: 10.3341/kjo.2020.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/03/2020] [Accepted: 04/16/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To investigate the efficacy of the combined phototherapeutic keratectomy (PTK) and peripheral anterior stromal puncture (ASP) compared with that of PTK alone in patients with recurrent corneal erosion syndrome (RCES). METHODS The medical records of 25 patients (25 eyes) who underwent combined treatment of PTK and peripheral ASP for RCES from March 2016 to May 2017 were retrospectively reviewed. Twenty-three patients (23 eyes) treated with PTK alone from March 2015 to February 2016 served as a control group. All surgeries were performed by a single surgeon. This retrospective clinical study comprised 48 patients (48 eyes) who were followed up for more than 18 months. Clinical records of age, sex, laterality, etiology of RCES, and history of recurrence after treatment were evaluated. RESULTS Twenty-five eyes were treated with combined PTK and ASP, and 23 eyes were treated with PTK only. The mean follow-up period was 19.63 ± 2.97 and 19.75 ± 6.83 months, respectively. There were no differences in baseline parameters between the groups. In the combined treatment group, one patient experienced recurrence 6 months after the surgery. In the single treatment group, five patients showed recurrence at 4, 7, 8, 11, and 13 months after the surgery, respectively. Compared to the single treatment group, the combined treatment group showed significantly lower recurrence rate (p < 0.05). All recurred patients required no additional treatment except temporary therapeutic contact lenses and topical lubricants. CONCLUSIONS Our findings suggest that combined treatment of PTK and peripheral ASP is effective in alleviation of symptoms and prevention of recurrence in refractory RCES compared with treatment using PTK alone.
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Affiliation(s)
- Mi Yeon Song
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | | | - Kook Young Kim
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Kyu Yeon Hwang
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Young A Kwon
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Sang Wroul Song
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Byung Yeop Kim
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Kyungmin Koh
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea.
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19
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Kang EYC, Chen HT, Hsueh YJ, Chen HC, Tan HY, Hsiao CH, Yeh LK, Wu WC. Corneal Sensitivity and Tear Function in Recurrent Corneal Erosion Syndrome. Invest Ophthalmol Vis Sci 2020; 61:21. [PMID: 32181797 PMCID: PMC7401482 DOI: 10.1167/iovs.61.3.21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine the association of corneal sensitivity and tear functions on the prognosis of eyes after posttraumatic recurrent corneal erosion syndrome (RCES). Methods Patients were enrolled retrospectively and had unilateral RCES and a history of ocular surface trauma. A corneal sensitivity test and tear function test (tear break-up time and Schirmer test) were performed at three time points (month 1 to month 3, month 3 to month 6, and month 6 to month 12). Depending on the number of recurrences during the follow-up, patients were divided into group A (n > 2) or group B (n = 2). A comparison between diseased and normal fellow eyes in each patient was performed. Results A total of 31 patients were enrolled and divided into group A (n = 14) and group B (n = 17). The mean age was 40.3 ± 12.2 years, whereas the mean follow-up was 28.0 ± 3.6 months. During the study period, corneal sensitivity, tear break-up time, and the Schirmer test results were all lower in diseased eyes than in normal fellow eyes in both groups. Compared to the first time point, recovery of corneal sensitivity and the Schirmer test values were observed in diseased eyes in group B at the second and third time points. Conclusions Poor corneal sensitivity and tear function are associated with posttraumatic RCES. Recovery of corneal sensitivity and tear function may be associated with a reduction of recurrence in eyes with posttraumatic RCES.
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20
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Jan RL, Tai MC, Ho CH, Chu CC, Wang JJ, Tseng SH, Chang YS. Risk of recurrent corneal erosion in patients with diabetes mellitus in Taiwan: a population-based cohort study. BMJ Open 2020; 10:e035933. [PMID: 32565466 PMCID: PMC7311018 DOI: 10.1136/bmjopen-2019-035933] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To investigate the risk of recurrent corneal erosion (RCE) in patients with diabetes mellitus (DM). DESIGN, SETTING AND PARTICIPANTS This retrospective, nationwide, matched cohort study included 239 854 patients with DM recruited between 2003 and 2005 from the Longitudinal Cohort of Diabetes Patients database. The control group included the same number of age-matched and sex-matched patients without DM selected from the Taiwan Longitudinal Health Insurance Database, 2000. Data for each patient were collected from the index date until December 2013. MAIN OUTCOMES AND MEASURES The incidence and risk of RCE were compared between the two groups. Cox proportional hazards regression was used to calculate the HR for RCE after adjustment for potential confounders. The cumulative RCE incidence rate was calculated using Kaplan-Meier analysis. RESULTS In total, 1236 patients with DM and 884 controls developed RCE during the follow-up period, resulting in an incidence rate of RCE in patients with DM (5.87/10 000 person-years (PY)) higher than that in the controls (4.23/10 000 PY). After adjustment for potential confounders, including hypertension, hyperlipidaemia, chronic renal disease and keratoconjunctivitis sicca, patients with DM were 1.35 times (95% CI, 1.24 to 1.48) more likely to develop RCE than the total sample cohort. CONCLUSIONS DM increases the risk of RCE, which is an interdisciplinary issue. Therefore, close collaboration between endocrinologists and ophthalmologists is important in managing RCE following DM.
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Affiliation(s)
- Ren-Long Jan
- Department of Pediatrics, Chi Mei Medical Center, Liouying, Tainan, Taiwan
- Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan
| | - Ming-Cheng Tai
- Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
- Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Chin-Chen Chu
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
- Department of Recreation and Health-Care Management, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Jhi-Joung Wang
- Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Sung-Huei Tseng
- Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan
| | - Yuh-Shin Chang
- Graduate Institute of Medical Science, College of Health Science, Chang Jung Christian University, Tainan, Taiwan
- Department of Ophthalmology, Chi Mei Medical Center, Tainan, Taiwan
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21
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Design and in vitro evaluation of doxycycline hyclate niosomes as a potential ocular delivery system. Int J Pharm 2019; 567:118431. [DOI: 10.1016/j.ijpharm.2019.06.022] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/21/2019] [Accepted: 06/09/2019] [Indexed: 12/20/2022]
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22
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Labetoulle M, Rousseau A, M'Garrech M, Kaswin G, Dupas B, Baudouin C, Barreau E, Bourcier T, Chiambaretta F. Efficacy of a Topical Heparan Sulfate Mimetic Polymer on Ocular Surface Discomfort in Patients with Cogan's Epithelial Basement Membrane Dystrophy. J Ocul Pharmacol Ther 2019; 35:359-365. [PMID: 31225775 DOI: 10.1089/jop.2019.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Treatment of persistent ocular discomfort in patients with Cogan's epithelial basement membrane dystrophy (EBMD) is a challenge for ophthalmologists. This study aimed to determine the efficacy of a topical heparan sulfate mimetic polymer (HSMP) in reducing ocular discomfort in EBMD patients. Methods: This retrospective, noninterventional study included 22 consecutive patients in 3 tertiary ophthalmological units with spontaneous, recurrent, acute ocular pain, resistant to various topical lubricants. After EBMD diagnosis, HSMP treatment was initiated while lubricating eye drops were continued. The main study outcome was the change in ocular discomfort assessed using the ocular surface disease index (OSDI) from initiation of treatment to last follow-up visit. Results: The mean OSDI decreased from 46.7 ± 22.3 to 31.6 ± 17.4 (P < 0.001) at first visit and 32.5 ± 17.9 (P < 0.01) at last visit. The rate of patients with severe ocular surface disease (OSDI >33) decreased from 68.2% to 36.4% at first visit and 42.9% at last visit. After a median follow-up of 8.5 months, 7 (31.8%) patients discontinued the HSMP treatment due to a marked improvement in ocular surface comfort and no recurrence of ocular pain, 5 (22.7%) due to lack of efficacy, and 1 (4.5%) due to an ocular adverse event (not treatment related). Eight patients continued treatment after the last visit and 1 patient was lost to follow-up. Globally, HSMP prevented acute painful episodes in 11 (61.1%) of 18 patients followed for ∼4 months. Conclusions: Topical HSMP may be an option for alleviating ocular discomfort in patients with EBMD resistant to standard symptomatic treatments.
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Affiliation(s)
- Marc Labetoulle
- 1Department of Ophthalmology, Bicêtre Hospital, APHP, South Paris University, Le Kremlin Bicêtre, France.,2IMVA (Centre for Immunology of Viral Infections and Autoimmune Diseases), UMR 1184, INSERM, CEA, South Paris University, Fontenay aux Rosex, France
| | - Antoine Rousseau
- 1Department of Ophthalmology, Bicêtre Hospital, APHP, South Paris University, Le Kremlin Bicêtre, France.,2IMVA (Centre for Immunology of Viral Infections and Autoimmune Diseases), UMR 1184, INSERM, CEA, South Paris University, Fontenay aux Rosex, France
| | - Mohamed M'Garrech
- 1Department of Ophthalmology, Bicêtre Hospital, APHP, South Paris University, Le Kremlin Bicêtre, France
| | - Godefroy Kaswin
- 1Department of Ophthalmology, Bicêtre Hospital, APHP, South Paris University, Le Kremlin Bicêtre, France
| | | | | | - Emmanuel Barreau
- 1Department of Ophthalmology, Bicêtre Hospital, APHP, South Paris University, Le Kremlin Bicêtre, France
| | - Tristan Bourcier
- 4Department of Ophthalmology, New Civil Hospital, Strasbourg University Hospital, FMTS, Strasbourg, France
| | - Frédéric Chiambaretta
- 5Department of Ophthalmology, University Hospital of Clermont-Ferrand, Gabriel-Montpied Hospital, Clermont-Ferrand, France
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23
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De Benedetti G, Vaiano AS. Oral azithromycin and oral doxycycline for the treatment of Meibomian gland dysfunction: A 9-month comparative case series. Indian J Ophthalmol 2019; 67:464-471. [PMID: 30900575 PMCID: PMC6446637 DOI: 10.4103/ijo.ijo_1244_17] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Purpose To compare the efficacy and safety profile of oral azithromycin with that of doxycycline over 9 months in patients experiencing failure with conservative and topical treatment for Meibomian gland dysfunction (MGD), to assess recurrence of MGD, and to determine the number of treatments required. Methods This is a randomized controlled trial with a cross-over design at a tertiary care center. In all, 115 consecutive patients underwent a complete ophthalmological examination before being randomly assigned to oral treatment with doxycline (4 g for 30 days) or azithromycin (1.25 g for 5 days). Patients were evaluated at 3, 6, and 9 months. Therapy was switched or conservative management maintained according to signs and symptoms. Results In the azithromycin group, 83.25% of the patients were stable after one treatment, 16.5% needed a further one or two treatments (some had previously been switched to doxycycline), and 5.77% did not improve despite treatment. In the doxycycline group, 33.79% of patients were stable after one treatment, 66.21% needed a further one or two treatments (some had previously switched to azithromycin), and 29.41% did not improve despite treatment (P < 0.05). Minimal gastrointestinal adverse effects (nausea, diarrhea, abdominal cramp, and decreased appetite) were reported, mostly unchanged at the follow-up visits. At the first visit, more adverse effects were reported in the doxycycline group (14/51, 24%) than in the azithromycin group (3/52, 6%; P < 0.005). Conclusion Both antibiotics were effective and safe for treating patients with persistent MGD, although azithromycin was superior when the reduced dose and the shorter course of therapy (5 days vs. 4 weeks) were taken into consideration. Given the chronic nature of the disease and the improvement in some signs with minimal adverse effects, a shorter therapy seems a safer and more logical alternative to longer regimens.
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Wladis EJ, Lau KW, Adam AP. Nuclear Factor Kappa-B Is Enriched in Eyelid Specimens of Rosacea: Implications for Pathogenesis and Therapy. Am J Ophthalmol 2019; 201:72-81. [PMID: 30703356 DOI: 10.1016/j.ajo.2019.01.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 01/16/2019] [Accepted: 01/19/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To assess the role of nuclear factor kappa-B (NFKB) in cutaneous specimens of rosacea and unaffected tissue. METHODS Immunohistochemical staining was performed for the activated, phosphorylated variant of NFKB (pNFKB) in eyelid specimens of rosacea (n = 12) and normal, healthy tissue (n = 12). The numbers of positively staining cells/40× microscopic field were counted across 5 consecutive fields. Additionally, quantitative Western blotting was carried out for pNFKB and NFKB in specimens of rosacea (n = 15) and normal controls (n = 14). Statistical comparisons were performed via a dedicated software package. RESULTS The mean number of cells/40× microscopic field that stained positively for pNFKB was 18.4 (standard deviation = 15.3) for control patients and 39.3 (standard deviation = 16.9) for rosacea patients, and the difference between the 2 groups was statistically significant (P = .0024). On Western blotting, the mean ratios of pNFKB:NFKB for control and rosacea patients measured 0.58 (standard deviation = 0.81) and 3.11 (standard deviation = 3.53), respectively. The 2 groups were statistically significantly different (P = .0002). CONCLUSIONS The activated form of NFKB is enriched in rosacea, indicating a role for this pathway in the pathogenesis of this disease. Interference with NFKB signaling may represent a novel therapy for rosacea as clinical agents become available. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
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Abstract
Purpose To comprehensively review the literature regarding recurrent corneal erosion (RCE) and to present treatment options and recommendations for management. Overview RCE usually presents with sharp, unilateral pain upon awakening, in an eye with an underlying basement membrane dystrophy, prior ocular trauma, stromal dystrophy or degeneration, or prior surgery for refractive errors, cataracts, or corneal transplantation. Making the correct diagnosis requires a careful slit-lamp examination of both eyes coupled with a high degree of suspicion. Several treatments are commonly used for RCE but new therapies have been introduced recently. Conservative treatment consists of antibiotic and preservative-free lubricating drops, with topical cycloplegics and oral analgesics to control pain. Patients who are unresponsive to these therapies may benefit from therapeutic bandage contact lenses (BCL). Newer therapies include oral matrix metalloproteinase (MMP) inhibitors, blood-derived eye drops, amniotic membrane graft application, and judicious application of topical corticosteroids. Once the epithelium is healed, a course of hypertonic saline solution and/or ointment can be used. Surgical procedures may be performed in patients who fail conservative therapy. Punctal occlusion with plugs increases the tear film volume. Epithelial debridement with diamond burr polishing (DBP), anterior stromal puncture (ASP), or alcohol delamination should be considered in selected patients. DBP can be used for patients with basement membrane dystrophies and is the preferred treatment overall due to a low recurrence rate. ASP can be used for erosions outside the central visual axis. Excimer laser phototherapeutic keratectomy is an attractive option in eyes with central RCE since it precisely removes tissue while preserving corneal transparency. In patients with RCE who are also candidates for refractive surgery, photorefractive keratectomy can be considered. Summary Newly introduced therapies for RCE enable therapy to be individualized and lower the recurrence rate.
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Affiliation(s)
- Darby D Miller
- Department of Ophthalmology, Mayo Clinic, Jacksonville, FL 32224, USA,
| | - Syed A Hasan
- Department of Ophthalmology, Mayo Clinic, Jacksonville, FL 32224, USA,
| | - Nathaniel L Simmons
- Department of Ophthalmology, University of Rochester, Rochester, NY 14642, USA
| | - Michael W Stewart
- Department of Ophthalmology, Mayo Clinic, Jacksonville, FL 32224, USA,
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Fadel D, Kramer E. Potential contraindications to scleral lens wear. Cont Lens Anterior Eye 2019; 42:92-103. [DOI: 10.1016/j.clae.2018.10.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 10/28/2018] [Accepted: 10/30/2018] [Indexed: 12/11/2022]
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Kim YM, Eom HD, Yoon DH, Kim HK. Clinical Analysis of Findings for Anterior Segment Optical Coherent Tomography in Recurrent Corneal Erosion Syndrome. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.12.1155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yu Min Kim
- Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hee Dong Eom
- Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Dong Hee Yoon
- Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hong Kyun Kim
- Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea
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Kwon MY, Park DJ. The Clinical Result of Extended Wear of Therapeutic Contact Lenses and 5% NaCl for Traumatic Recurrent Corneal Erosion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2019. [DOI: 10.3341/jkos.2019.60.1.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Mi Young Kwon
- Department of Ophthalmology, Daegu Fatima Hospital, Daegu, Korea
| | - Dae Jin Park
- Department of Ophthalmology, Daegu Fatima Hospital, Daegu, Korea
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Lee HK, Lee C, Kim MK. Corneal dysplastic melanosis associated with recurrent corneal erosions: A case report. Medicine (Baltimore) 2018; 97:e13367. [PMID: 30572441 PMCID: PMC6319972 DOI: 10.1097/md.0000000000013367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Pigmented lesions of conjunctiva and cornea can be observed in various conditions, from the benign nevus to malignant melanoma. Pigmented acquired melanosis (PAM) is one of them, which is a neoplastic proliferation with malignant transformation potential of melanocytes. However, to our knowledge, there has been no report as to a disturbance of corneal barrier function caused by PAM. Here we report a case of corneal PAM which led to recurrent corneal erosions. PATIENT CONCERNS A 60-year-old woman was referred with a 4-month history of intractable recurrent epithelial erosions in the left eye. She denied any history of ocular trauma or surgery. Slit-lamp examination showed small epithelial defects and loose epithelium of overlying pigmented corneal lesions. The pigmentations were scattered in the corneal epithelial layer, from limbus to the central cornea. DIAGNOSIS Conservative treatment with therapeutic contact lens and oral doxycycline did not completely cure the corneal erosion. En bloc resection of the pigmented epithelium with cryotherapy and temporary amniotic membrane transplantation were performed. Histopathologic examination demonstrated pigmented melanocytes with mild atypia, scattered mainly in the corneal basal epithelium. Immunohistochemically, the cells were positive for Melan A/MART-1 and negative for CD68 and S100. The Ki-67 proliferation index was low. Therefore, it was diagnosed as primary acquired dysplastic melanosis causing epithelial barrier dysfunction. INTERVENTIONS We performed en bloc resection of the pigmented epithelium with cryotherapy and temporary amniotic membrane transplantation. OUTCOMES After the resection, recurrent corneal erosions and epithelial loosening were completely resolved. Although some pigmented lesions were recurred in the limbal epithelium at 8 o'clock, corneal erosion did not recur during the follow-up for 9 months. LESSONS Our report suggests that primary acquired dysplastic corneal melanosis may cause epithelial dysfunction resulting in recurrent corneal epithelial erosions.
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Affiliation(s)
- Hyo Kyung Lee
- Department of Ophthalmology, Seoul National University College of Medicine
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute
| | - Cheol Lee
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute
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Ní Mhéalóid Á, Lukasik T, Power W, Murphy CC. Alcohol delamination of the corneal epithelium for recurrent corneal erosion syndrome. Int J Ophthalmol 2018; 11:1129-1131. [PMID: 30046528 DOI: 10.18240/ijo.2018.07.09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 04/16/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To evaluate the outcomes of alcohol delamination (ALD) of the corneal epithelium for the treatment of recurrent corneal erosion syndrome (RCES) and to implement a standardized treatment protocol for this condition utilizing evidence based practice and the findings of an internal audit. METHODS A retrospective analysis of 42 eyes of 40 patients diagnosed with RCES who were treated with ALD between January 2006 and March 2016 was conducted. Patients had 20% alcohol applied to the cornea with the use of a well for 40s. Patients were reviewed one week later in the Outpatient Department. Outcome criteria were established based on standards from other studies in the medical literature. These included, a treatment success rate of at least 72% (defined as complete resolution of symptoms one month after treatment), a postoperative complication a rate of <5% (mainly infective keratitis, and subepithelial haze), and the absence of any detrimental effect on visual acuity in ≥95% of patients. RESULTS The mean age at the time of ALD was 41.17±13.44y. Patients were followed for an average of 12.8±15.65mo. The majority were female (52.5%, n=21) and the majority of eyes treated with ALD were left eyes (62.9%, n=26). Trauma was the primary aetiology in our study population. Treatment was successful in 73.8% (n=31) of eyes and in 75% (n=30) of patients. Recurrence occurred in 26.2% of eyes at a mean of 10.41±12.63mo post treatment. CONCLUSION ALD is an efficacious and cost-effective primary surgical intervention for RCES.
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Affiliation(s)
- Áine Ní Mhéalóid
- Education and Research Centre, Royal Victoria Eye and Ear Hospital, Dublin D02XK51, Ireland
| | - Taylor Lukasik
- School of Medicine, RCSI School of Medicine, Dublin D02VN51, Ireland
| | - William Power
- Ophthalmology Department, Royal Victoria Eye and Ear Hospital, Dublin D02XK51, Ireland
| | - Conor C Murphy
- Education and Research Centre, Royal Victoria Eye and Ear Hospital, Dublin D02XK51, Ireland
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Churashov SV, Kudryashova EV, Kulikov AN, Boiko EV, Chernysh VF, Maltsev DS. "Wet" transepithelial phototherapeutic keratectomy in the management of persistent epithelial defects in the graft. Clin Ophthalmol 2018; 12:895-901. [PMID: 29785085 PMCID: PMC5957060 DOI: 10.2147/opth.s161018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to evaluate the efficacy of “wet” transepithelial phototherapeutic keratectomy (TE-PTK) for treating persistent epithelial defects (PEDs) in the corneal graft following penetrating keratoplasty (PKP). Methods This study describes a noncomparative, prospective interventional case series. Patients with post-PKP graft epithelial defects lasting >3 months despite previous treatments with extensive wear soft contact lenses, amniotic membrane transplantation, and tarsorrhaphy were treated with wet TE-PTK. A wet TE-PTK procedure including a “wet ablation” step was performed using the EC-5000 excimer laser. Follow-up visits were at post-PTK days 3, 5, 10, and 30, and at each month thereafter. Results Eight patients (8 eyes; 5 men and 3 women; mean age, 51.3±14.3 years; mean follow-up period, 9.1±3.0 months) were included in this study. The mean best-corrected visual acuity was 1.76±0.28 log minimum angle of resolution (logMAR) at baseline and improved to 1.1±0.22 logMAR at 10 days postoperatively (p=0.0156; the improvement was significant). This effect remained stable throughout the remainder of the follow-up period. The mean time from wet TE-PTK to complete reepithelization was 4.3±1.3 days. Conclusion Wet TE-PTK appears to be effective for patients with post-PKP PEDs in the corneal graft who have failed conservative measures or previous surgical interventions.
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Affiliation(s)
- Sergei V Churashov
- Department of Ophthalmology, Military Medical Academy, St Petersburg, Russia
| | - Elena V Kudryashova
- Department of Ophthalmology, Military Medical Academy, St Petersburg, Russia
| | - Alexei N Kulikov
- Department of Ophthalmology, Military Medical Academy, St Petersburg, Russia
| | - Ernest V Boiko
- Department of Ophthalmology, Military Medical Academy, St Petersburg, Russia.,St Petersburg Branch, The S Fyodorov Eye Microsurgery Federal State Institution, St Petersburg, Russia.,Department of Ophthalmology, Mechnikov North-Western State Medical University, St Petersburg, Russia
| | - Valerii F Chernysh
- Department of Ophthalmology, Military Medical Academy, St Petersburg, Russia
| | - Dmitrii S Maltsev
- Department of Ophthalmology, Military Medical Academy, St Petersburg, Russia
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Treatment of ocular rosacea. Surv Ophthalmol 2018; 63:340-346. [DOI: 10.1016/j.survophthal.2017.07.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 07/30/2017] [Accepted: 07/31/2017] [Indexed: 02/06/2023]
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Ozek D, Evren Kemer Ö, Artüz F. Assessment of Tear Functions in Patients with Acne Rosacea without Meibomian Gland Dysfunction. Ocul Immunol Inflamm 2018. [DOI: 10.1080/09273948.2018.1433305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Dilay Ozek
- Department of Ophthalmology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Özlem Evren Kemer
- Department of Ophthalmology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Ferda Artüz
- Department of Ophthalmology, Ankara Numune Education and Research Hospital, Ankara, Turkey
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34
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Kim HJ, Koh JW. Effects of Diamond Burr in Patients with Recurrent Corneal Erosion. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2018. [DOI: 10.3341/jkos.2018.59.8.711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Hyun Ju Kim
- Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Korea
| | - Jae Wong Koh
- Department of Ophthalmology, Chosun University College of Medicine, Gwangju, Korea
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35
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Abstract
A 31-year-old woman with a history of unusual appearing recurrent linear corneal epithelial defects and subepithelial scaring in both eyes underwent 2 years of evaluation and treatment. It was eventually discovered that the patient was using a sleep mask with excessive fabric pilling, which was found to be the source of her chronic epitheliopathy. After discontinuation of the sleep mask, the patient experienced complete resolution of symptoms. When evaluating recurrent corneal epithelial defects, external sources of repeated trauma, including sleepwear, should be investigated.
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36
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Tang Y, Chen X, Zhang X, Tang Q, Liu S, Yao K. Clinical evaluation of corneal changes after phacoemulsification in diabetic and non-diabetic cataract patients, a systematic review and meta-analysis. Sci Rep 2017; 7:14128. [PMID: 29074989 PMCID: PMC5658349 DOI: 10.1038/s41598-017-14656-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 10/13/2017] [Indexed: 01/26/2023] Open
Abstract
Corneal endothelium morphological abnormalities result in fluid imbalance, stromal swelling, and loss of transparency, thus impairing visual function. Recently, growing number of studies have focused on diabetic corneal abnormalities after cataract surgery and its comparison with non-diabetic patients, the results remain conflicting. Thus, to evaluate the effect of phacoemulsification on the corneal properties in diabetic and non-diabetic patients, prospective studies were comprehensively searched through PubMed, EMBASE, and Cochrane databases updated to Jan 2017. A meta-analysis of the 13 identified studies was performed using weighted mean difference (WMD) and 95% confidence interval (CI). For the dynamic changes between preoperative and postoperative values, significant differences were identified between the two groups in endothelial cell density (ECD) and hexagon cells (HC%) at 1 day, 1 week, 1 month, and 3 months postoperatively, in central corneal thickness (CCT) at 1 month postoperatively, and in coefficient variation (CV) at 1 week and 1 month postoperatively. However, no significant differences were observed in CCT at 1 day, 1 week and 3 months postoperatively or in CV at 1 day and 3 months postoperatively. Diabetic corneas are more vulnerable to stress and trauma, resulting in greater morphological abnormalities and longer recovery time.
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Affiliation(s)
- Yizhen Tang
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China.,Key Laboratory of Ophthalmology of Zhejiang Province, Hangzhou, P.R. China
| | - Xinyi Chen
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China.,Key Laboratory of Ophthalmology of Zhejiang Province, Hangzhou, P.R. China
| | - Xiaobo Zhang
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China.,Key Laboratory of Ophthalmology of Zhejiang Province, Hangzhou, P.R. China
| | - Qiaomei Tang
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China.,Key Laboratory of Ophthalmology of Zhejiang Province, Hangzhou, P.R. China
| | - Siyu Liu
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China.,Key Laboratory of Ophthalmology of Zhejiang Province, Hangzhou, P.R. China
| | - Ke Yao
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, P.R. China. .,Key Laboratory of Ophthalmology of Zhejiang Province, Hangzhou, P.R. China.
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Epithelial Erosions and Refractive Results After Single-Step Transepithelial Photorefractive Keratectomy and Alcohol-Assisted Photorefractive Keratectomy in Myopic Eyes: A Comparative Evaluation Over 12 Months. Cornea 2017; 37:45-52. [DOI: 10.1097/ico.0000000000001428] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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38
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Zidan G, Rupenthal ID, Greene C, Seyfoddin A. Medicated ocular bandages and corneal health: potential excipients and active pharmaceutical ingredients. Pharm Dev Technol 2017; 23:255-260. [DOI: 10.1080/10837450.2017.1377232] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- Ghada Zidan
- Drug Delivery Research Group, School of Science, Auckland University of Technology, Auckland, New Zealand
| | - Ilva D. Rupenthal
- Buchanan Ocular Therapeutics Unit, Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
- Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
| | - Carol Greene
- Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand
| | - Ali Seyfoddin
- Drug Delivery Research Group, School of Science, Auckland University of Technology, Auckland, New Zealand
- School of Interprofessional Health Studies, Auckland University of Technology, Auckland, New Zealand
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Devi Nivean P, Malarkodi S, Nishanth M, Nivean M. Custard apple seed induced keratitis: a harmful traditional practice in South India. GMS OPHTHALMOLOGY CASES 2017; 7:Doc23. [PMID: 28944154 PMCID: PMC5598200 DOI: 10.3205/oc000074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Custard apple seeds have been used as a traditional remedy for scalp infestation of lice and dandruff since many years in our part of the world. Not many people, doctors even, are aware about the ill effects of this practice. Surprisingly, there are very few reports on poisoning due to these seeds and the management is not very well streamlined. Rohit Shetty et al. highlighted the ill effects of the seeds and the need to avoid steroids in these cases as they worsen the clinical scenario. We present 2 patients who developed keratoconjunctivitis due to ocular exposure with custard apple seeds. However, we managed our cases slightly differently. We scraped off the loose epithelium and patched the eye for a day or two with topical antibiotics and lubricants. The patients responded very well. We highlight our series to describe an alternate way of treatment for cases with custard apple seed injury.
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Affiliation(s)
- Pratheeba Devi Nivean
- M.N. Eye Hospital, Chennai, India,*To whom correspondence should be addressed: Pratheeba Devi Nivean, M.N. Eye Hospital, No.781 T.H. Road, Tondiarpet, Chennai - 600021, India, E-mail:
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Hirata H, Mizerska K, Dallacasagrande V, Guaiquil VH, Rosenblatt MI. Acute corneal epithelial debridement unmasks the corneal stromal nerve responses to ocular stimulation in rats: implications for abnormal sensations of the eye. J Neurophysiol 2017; 117:1935-1947. [PMID: 28250152 PMCID: PMC5411471 DOI: 10.1152/jn.00925.2016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 02/27/2017] [Accepted: 02/27/2017] [Indexed: 11/22/2022] Open
Abstract
It is widely accepted that the mechanisms for transducing sensory information reside in the nerve terminals. Occasionally, however, studies have appeared demonstrating that similar mechanisms may exist in the axon to which these terminals are connected. We examined this issue in the cornea, where nerve terminals in the epithelial cell layers are easily accessible for debridement, leaving the underlying stromal (axonal) nerves undisturbed. In isoflurane-anesthetized rats, we recorded extracellularly from single trigeminal ganglion neurons innervating the cornea that are excited by ocular dryness and cooling: low-threshold (<2°C cooling) and high-threshold (>2°C) cold-sensitive plus dry-sensitive neurons playing possible roles in tearing and ocular pain. We found that the responses in both types of neurons to dryness, wetness, and menthol stimuli were effectively abolished by the debridement, indicating that their transduction mechanisms lie in the nerve terminals. However, some responses to the cold, heat, and hyperosmolar stimuli in low-threshold cold-sensitive plus dry-sensitive neurons still remained. Surprisingly, the responses to heat in approximately half of the neurons were augmented after the debridement. We were also able to evoke these residual responses and follow the trajectory of the stromal nerves, which we subsequently confirmed histologically. The residual responses always disappeared when the stromal nerves were cut at the limbus, suggesting that the additional transduction mechanisms for these sensory modalities originated most likely in stromal nerves. The functional significance of these residual and enhanced responses from stromal nerves may be related to the abnormal sensations observed in ocular disease.NEW & NOTEWORTHY In addition to the traditional view that the sensory transduction mechanisms exist in the nerve terminals, we report here that the proximal axons (stromal nerves in the cornea from which these nerve terminals originate) may also be capable of transducing sensory information. We arrived at this conclusion by removing the epithelial cell layers of the cornea in which the nerve terminals reside but leaving the underlying stromal nerves undisturbed.
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Affiliation(s)
- Harumitsu Hirata
- Department of Ophthalmology, Weill Cornell Medical College, New York, New York; and
| | - Kamila Mizerska
- Department of Ophthalmology, Weill Cornell Medical College, New York, New York; and
| | | | - Victor H Guaiquil
- Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois-Chicago, Chicago, Illinois
| | - Mark I Rosenblatt
- Department of Ophthalmology and Visual Sciences, College of Medicine, University of Illinois-Chicago, Chicago, Illinois
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41
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Shin DY, Chung SH. Efficacy of Anterior Stromal Puncture Using 5% NaCl Eye Drops for Prolonged Time in Recurrent Corneal Erosion Syndrome. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2017. [DOI: 10.3341/jkos.2017.58.5.503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Da-Young Shin
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - So Hyang Chung
- Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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42
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Simeone CA, Colitz CMH, Colegrove KM, Field CL, Rios C, Chandler HL, Johnson SP. Subconjunctival antimicrobial poloxamer gel for treatment of corneal ulceration in stranded California sea lions (Zalophus californianus
). Vet Ophthalmol 2016; 20:441-449. [DOI: 10.1111/vop.12447] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Claire A. Simeone
- The Marine Mammal Center; Sausalito CA 94965 USA
- Office of Protected Resources; National Marine Fisheries Service; National Oceanic and Atmospheric Administration; Silver Spring MD 20910 USA
| | | | - Kathleen M. Colegrove
- Zoological Pathology Program; University of Illinois at Urbana-Champaign; Brookfield IL 60513 USA
| | | | - Carlos Rios
- The Marine Mammal Center; Sausalito CA 94965 USA
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Sassani JW, Mc Laughlin PJ, Zagon IS. The Yin and Yang of the Opioid Growth Regulatory System: Focus on Diabetes-The Lorenz E. Zimmerman Tribute Lecture. J Diabetes Res 2016; 2016:9703729. [PMID: 27703986 PMCID: PMC5039296 DOI: 10.1155/2016/9703729] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 04/24/2016] [Indexed: 12/16/2022] Open
Abstract
The Opioid Growth Regulatory System consists of opioid growth factor (OGF), [Met5]-enkephalin, and its unique receptor (OGFr). OGF inhibits cell division when bound to OGFr. Conversely, blockade of the interaction of OGF and OGFr, using the potent, long-acting opioid receptor antagonist, naltrexone (NTX), results in increased DNA synthesis and cell division. The authors have demonstrated both in vitro and in vivo that the addition of exogenous OGF or an increase in available OGFr decreases corneal epithelial cell division and wound healing. Conversely, blockade of the OGF-OGFr interaction by NTX or a decrease in the production of the OGFr increases corneal epithelial cell division and facilitates corneal epithelial wound healing. The authors also have demonstrated that depressed corneal and cutaneous wound healing, dry eye, and abnormal corneal sensitivity in type 1 and type 2 diabetes in animals can be reversed by OGF-OGFr blockade by NTX. Thus, the function of the Opioid Growth Regulatory System appears to be disordered in diabetic animals, and its function can be restored with NTX treatment. These studies suggest a fundamental role for the Opioid Growth Regulatory System in the pathobiology of diabetic complications and a need for studies to elucidate this role further.
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Affiliation(s)
- Joseph W. Sassani
- Departments of Ophthalmology and Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA 17033, USA
| | - Patricia J. Mc Laughlin
- Department of Neural and Behavioral Sciences, The Penn State University College of Medicine, Hershey, PA 17033, USA
| | - Ian S. Zagon
- Department of Neural and Behavioral Sciences, The Penn State University College of Medicine, Hershey, PA 17033, USA
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Cejkova J, Cejka C, Trosan P, Zajicova A, Sykova E, Holan V. Treatment of alkali-injured cornea by cyclosporine A-loaded electrospun nanofibers – An alternative mode of therapy. Exp Eye Res 2016; 147:128-137. [DOI: 10.1016/j.exer.2016.04.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 02/14/2016] [Accepted: 04/19/2016] [Indexed: 11/29/2022]
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López-Valverde G, Garcia-Martin E, Larrosa-Povés JM, Polo-Llorens V, Pablo-Júlvez LE. Therapeutical Management for Ocular Rosacea. Case Rep Ophthalmol 2016; 7:237-42. [PMID: 27462249 PMCID: PMC4943766 DOI: 10.1159/000446104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 04/12/2016] [Indexed: 01/20/2023] Open
Abstract
Purpose The purpose of this study is to describe a case of ocular rosacea with a very complex evolution. Rosacea is a chronic dermatological disease that may affect the ocular structures up to 6-72% of all cases. This form is often misdiagnosed, which may lead to long inflammatory processes with important visual consequences for affected patients. Therefore, an early diagnosis and an adequate treatment are important. Methods We report the case of a 43-year-old patient who had several relapses of what seemed an episode of acute bacterial conjunctivitis. Two weeks later, he developed a corneal ulcer with a torpid evolution including abundant intrastromal infiltrators and calcium deposits. He was diagnosed with ocular rosacea and treated with systemic doxycycline and topical protopic. Results A coating with amniotic membrane was placed in order to heal the ulcer, but a deep anterior lamellar keratoplasty to restore the patient's vision because of the corneal transparency loss was necessary. Conclusions Ocular rosacea includes multiple ophthalmic manifestations ranging from inflammation of the eyelid margin and blepharitis to serious corneal affectations. A delayed diagnosis can result in chronic inflammatory conditions including keratinization and loss of corneal transparency, which lead to important visual sequelae for affected patients.
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Affiliation(s)
- Gloria López-Valverde
- Hospital Royo Villanova, Zaragoza, Spain; Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Elena Garcia-Martin
- Hospital Universitario Miguel Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragon), Zaragoza, Spain
| | - José Manuel Larrosa-Povés
- Hospital Universitario Miguel Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragon), Zaragoza, Spain
| | - Vicente Polo-Llorens
- Hospital Universitario Miguel Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragon), Zaragoza, Spain
| | - Luis E Pablo-Júlvez
- Hospital Universitario Miguel Servet, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragon), Zaragoza, Spain
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Wladis EJ, Bradley EA, Bilyk JR, Yen MT, Mawn LA. Oral Antibiotics for Meibomian Gland-Related Ocular Surface Disease: A Report by the American Academy of Ophthalmology. Ophthalmology 2015; 123:492-6. [PMID: 26707417 DOI: 10.1016/j.ophtha.2015.10.062] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 10/28/2015] [Accepted: 10/28/2015] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To review the existing medical literature on the role of oral antibiotics in the management of ocular surface disease (OSD) that arises from disorders of the meibomian glands and to assess the efficacy of oral antibiotics in the management of this common ocular disease. METHODS A literature search was last conducted on August 12, 2015, in the PubMed and Cochrane databases for English-language original research investigations that evaluated the role of doxycycline, minocycline, and azithromycin in OSD among adult patients. The searches identified 87 articles, and 8 studies ultimately met the criteria outlined for this assessment. RESULTS The 8 studies identified in the search documented an improvement in meibomian gland-related OSD after treatment with these agents, although side effects were common. This search identified only 1 randomized, controlled trial to assess the efficacy of these medications. CONCLUSIONS Although oral antibiotics are used commonly in the management of OSD, there is no level I evidence to support their use. There are only a few studies that have assessed the efficacy of oral antibiotics in clinically meaningful ways in the management of OSD that arises from disorders of the meibomian glands. The current level of evidence is insufficient to conclude that antibiotics are useful in managing OSD arising from disorders of the meibomian glands. The few existing studies on the topic indicate that oral antibiotics may be an effective treatment for OSD that results from meibomian gland disease.
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Affiliation(s)
- Edward J Wladis
- Ophthalmic Plastic Surgery, Department of Ophthalmology, Albany Medical Center, Albany (Slingerlands), New York
| | | | | | - Michael T Yen
- Cullen Eye Institute, Baylor College of Medicine, Houston, Texas
| | - Louise A Mawn
- Vanderbilt Eye Institute, Vanderbilt University, Nashville, Tennessee
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Partial denervation of sub-basal axons persists following debridement wounds to the mouse cornea. J Transl Med 2015; 95:1305-18. [PMID: 26280222 PMCID: PMC4626298 DOI: 10.1038/labinvest.2015.113] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 06/18/2015] [Accepted: 06/24/2015] [Indexed: 01/09/2023] Open
Abstract
Although sensory reinnervation occurs after injury in the peripheral nervous system, poor reinnervation in the elderly and those with diabetes often leads to pathology. Here we quantify sub-basal axon density in the central and peripheral mouse cornea over time after three different types of injury. The mouse cornea is highly innervated with a dense array of sub-basal nerves that form a spiral called the vortex at the corneal center or apex; these nerves are readily detected within flat mounted corneas. After anesthesia, corneal epithelial cells were removed using either a dulled blade or a rotating burr within an area demarcated centrally with a 1.5 mm trephine. A third wound type, superficial trephination, involved demarcating the area with the 1.5 mm trephine but not removing cells. By 7 days after superficial trephination, sub-basal axon density returns to control levels; by 28 days the vortex reforms. Although axon density is similar to control 14 days after dulled blade and rotating burr wounding, defects in axon morphology at the corneal apex remain. After 14 days, axons retract from the center leaving the sub-basal axon density reduced by 37.2 and 36.8% at 28 days after dulled blade and rotating burr wounding, respectively, compared with control. Assessment of inflammation using flow cytometry shows that persistent inflammation is not a factor in the incomplete reinnervation. Expression of mRNAs encoding 22 regeneration-associated genes involved in axon targeting assessed by QPCR reveals that netrin-1 and ephrin signaling are altered after wounding. Subpopulations of corneal epithelial basal cells at the corneal apex stop expressing ki67 as early as 7 days after injury and by 14 and 28 days after wounding, many of these basal cells undergo apoptosis and die. Although sub-basal axons are restored to their normal density and morphology after superficial trephination, sub-basal axon recovery is partial after debridement wounds. The increase in corneal epithelial basal cell apoptosis at the apex observed at 14 days after corneal debridement may destabilize newly reinnervated sub-basal axons and lead to their retraction toward the periphery.
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de Alba-Castilla MA, López-Rubio S, Rodríguez-García A. Síndrome erosivo corneal recurrente enmascarado como queratitis epitelial herpética. REVISTA MEXICANA DE OFTALMOLOGÍA 2015. [DOI: 10.1016/j.mexoft.2015.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Putting on the brakes: Bacterial impediment of wound healing. Sci Rep 2015; 5:14003. [PMID: 26365869 PMCID: PMC4650533 DOI: 10.1038/srep14003] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 08/03/2015] [Indexed: 12/17/2022] Open
Abstract
The epithelium provides a crucial barrier to infection, and its integrity requires
efficient wound healing. Bacterial cells and secretomes from a subset of tested
species of bacteria inhibited human and porcine corneal epithelial cell migration
in vitro and ex vivo. Secretomes from 95% of Serratia
marcescens, 71% of Pseudomonas aeruginosa, 29% of Staphylococcus
aureus strains, and other bacterial species inhibited epithelial cell
migration. Migration of human foreskin fibroblasts was also inhibited by S.
marcescens secretomes indicating that the effect is not cornea specific.
Transposon mutagenesis implicated lipopolysaccharide (LPS) core biosynthetic genes
as being required to inhibit corneal epithelial cell migration. LPS depletion of
S. marcescens secretomes with polymyxin B agarose rendered secretomes
unable to inhibit epithelial cell migration. Purified LPS from S. marcescens,
but not from Escherichia coli or S. marcescens strains with mutations
in the waaG and waaC genes, inhibited epithelial cell migration in
vitro and wound healing ex vivo. Together these data suggest that
S. marcescens LPS is sufficient for inhibition of epithelial wound
healing. This study presents a novel host-pathogen interaction with implications for
infections where bacteria impact wound healing and provides evidence that secreted
LPS is a key factor in the inhibitory mechanism.
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Maharana PK, Dubey A, Jhanji V, Vajpayee RB. The diagnosis and management of recurrent corneal erosion syndrome. EXPERT REVIEW OF OPHTHALMOLOGY 2015. [DOI: 10.1586/17469899.2015.1076335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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