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Shaaban YM, Badran TA. Compensatory Corneal Epithelial Changes After Femtolaser - Assisted Intracorneal Rings Implantation in Early and Moderate Cases of Keratoconus. Clin Ophthalmol 2023; 17:3591-3599. [PMID: 38026597 PMCID: PMC10676668 DOI: 10.2147/opth.s432446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/07/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose To study the compensatory corneal epithelial changes after femtolaser-assisted intracorneal ring segment (ICRS) implantation in early and moderate cases of keratoconus (KC) using anterior segment optical coherence tomography (AS-OCT). Patients and Methods A prospective observational non-randomized study of 40 eyes with mild to moderate KC received femtolaser-assisted ICRS implantation. Ferrara ICRS with different arc lengths and thicknesses were used according to the patients' tomographic pattern. Patients had a clear central cornea, keratometry reading < 60 diopters, and corneal thickness > 400 microns. AS-OCT was performed preoperatively and at 1, 3, and 6 months after surgery. Corneal epithelial thickness (CET) was measured over 17 points (2 mm central and 16 points on 2-5 mm and 5-7 mm annular zones) over the pupil center. All data were collected and analyzed. Results Comparing the preoperative and postoperative data, there was a statistically significant increase in the CET postoperatively throughout the 6-month follow-up period in all zones (p<0.001). The epithelial thickness (ET) was noticed shortly around and central to the ring ridges by the first month (5-7 mm zone). By the third month, the flattened central cornea (2 mm zone) and the 2-5 mm zone showed a significant increase in ET up to the 6th month. Conclusion ICRS implantation in KC results in a thicker and more regular epithelium in the central corneal zone as a secondary response to the corneal stromal changes induced by the implants.
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Affiliation(s)
- Yasmine Maher Shaaban
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, 1181, Egypt
- Ain Shams University Hospitals and Ain Shams Specialized Hospital, Cairo, 11588, Egypt
| | - Tamer Abdelfattah Badran
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, 1181, Egypt
- The Eye Subspeciality Center (ESC), Cairo, 11402, Egypt
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2
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Latul YP, Vodegel EV, Kastelein AW, Alkemade L, Ras L, Hilty MP, Favaron E, Ince Y, Ince C, Jeffery S, Guler Z, Roovers JPWR. The effect of CO 2 laser therapy on vaginal microcirculatory parameters in an animal model for genitourinary syndrome of menopause. Neurourol Urodyn 2023. [PMID: 37334848 DOI: 10.1002/nau.25227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Vaginal laser therapy for the treatment of genitourinary syndrome of menopause (GSM) has been introduced to the market with limited (pre)clinical and experimental evidence supporting its efficacy. It is suggested that vaginal laser therapy increases epithelial thickness and improves vascularization, but the underlying biological working mechanism has not been substantiated yet. OBJECTIVE To evaluate the effects of CO2 laser therapy on vaginal atrophy using noninvasive incident dark field (IDF) imaging in a large animal model for GSM. DESIGN, SETTING, AND PARTICIPANTS An animal study was conducted between 2018 and 2019 and included 25 Dohne Merino ewes, of which 20 underwent bilateral ovariectomy (OVX) to induce iatrogenic menopause, and 5 did not. The total study duration was 10 months. INTERVENTIONS Five months after OVX, ovariectomized ewes received monthly applications of CO2 laser (n = 7), vaginal estrogen (n = 7), or no treatment (n = 6) for 3 months. IDF imaging was performed monthly in all animals. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary outcome was the proportion of image sequences containing capillary loops (angioarchitecture). Secondary outcomes included focal depth (epithelial thickness), and quantitative measures of vessel density and perfusion. Treatment effects were evaluated using ANCOVA and binary logistic regression. RESULTS AND LIMITATIONS Compared to OVX-only, ewes treated with estrogen demonstrated a higher capillary loops proportion (4% vs. 75%, p < 0.01), and higher focal depth (60 (IQR 60-80) vs. 80 (IQR 80-80) p < 0.05). CO2 laser therapy did not change microcirculatory parameters. As the ewes' vaginal epithelium is thinner than that of humans, it may demand different laser settings. CONCLUSIONS In a large animal model for GSM, CO2 laser therapy does not affect microcirculatory outcomes related to GSM, whereas vaginal estrogen treatment does. Until more homogeneous and objective evidence about its efficacy is available, CO2 laser therapy should not be adopted into widespread practice for treating GSM.
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Affiliation(s)
- Yani P Latul
- Department of Obstetrics and Gynecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Eva V Vodegel
- Department of Obstetrics and Gynecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Arnoud W Kastelein
- Department of Obstetrics and Gynecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Lily Alkemade
- Department of Obstetrics and Gynecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Lamees Ras
- Department of Urology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Matthias P Hilty
- University Hospital of Zurich, Institute of Intensive Care Medicine, Zurich, Switzerland
- Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Emanuele Favaron
- Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Yasin Ince
- Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Can Ince
- Department of Intensive Care, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Stephen Jeffery
- Department of Urology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Zeliha Guler
- Department of Obstetrics and Gynecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Jan-Paul W R Roovers
- Department of Obstetrics and Gynecology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development Research Institute, Amsterdam, The Netherlands
- Department of Urology, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
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Storp JJ, Lahme L, Al-Nawaiseh S, Eter N, Alnawaiseh M. Descemet Membrane Endothelial Keratoplasty (DMEK) Reduces the Corneal Epithelial Thickness in Fuchs' Patients. J Clin Med 2023; 12:jcm12103573. [PMID: 37240679 DOI: 10.3390/jcm12103573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Fuchs' endothelial corneal dystrophy (FECD) is the occurrence of corneal edema due to endothelial cell dystrophy. Descemet membrane endothelial keratoplasty (DMEK) is considered to be the gold standard of treatment. The aim of this study was to investigate the changes in the corneal epithelial thickness of FECD patients before and after DMEK and to compare these results with a healthy control cohort. In this retrospective analysis, 38 eyes of patients with FECD that were treated with DMEK and 35 healthy control eyes received anterior segment optical coherence tomography (OCT; Optovue, XR-Avanti, Fremont, CA, USA). The corneal epithelial thicknesses in different locations were analyzed and compared between the preoperative, postoperative, and control cohorts. The median follow-up time was 9 months. There was a significant degression of the mean epithelial thickness after DMEK in the central, paracentral, and mid-peripheral zones (p < 0.01) of the cornea. The total corneal thickness and stromal thickness decreased significantly as well. No significant differences were observed between the postoperative and control cohorts. In conclusion, the FECD patients had an increased epithelial thickness compared to the healthy controls, which decreased significantly after DMEK and reached thickness levels comparable to those of healthy control eyes. This study emphasized the importance of distinguishing between the corneal layers in anterior segment pathologies and surgical procedures. Moreover, it accentuated the fact that the structural alterations in FECD extend beyond the corneal stroma.
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Affiliation(s)
- Jens Julian Storp
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | - Larissa Lahme
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | - Sami Al-Nawaiseh
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | - Nicole Eter
- Department of Ophthalmology, University of Muenster Medical Center, 48149 Muenster, Germany
| | - Maged Alnawaiseh
- Department of Ophthalmology, Klinikum Bielefeld gem. GmbH, 33604 Bielefeld, Germany
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Başkan C, Kılıcarslan A. How Can We Diagnose Ocular Surface Squamous Neoplasia With Optical Coherence Tomography? Cureus 2023; 15:e36320. [PMID: 36941905 PMCID: PMC10023871 DOI: 10.7759/cureus.36320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 03/19/2023] Open
Abstract
AIM We aimed to evaluate the effectiveness of optical coherence tomography (OCT) in the differential diagnosis of anterior segment diseases such as ocular surface squamous neoplasia (OSSN) and pterygium. METHODS Patients who were pre-diagnosed with either OSSN (21) or pterygium (19) between January 2020 and November 2022 were included in this retrospective study. Anterior segment photographs and anterior segment optical coherence tomography (AS-OCT) measurements were obtained from each patient. Excisional or incisional biopsy materials underwent pathological evaluation. RESULTS Preoperative AS-OCT images of the patients with OSSN showed similarities with histopathological specimens. Both ocular and pathological specimens appeared to have a thicker epithelial layer with a distinct change from healthy to neoplastic epithelium. Preoperative AS-OCT images of individuals with pterygium were also comparable with histopathological samples. Both pathological and AS-OCT images of the pterygium patients showed a normal thickness epithelium and a thickened subepithelial layer under the epithelium. The mean epithelial thickness measured with AS-OCT in OSSN patients was found to be 295.3 ± 111.3 µm, while it was 80.7 ± 43.4 µm in pterygium patients. The difference was statistically significant (P<0.001). The receiver operating characteristic (ROC) curve analysis revealed a cut-off value of 97 µm for the differential diagnosis of OSSN from pterygium, with a sensitivity of 100% and specificity of 94.7%. CONCLUSIONS AS-OCT can be used as a noninvasive diagnostic tool for the evaluation of ocular surface lesions. Its ability to distinguish between OSSN and pterygium is demonstrated by the statistically significant difference in epithelial thickness and the significant morphological association with histopathological findings.
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Affiliation(s)
- Ceyda Başkan
- Ophthalmology, Ankara Bilkent City Hospital, Ankara, TUR
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Gaspar A, Silva J, Calderon A, Di Placido V, Vizintin Z. Histological findings after non-ablative Er:YAG laser therapy in women with severe vaginal atrophy. Climacteric 2021; 23:S11-S13. [PMID: 33124455 DOI: 10.1080/13697137.2020.1764525] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective: The aim of this study was to evaluate the effect of non-ablative erbium vaginal laser treatment on vaginal mucosa tissue affected by severe atrophy.Methods: Ten patients with severe genitourinary syndrome of menopause were treated with two sessions of the non-ablative erbium-doped yttrium aluminium garnet laser (Er:YAG laser) separated by 4 weeks. Vaginal biopsies were performed before and 3 months after the second treatment. The improvement in vaginal atrophy was assessed using multiple measuring tools before and 6 months after the treatment. The degree of patients' satisfaction was also assessed.Results: Microscopic examination showed significant changes in the main structural components of the vaginal wall mucosa after two non-ablative Er:YAG laser sessions. The epithelial thickness increased from 45 µm (10-106 µm) to 153 µm (97-244 µm) measured 3 months after the final laser treatment. Vaginal atrophy improved in all patients by all measured outcomes. The degree of patient satisfaction was very high (3.6 on the Likert four-point scale). No adverse events or complications were observed in any of the sessions. Conclusion: The non-ablative Er:YAG laser seems to be a safe and effective method to increase epithelial thickness of the vaginal mucosa in patients with severe vaginal atrophy.
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Affiliation(s)
- A Gaspar
- Espacio Gaspar Clinic, Mendoza, Argentina
| | - J Silva
- Gynecology Department, Uroclinica, Mendoza, Argentina
| | - A Calderon
- Espacio Gaspar Clinic, Mendoza, Argentina
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Loureiro TDO, Rodrigues-Barros S, Lopes D, Carreira AR, Gouveia-Moraes F, Vide-Escada A, Campos NP. Corneal Epithelial Thickness Profile in Healthy Portuguese Children by High-Definition Optical Coherence Tomography. Clin Ophthalmol 2021; 15:735-743. [PMID: 33658753 PMCID: PMC7917471 DOI: 10.2147/opth.s293695] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 12/25/2020] [Indexed: 12/31/2022] Open
Abstract
Introduction and Objective To evaluate corneal epithelial thickness (ET) and corneal thickness (CT) profiles in healthy eyes of Portuguese children and provide information to establish the first normative Caucasian database for these age group. Methods Sixty healthy eyes of 60 children aged between 8 and 18 were evaluated using the Cirrus high-definition optical coherence tomography device. The average ET and CT were assessed using Cirrus Review Software with predefined concentric corneal ring-shaped zones. Specific regions of ET (central, superior, inferior, temporal, nasal, superonasal, inferotemporal, superotemporal and inferonasal) were also assessed. The mean ET, the mean CT and the difference of ET in corresponding octants were compared by gender. Correlations between central epithelial thickness (CET), age and refractive error were evaluated. Results and Discussion The average ET was lower in the peripheric zones, whereas the average CT was higher. ET was thinner in the superior area than in the inferior (p<0.05). ET was thicker in boys than in girls (p<0.05), but CT did not differ. CET was not correlated with older age or refractive error. Conclusion Optical coherence tomography analysis of ET reveals that it is thinner in the periphery, where the CT is thicker. Unlike CT, ET seems to be influenced by gender. ET profile proved to be a useful tool in keratoconus diagnosis and subclinical keratoconus detection in adults. As epithelial changes occur early in the disease and keratoconus is more aggressive in pediatric population, a normative database of ET profile could contribute to enhance early recognition of the disease in this age group.
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Affiliation(s)
| | | | - Diogo Lopes
- Ophthalmology Department, Hospital Garcia de Orta, Almada, Portugal
| | | | | | - Ana Vide-Escada
- Ophthalmology Department, Hospital Garcia de Orta, Almada, Portugal
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Albrecht M, Schnabel C, Mueller J, Golde J, Koch E, Walther J. In Vivo Endoscopic Optical Coherence Tomography of the Healthy Human Oral Mucosa: Qualitative and Quantitative Image Analysis. Diagnostics (Basel) 2020; 10:E827. [PMID: 33076312 PMCID: PMC7602587 DOI: 10.3390/diagnostics10100827] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/08/2020] [Accepted: 10/10/2020] [Indexed: 12/18/2022] Open
Abstract
To date, there is still a lack of reliable imaging modalities to improve the quality of consultation, diagnostic and medical examinations of the oral mucosa in dentistry. Even though, optical technologies have become an important element for the detection and treatment of different diseases of soft tissue, for the case of oral screenings the evidence of the benefit in comparison to conventional histopathology is mostly still pending. One promising optical technology for oral diagnostics is optical coherence tomography (OCT). To prove the potential of OCT, even the amount of freely accessible OCT data is not sufficient to describe the variance of healthy human oral soft tissue in vivo. In order to remedy this deficiency, the present study provides in vivo OCT cross sections of the human oral mucosa of the anterior and posterior oral cavity as well as the oropharynx of 47 adult volunteers. A collection of representative OCT cross sections forms the basis for a randomized blinded image analysis by means of seven criteria to assess the main features of the superficial layers of the human oral mucosa and to determine its correlation to regional features known from hematoxylin and eosin (HE) stained histology.
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Affiliation(s)
- Marius Albrecht
- Department of Medical Physics and Biomedical Engineering, Technische Universitaet Dresden, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany; (M.A.); (C.S.)
| | - Christian Schnabel
- Department of Medical Physics and Biomedical Engineering, Technische Universitaet Dresden, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany; (M.A.); (C.S.)
- Department of Anesthesiology and Intensive Care Medicine, Technische Universität Dresden, Clinical Sensoring and Monitoring, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany; (J.M.); (J.G.); (E.K.)
| | - Juliane Mueller
- Department of Anesthesiology and Intensive Care Medicine, Technische Universität Dresden, Clinical Sensoring and Monitoring, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany; (J.M.); (J.G.); (E.K.)
| | - Jonas Golde
- Department of Anesthesiology and Intensive Care Medicine, Technische Universität Dresden, Clinical Sensoring and Monitoring, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany; (J.M.); (J.G.); (E.K.)
| | - Edmund Koch
- Department of Anesthesiology and Intensive Care Medicine, Technische Universität Dresden, Clinical Sensoring and Monitoring, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany; (J.M.); (J.G.); (E.K.)
| | - Julia Walther
- Department of Medical Physics and Biomedical Engineering, Technische Universitaet Dresden, Carl Gustav Carus Faculty of Medicine, Fetscherstraße 74, 01307 Dresden, Germany; (M.A.); (C.S.)
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Elmekawey H, Abdelaziz M, El Baradey M, Kotb M. Epithelial Remodeling Following Phacoemulsification in Diabetic Patients Using Anterior-Segment Optical Coherence Tomography: A Comparative Study. Clin Ophthalmol 2020; 14:2515-2523. [PMID: 32921979 PMCID: PMC7457868 DOI: 10.2147/opth.s266464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 07/27/2020] [Indexed: 11/26/2022] Open
Abstract
Purpose To compare the effect of phacoemulsification on corneal epithelial thickness in diabetic and nondiabetic cataract patients. Methods Fifty eyes with cataracts were enrolled in a prospective comparative interventional study. They were divided into two groups: group A (diabetics) and group B (nondiabetics) and underwent uneventful phacoemulsification. Epithelial thickness was assessed in the central, paracentral, and peripheral cornea on the first day and at 1 week, 1 month, and 3 months postoperatively using spectral-domain ocular coherence tomography. Results A significant increase in the first-day postoperative central epithelial thickness was noticed in both groups (57.16±3.5 µm and 55.96±2.81 µm in groups A and B, respectively), with increased baseline epithelial thickness of 3.8±2.1 µm and 3.4±2.14 µm in groups A and B, respectively (P<0.001). A significant decrease in epithelial thickness was noticed in both groups after 1 week (−2.40±3.1 µm and −2.76±2.71 µm in group A and B, respectively). No further significant change was noticed in the nondiabetic group at 1 month; however, significant reductions in for central epithelial thickness were found in the diabetic group up to the first month (−0.80±1.9 µm, P=0.05). Central corneal thickness followed the same pattern of change as the epithelium. A nonsignificant delay in visual acuity improvement was noticed in diabetic patients. Conclusion Phacoemulsification induces a temporary increase in corneal and epithelial thickness that should resolve by the first week postoperatively. However, diabetic patients had slower epithelial recovery that took up to 1 month, which could be reflected in delayed visual recovery with no effect on the final visual outcome.
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Affiliation(s)
- Hany Elmekawey
- Ophthalmology, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Magda Abdelaziz
- Ophthalmology, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed El Baradey
- Ophthalmology, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Kotb
- Ophthalmology, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt
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Manciula LG, Berce C, Tabaran F, Trombitaș V, Albu S. The Effects of Postoperative Astaxanthin Administration on Nasal Mucosa Wound Healing. J Clin Med 2019; 8:E1941. [PMID: 31718054 PMCID: PMC6912356 DOI: 10.3390/jcm8111941] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/06/2019] [Accepted: 11/08/2019] [Indexed: 12/20/2022] Open
Abstract
. BACKGROUND Wound healing of the nasal mucosa after endoscopic sinus surgery (ESS) is frequently complicated by scaring and consequently recurrences are encountered. Methods of optimizing results have been sought. In the present study we evaluated the effects of a powerful antioxidant, astaxanthin, on nasal mucosa healing after surgery, comparing it to the extensively studied properties of dexamethasone. MATERIALS AND METHODS 63 Wistar rats were used. The nasal mucosa from one side was damaged employing the brushing method. They were randomly divided into three experimental groups, one treated with astaxanthin, the second treated with dexamethasone and the third one acted as the control and was given normal saline. The rats were killed on days 5, 14 and 28 following injury. We observed the temporal evolution of the wound healing process and quantified the results by assessing four parameters: the epithelial thickness index (ETI), the subepithelial thickness index (STI), the goblet cell count and the subepithelial fibrosis index (SFI). RESULTS At 28 days, the ETI was significantly lower in the astaxanthin group (p < 0.05) compared to the other two groups. The STI was also lower in the astaxanthin group (p < 0.05), but comparable to the dexamethasone group at 28 days. The goblet cell count was higher in the astaxanthin group. The SFI had similar results in both dexamethasone and astaxanthin groups, with lower values compared to the control group. In the astaxanthin group there was no synechia formation. CONCLUSION Astaxanthin given in the post injury period significantly decreases fibrosis, inhibits synechia development and significantly decreases subepithelial fibrosis. Moreover, it has no general or local toxic effects.
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Affiliation(s)
- Lavinia-Gianina Manciula
- 2nd Department of Otolaryngology, Iuliu Hatieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania; (V.T.); (S.A.)
| | - Cristian Berce
- Department of Experimental Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania;
| | - Flaviu Tabaran
- Pathology Department, University of Agricultural Sciences and Veterinary Medicine, 400372 Cluj-Napoca, Romania;
| | - Veronica Trombitaș
- 2nd Department of Otolaryngology, Iuliu Hatieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania; (V.T.); (S.A.)
| | - Silviu Albu
- 2nd Department of Otolaryngology, Iuliu Hatieganu University of Medicine and Pharmacy, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania; (V.T.); (S.A.)
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Iqbal A, Tamgadge S, Tamgadge A, Pereira T, Kumar S, Acharya S, Jadhav A. Evaluation of Ki-67 Expression in Oral Submucous Fibrosis and Its Correlation with Clinical and Histopathological Features. J Microsc Ultrastruct 2019; 8:20-24. [PMID: 32166060 PMCID: PMC7045623 DOI: 10.4103/jmau.jmau_28_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 09/10/2019] [Indexed: 11/10/2022] Open
Abstract
Objectives: Oral submucous fibrosis (OSMF) is a potentially malignant disorder. Although it shows atrophic epithelium, it has a high proliferative capacity. Therefore, this study correlates the Ki-67. (The name “ki” is derived from the city of origin [Kiel, Germany] expression with functional grading and epithelial thickness in OSMF). Methods: The study group comprised of thirty patients of OSMF, divided randomly into Group A, Group B, Group C, and Group D as per mouth opening (functional staging). Five participants without OSMF formed the negative control group. The positive control group comprised of five patients of diagnosed cases of squamous cell carcinoma. All the sections of biopsy were subjected for hematoxylin and eosin and immunohistochemistry staining and observed for expression of Ki-67. Epithelial thickness was evaluated using image analysis software of Leica research microscope. Images were analyzed by three independent observers who were blindfolded. All the findings were tabulated and statistically analyzed. Results: In the present study, as the functional staging increased, the Ki-67 expression also increased. Ki-67 expression was highest in severe functional staging/severely decreased mouth opening (100.78) and is least in mild functional staging/mild decreased mouth opening (10.39). However, there was no significant correlation between epithelial thickness and functional staging/mouth opening (P > 0.05). Conclusion: A decrease in functional staging (mouth opening) showed a greater expression of Ki-67, and there was no significant correlation between functional staging and epithelial thickness.
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Affiliation(s)
- Asif Iqbal
- Department of Oral and Maxillofacial Pathology and Microbiology, D. Y. Patil Deemed to be University School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Sandhya Tamgadge
- Department of Oral and Maxillofacial Pathology and Microbiology, D. Y. Patil Deemed to be University School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Avinash Tamgadge
- Department of Oral and Maxillofacial Pathology and Microbiology, D. Y. Patil Deemed to be University School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Treville Pereira
- Department of Oral and Maxillofacial Pathology and Microbiology, D. Y. Patil Deemed to be University School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Sourab Kumar
- Department of Oral and Maxillofacial Pathology and Microbiology, D. Y. Patil Deemed to be University School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Siddarth Acharya
- Department of Public Health Dentistry, D. Y. Patil University School of Dentistry, Nerul, Navi Mumbai, Maharashtra, India
| | - Abhishek Jadhav
- Department of Oral and Maxillofacial Pathology and Microbiology, D. Y. Patil Deemed to be University School of Dentistry, Navi Mumbai, Maharashtra, India
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El Wardani M, Hashemi K, Aliferis K, Kymionis G. Topographic changes simulating keratoconus in patients with irregular inferior epithelial thickening documented by anterior segment optical coherence tomography. Clin Ophthalmol 2019; 13:2103-2110. [PMID: 31802839 PMCID: PMC6827357 DOI: 10.2147/opth.s208101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Accepted: 08/06/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To present six patients with keratoconus-like topographic changes due to inferior inhomogenous epithelial thickening, demonstrated by AS-OCT epithelium map. Patients and methods We present twelve eyes of six patients evaluated in the refractive surgery consultation with Pentacam® HR Scheimpflug rotating camera system, presenting topographical irregularities suggestive of keratoconus. Slit-lamp examination, best-corrected visual acuity, Scheimpflug tomography and anterior segment optical coherence tomography epithelium map (Optovue® ) were conducted and analyzed. Results The mean age was 42 years and the female:male ratio was 2:1. Mean Kmax was 45±2 D. The mean corneal thickness at apex was 560±33 µm and the mean thickness at the thinnest location was 555±34 µm. All patients had an abnormal index of height decentration (IHD) in at least one eye. In all cases, anterior segment OCT demonstrated relative epithelial thickening over the steep area measured by tomography. The mean thickness of the inferior epithelium over the suspicious area was 60±2 µm, whereas the mean thickness of the superior epithelium was 56±2 µm. Conclusion Epithelial irregularity, as measured by anterior segment OCT, should be considered as a possible contributing factor in the appearance of suspicious keratoconus-like topographies.
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Affiliation(s)
- Mohamad El Wardani
- Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Foundation Asile des Aveugles, Lausanne, Switzerland
| | - Kattayoon Hashemi
- Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Foundation Asile des Aveugles, Lausanne, Switzerland
| | - Konstantinos Aliferis
- Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Foundation Asile des Aveugles, Lausanne, Switzerland
| | - George Kymionis
- Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Foundation Asile des Aveugles, Lausanne, Switzerland.,Department of Ophthalmology, 'G. Gennimatas Hospital', National and Kapodistrian University of Athens, Athens, Greece
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Ceylan SM, Uysal E, Sokucu M, Sezgin E, Kanmaz MA, Yurtseven DG, Bilal N. The Effects of Halofuginone on Wound Healing in the Rat Nasal Mucosa. Am J Rhinol Allergy 2019; 34:9-15. [PMID: 31438721 DOI: 10.1177/1945892419866312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background Halofuginone is an alkaloid febrifugine analogue and bioactive molecule that was isolated incidentally from the Dichroa febrifuga plant. The therapeutic efficacy of halofuginone in parasitic infections, scleroderma, inflammation, and fibrosis-related diseases, as well as in some types of cancer, has been previously reported. The effects of halofuginone on nasal mucosal damage are not yet known. Objective The aim of this study was to investigate the potential effect of topically applied halofuginone on wound healing in the mechanically injured nasal mucosa of rats. Methods A unilateral mucosal wound was created in the nasal cavity of 32 rats (aged 4 weeks) using the brushing technique. These rats were randomly divided into 4 groups. Although the control group did not receive an intervention, a dry pad, a saline-impregnated pad, or a pad impregnated with halofuginone were placed in the rats of the other 3 groups and left for 5 minutes. Rats were sacrificed on the 14th day, and a histological examination was performed. The nasal mucosa was assessed via hematoxylin-eosin and Masson’s trichrome staining. Results There were no statistically significant differences in epithelial thickness, inflammation, goblet cell formation, and epithelial disarray values between the halofuginone group and the control group ( P > .05). The subepithelial thickness was significantly decreased in the saline-treated group and the halofuginone-treated group ( P < .05), but a significantly lower level of subepithelial fibrosis was only observed in the halofuginone group compared to the other groups ( P < .05). Conclusions Topical halofuginone administration reduces the development of fibrosis and subepithelial edema after experimentally induced nasal mucosal injury, but it does not exert therapeutic or preventive effects on epithelial damage, inflammation, and goblet cell hyperplasia.
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Affiliation(s)
- Seyit Mehmet Ceylan
- Department of Otorhinolaryngology, Faculty of Medicine, SANKO University, Gaziantep, Turkey
| | - Erdal Uysal
- Department of General Surgery, Faculty of Medicine, SANKO University, Gaziantep, Turkey
| | - Mehmet Sokucu
- Department of Pathology, Faculty of Medicine, SANKO University, Gaziantep, Turkey
| | - Efe Sezgin
- Laboratory of Nutrigenomics and Epidemiology, Department of Food Engineering, Izmir Institute of Thechnology, Izmir, Turkey
| | - Mahmut Alper Kanmaz
- Department of Otorhinolaryngology, Faculty of Medicine, SANKO University, Gaziantep, Turkey
| | - Duygu Gok Yurtseven
- Department of Histology and Embryology, Faculty of Medicine, SANKO University, Gaziantep, Turkey
| | - Nagihan Bilal
- Department of Otorhinolaryngology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
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Mogaddami Z, Sheikhzadeh F, Hatami H, Khojasteh SMB, Khajehnasiri N, Hemmati ARA, Dastranj A. Effects of short- and long-term regular exercise on reproductive tissue in streptozotocin-induced diabetic male Wistar rats. Endocr Regul 2018; 52:167-75. [PMID: 31517613 DOI: 10.2478/enr-2018-0021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE Reproductive disorders are one of the complications of diabetes mellitus. Since conflicting results have been obtained from different studies, which examined serum levels of cytokines in patients with diabetes, and considering the fact that the origin of cytokines cannot be accurately determined from their serum changes, attempts were made in the present study to study histological changes and testicular tissue levels of TNF-α and IL-1 in rats treated with exercise. Considering the effects of exercise in reducing blood sugar level and its complications, two types of short-term and long-term regular exercises were also considered to evaluate their effects on male reproductive tissues. METHODS In this study, 60 male rats with the weight range of 250±50 g were used and were randomly divided into six groups (10 rats each). Healthy groups included sedentary control group, and groups treated with two and eight weeks of exercise. Rats with type 1 diabetes (induced by streptozotocin) included sedentary control group, groups treated with two and eight weeks of exercise (six groups). All groups were evaluated in terms of testicular tissue levels of TNF-α and IL-1 using ELISA and the histometry of spermatogonia, primary spermatocytes, Sertoli cells, epithelial thickness, diameter of veins, and thickness of the seminiferous tubule. RESULTS Histological changes resulting from diabetes, particularly in the diameter of testicular veins and a number of cells, including Sertoli, highlights the important fact that tissue perfusion in patients with diabetes is especially crucial, in a way that exercise proved useful for tissue structures by offsetting this complication. Measurement of the cytokines IL-1 and TNF-α in the current study showed that perfusion problems are more important in diabetic complications than inflammatory factors. CONCLUSIONS The main result of this research is recommendation of investigating the tissue of interest for diagnosis of diabetes complications, measuring inflammatory mediators of tissue rather than evaluating their serum concentrations, and focusing on vascular complications as a major complication of diabetes. Furthermore, regular exercise could help improve the function of reproductive organs in healthy groups and prevent diabetes infertility complications to an acceptable degree in diabetic groups.
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Ersan I, Arikan S, Kara S, Gencer B, Koklu A, Tufan HA. Non-invasive assessment of corneal and conjunctival deterioration in soft contact lens users using anterior segment optical coherence tomography. Clin Exp Optom 2016; 99:564-567. [PMID: 27029024 DOI: 10.1111/cxo.12363] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 09/24/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The aim was to evaluate the corneal and bulbar conjunctival thicknesses of soft contact lens (SCL) wearers using anterior segment optical coherence tomography (AS-OCT). METHODS The epithelial and overall thicknesses of both the central cornea and the infero-temporal bulbar conjunctiva of SCL wearers (30 subjects) were obtained by Cirrus HD-OCT and compared with those of refraction-matched controls (30 subjects) and patients with emmetropia (30 subjects). RESULTS The mean corneal epithelial thicknesses in SCL wearing, spectacle-wearing and emmetropic groups were 48.97 ± 5.45, 52.18 ± 4.84 and 53.18 ± 5.05 µm, respectively. The corneal epithelium of members of the SCL group was significantly thinner than in both the spectacles and emmetropic groups (p = 0.044 and 0.006, respectively), whereas the central corneal thickness did not differ between groups (p = 0.210). The mean conjunctival epithelial thicknesses in SCL, spectacles and emmetropic groups were 41.50 ± 7.75, 54.33 ± 8.39 and 49.10 ± 7.11 µm, respectively. Conjunctival epithelium in the SCL group was significantly thinner than in both spectacle-wearing and emmetropic groups (p < 0.001 and p = 0.001, respectively). The conjunctiva was significantly thinner in the SCL group compared to the spectacles group (p = 0.001) but not the emmetropic group. CONCLUSIONS Contact lens wear is related to thinning of both corneal and conjunctival layers. AS-OCT is a non-invasive and clinically applicable technique for assessing the involvement of the cornea and conjunctiva in contact lens wearers.
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Affiliation(s)
- Ismail Ersan
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey.
| | - Sedat Arikan
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Selcuk Kara
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Baran Gencer
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Asiye Koklu
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Hasan Ali Tufan
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
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Calabuig-Goena M, López-Miguel A, Marqués-Fernández V, Coco-Martín MB, Iglesias-Cortiñas D, Maldonado MJ. Early Changes in Corneal Epithelial Thickness after Cataract Surgery--Pilot Study. Curr Eye Res 2015; 41:311-7. [PMID: 25803625 DOI: 10.3109/02713683.2015.1014565] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To assess early variations in central and paracentral corneal epithelial and non-epithelial thicknesses after uneventful clear corneal incision phacoemulsification. MATERIALS AND METHODS Twenty patients with a senile cataract underwent coaxial phacoemulsification through a 2.75-mm-wide corneal incision created at 180° in a prospective cohort pilot study. Corneal sublayer thickness measurements were obtained with Fourier-domain optical coherence tomography (FD-OCT, Cirrus HD-OCT, Carl Zeiss Meditec, Inc., Dublin, CA) before and after 1 week and 1 month postoperatively. Central measurements were performed in the middle of the FD-OCT scan and in the 3-mm corneal diameter (paracentral 180° and 0° locations). Epithelial, non-epithelial and total corneal pachymetry were measured at the central and paracentral locations. RESULTS No significant changes in epithelial thickness were seen 1 week postoperatively. However, 1 month postoperatively, the central, 180°, and 0° paracentral epithelial thicknesses (52.7 ± 3.8, 53.1 ± 5.4, and 52.7 ± 5.3 µm, respectively) decreased significantly (p < 0.01) compared to preoperatively (57.2 ± 4.8, 58.0 ± 5.7, 56.6 ± 5.3 µm, respectively). The 1-week central, 180°, and 0° paracentral non-epithelial corneal thicknesses (515.5 ± 39.6, 534.3 ± 45.6, and 521.3 ± 36.9 µm) were significantly (p < 0.01) higher than preoperatively (486.2 ± 34.7, 498.2 ± 33.8, 497.5 ± 32.3 µm, respectively). The non-epithelial corneal thickness increase was significantly (p = 0.02) greater after 1 week in the central (29.3 ± 17.2 µm) and the 180° paracentral (36.1 ± 28.7 µm) locations than at the 0° paracentral location (23.8 ± 16.5 µm). CONCLUSIONS Immediate postoperative corneal edema following phacoemulsification irregularly affects the cornea at the sublayer level. The initial central and paracentral non-epithelial thickening is compensated by subsequent central and paracentral epithelial thinning. These initial changes occurred more markedly closest to the main incision over the entrance pupil, which may have visual implications.
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Affiliation(s)
- María Calabuig-Goena
- a IOBA, Universidad de Valladolid , Valladolid , Spain and.,b Departamento de Oftalmología , Hospital Universitario Rio Hortega , Valladolid , Spain
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Wolffsohn JS, Drew T, Dhallu S, Sheppard A, Hofmann GJ, Prince M. Impact of soft contact lens edge design and midperipheral lens shape on the epithelium and its indentation with lens mobility. Invest Ophthalmol Vis Sci 2013; 54:6190-7. [PMID: 23942975 DOI: 10.1167/iovs.13-12425] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate the influence of soft contact lens midperipheral shape profile and edge design on the apparent epithelial thickness and indentation of the ocular surface with lens movement. METHODS Four soft contact lens designs comprising of two different plano midperipheral shape profiles and two edge designs (chiseled and knife edge) of silicone-hydrogel material were examined in 26 subjects aged 24.7 ± 4.6 years, each worn bilaterally in randomized order. Lens movement was imaged enface on insertion, at 2 and 4 hours with a high-speed, high-resolution camera simultaneous to the cross-section of the edge of the contact lens interaction with the ocular surface captured using optical coherence tomography (OCT) nasally, temporally, and inferiorly. Optical imaging distortions were individually corrected for by imaging the apparent distortion of a glass slide surface by the removed lens. RESULTS Apparent epithelial thickness varied with edge position (P < 0.001). When distortion was corrected for, epithelial indentation decreased with time after insertion (P = 0.010), changed after a blink (P < 0.001), and varied with position on the lens edge (P < 0.001), with the latter being affected by midperipheral lens shape profile and edge design. Horizontal and vertical lens movement did not change with time postinsertion. Vertical motion was affected by midperipheral lens shape profile (P < 0.001) and edge design (P < 0.001). Lens movement was associated with physiologic epithelium thickness for lens midperipheral shape profile and edge designs. CONCLUSIONS Dynamic OCT coupled with high-resolution video demonstrated that soft contact lens movement and image-corrected ocular surface indentation were influenced by both lens edge design and midperipheral lens shape profiles.
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Affiliation(s)
- James S Wolffsohn
- Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, United Kingdom
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