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1.
Vestn Oftalmol. 2019;135(5):75-79. doi: 10.17116/oftalma201913505175.

[Autokeratoplasty in perforation of the ectatic leukoma of the only functionally perspective eye].

[Article in Russian; Abstract available in Russian from the publisher]

Author information

1
Novokuznetsk State Institute of Advanced Training of Physicians, Russian Medical Academy of Continuing Professional Education, 5 Stroiteley Av., Novokuznetsk, Kemerovo region, Russian Federation, 654005.

Abstract

Treatment and rehabilitation of patients with destructive lesions of the cornea is a serious problem for ophthalmologists due to severity of the outcome of the disease - the formation of leukomas with a persistent decrease in vision, or even a complete loss of visual functions. The article presents a clinical case of a patient with posttraumatic ectaticized leukoma of the functionally promising eye, which course was complicated by perforation. The authors, in the absence of the donor cornea, faced a complex clinical task - the risk of functional and anatomical death of the single eyeball in the absence of adequate care for the patient. After enucleation of the subatrophic blind right eye, we took a corneal specimen with a scleral rim of 12 mm trepan. To collect the material, we used an original method of introducing viscoelastic into the vitreal cavity of the hypotonic enucleated eyeball through the intersected optic nerve. This allowed to create the normotony of the enucleated eyeball and perform trepanation of the corneoscleral disc. Trepanation of the sharply ectatic cornea of the left eye was performed after paracentesis and massage of the dome of ectatic cornea with a spatula, which led to the 'subsidence' of the hyperinflated tissue. The corneoscleral disc was fixated with interrupted suture with a 9-0 thread. The postoperative period proceeded smoothly. The autograft has taken with active vascularization. For optical rehabilitation, the patient is scheduled to undergo a keratoprosthetic operation in a planned manner.

KEYWORDS:

autokeratoplasty; ectasia of the cornea; urgent ophthalmic surgery

PMID:
31714516
DOI:
10.17116/oftalma201913505175
[Indexed for MEDLINE]
2.
Vestn Oftalmol. 2019;135(5. Vyp. 2):209-214. doi: 10.17116/oftalma2019135052209.

[Ipsilateral automated anterior lamellar rotational autokeratoplasty in the treatment of superficial central stromal opacity].

[Article in Russian; Abstract available in Russian from the publisher]

Author information

1
Research Institute of Eye Diseases, 11A Rossolimo St., Moscow, Russian Federation, 119021.
2
I.M. Sechenov First Moscow State Medical University, 8-2 Malaya Trubetskaya St., Moscow, Russian Federation, 119991.

Abstract

Corneal opacity is one of the main causes of monocular blindness in the world. Various modifications of keratoplasty are considered radical, effective - and in some cases the only - way of visual rehabilitation of this category of patients. The article describes a case of using the original surgical method of ipsilateral automated anterior lamellar rotational autokeratoplasty. Application of the described surgical technique made it possible to preserve the advantages of the known methods of ipsilateral rotational penetrating autokeratoplasty (IRA) and to level out their main disadvantages. In addition, the use of anterior lamellar rotational autokeratoplasty allowed the endothelial layer of the cornea to remain intact; its decompensation is one of the main reasons for unsatisfactory outcomes of penetrating keratoplasty. The use of a microkeratome device and the formation of an interface between the layers of its own tissues made it possible to achieve clinically insignificant violation of light scattering in this zone. With the right choice of a patient with shallow local central corneal opacity and careful planning of the original method, ipsilateral lamellar rotational automated autokeratoplasty can be an alternative to both standard penetrating and lamellar allokeratoplasty.

KEYWORDS:

anterior lamellar rotational keratoplasty; autokeratoplasty; keratoplasty; opacity

PMID:
31691662
DOI:
10.17116/oftalma2019135052209
[Indexed for MEDLINE]
3.
Invest Ophthalmol Vis Sci. 2019 Sep 3;60(12):3952-3962. doi: 10.1167/iovs.19-27810.

CCR6-Positive γδ T Cells Provide Protection Against Intracorneal HSV-1 Infection.

Author information

1
Department of Microbiology & Immunology, University of South Alabama Mobile, Alabama, United States.

Abstract

Purpose:

γδ T cells offer an important early immune defense against many different pathogens, both bacterial and viral. Herein, we examined the capacity of γδ T cell subsets to provide protection in the cornea against herpes simplex virus-1 (HSV-1).

Methods:

C57Bl/6 (wild-type [WT]), γδ T-cell deficient (TCRδ-/-) and CCR6-deficient (CCR6-/-) mice were infected intracorneally with HSV-1. At multiple time points following infection, corneas were excised, and cells were immunostained for surface markers, intracellular cytokines, and analyzed using flow cytometry. WT and CCR6-/- γδ T cells were adoptively transferred into TCRδ-/- mice and corneal scores and survival were measured.

Results:

Intracorneal infection of mice lacking γδ T cells exhibited increased corneal opacity scores, elevated viral titers, and higher mortality compared with WT mice. Both CCR6+ and CCR6neg γδ T cell subsets were observed in corneas after virus infection. CCR6+ γδ T cells produced IL-17A and were predominantly CD44+CD62L+, consistent with natural IL-17+ γδ T cells. In contrast IL-17A production by CCR6neg γδ T cells was infrequent, and this subset was largely single positive for CD62L or CD44. The CCR6+ subset appeared to provide protection against HSV-1 as follows: (1) CCR6-/- mice had more severe corneal opacity compared with WT mice; and (2) adoptive transfer of γδ T cells from WT mice restored protection in TCRδ-/- mice whereas transfer of γδ T cells from CCR6-/- mice did not.

Conclusions:

γδ T cells in the cornea can be divided into CCR6+ and CCR6neg subsets with the former conferring protection early after intracorneal HSV-1 infection.

PMID:
31560369
DOI:
10.1167/iovs.19-27810
[Indexed for MEDLINE]
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4.
BMC Ophthalmol. 2019 Aug 7;19(1):172. doi: 10.1186/s12886-019-1186-y.

Corneal biomechanics and intraocular pressure assessment after penetrating keratoplasty for non keratoconic patients, long term results.

Author information

1
Department of Ophthalmology, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt. MOHAMMED.SAMI66@med.menofia.edu.eg.
2
Department of Ophthalmology, Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt.
3
Memorial Institute of Ophthalmology, Giza, Egypt.

Abstract

BACKGROUND:

To evaluate corneal biomechanical properties by the Ocular Response Analyzer (ORA) in non keratoconic patients underwent penetrating keratoplasty (PK).

METHODS:

Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann- correlated intraocular pressure (IOPg), cornea-compensated IOP (IOPcc) using the ORA, and central graft thickness (CGT) were measured in 30 eyes at least two years after penetrating keratoplasty for non keratoconic indications. IOP using the Goldmann applanation tonometer (GAT) was also obtained after compensation for graft thickness and astigmatism.

RESULTS:

The mean age of patients was 33.1 ± 10.13 years; indications for PK were herpetic corneal scar (53.3%), corneal stromal dystrophy (23.3%), traumatic corneal opacity (10%), chemical corneal opacity (6.7%), and Fuchs endothelial dystrophy (6.7%). Mean CH and CRF were 8.52 ± 1.81 mmHg, and 8.56 ± 1.59 mmHg, respectively. Mean CGT was 532.43 ± 30 μm. Mean IOP GAT, IOPg, and IOPcc were 11.88 ± 3.66, 14.64 ± 4.08, and 17.27 ± 4.60 mmHg, respectively (P < 0.001). No significant association was found between CGT and IOP readings obtained using either the ORA or GAT. There were significant negative association between CH with both IOP GAT and IOPcc, while CRF had significant positive association with IOPg.

CONCLUSION:

After penetrating keratoplasty for non keratoconic patients, graft biomechanics does not return to average values even 2 years after the operation; moreover, intraocular pressure measurement with ORA gives higher values than thickness compensated GAT.

KEYWORDS:

Corneal biomechanics; Corneal hysteresis; Corneal resistance factor; Ocular response analyzer; Penetrating keratoplasty

PMID:
31391006
PMCID:
PMC6686420
DOI:
10.1186/s12886-019-1186-y
[Indexed for MEDLINE]
Free PMC Article
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5.
Eye Contact Lens. 2019 Jul;45(4):e15-e23. doi: 10.1097/ICL.0000000000000575.

Central Toxic Keratopathy After Contact Lens Wear and Mechanical Debridement: Clinical Characteristics, and Visual and Corneal Tomographic Outcomes.

Author information

1
Sunderland Eye Infirmary (D.S.J.T., S.G.), Queen Alexandra Road, Sunderland, United Kingdom; and Academic Ophthalmology (D.S.J.T.), Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.

Abstract

OBJECTIVES:

To highlight the clinical characteristics, and visual and corneal tomographic outcomes of central toxic keratopathy (CTK) after contact lens (CL) wear and mechanical debridement.

METHODS:

A retrospective observational case series with literature review.

RESULTS:

Four patients (4 eyes) were included in this study; 3 (75%) females, mean age 29.3±8.1 years. The mean follow-up was 13.5±7.5 months. Early central or paracentral stromal opacification, assuming an inverse dome-shaped pattern observed under anterior-segment optical coherence tomography, with corneal flattening (Kmean 40.4±1.3 D) and thinning (mean thinnest pachymetry=404.8±29.4 microns) were observed in all cases. All patients had a recent use of CL wear, with three after mechanical debridement for recurrent corneal erosion syndrome. None of them had any previous laser refractive surgery (LRS). The mean corrected distance visual acuity improved from 20/40 (ranged 20/25-20/50) initially to 20/30 (ranged 20/20-20/40) at final follow-up, and the outcome was not influenced by the use of topical steroids. A mean improvement of corneal flattening (+Kmean 1.2±1.2 D), thinning (+123.5±23.8 microns), and astigmatism (-3.0±2.7 D), via epithelial and stromal remodeling, was observed up to 15 months after CTK. Persisting reduced corneal sensation was noted in all patients at the final follow-up.

CONCLUSIONS:

Central toxic keratopathy is not an exclusive complication of LRS, and it may occur after CL wear and mechanical debridement. Our findings are similar to those of LRS-related CTK and toxic peripheral keratopathy. Awareness of the clinical associations and understanding of the clinical course and tomographic characteristics of CTK helps obviate unnecessary investigation and overtreatment. Further studies are required to elucidate the underlying pathogenesis of this rare clinical entity.

PMID:
31241605
DOI:
10.1097/ICL.0000000000000575
[Indexed for MEDLINE]
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6.
7.
BMJ Case Rep. 2019 Jun 18;12(6). pii: e229397. doi: 10.1136/bcr-2019-229397.

Management of dislocated nucleus with corneal opacity by combined deep anterior lamellar keratoplasty, pars- plana vitrectomy and phaco-fragmentation.

Author information

1
Vitreo-Retina and Uvea Services, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India.
2
Department of Cornea and Refractive Surgery, Shri Sadguru Seva Sangh Trust Chitrakoot Centre, Chitrakoot, Madhya Pradesh, India.

Abstract

A 32-year-old man presented with bilateral diminution of vision for 10 years. Visual acuity was light perception in both eyes with inaccurate projection in the oculus dextrus(OD) and accurate projection in the in oculus sinister (OS). Intraocular pressure was 6 and 12 mm Hg in the OD and OS, respectively. Slit-lamp examination revealed the presence of leucomatous corneal opacification with microcornea in oculus uterque (OU). Both eyes had a dislocated nucleus in the vitreous cavity on ultrasound B-scan with advanced cupping in the right eye. Ultrasound biomicroscopy revealed ciliary body atrophy in the OD and preserved ciliary processes (two quadrants) in the OS. In view of a partially preserved ciliary body function and a potential for gaining useful vision, we planned surgical intervention in the left eye. Deep anterior lamellar keratoplasty with pars planavitrectomy (PPV) and phacofragmentation of the nucleus was done. Donor lamellar graft was sutured after completion of PPV and nucleus fragmentation. The patient regained useful ambulatory vision postoperatively with clear corneal graft.

KEYWORDS:

DALK; Keratoprosthesis; Nucleus Drop; Paes Plana Vitrectomy; Phacofragmentation

PMID:
31217213
DOI:
10.1136/bcr-2019-229397
[Indexed for MEDLINE]
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8.
Semin Ophthalmol. 2019;34(4):205-210. doi: 10.1080/08820538.2019.1620796. Epub 2019 Jun 12.

Methods for Assessing Corneal Opacity.

Author information

1
a Schepens Eye Research Institute/Massachusetts Eye and Ear Infirmary , Harvard Medical School , Boston , MA , USA.

Abstract

Purpose: Corneal opacity is a common clinical problem that directly impedes the cornea's function of light transmission. Despite this, there are no standard means of quantifying opacity. The purpose of this review is to summarize the reported options both clinicians and researchers have for objectively assessing corneal opacityMethods: Review of the peer-reviewed literature reporting methods for assessing clinical opacity and transparency in both the research and clinic setting. Conclusion: Although a number of techniques for assessing corneal opacity have been reported in the literature, none have been widely adopted, highlighting the fact that there is still a need for an accessible, objective and easy to use method for quantifying corneal opacity.

KEYWORDS:

Cornea; OCT; fibrosis; imaging; opacity

PMID:
31188043
DOI:
10.1080/08820538.2019.1620796
[Indexed for MEDLINE]
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9.
Lipids Health Dis. 2019 Jun 5;18(1):132. doi: 10.1186/s12944-019-1045-0.

Identification and functional analysis of missense mutations in the lecithin cholesterol acyltransferase gene in a Chilean patient with hypoalphalipoproteinemia.

Author information

1
Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
2
INYTA, University of Granada, Granada, Spain.
3
Facultad de Medicina y Ciencia, Universidad San Sebastián, Campus Los Leones, Santiago, Chile.
4
Departamento de Estadísticas, Facultad de Matemáticas, Pontificia Universidad Católica de Chile, Santiago, Chile.
5
INTA, Universidad de Chile, Santiago, Chile.
6
Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", Center of Biomedical Research, University of Granada, Granada, Spain.
7
División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
8
Fundación Ciencia & Vida, Santiago, Chile.
9
Pfizer Global Research and Development, San Diego, USA.
10
Centro de Nutrición Molecular y Enfermedades Crónicas, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
11
Department of Nutrition, Diabetes and Metabolism, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. jsantosm@uc.cl.

Abstract

BACKGROUND:

Lecithin-cholesterol acyltransferase (LCAT) is a plasma enzyme that esterifies cholesterol in high- and low-density lipoproteins (HDL and LDL). Mutations in LCAT gene causes familial LCAT deficiency, which is characterized by very low plasma HDL-cholesterol levels (Hypoalphalipoproteinemia), corneal opacity and anemia, among other lipid-related traits. Our aim is to evaluate clinical/biochemical features of a Chilean family with a proband showing clinical signs of familial LCAT deficiency, as well as to identify and assess the functional effects of LCAT mutations.

METHODS:

An adult female proband with hypoalphalipoproteinemia, corneal opacity and mild anemia, as well as her first-degree relatives, were recruited for clinical, biochemical, genetic, in-silico and in-vitro LCAT analysis. Sequencing of exons and intron-exon boundaries was performed to identify mutations. Site-directed mutagenesis was carried out to generate plasmids containing cDNA with wild type or mutant sequences. Such expression vectors were transfected to HEK-239 T cells to asses the effect of LCAT variants in expression, synthesis, secretion and enzyme activity. In-silico prediction analysis and molecular modeling was also used to evaluate the effect of LCAT variants.

RESULTS:

LCAT sequencing identified rare p.V333 M and p.M404 V missense mutations in compound heterozygous state in the proband, as well the common synonymous p.L363 L variant. LCAT protein was detected in proband's plasma, but with undetectable enzyme activity compared to control relatives. HEK-293 T transfected cells with vector expression plasmids containing either p.M404 V or p.V333 M cDNA showed detectable LCAT protein expression both in supernatants and lysates from cultured cells, but with much lower enzyme activity compared to cells transfected with the wild-type sequence. Bioinformatic analyses also supported a causal role of such rare variations in LCAT lack of function. Additionally, the proband carried the minor allele of the synonymous p.L363 L variant. However, this variant is unlikely to affect the clinical phenotype of the proband given its relatively high frequency in the Chilean population (4%) and its small putative effect on plasma HDL-cholesterol levels.

CONCLUSION:

Genetic, biochemical, in vitro and in silico analyses indicate that the rare mutations p.M404 V and p.V333 M in LCAT gene lead to suppression of LCAT enzyme activity and cause clinical features of familial LCAT deficiency.

KEYWORDS:

HDL-cholesterol; Hypoalphalipoproteinemia; Lecithin-cholesterol acyltransferase; Variants

PMID:
31164121
PMCID:
PMC6549291
DOI:
10.1186/s12944-019-1045-0
[Indexed for MEDLINE]
Free PMC Article
Icon for BioMed Central Icon for PubMed Central
10.
Nutrients. 2019 May 27;11(5). pii: E1184. doi: 10.3390/nu11051184.

Cucurbita argyrosperma Seed Extracts Attenuate Angiogenesis in a Corneal Chemical Burn Model.

Author information

1
Laboratorio de Investigacíon de Productos Naturales, Escuela de Ingeniería Química e Industrias Extractivas, Instituto Politécnico Nacional, Unidad Profesional Adolfo López Mateos, Av. Instituto Politécnico Nacional S/N, Ciudad de México 07708, México. fernandaestrella29@hotmail.com.
2
División de Investigación, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Ciudad de México 07760, México. microcirugiafco@hotmail.com.
3
División de Investigación, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Ciudad de México 07760, México. adolfolopezmd@gmail.com.
4
Laboratorio de Investigacíon de Productos Naturales, Escuela de Ingeniería Química e Industrias Extractivas, Instituto Politécnico Nacional, Unidad Profesional Adolfo López Mateos, Av. Instituto Politécnico Nacional S/N, Ciudad de México 07708, México. rmpg@prodigy.net.mx.
5
División de Investigación, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Ciudad de México 07760, México. javier_70_1999@yahoo.com.

Abstract

Severe corneal inflammation produces opacity or even perforation, scarring, and angiogenesis, resulting in blindness. In this study, we used the cornea to examine the effect of new anti-angiogenic chemopreventive agents. We researched the anti-angiogenic effect of two extracts, methanol (Met) and hexane (Hex), from the seed of Cucurbita argyrosperma, on inflamed corneas. The corneas of Wistar rats were alkali-injured and treated intragastrically for seven successive days. We evaluated: opacity score, corneal neovascularization (CNV) area, re-epithelialization percentage, and histological changes. Also, we assessed the inflammatory (cyclooxigenase-2, nuclear factor-kappaB, and interleukin-1β) and angiogenic (vascular endothelial growth factor A, VEGF-A; -receptor 1, VEGFR1; and -receptor 2, VEGFR2) markers. Levels of Cox-2, Il-1β, and Vegf-a mRNA were also determined. After treatment, we observed a reduction in corneal edema, with lower opacity scores and cell infiltration compared to untreated rats. Treatment also accelerated wound healing and decreased the CNV area. The staining of inflammatory and angiogenic factors was significantly decreased and related to a down-expression of Cox-2, Il-1β, and Vegf. These results suggest that intake of C. argyrosperma seed has the potential to attenuate the angiogenesis secondary to inflammation in corneal chemical damage.

KEYWORDS:

Cucurbita argyrosperma; angiogenesis; corneal chemical burn; corneal neovascularization (CNV); cyclooxigenase-2 (COX-2); interleukin-1β (IL-1β); nuclear factor-kappaB (NF-κB); vascular endothelial growth factor (VEGF)

PMID:
31137826
PMCID:
PMC6567871
DOI:
10.3390/nu11051184
[Indexed for MEDLINE]
Free PMC Article
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11.
Mol Genet Metab. 2019 May;127(1):23-27. doi: 10.1016/j.ymgme.2019.02.002. Epub 2019 Feb 15.

Ophthalmological findings in Gaucher disease.

Author information

1
Section on Molecular Neurogenetics, Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
2
National Eye Institute, National Institutes of Health, Bethesda, MD, USA.
3
Section on Molecular Neurogenetics, Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA. Electronic address: sidranse@mail.nih.gov.

Abstract

Gaucher disease is an autosomal recessive lysosomal storage disorder caused by mutations in the gene GBA1, which encodes the lysosomal protein glucocerebrosidase. Patients with Gaucher disease generally have a variety of clinical manifestations ranging from visceral to neurological involvement and some develop ocular involvement. The most commonly affected organs include the spleen, liver, and bone. Moreover, patients often have hepatosplenomegaly, thrombocytopenia, anemia, and bone involvement related to deficient glucocerebrosidase and the subsequent accumulation of glucosylceramide and glucosylsphingosine in cells. A subset of patients develops neurological manifestations, including seizures, myoclonic epilepsy, and progressive neurodegeneration. Eye involvement tends to be less common and presents with diverse clinical findings. These rare and variable ocular manifestations, involving the vitreous, retina, cornea, uvea, conjunctiva and eye movements, can pose a diagnostic challenge for clinicians, especially those not familiar with the disorder. In this review, we explore the different ophthalmologic findings reported in patients with Gaucher disease, aiming to facilitate diagnosis and expedite treatment for patients presenting with ocular manifestations of this rare disorder.

KEYWORDS:

Corneal clouding; Gaucher disease; Glucocerebrosidase; Intravitreal spots; Pinguecula; Retinal opacities; Saccadic eye movements

PMID:
31047801
DOI:
10.1016/j.ymgme.2019.02.002
[Indexed for MEDLINE]
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12.
Cornea. 2019 Jul;38(7):868-872. doi: 10.1097/ICO.0000000000001962.

Causes and Management Outcomes of Acquired Corneal Opacity in a Preschool Age (0-5 Years) Group: A Hospital-Based Study.

Author information

1
Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
2
Department of Ophthalmology, Government Medical College, Srinagar, India.
3
Cornea, Cataract and External Disease Services, Refractive Surgery Service, University of Pittsburgh School of Medicine, Pittsburgh, PA.
4
Vision Eye Institute, Royal Victorian Eye and Ear Hospital, North West Academic Centre, University of Melbourne, Australia.

Abstract

PURPOSE:

To evaluate the causes and management outcomes of acquired corneal opacity in a preschool age group (0-5 years) at a tertiary care hospital.

METHODS:

Medical records of all cases (0-5 years) with acquired corneal opacity presenting to the cornea clinic of a tertiary eye care hospital from February 2013 to January 2014 were evaluated for age of onset, age at presentation, sex, laterality, cause of opacity, visual acuity, nutritional status, and socioeconomic class of the parents. The etiology of corneal opacity and the type of intervention with outcome at 3 months follow-up were recorded.

RESULTS:

A total of 106 cases were included in the study. The most common cause of corneal scarring was healed infective keratitis (35.8%). Chemical injury, mechanical trauma, and keratomalacia were the other causes, affecting 21.8%, 20.8%, and 16% of the cases, respectively. Optical iridectomy was the most commonly performed procedure (35.8%), followed by lens aspiration with intraocular lens implantation (17.9%) and penetrating keratoplasty (17%). The mean corrected visual acuity (spectacle or contact lens) at the time of presentation and at 3 months after treatment was 2.9 ± 0.3 (perception of light) and 2.2 ± 0.9 (hand motions) logarithm of minimum angle of resolution (logMAR) units, respectively.

CONCLUSIONS:

Chemical injury and keratomalacia are the major causes of acquired corneal opacity in preschool age groups in India and are associated with poor visual prognosis.

PMID:
31045962
DOI:
10.1097/ICO.0000000000001962
[Indexed for MEDLINE]
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13.
14.
Toxicol In Vitro. 2019 Sep;59:100-114. doi: 10.1016/j.tiv.2019.04.011. Epub 2019 Apr 11.

Development of a defined approach for eye irritation or serious eye damage for neat liquids based on cosmetics Europe analysis of in vitro RhCE and BCOP test methods.

Author information

1
L'Oréal Research & Innovation, Aulnay Sous Bois, France.
2
Adriaens Consulting, Aalter, Belgium. Electronic address: adriaens.consulting@telenet.be.
3
Kao Corporation, Safety Science Research, Kanagawa, Japan.
4
Colgate-Palmolive Co., Piscataway, NJ, USA.
5
Cosmetics Europe - The Personal Care Association, Brussels, Belgium.
6
Chanel Parfums Beauté, Neuilly sur Seine, France.
7
Henkel AG & Co. KGaA, Düsseldorf, Germany.
8
Beiersdorf AG, Hamburg, Germany.
9
Kao Corporation, S.A., Barcelona, Spain; HP Inc., Barcelona, Spain.
10
VITO NV (Flemish Institute for Technological Research), Mol, Belgium.
11
The Procter & Gamble Company, Egham, United Kingdom.

Abstract

The focus of Cosmetics Europe's ocular toxicity programme is on development of testing strategies and defined approaches for identification of ocular effects of chemicals in the context of OECD's Guidance Document on an Integrated Approach on Testing and Assessment (IATA) for Serious Eye Damage and Eye Irritation. Cosmetics Europe created a comprehensive database of chemicals for which in vitro data are available with corresponding historical in vivo Draize eye data and physicochemical properties. This database allowed further exploration of the initially proposed strategies from the CON4EI project and to identify opportunities for refinement. One key outcome of this project is that combining in vitro test methods (RhCE and BCOP LLBO) with physicochemical properties in a two-step Bottom-Up approach applicable to neat liquids, resulted in an improvement of the specificity, without reducing the sensitivity, when compared to the combination of in vitro methods alone. The Bottom-Up approach proposed here for neat liquids correctly predicted 58.3% (EpiOcular™ EIT followed by BCOP LLBO) to 62.6% (SkinEthic™ HCE EIT followed by BCOP LLBO) of No Cat., 59.1% to 68.7% of Cat. 2, and 76.5% of Cat. 1. Incorporating specific physicochemical properties with this Bottom-Up approach increased the correct identification of No Cat. neat liquids to between 72.7% and 79.7%.

KEYWORDS:

Defined approach; Draize eye reference database; IATA; Physicochemical properties; Serious eye damage and eye irritation; in vitro test methods

PMID:
30981694
DOI:
10.1016/j.tiv.2019.04.011
[Indexed for MEDLINE]
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15.
Cornea. 2019 Sep;38(9):1182-1184. doi: 10.1097/ICO.0000000000001948.

Bilateral Congenital Corneal Opacities as an Early-Onset Ocular Feature of Kabuki Syndrome.

Author information

1
Department of Ophthalmology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
2
Department of Ophthalmology, National Taiwan University, Taipei, Taiwan.
3
Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Abstract

PURPOSE:

Kabuki syndrome (KS) is a rare congenital disorder characterized by multiple systemic anomalies and unique facial characteristics. Here, we present the first case, to the best of our knowledge, of bilateral congenital corneal opacities as an early-onset ocular manifestation of KS associated with a KMT2D gene mutation.

METHODS:

The proband is a girl. At birth, bilateral corneal opacities, short fifth fingers, patent ductus arteriosus, absence of the uvula, and an ectopic kidney on the right side were noted. Ophthalmic examinations revealed vascularized, nonhomogeneous opacities in both corneas; to prevent deprivation amblyopia, bilateral corneal transplantations were performed.

RESULTS:

At 1 year and 10 months of age, she was referred by a general practitioner to our pediatric endocrinologist for failure to thrive. Genetic analysis at that age revealed the presence of a KMT2D gene mutation, and the patient was diagnosed with KS.

CONCLUSIONS:

The clinical diagnosis of KS is challenging because the most remarkable facial features are not evident until early childhood. In this case, bilateral congenital corneal opacities were identified as an early-onset ocular manifestation of KS. KS should be considered as a differential diagnosis in patients with bilateral congenital corneal opacities.

PMID:
30950893
DOI:
10.1097/ICO.0000000000001948
[Indexed for MEDLINE]
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16.
J Fr Ophtalmol. 2019 May;42(5):477-484. doi: 10.1016/j.jfo.2018.05.020. Epub 2019 Mar 28.

[Severe color change in corneal tattoos: Report of 3 cases (French translation of the article)].

[Article in French]

Author information

1
Ophthalmology Service, Hôpital Charles Nicolle, 76031 Rouen, France.
2
Ophthalmology Service, Hôpital Charles Nicolle, 76031 Rouen, France. Electronic address: marc.muraine@chu-rouen.fr.

Abstract

INTRODUCTION:

Corneal tattooing is a noninvasive technique which appears relatively well-tolerated in the medium term. We report the cases of 3 patients with a significant change in the color of their tattoos performed over 5 years previously.

PATIENTS AND METHODS:

Three patients with a history of intracorneal tattooing several years previously were studied because of a significant change from their initial color. Each patient's file was reviewed with analysis of slit lamp photographs, OCT and specular microscopy.

RESULTS:

All three patients experienced a significant color change in their tattoos between 5 and 6 years after surgery. The color had changed to golden-brown.

DISCUSSION:

Retrospective analysis of the components of the tattoo ink found the presence of iron in the black pigment. We believe that pigments composed of iron oxide are transformed into golden-brown ferric iron oxide in the presence of oxygen in the aqueous environment. The presence of moderate corneal edema in these three cases of multioperated patients could explain, in these specific cases, the occurrence of oxidation typically not described.

CONCLUSION:

Corneal tattooing remains a simple and very interesting technique when partial or total absence of iris causes significant photophobia. However, the significant changes in color that we report more than 5 years later suggest omitting iron from the dyes used for the cornea and limiting its use in cases of limited endothelial prognosis. A long-term evaluation of corneal tattoos appears necessary.

KEYWORDS:

Cornea; Cornée; Follow-Up Studies; Iris trauma; Pigment; Pigments; Suivi à long terme; Tatouage; Tattoo; Traumatisme de l’iris

PMID:
30928242
DOI:
10.1016/j.jfo.2018.05.020
[Indexed for MEDLINE]
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18.
J Fr Ophtalmol. 2019 Apr;42(4):415-417. doi: 10.1016/j.jfo.2018.10.010. Epub 2019 Mar 16.

[Short-term follow-up of non-necrotizing interstitial stromal herpetic keratitis].

[Article in French]

Author information

1
Service d'ophtalmologie A, Hôpital des spécialités, Université Mohammed V, Rabat, Maroc. Electronic address: bmarwaa4@gmail.com.
2
Service d'ophtalmologie A, Hôpital des spécialités, Université Mohammed V, Rabat, Maroc.

KEYWORDS:

Corticothérapie; Herpès; Non nécrosante; kératite stromale

PMID:
30885391
DOI:
10.1016/j.jfo.2018.10.010
[Indexed for MEDLINE]
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19.
Invest Ophthalmol Vis Sci. 2019 Mar 1;60(4):868-876. doi: 10.1167/iovs.18-25761.

Mediators of Corneal Haze Following Implantation of Presbyopic Corneal Inlays.

Fenner BJ1,2, Liu YC1,2,3, Koh SK2, Gao Y2, Deng L4, Beuerman RW2,3,5, Zhou L2,3,6, Theng JTS7, Mehta JS1,2,3.

Author information

1
Singapore National Eye Centre, Singapore.
2
Singapore Eye Research Institute, Singapore.
3
Eye Academic Clinical Program, Duke-NUS Graduate Medical School, Singapore.
4
Department of Statistics and Applied Probability, National University of Singapore.
5
Neuroscience Signature Research Program, Duke-NUS Graduate Medical School, Singapore.
6
Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
7
Eagle Eye Centre, Singapore.

Abstract

Purpose:

To identify protein mediators of corneal haze following presbyopic corneal inlay surgery.

Methods:

Tears were collected from eyes with corneal haze following surgery with a shape-changing corneal inlay. Samples were subjected to quantitative proteomic analysis using iTRAQ and proteins significantly increased or decreased (1.3-fold or more) in haze eyes relative to fellow eyes were identified. Expression ratios were compared to postoperative eyes without corneal haze to identify proteins selectively increased or decreased in corneal haze eyes.

Results:

Inlay-associated haze occurred in 35% of eyes (6 of 17). Of 1443 unique tear proteins identified, eight proteins were selectively reduced in tears from postoperative haze eyes and one protein selectively increased. Proteins reduced in haze eyes included complement 4a (level relative to nonhaze eyes 0.464, P = 0.037), complement factor H (0.589, P = 0.048), immunoglobulin kappa variable 2-29 (0.128, P = 0.006), immunoglobulin kappa variable 2D-28 (0.612, P = 0.025), immunoglobulin lambda variable 7-46 (0.482, P = 0.007), S100 calcium binding protein A4 (0.614, P = 0.048), Shootin-1 (0.614, P = 0.048), and tissue inhibitor of metalloproteinase-1 (0.736, P = 0.023). The Xaa-Pro aminopeptidase 1 was increased in haze eyes relative to nonhaze eyes (1.517, P = 0.023).

Conclusions:

Corneal haze following corneal inlay surgery is associated with reduction in levels of known inflammatory and immune mediators. These findings represent a starting point for elucidation of pathways involved in corneal haze following synthetic inlay implantation and may enable development of targeted therapies that modulate the haze response.

PMID:
30821812
DOI:
10.1167/iovs.18-25761
[Indexed for MEDLINE]
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20.
Toxicol In Vitro. 2019 Jun;57:154-163. doi: 10.1016/j.tiv.2019.02.019. Epub 2019 Feb 26.

Development of a defined approach for eye irritation or serious eye damage for liquids, neat and in dilution, based on cosmetics Europe analysis of in vitro STE and BCOP test methods.

Author information

1
L'Oréal Research & Innovation, Aulnay Sous Bois, France.
2
Adriaens Consulting, Aalter, Belgium. Electronic address: adriaens.consulting@telenet.be.
3
Kao Corporation, Safety Science Research, Kanagawa, Japan.
4
D. Bagley, Colgate-Palmolive Co., Piscataway, NJ, USA.
5
Cosmetics Europe - The Personal Care Association, Brussels, Belgium.
6
Chanel Parfums Beauté, Neuilly sur Seine, France.
7
Henkel AG & Co. KGaA, Düsseldorf, Germany.
8
Beiersdorf AG, Hamburg, Germany.
9
Kao Corporation, S.A., Barcelona, Spain; HP Inc., Barcelona, Spain.
10
VITO NV (Flemish Institute for Technological Research), Mol, Belgium.
11
The Procter & Gamble Company, Egham, United Kingdom.

Abstract

The focus of Cosmetics Europe's programme on serious eye damage/eye irritation is on development of testing strategies and defined approaches for identification of ocular effects of chemicals in the context of OECD's Guidance Document on an Integrated Approach on Testing and Assessment (IATA) for Serious Eye Damage and Eye Irritation. Cosmetics Europe created a comprehensive database of chemicals for which in vitro data are available with corresponding historical in vivo Draize eye data. This database allowed further exploration of the initially proposed strategies from the CON4EI project and to identify opportunities for refinement. The current analysis focused on the development of a defined approach, applicable to liquid non-surfactant chemicals, neat and in dilution, that can distinguish between the three UN GHS categories (Cat. 1, Cat. 2, and No Cat.). Combining the modified-protocol Short Time Exposure (STE) test method (OECD TG 491 with extension to highly volatile substances) with the Bovine Corneal Opacity and Permeability Laser Light-Based Opacitometer (BCOP LLBO) test method in a Bottom-Up approach identified 81.2% Cat. 1, 56.3% Cat. 2, and 85.3% No. Cat correctly, with an NPV of 96.7% and a PPV of 68.6%. Therefore, the performance of the defined approach was better than the standalone test methods.

KEYWORDS:

BCOP LLBO; Defined approach; Draize eye test reference database; IATA; Modified STE; Serious eye damage and eye irritation

PMID:
30817952
DOI:
10.1016/j.tiv.2019.02.019
[Indexed for MEDLINE]
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