Corneal endothelium in paediatric patients with uveitis: a prospective longitudinal study

2020 ◽  
pp. bjophthalmol-2020-316120
Author(s):  
Simon Sheung Man Fung ◽  
Ali El Hamouly ◽  
Hamza Sami ◽  
Dishay Jiandani ◽  
Sara Williams ◽  
...  
Keyword(s):  
Anterior Chamber ◽  
Corneal Endothelium ◽  
Specular Microscopy ◽  
Ophthalmic Surgery ◽  
Prospective Longitudinal Study ◽  
Surgery Group ◽  
Group 2 ◽  
Prospective Longitudinal ◽  
Group 1

PurposeTo study the longitudinal effect of anterior chamber inflammation on the corneal endothelium in children.MethodsIn this prospective longitudinal observational study, children (aged <18 years) with anterior chamber inflammation and those at risk of developing uveitis due to juvenile idiopathic arthritis (JIA) were included. Changes in central endothelial cell density (ECD) and morphological variables were determined by non-contact specular microscopy, and their correlations with uveitis activity and surgical interventions were analysed.ResultsNinety-nine eyes of 99 children (mean age (±SD): 10.0±4.1 years) with a history of anterior chamber inflammation were recruited. Mean follow-up was 12.3±3.5 months. Eleven children, who were under surveillance but had not developed JIA-associated uveitis were included as controls. While there were no significant differences in mean ECD between controls and subjects without prior surgery (group 1) at all time points, those who had prior ophthalmic surgery (group 2) displayed significantly lower ECD than the controls at recruitment (p=0.002) and at follow-up (p=0.004). However, longitudinal ECD assessments did not show significant changes in either group (group 1, p=0.07, group 2, p=0.54). On regression analysis, once the patient’s age was adjusted for, only the occurrence of intraocular procedures during the study (r=0.43, adjusted p=0.03) was associated with a significant annual rate of ECD loss.ConclusionDuring the study period, longitudinal ECD changes among children with uveitis were associated with intraocular surgery for uveitis-related complications but not uveitis activity. By reducing the need for surgical intervention, the corneal endothelium in these children may be preserved.

A two-group study to evaluate the impact of an educational handbook in the care of patients with head and neck cancer (HNC).

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 228-228
Author(s):  
Jessica Ruth Bauman ◽  
Areej El-Jawahri ◽  
Karen Quinn ◽  
Lisa Arcikowski ◽  
Gina Chan ◽  
...  
Keyword(s):  
Head And Neck ◽  
Illness Perception ◽  
Depression Scale ◽  
Symptom Burden ◽  
Prospective Longitudinal Study ◽  
Illness Perception Questionnaire ◽  
Group 2 ◽  
Prospective Longitudinal ◽  
The Impact ◽  
Group 1

228 Background: Patients undergoing chemoradiotherapy for HNC have a significant symptom burden, psychological distress, and educational needs. We evaluated the impact of an educational handbook integrated into oncology care on patient outcomes. Methods: We conducted a two group, prospective, longitudinal study. Patients enrolled in group 1 received standard care as a control. Then, patients in group 2 received the intervention of a specialized handbook integrated into weekly visits with oncology clinicians during treatment. To assess preliminary efficacy, we evaluated satisfaction (Information Satisfaction Questionnaire-ISQ), mood (Hospital Anxiety and Depression Scale-HADS), illness perception (Brief Illness Perception Questionnaire-IPQ), and quality of life (QOL) (MD Anderson Symptom Inventory-Head and Neck-MDASI-HN) at baseline and week 3. We compared outcomes using two sample t-tests and measured effect size using Cohen’s D. Results: From 8/2014-5/2015 we enrolled and followed 30 patients in group 1. From 5/2015-12/2015, we enrolled and followed 30 patients in group 2. There were no significant differences in baseline characteristics. There were more missing data from group 2. There were high levels of satisfaction in both groups. 20/23 (87%) reported they would ‘definitely’ recommend the handbook to others. Changes in outcomes are shown in Table 1. Compared to group 1, group 2 reported a less threatening view of illness, lower better symptom burden, and less anxiety, but these were not statistically significant. Conclusions: The specialized handbook for patients with HNC was well received. The sample size was too small to detect differences in mood, QOL, illness perception, or satisfaction. Further development in a larger cohort is warranted. Clinical trial information: NCT02204631. [Table: see text]

scholarly journals Evaluation of the Risk of Spreading Endometrial Cell by Hysteroscopy: A Prospective Longitudinal Study

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Rievani de Sousa Damião ◽  
Reginaldo Guedes Coelho Lopes ◽  
Emilly Serapião dos Santos ◽  
Umberto Gazzi Lippi ◽  
Eduardo Borges da Fonseca
Keyword(s):  
Endometrial Cancer ◽  
Peritoneal Cavity ◽  
Low Pressure ◽  
Prospective Longitudinal Study ◽  
Endometrial Cells ◽  
Previous Diagnosis ◽  
Peritoneal Washing ◽  
Group 2 ◽  
Prospective Longitudinal ◽  
Group 1

Objective. The aim was to assess the intraperitoneal spread of endometrial cells during hysteroscopy.Study Design. Seventy-six women were submitted to a hysteroscopy with under a low pressure. Group 1 had not previous diagnosis of endometrial cancer, and group 2 had previous diagnosis of endometrial cancer (stage I-92.3%). Two peritoneal washing samples were taken before (PW1) and immediately after (PW2) the procedure. The dissemination for the peritoneal cavity was defined by the presence of endometrial cells in the PW2; such cells should be absent in WP1.Results. Four patients were excluded for presenting endometrial cells in PW1. In the 72 patients left, there was no passage of cells for the peritoneal cavity. In group 1, 88% presented secretory endometrial phase with correlation of 80% between hysteroscopy and biopsy.Conclusion. Hysteroscopy performed under a low pressure of does not cause spreading of endometrial cells into the peritoneal cavity.

scholarly journals Analysis of the corneal endothelium in eyes of chickens using contact specular microscopy

2015 ◽  
Vol 36 (6Supl2) ◽  
pp. 4199
Author(s):  
Luciane Albuquerque ◽  
João Antonio Tadeu Pigatto ◽  
Luciana Vicente da Rosa Pacicco Freitas
Keyword(s):  
Endothelial Cell ◽  
Corneal Endothelium ◽  
Single Layer ◽  
Specular Microscopy ◽  
Cell Area ◽  
Average Cell ◽  
Group 3 ◽  
Group 2 ◽  
Cellular Pleomorphism ◽  
Group 1

The corneal endothelium is a single layer of polygonal cells essential for corneal transparency. The objective of this study was to assess the parameters corneal endothelial cells in healthy chickens of different ages using a contact specular microscopy. A total 36 eyes of 18 chickens were evaluated in this study. After the humane slaughter of birds and subconjunctival enucleation, the eye bulbs were arranged into three groups according to the age of the chickens. Group 1 consisted of bulbs eyes of 6 chickens with ages ranging from 1 to 3 months old. Group 2 consisted of ocular bulbs 6 chickens with ages ranging from 5 to 12 months old. Group 3 consisted of bulbs eyes of 6 chickens with ages ranging from 24 to 40 months old. The contact specular microscopy was easy to perform and provided data such as endothelial cell density, average cell area and cellular pleomorphism. The results obtained with a contact specular microscopy revealed that the aging causes a decrease in the density of the corneal endothelium healthy chickens. Similarly, increasing the average endothelial cell area as well as the pleomorphism occurs. The present work suggests that the parameters of corneal endothelium of healthy chickens present change with advancing age.

scholarly journals Effect of Reformation of the Anterior Chamber by Air or by a Balanced Salt Solution (BSS) on Corneal Endothelium after Phacoemulsification: A Comparative Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Alahmady Hamad Alsmman ◽  
Mohammed Ezzeldawla ◽  
Amr Mounir ◽  
Ashraf Mostafa Elhawary ◽  
Osama Ali Mohammed ◽  
...  
Keyword(s):  
Comparative Study ◽  
Anterior Chamber ◽  
Salt Solution ◽  
Corneal Endothelium ◽  
University Hospital ◽  
Dissipated Energy ◽  
Cumulative Dissipated Energy ◽  
Group 2 ◽  
Age Range ◽  
Group 1

Aim. To study the effect of reformation of the anterior chamber by air or by a balanced salt solution, after smooth phacoemulsification on the corneal endothelial count and morphology. Methods. A prospective interventional nonrandomized comparative study included 500 eyes of 500 patients with age range between 50 and 60 years, prepared for cataract surgery and presented to the Ophthalmology department of Sohag University Hospital in the period from October 2016 to May 2017. Corneal endothelial morphology and count were examined, and the results were recorded for all cases before the surgery. Patients were divided into two groups, and both groups were diagnosed with grade 2 cataract and underwent uncomplicated phacoemulsification performed by well-trained surgeons. At the end of the surgery, group 1 was subjected to a reformation of the anterior chamber via a balanced salt solution (BSS) injection while group 2 was subjected to a reformation of the anterior chamber via air injection. Corneal endothelial morphology and count were evaluated in the first and 3rd month postoperatively. Results. The study included 500 patients (250 in each group), 220 males (44%) and 280 females (56%) with no significant statistical age differences. Both preoperative and postoperative (3 months after the operation) recorded parameters of the corneal endothelium did not show any significant statistical differences. The cumulative dissipated energy was recorded, for all cases of both groups, during phacoemulsification with no significant statistical differences (P=0.7). Conclusion. There is no difference between the effect of reformation of the anterior chamber after phacoemulsification, using air or using a BSS injection, on the corneal endothelial count and morphology.

scholarly journals Analysis of the corneal endothelium in eyes of chickens using contact specular microscopy

2015 ◽  
Vol 36 (6Supl2) ◽  
pp. 4199 ◽  
Author(s):  
Luciane Albuquerque ◽  
João Antonio Tadeu Pigatto ◽  
Luciana Vicente da Rosa Pacicco Freitas
Keyword(s):  
Endothelial Cell ◽  
Corneal Endothelium ◽  
Single Layer ◽  
Specular Microscopy ◽  
Cell Area ◽  
Average Cell ◽  
Group 3 ◽  
Group 2 ◽  
Cellular Pleomorphism ◽  
Group 1

The corneal endothelium is a single layer of polygonal cells essential for corneal transparency. The objective of this study was to assess the parameters corneal endothelial cells in healthy chickens of different ages using a contact specular microscopy. A total 36 eyes of 18 chickens were evaluated in this study. After the humane slaughter of birds and subconjunctival enucleation, the eye bulbs were arranged into three groups according to the age of the chickens. Group 1 consisted of bulbs eyes of 6 chickens with ages ranging from 1 to 3 months old. Group 2 consisted of ocular bulbs 6 chickens with ages ranging from 5 to 12 months old. Group 3 consisted of bulbs eyes of 6 chickens with ages ranging from 24 to 40 months old. The contact specular microscopy was easy to perform and provided data such as endothelial cell density, average cell area and cellular pleomorphism. The results obtained with a contact specular microscopy revealed that the aging causes a decrease in the density of the corneal endothelium healthy chickens. Similarly, increasing the average endothelial cell area as well as the pleomorphism occurs. The present work suggests that the parameters of corneal endothelium of healthy chickens present change with advancing age.

scholarly journals Endothelial cell loss rate after penetrating keratoplasty: Optical versus therapeutic grafts

2021 ◽  
Vol 10 (2) ◽  
pp. 74-79
Author(s):  
Abdelrhman Shams ◽  
Ayman Abdelmoneim Gaafar ◽  
Rania Serag Elkitkat ◽  
Mohamed Omar Yousif
Keyword(s):  
Endothelial Cell ◽  
Graft Rejection ◽  
Penetrating Keratoplasty ◽  
Cell Loss ◽  
Specular Microscopy ◽  
Endothelial Cell Loss ◽  
Group 2 ◽  
Cell Loss Rate ◽  
Group 1

Background: This study aimed to compare the rate of endothelial cell loss (ECL) after penetrating keratoplasty (PKP) for optical versus therapeutic grafts at 3-, 6-, and 12-month postoperatively. Furthermore, the study aimed to investigate postoperative graft viability and the rate of graft rejection during the first year of follow-up for both indications. Methods: This was a prospective, observational, comparative study that included patients who sought medical advice at the cornea outpatient clinic of Ain Shams University Hospitals, Cairo, Egypt. The study recruited 60 patients: group 1 included 30 transplanted corneas of 30 patients who underwent optical PKP for various indications, while group 2 included 30 transplanted corneas of 30 patients who underwent therapeutic PKP for unhealed, resistant infectious keratitis. Specular microscopy was performed for all patients at the 3-, 6-, and 12-month follow-up visits using Nidek CEM-530 specular microscopy. Postoperative clinical examinations were performed at the same follow-up visits to detect graft rejection. Results: There were no statistically significant differences between the groups concerning the postoperative timing of graft clarity or the rate of ECL at 3- and 6-months postoperatively; however, the rate of ECL was significantly greater in group 2 than in group 1 at 12-months postoperatively (P = 0.03), although the difference was small from a clinical point of view. Moreover, there was no statistically significant difference between the groups in terms of the graft rejection rate. Conclusions: Therapeutic PKP results were comparable to optical PKP with respect to graft viability, the rate of ECL, and the rate of graft rejection 1 year after grafting. How to cite this article: Shams A, Abdelmoneim Gaafar A, Elkitkat RS, Omar Yousif M. Endothelial cell loss rate after penetrating keratoplasty: Optical versus therapeutic grafts. Med Hypothesis Discov Innov Ophthalmol. 2021 Summer; 10(2): 74-79. https://doi.org/10.51329/mehdiophthal1424

scholarly journals Corneal Collagen Cross-Linking with and without Epithelial Removal: A Contralateral Study with 0.5% Hypotonic Riboflavin Solution

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Aleksandar Stojanovic ◽  
Wen Zhou ◽  
Tor Paaske Utheim
Keyword(s):  
Visual Acuity ◽  
Postoperative Pain ◽  
Patient Questionnaire ◽  
Cross Linking ◽  
Specular Microscopy ◽  
Group 2 ◽  
Collagen Cross Linking ◽  
Corneal Collagen ◽  
Group 1

Purpose. Our main purpose was to compare safety and efficacy in the treatment of progressive keratoconus with “epithelium-on” and “epithelium-off” corneal collagen cross-linking (CXL). Our secondary purpose was to evaluate efficacy of CXL when hypotonic 0.5% riboflavin is used as photosensitizer.Methods. One eye of 20 patients with bilateral progressive keratoconus was randomly treated for “epithelium-on” CXL (group 1) while the fellow eye underwent “epithelium-off” CXL (group 2). Hypotonic 0.5% riboflavin was used in both groups. Visual acuity, refraction, corneal topography, and wavefront aberrometry were evaluated at baseline and after 1, 6, and 12 months. Specular microscopy was performed on 10 patients preoperatively and after 12 months. Postoperative pain was evaluated using a patient questionnaire.Results. Uncorrected and corrected distance visual acuity improved significantly in both groups. Refraction, topography, and aberrometry showed nonsignificant changes from the preoperative status throughout the 12-month follow-up in both groups. Moreover, the outcomes between the groups were comparable at all follow-up points. Endothelial cell-count was stable. Postoperative pain length was shorter in group 1P<0.001.Conclusion. “Epithelium-on” and “epithelium-off” CXL using hypotonic 0.5% riboflavin were equally safe and effective in stabilization of keratoconus. Topography and aberrometry outcomes in both groups failed to show any significant improvements. This study is registered at ClinicalTrials.gov:NCT01181219.

scholarly journals Effect of Myopic Femtosecond Laser-Assisted LASIK on Anterior Chamber Inflammation (Flare Values) and Corneal Endothelium: A Prospective before and after Study

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Kemal Turgay Özbilen ◽  
Emre Altinkurt ◽  
Nihan Aksu Ceylan ◽  
Gizem Sayar Bilgin ◽  
Nilüfer Gözüm
Keyword(s):  
Endothelial Cells ◽  
Femtosecond Laser ◽  
Cell Count ◽  
Anterior Chamber ◽  
Morphological Changes ◽  
Specular Microscopy ◽  
Prospective Longitudinal Study ◽  
Significant Difference ◽  
Before And After ◽  
Prospective Longitudinal

Purpose. This study aimed to investigate whether femtosecond laser-assisted LASIK (FS-LASIK) surgery causes inflammation in the anterior chamber and to analyze its effect on endothelial cells. Methods. This prospective, longitudinal study included left eyes of 30 patients (19 females) who had undergone FS-LASIK surgery due to myopia and myopic astigmatism. Endothelial cell density (ECD) and morphological measurements were performed using a specular microscopy, and laser flare photometry was used to measure the anterior chamber flare values on the day of surgery. iFS™ Advanced FS and VISX STAR S4-IR Wavescan Excimer Laser platforms were used. Flare measurements were repeated on the postoperative 1st day and 7th day and the 1st and 3rd months. The endothelial measurements were repeated in the 3rd month. Results. Preoperatively, the mean flare was 5.59 ± 1.24 photons/ms; it was 6.49 ± 2.42 on the postoperative 1st day, 5.87 ± 2.27 on the 7th day, 5.68 ± 1.66 on the 1st month, and 5.35 ± 1.24 on the 3rd month. A significant difference was observed only between the preoperative and postoperative 1st day flare values ( p = 0.047 ). The decrease in the ECD was clinically insignificant but statistically significant, with an average of 97.0 ± 209.9 cell count/mm2 (3.3%, p = 0.017 ). However, there was no significant change in the coefficient of variation ( p = 0.448 ) and hexagonality ( p = 0.096 ). No significant correlation was found between the increase in the flare value on the postoperative 1st day and variables. A significant correlation was found between the decrease in ECD and the preoperative ECD (r = 0.356, p = 0.027 ). Conclusion. FS-LASIK caused minimal inflammation in the anterior chamber on only the 1st postoperative day; additionally, a minimal decrease of cell count with no morphological changes were noted in the endothelial cells on postoperative 3rd month. This trial is registered with NCT04899258.

scholarly journals Evaluation of the Effect of Myopic Femtosecond Laser Assisted-LASIK on Anterior Chamber Flare Values and Corneal Endothelial Cells: A Prospective Before-and-After Study

2021 ◽  
Author(s):  
Kemal Turgay Özbilen ◽  
Emre Altınkurt ◽  
Nihan Aksu Ceylan ◽  
Gizem Sayar Bilgin ◽  
Nilüfer Gözüm
Keyword(s):  
Endothelial Cells ◽  
Femtosecond Laser ◽  
Anterior Chamber ◽  
Morphological Changes ◽  
Specular Microscopy ◽  
Prospective Longitudinal Study ◽  
Significant Difference ◽  
Before And After ◽  
Prospective Longitudinal ◽  
Anterior Chamber Flare

Abstract Purpose This study aimed to investigate whether femtosecond laser-assisted LASIK (FS-LASIK) surgery causes inflammation in the anterior chamber and to analyze its effect on endothelial cells.Methods This prospective, longitudinal study included 60 eyes of 30 patients (19 females) who had undergone FS-LASIK surgery due to myopia and myopic astigmatism. Endothelial cell density (ECD) and morphological measurements were performed using a specular microscopy, and laser flare photometry was used to measure the anterior chamber flare values on the day of surgery. iFS™ Advanced FS and VISX STAR S4-IR Wavescan Excimer Laser platforms were used. Flare measurements were repeated on the postoperative 1st day and 7th day and the 1st and 3rd months. The endothelial measurements were repeated in the 3rd month.Results Preoperatively, the mean flare was 5.34 ± 1.13 photons/ms; it was 6.02 ± 2.0 on the postoperative 1st day, 5.78 ± 1.98 on the 7th day, 5.77 ± 3.16 in the 1st month, and 5.45 ± 1.13 in the 3rd month. A significant difference was observed between the preoperative values and the postoperative 1st day values (p = 0.010). The decrease in the ECD was statistically significant, with an average of 120.3 ± 260 cell-count/mm2 (p = 0.001) and a minimal change in the coefficient of variation (p = 0.043). A significant correlation was found between the increase in the flare value on the postoperative 1st day and the preoperative flare value (r = -0.281, p = 0.015). A significant correlation was found between the decrease in ECD and the preoperative ECD (r = 0.434, p < 0.001)Conclusion FS-LASIK only causes minimal inflammation in the anterior chamber on the 1st preoperative day; additionally, a statistically significant decrease of 4.2% and minimal morphological changes were noted in the endothelial cells.

Earlier use of systemic immunosuppression is associated with fewer ophthalmic surgeries in paediatric non-infectious uveitis

2019 ◽  
Vol 104 (7) ◽  
pp. 938-942 ◽  
Author(s):  
Crystal Sin Yi Cheung ◽  
Kamiar Mireskandari ◽  
Asim Ali ◽  
Earl Silverman ◽  
Nasrin Tehrani
Keyword(s):  
Multivariate Regression ◽  
Outcome Measure ◽  
Management Strategies ◽  
Ophthalmic Surgery ◽  
Main Outcome Measure ◽  
Systemic Immunosuppression ◽  
Infectious Uveitis ◽  
Group 2 ◽  
Group 1

Background/aimsThere is a paucity of large trials investigating the effect of management strategies for paediatric non-infectious uveitis on complications requiring surgery. The purpose of our study is to investigate whether earlier initiation of systemic immunosuppression in paediatric non-infectious uveitis is associated with fewer ophthalmic surgeries.MethodsA retrospective review was conducted on 48 children with non-infectious uveitis assessed in 1998–2013. Patients were divided into uveitis diagnosed before December 2008 (group 1) and after January 2009 (group 2). Duration from uveitis onset to methotrexate initiation (U-MTX) and biological addition (U-Biologic) were reviewed. Follow-up visits with topical corticosteroids >3 times daily and active uveitis (≥1+ cells) during 3.5 years were documented. The main outcome measure was the need for ≥1 ophthalmic surgery at 3.5 years.ResultsIn group 1, 69.5% of patients required ≥1 ophthalmic surgery at 3.5 years versus 26.9% in group 2 (p=0.005). U-MTX was 28.9±11.8 weeks and 14.2±10.0 weeks for groups 1 and 2 (p=0.028). U-Biologic was 134.6±46.0 weeks and 82.3±43.3 weeks for groups 1 and 2 (p=0.0016). Corticosteroid use >3 times daily was 85.9±52.7 weeks and 14.6±11.1 weeks for groups 1 and 2. Multivariate regression showed methotrexate initiation within 6 months of uveitis onset lowered the likelihood of needing ophthalmic surgery at 3.5 years (OR=6.2, 95% CI 1.2 to 33.4; p=0.033). Univariate regression demonstrated biological addition within 18 months of uveitis onset reduced the likelihood of requiring ophthalmic surgery (OR 12.57, 95% CI 1.28 to 123.48; p=0.030).ConclusionEarlier control of uveitis by addition of immunosuppressive therapy reduced the need for ophthalmic surgery.

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