scholarly journals A Controlled Study on the Correlation between Tear Film Volume and Tear Film Stability in Diabetic Patients

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Iman M. Eissa ◽  
Noha M. Khalil ◽  
Heba A. El-Gendy
Keyword(s):  
Anterior Segment ◽  
Tear Film ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Film Stability ◽  
Duration Of Diabetes ◽  
Significant Difference ◽  
Tear Meniscus ◽  
Tear Meniscus Height

Purpose. To assess the tear film quantity and correlate it with the quality and stability of the tear film in diabetics and compare them to age matched controls.Introduction. Diabetes affects tear film parameters in multiple ways. Poor metabolic control and neuropathy are postulated factors. To further understand how diabetes affects tear film parameters this study was conducted.Subjects and Methods. Tear meniscus height was measured by anterior segment OCT, along with tear thinning time, a subtype of noninvasive tear break-up time, and blinking rate per minute which were all recorded for 22 diabetic patients. Correlations between these tear film parameters were studied and then compared to 16 age matched controls.Results. A statistically significant difference was found in blinking rate between the diabetic and the control group (P=0.002), with higher blinking rate among diabetics. All tear film parameters were negatively correlated with duration of diabetes. A positive correlation was found between tear film volume and stability.Conclusion. Diabetes affects the tear film in various ways. Diabetics should be examined for dry eye signs even in absence of symptoms which may be masked by associated neuropathy. Duration of diabetes has an impact on tear film status.

scholarly journals Evaluation of implanted perforated lacrimal punctal plugs using anterior segment optical coherence tomography

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Raafat Mohyeldeen Abdelrahman Abdallah ◽  
Ahmed Mohamed Kamal Elshafei ◽  
Heba Radi AttaAllah
Keyword(s):  
Optical Coherence Tomography ◽  
Anterior Segment ◽  
Tear Film ◽  
Early Postoperative Period ◽  
Optical Coherence ◽  
Proper Position ◽  
Punctal Plugs ◽  
Tear Meniscus ◽  
Tear Meniscus Height ◽  
A Prospective Study

Abstract Purpose Evaluation of the patency and position of perforated lacrimal punctal plugs implanted for treating punctal stenosis together with quantitative assessment of the precorneal tear film using anterior segment optical coherence tomography (AS-OCT). Methods In a prospective study, the lower punctum of 54 eyes of 29 patients implanted with perforated punctal plugs were examined using AS-OCT during the early postoperative period. Preoperative tear meniscus height (TMH) and tear meniscus area (TMA) were evaluated. Postoperatively, the patency of the plug, its position, TMH and TMA were evaluated, and the results were correlated with postoperative epiphora. Munk scale was used for epiphora grading. Results Using AS-OCT, 48 (88.9%) plugs were found in proper position while 6 (11.1%) were rotated. The lumen of the plugs was completely patent in 47 (87%) plugs, partially obstructed in 2 (3.7%) plugs and completely occluded in 5 (9.2%) plugs. There was a statistically significant postoperative decrease of TMH and TMA (P < 0.001) and postoperative epiphora Munk score (P < 0.001). Conclusion AS-OCT is a valuable, reliable, and noninvasive investigative tool that can detect the proper positioning, patency, and contents of the implanted perforated lacrimal punctal plugs in addition to measurement of TMH and TMA. Trial registration ClinicalTrials.gov ID: NCT04624022, https://clinicaltrials.gov/ct2/show/NCT04624022

scholarly journals Assessment of Corneal Endothelium among Diabetic Patients in a Multispecialty Hospital in Tamil Nadu

2020 ◽  
Author(s):  
Soundaram Meenakshisundaram ◽  
Melina I Sahay ◽  
Damal Kandadai Sriram ◽  
Melvin George
Keyword(s):  
Blood Pressure ◽  
Endothelial Cell ◽  
Blood Sugar ◽  
Cell Density ◽  
Corneal Thickness ◽  
Diabetic Group ◽  
Control Group ◽  
Diabetic Patients ◽  
Duration Of Diabetes ◽  
Significant Difference

Introduction: Corneal damage is the common issue affecting 70% of diabetic patients. Diabetic cornea has functional abnormalities such as decreased corneal Endothelial Cell Density (ECD), thicker corneas with increased endothelial permeability, lesser corneal sensitivity, and elevated corneal auto-fluorescence. Aim: To study the corneal endothelial characteristics among diabetic patients and to identify the factors associated with endothelial damage and compare the corneal changes based on the duration of diabetes mellitus and glycaemic control. Materials and Methods: The hospital based cross-sectional study was conducted in 155 patients (100 diabetic and 55 control) from 24th September 2016 to 29th March 2018. The corneal endothelial morphological features were evaluated using a non-contact EM-3000 specular microscope. The morphological characteristics of endothelial cell like the ECD, Coefficient of Variation (CV), Central Corneal Thickness (CCT), and percentage of hexagonal cells were compared between diabetic patients and the control population. Age, gender, blood pressure, duration of diabetes, fasting and Postprandial Blood Sugar (PPBS) HbA1c value, blood urea, and serum creatinine, Intra Ocular Pressure (IOP) were also recorded, and the endothelial cell characteristics were compared between the diabetic groups according to the duration (< or ≥ 3 years) and HbA1c% (< or ≥ 7%). An independent t-test was performed to compare the means of endothelial characteristics between study subjects and the control group and also between duration of diabetes and HbA1C levels. A p-value of less than 0.05 was considered statistically significant. The data were analysed using a SPSS statistical program. Results: Baseline characteristics like Fasting Blood Sugar (FBS), PPBS, HbA1c, Systolic and Diastolic Blood Pressure (SBP and DBP) were significantly higher in diabetic group than control. A significant difference in corneal thickness (p=0.01) and hexagonality (p<0.001) were also observed between both the groups. The diabetic group showed a reduction in cell density and a higher coefficient variation of cell size however the differences were not statistically significant, There was no significant difference in the ECD, CCT, CV, and hexagonality irrespective to HbA1c level and duration of diabetes. Conclusion: Patients with diabetes had a significant increase in corneal thickness, and a higher frequency of pleomorphism compared to control subjects. In terms of ECD and co-efficient variation, no difference was observed between groups.

scholarly journals Assessment of tear secretion and tear film instability in cases with pterygium and normal subjects

2013 ◽  
Vol 5 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Narayani Roka ◽  
SP Shrestha
Keyword(s):  
Dry Eye ◽  
Tear Film ◽  
Strong Relationship ◽  
Normal Subjects ◽  
Controlled Study ◽  
Control Group ◽  
P Value ◽  
Tear Secretion ◽  
Schirmer’S Test ◽  
Significant Difference

Introduction: Dry eye is a common disorder affecting a significant percentage of the population. Materials and methods: This study is a prospective, hospital-based, case-controlled study conducted between January 2009 and May 2010. Seventy-six pterygium cases and 152 age-and- sex matched controls presenting to the OPD of Manipal Teaching Hospital were included. The TBUT Schirmer’s test and basal tear secretion were estimated in all patients. A TBUT of less than 10 seconds and a Schirmer’s test of less than 10 mm were considered abnormal. Results: Pterygium was bilateral in 15 (19.7 % ) and unilateral in 61 (80.3 %) patients. Ninety-two (92.1 %) pterygium patients reported either one or more of the six dry eye symptoms. Redness was the most common (67 %) symptom reported. The mean Schirmer’s test I, mean basal secretion and mean TBUT values were 16.19 mm, 10.01 mm and 10.56 seconds in pterygium cases and 20.22 mm,13.25 mm and 26.25 seconds in the control group respectively. There was a statistically significant difference in the dry eye results between the pterygium cases and the control group (p value < 0.05). The odds ratio between pterygium and dry eye was 3.28. Dry eye was present in 26 % of the normal patients and in 54 % of the pterygium cases. Conclusion: There is a strong relationship between dry eye and pterygium. Nepal J Ophthalmol 2013; 5(9):16-23 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7816

scholarly journals The effects of type 2 diabetes mellitus on the corneal endothelium and central corneal thickness

2020 ◽  
Author(s):  
Tae Gi Kim ◽  
Yoo Jin Kim
Keyword(s):  
Type 2 Diabetes ◽  
Endothelial Cell ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Corneal Endothelial Cell ◽  
Control Group ◽  
Diabetic Patients ◽  
Duration Of Diabetes ◽  
Significant Difference

Abstract Aim of this study is to evaluate the differences in corneal endothelial cell morphology and corneal thickness in patients with and without type 2 diabetes related to age, disease duration, and HbA1c percentage. This retrospective cross-sectional study included 511 type 2 diabetes patients (1022 eyes) and 900 (1799 eyes) non-diabetic patients. The endothelial cell density (ECD), variation in endothelial cell size (CV), percentage of hexagonal cells, and central corneal thickness (CCT) were analyzed using a noncontact specular microscope and a Pentacam Scheimpflug camera. We also examined the correlation between the corneal parameters and the duration of diabetes. Blood HbA1c results in DM patients were used within 2 months of ophthalmic examination. The controls had no diabetes confirmed by blood tests. For all ages, the subjects with type 2 diabetes showed significantly lower ECD, hexagonality, higher CV, and thicker CCT than the control group. This difference was more pronounced in patients with long-standing DM (≥10 years) and high HbA1c (≥7 %). When stratified by age group, from the 60s group, corneal endothelial cell parameters showed a statistically significant difference between DM and control groups. The duration of diabetes was inversely correlated with ECD (r=-0.167; P=0.000), but HbA1c was not correlated with ECD. These findings suggest that diabetes affects corneal endothelial cell in older age and those with long-standing DM and higher HbA1c. Regular corneal endothelial examinations are required in diabetic patients.

Prophylaxis of macular edema after cataract surgery in diabetic patients, topical Nepafenac versus intravitreal Ranibizumab

2021 ◽  
pp. 112067212110012
Author(s):  
Ahmed Howaidy ◽  
Zeiad H Eldaly ◽  
Mohamed Anis ◽  
Tageldin M Othman
Keyword(s):  
Cataract Surgery ◽  
Macular Edema ◽  
Study Groups ◽  
Macular Thickness ◽  
Controlled Study ◽  
Control Group ◽  
Diabetic Patients ◽  
Intravitreal Ranibizumab ◽  
Significant Difference ◽  
And Control

Purpose: To compare effect of topical Nepafenac versus intravitreal Ranibizumab on macular thickness after cataract surgery in diabetic patients with no preoperative macular edema. Patients and methods: A prospective randomized controlled study recruited diabetic patients with visually significant cataract and no diabetic macular edema (DME). Patient underwent uncomplicated phacoemulsification with IOL implantation and were randomly assigned to receive post-operative topical Nepafenac, intra-operative intravitreal Ranibizumab, or no prophylactic treatment. Changes in subfoveal and perifoveal macular thickness were assessed by SD-OCT. Results: The mean central macular thickness showed a significant increase in all study groups 1 week and 1 month postoperative when compared to baseline. At 3 months postoperative, there was a significant difference between Nepafenac and Control group ( p = 0.017), Ranibizumab and Control groups ( p = 0.009) with no significant difference between Nepafenac and Ranibizumab group ( p = 0.545) regarding CMT. Comparable results could be detected as regarding peri-foveal macular thickness changes. Concerning BCVA, there was a significant difference between topical Nepafenac/control ( p = 0.001) and intravitreal Ranibizumab/control ( p = 0.004) at 1-week visit. No significant difference in BCVA was observed between Nepafenac and Ranibizumab group throughout the whole study period. In postoperative visits, cystoid macular edema occurred in three patients (7.9%) in Nepafenac group, one patient (2.7%) in Ranibizumab group, and seven patients (17.07%) in control group. Conclusion: Both postoperative topical Nepafenac and intra-operative intra-vitreal Ranibizumab are effective adjunctive to phacoemulsification in diabetic patients for prophylaxis of macular edema.

scholarly journals The effects of type 2 diabetes mellitus on the corneal endothelium and central corneal thickness

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yoo Jin Kim ◽  
Tae Gi Kim
Keyword(s):  
Type 2 Diabetes ◽  
Endothelial Cell ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Corneal Endothelial Cell ◽  
Control Group ◽  
Diabetic Patients ◽  
Duration Of Diabetes ◽  
Significant Difference

AbstractAim of this study is to evaluate the differences in corneal endothelial cell morphology and corneal thickness in patients with and without type 2 diabetes related to age, disease duration, and HbA1c percentage. This retrospective cross-sectional study included 511 (1022 eyes) type 2 diabetes patients and 900 (1799 eyes) non-diabetic patients. The endothelial cell density (ECD), variation in endothelial cell size (CV), percentage of hexagonal cells, and central corneal thickness (CCT) were analyzed using a noncontact specular microscope and a Pentacam Scheimpflug camera. We also examined the correlation between the corneal parameters and the duration of diabetes. For total ages, the subjects with type 2 diabetes showed significantly lower ECD, hexagonality, higher CV, and thicker CCT than the control group. This difference was more pronounced in patients with long-standing DM (≥ 10 years) and high HbA1c (≥ 7%). When stratified by age group, from the 60 s group, corneal endothelial cell parameters showed a statistically significant difference between DM and control groups. The duration of diabetes was inversely correlated with ECD (r =  − 0.167; p = 0.000). These findings suggest that diabetes affects corneal endothelial cell in older age and those with long-standing DM and higher HbA1c. Regular corneal endothelial examinations are required in diabetic patients.

scholarly journals Effect of Airflow Exposure on the Tear Meniscus

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Shizuka Koh ◽  
Cynthia Tung ◽  
Ranjini Kottaiyan ◽  
James Zavislan ◽  
Geunyoung Yoon ◽  
...  
Keyword(s):  
Dry Eye ◽  
Anterior Segment ◽  
Tear Film ◽  
Normal Subjects ◽  
Dry Eyes ◽  
Before And After ◽  
Evaporative Dry Eye ◽  
Tear Meniscus ◽  
Tear Meniscus Height ◽  
Blink Frequency

Purpose. To compare the effect of airflow exposure on the tear meniscus and blink frequency in normal and evaporative dry eye subjects.Methods.In 9 normal subjects and 9 short tear breakup time (SBUT) dry eye subjects, lower tear meniscus height (TMH) and area (TMA) and blink frequency were measured with anterior segment optical coherence tomography (OCT) before and after 5 minutes of airflow exposure (1.5±0.5 m/s).Results.In SBUT dry eyes, both TMH and TMA decreased significantly (P=0.027,P=0.027) with a significant increase of blink frequency after airflow exposure, while significant increase in TMA was found in normal eyes.Conclusion. Measurement of the tear meniscus with anterior segment OCT seems to be useful as a noninvasive and objective method for evaluating the effect of airflow on tear film.

scholarly journals Changes in Ocular Surface Disease Evaluated after Nonpenetrating Deep Sclerectomy

2021 ◽  
Author(s):  
Carlota Fuente-García ◽  
Francisco José Muñoz-Negrete ◽  
Elisabet de Dompablo-Ventura ◽  
Javier Moreno-Montañés ◽  
Gema Rebolleda
Keyword(s):  
Ocular Surface ◽  
Anterior Segment ◽  
Tear Film ◽  
Ocular Surface Disease ◽  
Control Group ◽  
Deep Sclerectomy ◽  
Ocular Surface Disease Index ◽  
Non Invasive ◽  
Group A ◽  
Tear Meniscus Height

Abstract Objective: To analyse the ocular surface changes in eyes after the withdraw of anti-glaucomatous drugs when non-penetrating deep sclerectomy (NPDS) is performed.Methods: 31 patients (33 eyes) diagnosed of glaucoma that underwent NPDS, were included in this prospective study. Control group included 33 eyes of 33 age and sex-matched volunteers. Five variables were studied with Keratograph 5M (K5M): ocular hyperaemia (OH), non-invasive tear film break-up time (NI-BUT), lower tear meniscus height (LTMH) and meibography. LTMH was also measured using the anterior segment module of Spectralis Fourier-Domain Optical Coherence Tomography (FD-OCT). Also, an evaluation of corneal and conjunctival staining was performed.In addition, patients were asked to answer two questionnaires: Ocular Surface Disease Index (OSDI) and National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) before and 6-months after surgery.Results: Before NPDS, treated eyes, showed worse objective data than healthy controls (p ≤0.049). In this group, a significant improvement was observed in the questionnaires (p< 0.001), LTMH FD-OCT (p=0.037) and LTMH K5M (p=0.025), K5M OH (p=0.003), NI-BUT (=0.022) and conjunctival and corneal staining (p<0.001). No significant differences were observed between groups in FD-OCT and K5M LTMH, NI-BUT, corneal-conjunctival staining and in the most OH sector values at 6 months(p ≥0.62).Conclusion: A significant improvement in the ocular surface was observed 6 months after NPDS, suggesting that the withdrawn of the topical anti-glaucomatous treatment has a beneficial effect.

scholarly journals Short Term Effect of Virtual Reality on Tear Film Stability and Ocular Discomfort

2020 ◽  
Vol 4 (1) ◽  
pp. 40-46
Author(s):  
Mohd Zulfaezal Che Azemin ◽  
Keyword(s):  
Virtual Reality ◽  
Tear Film ◽  
Film Stability ◽  
The Public ◽  
Non Invasive ◽  
Significant Difference ◽  
Ocular Discomfort ◽  
Tear Film Stability ◽  
Before And After ◽  
Tear Meniscus Height

Virtual reality (VR) has been integrated and used with smartphones as one of the digital entertainments such as in gaming and movie streaming. With emergent of various VR brands in the market, it concerns the public on the possible side effects of VR on the ocular performance specifically on tear film stability and ocular discomfort. The purpose of this study was to compare the change on non-invasive keratograph tear break-up time (NIKBUT), tear meniscus height (TMH) before and after the use of VR for 30 minutes, and to measure the ocular discomfort after the use of VR quantitatively. Thirty-two subjects were recruited in this study and all the subjects were divided randomly into two groups; VR and laptop (used as a control) groups. Each subject needed to watch a movie for 30 minutes using the respective devices. The changes of tear film stability and ocular discomfort before and after the use of the devices were then compared and the results showed that there was no significant difference (p>0.05) after 30 minutes of the use. Comparison of the ocular parameters between the devices on post-watching activities was also not significant (p>0.05). Use of VR did not give any signs of dryness to the eyes and it can be used without any discomfort even after 30 minutes usage of the devices.

scholarly journals Evaluation of cognitive functions in diabetic patients

2020 ◽  
Vol 8 (6) ◽  
pp. 2039
Author(s):  
Emre Cakir ◽  
Nazmiye Ozlem Harmankaya ◽  
Hasret Cengiz ◽  
Ceyhun Varim
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Cognitive Impairment ◽  
Cognitive Functions ◽  
Cognitive Status ◽  
Control Group ◽  
Diabetic Patients ◽  
Duration Of Diabetes ◽  
General Internal ◽  
Significant Difference

Background: Diabetes Mellitus is an independent risk factor for cognitive impairment and dementia. In this study, authors investigated cognitive functions in the diabetes and control group with Mini Mental State Examination (MMSE). Authors analyzed the association of cognitive status with age, sex, duration of diabetes, insulin use and HbA1c in diabetic patients.Methods: Fifty patients with diabetes diagnosed between the ages of 50 and 70 who applied to this Diabetes and General Internal Medicine Clinics between January 2017 and September 2017 were included. Fifty patients with nondiabetes diagnosed with similar age and demographic characteristics were included in the control group. MMSE was applied to both groups. In the diabetic group, cognitive functions were investigated in relation with age, gender, duration of diabetes, insulin usage and HbA1c.Results: The MMSE score in diabetic patients was lower than the control group (p<0.05). In addition, cognitive impairment in diabetic patients was associated with duration of diabetes and HbA1c level. There wasn't significant difference was found between cognitive impairment and age, sex, insulin use.Conclusions: Diabetes Mellitus is a risk factor for cognitive impairment and dementia with many possible mechanisms. In the routine, there is no screening for cognitive impairment and dementia in diabetic patients; but if authors detect early cognitive impairment, authors can prevent cognitive impairment progression to dementia with medical treatment and cognitive exercises.

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