Ocular surface alterations and in vivo confocal microscopic characteristics of corneas in patients with myasthenia gravis

Purpose: To evaluate ocular surface alterations and characteristics of corneal basal epithelium and subbasal nerves in patients with myasthenia gravis. Materials and methods: Myasthenia gravis patients (n = 21) and healthy controls (n = 20) were enrolled. All participants underwent ocular surface testing in the following order: tear break-up time, lissamine green staining, Schirmer I test with anesthesia, and Ocular Surface Disease Index questionnaire. The Cochet-Bonnet esthesiometer was used to measure corneal sensitivity. Basal epithelial cells and subbasal nerves were evaluated using in vivo confocal microscopy. Results: Myasthenia gravis patients had higher Ocular Surface Disease Index score (13.9 ± 15.0 vs 1.4 ± 2.2, p < 0.001) and lissamine green staining score (0.6 ± 0.4 vs 0.2 ± 0.4, p = 0.007). Break-up time score (9.3 ± 3.0 vs 9.9 ± 1.9, p = 0.481) and Schirmer I test score (16.5 ± 9.2 vs 19.3 ± 8.4, p = 0.323) did not differ significantly. Corneal sensation was 0.4 g/mm2 in all eyes. Patients with myasthenia gravis had lower basal epithelial cell density (3775.7 ± 938.1 vs 4983.1 ± 608.5, p < 0.001) and total nerve density (1956.1 ± 373.3 vs 2277.9 ± 405.0, p = 0.012) and higher subbasal nerve tortuosity (1.9 ± 0.8 vs 1.6 ± 0.7, p = 0.007) than controls. A significant increase in Ocular Surface Disease Index scores was found with decreasing basal epithelial cell density (rho = −0.518, p = 0.001). There was a significantly moderate negative correlation between the duration of myasthenia gravis and the number of corneal nerves (rho = −0.497, p = 0.022). Conclusion: Significant alterations of basal epithelial cells and subbasal nerves were demonstrated in myasthenia gravis patients although there was no difference of corneal sensitivity between myasthenia gravis patients and healthy controls. Thus, it should be borne in mind that myasthenia gravis patients deserve further evaluation with regard to ocular surface disease.

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Changes in Tear-Film Status and Ocular Surface Disease Index Score Following Prolonged Use of Face Mask

Open Journal of Ophthalmology ◽

10.4236/ojoph.2021.114021 ◽

2021 ◽

Vol 11 (04) ◽

pp. 253-265

Author(s):

Nawreen Binte Anwar ◽

Basil Anwar ◽

Arup Krishna Choudhury ◽

Mahfuza Rahman Khan ◽

Md. Anisur Rahman

Keyword(s):

Ocular Surface ◽

Tear Film ◽

Face Mask ◽

Disease Index ◽

Index Score ◽

Ocular Surface Disease ◽

Ocular Surface Disease Index ◽

Score Following

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Validation of the Arabic version of the Ocular Surface Disease Index Questionnaire

International Journal of Ophthalmology ◽

10.18240/ijo.2021.10.18 ◽

2021 ◽

Vol 14 (10) ◽

pp. 1595-1601

Author(s):

May M. Bakkar ◽

◽

Mohammad Al Qadire ◽

Keyword(s):

Internal Consistency ◽

Ocular Surface ◽

Disease Index ◽

Ocular Surface Disease ◽

Clinical Population ◽

Arabic Version ◽

Ocular Surface Disease Index ◽

Retest Reliability ◽

Test Retest Reliability ◽

Acceptable Internal Consistency

AIM: To develop an Arabic version of the ocular surface disease index (OSDI) and to assess its reliability and validity. METHODS: A cross sectional study was carried out to validate the Arabic version of the OSDI questionnaire. Initially, forward-backward translation was used to translate the English version of OSDI into Arabic. The translated questionnaire was tested for equivalence and cultural adaptability. Totally 200 subjects were then recruited from a non-clinical population and asked to complete the Arabic version of the OSDI (ARB-OSDI). The reliability of the questionnaire was assessed using Cronbach’s-α. A subgroup of 30 participants was asked to complete the questionnaire on two occasions to test the test-retest reliability. RESULTS: A total of 200 participants were enrolled in the study. The average age of the study participants was 31.21±13.2y and 57% were male. An acceptable internal consistency level for the ARB-OSDI questionnaire measured by Cronbach’s-α was revealed. All questions showed good internal consistency. Test-retest reliability analysis revealed good stability (interclass correlation coefficient, r=0.832, P<0.001). The construct validity for the questionnaire was also high. CONCLUSION: The ARB-OSDI questionnaire shows very good psychometric properties (acceptable internal consistency and test-retest reliability). That makes the questionnaire a valid potential tool to use in Arabic-speaking countries to monitor symptoms of dry eye disease in a larger population.

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The Effect of Low-Dose Aspirin on Dry Eye Parameters and Ocular Surface Disease Index Questionnaire

Journal of Ocular Pharmacology and Therapeutics ◽

10.1089/jop.2017.0064 ◽

2018 ◽

Vol 34 (3) ◽

pp. 256-259 ◽

Cited By ~ 1

Author(s):

Alper Yazıcı ◽

Esin Sarı ◽

Erkan Ayhan ◽

Gözde Şahin ◽

Nesime Setge Tıskaoğlu ◽

...

Keyword(s):

Dry Eye ◽

Ocular Surface ◽

Low Dose ◽

Disease Index ◽

Ocular Surface Disease ◽

Ocular Surface Disease Index ◽

Dose Aspirin ◽

Low Dose Aspirin

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Efficacy of cyclic therapy with terpinen-4-ol in Demodex blepharitis

European Journal of Ophthalmology ◽

10.1177/1120672120919085 ◽

2020 ◽

pp. 112067212091908 ◽

Cited By ~ 2

Author(s):

Özlem Evren Kemer ◽

Emine Esra Karaca ◽

Dilay Özek

Keyword(s):

Ocular Surface ◽

Meibomian Gland ◽

Disease Index ◽

Ocular Surface Disease ◽

Schirmer Test ◽

Ocular Surface Disease Index ◽

Tea Tree ◽

Cyclic Treatment ◽

Pre Treatment ◽

Breakup Time

Purpose To describe the effectiveness of cyclic treatment with terpinen-4-ol, a tea tree oil component, on Demodex blepharitis. Methods The presence of Demodex was determined by eyelash rotation as proposed by Mastrota. Schirmer test, tear breakup time, ocular surface disease index, lid margin score, meibomian gland expressibility score, and Oxford grade were performed. Patients were advised to apply heat followed by terpinen-4-ol soaked wipes to eyelids twice a day for 2 weeks. At the end of 2 weeks, treatment was interrupted for 7–10 days. The same treatment was repeated once again. The patients were examined after the first and second cycle of treatment and after 1 year. Results There was a statistically significant improvement in Schirmer test (10.37 ± 4.73 and 13.13 ± 3.44 mm/5 min), tear breakup time (6.47 ± 3.31 and 7.6 ± 2.89 s), ocular surface disease index (47.94 ± 19.77 and 34.28 ± 13.40), lid margin score (3.2 ± 0.7 and 2.63 ± 0.71), meibomian gland expressibility scores (1.93 ± 0.64 and 1.4 ± 0.67), and Oxford grade (0.9 ± 0.8 and 0.5 ± 0.63) after the first cycle of treatment ( p < 0.05). The improvement in symptoms and tear function tests of the patients after the second cycle was significantly better than in pre-treatment levels. At 12-month follow-up, symptoms of two patients (93%) relapsed. Conclusion The administration of terpinen-4-ol to the eyelid margins in a cyclic manner in Demodex blepharitis is effective against adult and hatching Demodex and breaks the vicious cycle.

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