scholarly journals The pattern of central corneal thickness in patients attending a Tertiary Hospital in Dar-Es-Salaam

2021 ◽  
Vol 9 (2) ◽  
pp. 127-133
Author(s):  
Annamary Stanislaus ◽  
Ntsilane Susan Mosenene ◽  
Celina Mhina ◽  
John Stanslaus Kisimbi ◽  
Frederick Robert Burgess ◽  
...  
Keyword(s):  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Dar Es Salaam ◽  
Applanation Tonometry ◽  
P Value ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean

Background: Central Corneal Thickness (CCT) is an indicator of corneal health status as well as being an essential tool in assessment and management of corneal diseases. It is an important factor in the diagnosis and management of glaucoma as it affects the measurement of intraocular pressure. However, the pattern of central corneal thickness in our population is not known. Our study aimed to describe the CCT measurements and their variation with age and sex among patients attending the eye clinic at Muhimbili National Hospital (MNH), in Dar es Salaam, Tanzania. Methodology: A hospital-based descriptive, cross-sectional study used convenient sampling to recruit adult patients aged 18 years and above, presenting to the MNH between August 2016 and January 2017.Visual acuity assessment, Goldman applanation tonometry and CCT assessment using an ultrasound pachymeter were performed. Patients with previous intraocular surgery were excluded. Results: A total of 398 patients (208 males and 190 females) were recruited. The mean CCT was 526.64±38.30 µm; being 523.99±38.20 µm for males and 529.7±38.3 µm for females. 226 (56.85%) had CCT of less than 520 µm.There was no statistically significant difference in CCT between gender. The proportion of patients with thinner CCT increased with increasing age from 25.8% in those < 30 years to 75% in those aged 71years and above. The mean CCT decreased with increasing age with P-value<0.001. Conclusion: The average CCT in patients attending Muhimbili National Hospital is 526.64 µm (SD 38.30) which is generally thin, inversely proportion to age and similar that of other Africans and African-Americans. This finding has implications for the management of glaucoma in this population.

scholarly journals Usefulness of the Non-Contact Tonometry in Out-Patient Screening

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Satheesh Solomon T Selvin ◽  
Chris Elsa Samson Jacob ◽  
Thomas Kuriakose
Keyword(s):  
Central Corneal Thickness ◽  
Care Center ◽  
Corneal Thickness ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Applanation Tonometry ◽  
Cross Sectional ◽  
Significant Difference ◽  
Iop Measurement ◽  
The Mean

Purpose: Goldmann applanation tonometry (GAT) is considered the gold standard for Intraocular Pressure (IOP) measurement. It has the disadvantages of being a contact device, need for a slit-lamp, non-portability and need of a skilled examiner. Many hospitals are using a Non Contact Tonometry (NCT) as a screening device to save clinician time, however the usefulness is not proved in terms of reliability. This study was aimed to determine the usefulness of the Air-puff tonometer (TONOREF NIDEK II, NIDEK CO., LTD., JAPAN) over a GAT in a tertiary care center. Design: Cross-sectional Study Methods: This was a cross-sectional, non interventional observational study conducted on 224 eyes (right eye) from 224 patients. All patients underwent the IOP measurement with both methods and a central corneal thickness (CCT) measured. The data was analyzed using SPSS 20.0 software. Results: The mean age of the patients was 40.3±11.29 years. There was a statistically significant difference (p<0.001) between the mean NCT and GAT readings which persisted even after correction for central corneal thickness. The correlation between NCT and GAT using Pearson’s correlation coefficient was strong irrespective of the corrections for their corneal thickness (r = 0.751 and 0.718 for uncorrected and corrected values respectively). The correlation of the individual clinicians for the readings varied from moderate to strong. The ROC curve showed the best sensitivity and specificity to occur at around 13 to 14 mmHg. Conclusion: NCT seems to overestimate the IOP at low ranges as compared to the GAT and underestimate at higher ranges. The crossover of the values is seen between 12 to 13 mmHg.  The clinician should do an individualized analysis of his/her GAT measurements to the readings of the NCT machine at the clinic to obtain clinician specific nomogram. 

Comparison between different tonometers following intrastromal corneal ring segments implantation

2021 ◽  
pp. 112067212110425
Author(s):  
Mennatullah M Elfwwal ◽  
Mohamed K Elbasty ◽  
Mohamed F Khattab ◽  
Malak I ElShazly
Keyword(s):  
Intraocular Pressure ◽  
Femtosecond Laser ◽  
Central Corneal Thickness ◽  
Pressure Range ◽  
Corneal Thickness ◽  
Applanation Tonometry ◽  
Ocular Response Analyzer ◽  
P Value ◽  
Cross Sectional ◽  
Intrastromal Corneal Ring

Purpose: To compare different intraocular pressure (IOP) readings in corneas with intrastromal corneal ring segments (ICRS) taken by three different tonometers; Goldmann applanation tonometry (GAT), air puff tonometer, and ocular response analyzer (ORA) corneal-compensated IOP (ORA-IOPcc) and determine the relation of these measurements to different corneal parameters taken by Pentacam. Methods: An observational cross-sectional analytic study included patients who underwent ICRS keraring implantation at 3 months. In each eye, the two rings were placed using the femtosecond laser assisted technique 5.5 or 6 mm from the center. IOP was measured using three different tonometers; GAT, air puff tonometer, and ocular response analyzer (ORA) corneal-compensated IOP (ORA-IOPcc). Results: Fifty eyes of 30 patients (20 males and 10 females) aged 27.56 ± 6.38 years were included. IOP measurements by GAT, air puff tonometer, and ORA-IOPcc were 13.28 ± 2.13 mmHg, 10.47 ± 2.55 mmHg, and 13.19 ± 2.78 mmHg, respectively. Comparisons between air puff and each of GAT and ORA-IOPcc were statistically highly significant ( p-value <0.001). Conclusion: IOP measurements taken by air puff tonometer were significantly lower than those taken by GAT and ORA-IOPcc. These differences were not constant across the pressure range but increased as the pressure values determined using GAT and ORA increased. ORA-IOPcc and GAT showed similar readings. No correlation was found between any of the IOP readings taken by the three tonometers and the central corneal thickness.

scholarly journals Evaluation of the relation between myopia and central corneal thickness in patients admitted to vali-e-asr hospital in birjand, iran

2021 ◽  
pp. 138-143
Keyword(s):  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Epidemiologic Study ◽  
T Test ◽  
P Value ◽  
Study Results ◽  
Significant Difference ◽  
The Mean ◽  
And Gender ◽  
The Right

Introduction: Considering the increasing prevalence of myopia and the subsequent complications, and due to the dearth of studies on the correlation between myopia and gender with corneal thickness in Iran, this study aimed to determine this relationship in patients admitted to the ophthalmic clinic of Vali-e-Asr Hospital, Birjand, Iran. Methods: This descriptive-analytic epidemiologic study was conducted on 100 patients admitted to Vali-e-Asr ophthalmic clinic in Birjand, Iran, for one year since January 2017. According to the degree of myopia, the patients were divided into three groups of low (0-3 D), moderate (3-6 D), and high myopia (6≤D). Corneal thickness was measured using Orbscan and Pentacam. The data were analyzed in SPSS software (Version 19) through ANOVA and T-test to determine the possible relationship between myopia and central corneal thickness. A p-value equal to and less than (P≤0.05) was considered statistically significant. Results: Overall, 100 patients (49 males and 51 females) were enrolled in this study. Moderate myopia had the highest frequency in both eyes. The results of the T-test revealed that no significant difference was observed in the mean corneal thickness measured by Pentacam between the two genders (P=0.18 in the right eye and P=0.32 in the left eye). Based on the ANOVA findings, the mean corneal thickness measured by Pentacam was not significantly different among the myopia categories (P=0.05 in the right eye and P=0.51 in the left eye) Conclusions: The study results revealed that there was no significant relationship between myopia and gender with corneal thickness.

scholarly journals CENTRAL CORNEAL THICKNESS

2018 ◽  
Vol 25 (02) ◽  
pp. 252-260
Author(s):  
Muhammad Ijaz Ahmad ◽  
Manzoor Ahmad Qureshi ◽  
Muhammad Shakeel Ahmad ◽  
Yousef Homood Aldebasi
Keyword(s):  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Mean Value ◽  
T Test ◽  
Kingdom Of Saudi Arabia ◽  
Cross Sectional ◽  
Ultrasound Pachymetry ◽  
Significant Difference ◽  
The Mean ◽  
Ultrasonic Pachymetry

Objectives: To compare central corneal thickness in myopic and keratoconuseyes by ultrasound pachymetry and pentacam HR. Study Design: Cross sectional study.Setting: Qassim University, Optometry Clinics, Kingdom of Saudi Arabia. Period: October2016 to April 2017. Methodology: One hundred myopic and keratoconus participants. CentralCorneal Thickness (CCT) were measured with two techniques by ultrasonic pachymetry andpentacam HR in two groups. Group one consisted of 80 myopic participants and group two of 20Keratoconuspatients.Pentacamreadings were recorded first. CCT were compared and analyzedstatistically using unpaired t-test and histogram. Results: One hundred participants (100) wereincluded in which 80 participants were myopic and 20 with keratoconus. Both eyes (200) of allthe participants were examined. Age of the myopics ranged from 18-30 years (Mean=23.03).The mean value with ultrasound pachymetery was 555μm (SD±32.021) and with pentacam566μm (SD±37.367). We observed a tendency of overestimation of CCT measurements withpentacam. Statistically a significant difference of reading between two devices (P<0.001) wasfound. In keratoconus participants, the mean age was 23.7 years (21- 26). The mean CCT takenwith Pentacam HR and US Pachymetry was 476μm (SD± 16.980) and 465μm (SD± 35.868)respectively. The t-test showed no statistical difference between thepentacam HR andultrasound pachymetry (p>0.214). Conclusion: Measurements of central corneal thicknessdone with Ultrasound Pachymeter and Pentacam HR are closely related to each other andare interchangeable when used in normal refractive error cases. While in Keratonus patientsultrasound pachymetry is preferred because of its reliability.

scholarly journals Corneal Biomechanical Parameters and Central Corneal Thickness in Glaucoma Patients, Glaucoma Suspects, and a Healthy Population

2021 ◽  
Vol 10 (12) ◽  
pp. 2637
Author(s):  
Mª. Ángeles del Buey-Sayas ◽  
Elena Lanchares-Sancho ◽  
Pilar Campins-Falcó ◽  
María Dolores Pinazo-Durán ◽  
Cristina Peris-Martínez
Keyword(s):  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Mean Difference ◽  
The Other ◽  
Control Group ◽  
Healthy Population ◽  
Diagnostic Categories ◽  
Significant Difference ◽  
Biomechanical Parameters ◽  
The Mean

Purpose: To evaluate and compare corneal hysteresis (CH), corneal resistance factor (CRF), and central corneal thickness (CCT), measurements were taken between a healthy population (controls), patients diagnosed with glaucoma (DG), and glaucoma suspect patients due to ocular hypertension (OHT), family history of glaucoma (FHG), or glaucoma-like optic discs (GLD). Additionally, Goldmann-correlated intraocular pressure (IOPg) and corneal-compensated IOP (IOPcc) were compared between the different groups of patients. Methods: In this prospective analytical-observational study, a total of 1065 patients (one eye of each) were recruited to undergo Ocular Response Analyzer (ORA) testing, ultrasound pachymetry, and clinical examination. Corneal biomechanical parameters (CH, CRF), CCT, IOPg, and IOPcc were measured in the control group (n = 574) and the other groups: DG (n = 147), FHG (n = 78), GLD (n = 90), and OHT (n = 176). We performed a variance analysis (ANOVA) for all the dependent variables according to the different diagnostic categories with multiple comparisons to identify the differences between the diagnostic categories, deeming p < 0.05 as statistically significant. Results: The mean CH in the DG group (9.69 mmHg) was significantly lower compared to controls (10.75 mmHg; mean difference 1.05, p < 0.001), FHG (10.70 mmHg; mean difference 1.00, p < 0.05), GLD (10.63 mmHg; mean difference 0.93, p < 0.05) and OHT (10.54 mmHg; mean difference 0.84, p < 0.05). No glaucoma suspects (FHG, GLD, OHT groups) presented significant differences between themselves and the control group (p = 1.00). No statistically significant differences were found in the mean CRF between DG (11.18 mmHg) and the control group (10.75 mmHg; mean difference 0.42, p = 0.40). The FHG and OHT groups showed significantly higher mean CRF values (12.32 and 12.41 mmHg, respectively) than the DG group (11.18 mmHg), with mean differences of 1.13 (p < 0.05) and 1.22 (p < 0.001), respectively. No statistically significant differences were found in CCT in the analysis between DG (562 μ) and the other groups (control = 556 μ, FHG = 576 μ, GLD = 569 μ, OHT = 570 μ). The means of IOPg and IOPcc values were higher in the DG patient and suspect groups than in the control group, with statistically significant differences in all groups (p < 0.001). Conclusion: This study presents corneal biomechanical values (CH, CRF), CCT, IOPg, and IOPcc for diagnosed glaucoma patients, three suspected glaucoma groups, and a healthy population, using the ORA. Mean CH values were markedly lower in the DG group (diagnosed with glaucoma damage) compared to the other groups. No significant difference was found in CCT between the DG and control groups. Unexpectedly, CRF showed higher values in all groups than in the control group, but the difference was only statistically significant in the suspect groups (FHG, GLD, and OHT), not in the DG group.

scholarly journals Effect of Desonide 0.25% Ophthalmic Solution on Central Corneal Thickness and Intraocular Pressure of Patients with Allergic Conjunctivitis

1970 ◽  
Vol 12 (3) ◽  
pp. 156-158
Author(s):  
Ozlem Gurses Sahin
Keyword(s):  
Intraocular Pressure ◽  
Allergic Conjunctivitis ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Ophthalmic Solution ◽  
Applanation Tonometry ◽  
Goldmann Applanation Tonometry ◽  
Mean Values ◽  
Conjunctival Hyperaemia ◽  
Significant Difference

Aim: To evaluate whether a significant difference exists between the initial and final mean central corneal thickness that might affect Goldmann applanation tonometer recordings of patients with allergic conjunctivitis treated with desonide 0.25% ophthalmic solution, and to determine the effect of desonide on intraocular pressure by using adjusted intraocular pressure values.Methods: This double-blind randomised placebo-controlled trial enrolled 30 patients (60 eyes) with allergic conjunctivitis. Patients were randomly assigned to receive desonide to 1 eye (study eye) and preservative-free tear supplement (Tears Naturale Free®) to the other eye (control eye) 3 times daily for 3 weeks. Goldmann applanation tonometry and central corneal thickness of both eyes were recorded on the day of presentation and 3 weeks later.Results: Regression of itching, tearing, conjunctival hyperaemia, and tarsal conjunctival papillary reaction were noted in the study eyes after 3 weeks of treatment. The control eyes showed mild regression of pruritis, tearing, conjunctival hyperaemia, and tarsal conjunctival papillary reaction after 3 weeks. There was a significant difference between the initial and final mean central corneal thickness values for the study eyes (p = 0.003). There were no statistically significant differences between the initial and final mean values of Goldmann applanation tonometry and adjusted intraocular pressure for the study eyes. No statistically significant differences were found between the initial and final mean values of any of the parameters for the control eyes.Conclusion: Inflammation-induced increase in central corneal thickness of patients with allergic conjunctivitis treated with desonide showed statistically significant regression. However, this regression did not significantly affect Goldmann applanation tonometry and adjusted intraocular pressure values of the treated eyes.

scholarly journals Difference of Procalcitonin Levels in Gram-Positive and Gram-Negative Bacterial Sepsis Patients of Indonesia Army Central Hospital Gatot Soebroto in 2016

2022 ◽  
Vol 13 (1) ◽  
pp. 38
Author(s):  
Nindy Handayani ◽  
Soroy Lardo ◽  
Nunuk Nugrohowati
Keyword(s):  
Mean Difference ◽  
P Value ◽  
Central Hospital ◽  
Bacterial Sepsis ◽  
Gram Positive ◽  
Cross Sectional ◽  
Gram Negative ◽  
Gram Positive Bacteria ◽  
Significant Difference ◽  
The Mean

Introduction: Procalcitonin is known as a marker of infection and indicator for severity of infections. In sepsis, elevated procalcitonin levels in blood have a significant value that can be used as a sepsis biomarker. The aim of this study was to determine the mean difference of procalcitonin levels in Gram-positive and Gram-negative bacterial sepsis patients.Methods: This study used quantitative method with cross sectional approach. The sample of this study were bacterial sepsis patients of Indonesia Army Central Hospital Gatot Soebroto in 2016 which were divided into two groups: Gram-positive and Gram-negative bacterial sepsis patients with the number of each group was 30 samples. The data were analyzed by using independent t test.Results: This study showed that mean levels of procalcitonin in Gram-positive bacterial sepsis patients was 6.47 ng/ml and Gram-negative was 66.04 ng/ml. There was a significant difference between mean levels of procalcitonin in Gram-positive and Gram-negative bacterial sepsis patients of Indonesia Army Central Hospital Gatot Soebroto in 2016 with p value = 0.000 (p < 0.05).Conclusion: The mean difference of procalcitonin levels in Gram-negative bacterial sepsis patients were higher than Gram-positive bacterial sepsis patients, because Gram-negative bacteria have lipopolysaccharide which is a strong immunostimulator and increases TNF-α production higher than Gram-positive bacteria. 

scholarly journals Prevalence of Malnutrition Inflammation Complex Syndrome among Patients on Maintenance Haemodialysis at Muhimbili National Hospital in Tanzania: A Cross-Sectional Study

2020 ◽  
Author(s):  
Puneet Kishore Bramania ◽  
Paschal Ruggajo ◽  
Rimal Bramania ◽  
Muhiddin Mahmoud ◽  
Francis Fredrick Furia
Keyword(s):  
Total Cholesterol ◽  
Complete Blood Count ◽  
Early Recognition ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Reverse Epidemiology ◽  
Maintenance Haemodialysis

Abstract Background: Malnutrition, inflammation, and the combination thereof are predictors of poor outcomes in haemodialysis patients. Malnutrition Inflammation Complex Syndrome (MICS) is an accelerator of atherosclerosis and portends high mortality. Early recognition and treatment of MICS may help to improve the clinical outlook of such patients. This study investigated the prevalence of MICS and its associated factors among patients on maintenance haemodialysis at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. Methods: This was a prospective cross-sectional observational study done among 160 adult patients on maintenance haemodialysis at MNH in 2019. All participants provided written informed consent. Questionnaires were used to collect data and patients’ blood was tested for complete blood count (CBC), C-reactive protein (CRP), ferritin, transferrin, creatinine, urea, total cholesterol, and albumin. The Malnutrition Inflammation Score was used to assess MICS and its severity. Data analysis was done using the SPSS 20 software. Results: Of the 160 patients included in the study, 111 (69.4%) were male. The mean age (±SD) of patients and mean duration (±SD) on haemodialysis were 52.2(13.3) years and 22(18) months respectively. MICS was prevalent in 46.3% (mild in 24.4% and moderate to severe in 21.9%). Long-term haemodialysis (>4years) was an independent predictor of MICS [Adjusted Odds Ratio, AOR 5.04 (95% CI: 1.33–19.2), p<0.05]. Hypercholesterolaemia was a negative predictor of MICS [AOR 0.11 (95% CI: 0.01-0.97), p<0.05]. Patients with MICS had significantly lower mean body mass index, serum albumin, total cholesterol, transferrin, haemoglobin, and creatinine levels. The presence of MICS was higher in underweight patients and those who had inflammation. Haemodialysis adequacy did not correlate with MICS. Conclusion: Malnutrition Inflammation Complex Syndrome is relatively common among patients on haemodialysis in Dar es Salaam, Tanzania. Our study has shown a longer duration on haemodialysis to be associated with the occurrence of MICS; on the contrary, having hypercholesterolaemia seems to be protective against MICS consistent with the concept of reverse epidemiology. Patients on haemodialysis should be assessed regularly for malnutrition and inflammation and should receive appropriate and timely treatment to reduce the burden of associated morbidity, and mortality to these patients.

Significance of dynamic contour tonometry in evaluation of progression of glaucoma in patients with a history of laser refractive surgery

2019 ◽  
Vol 104 (2) ◽  
pp. 276-281 ◽  
Author(s):  
Sang Yeop Lee ◽  
Eun Woo Kim ◽  
Wungrak Choi ◽  
Chan Keum Park ◽  
Sangah Kim ◽  
...  
Keyword(s):  
Refractive Surgery ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Significant Risk ◽  
Applanation Tonometry ◽  
Dynamic Contour Tonometry ◽  
Significant Difference ◽  
History Of ◽  
The Mean ◽  
Laser Refractive Surgery

AimsIn this study, we tested the hypothesis that intraocular pressure (IOP) parameters measured by dynamic contour tonometry (DCT) would be more relevant in progression of glaucoma when there is a history of laser refractive surgery (LRS) than the IOP parameters measured by Goldmann applanation tonometry (GAT) or calculated by correction formulae.MethodsNinety-eight eyes in 54 patients with open-angle glaucoma and a history of LRS were included in this retrospective study. IOP was measured by both GAT and DCT during follow-up. Baseline, mean, and peak IOP, IOP fluctuation, and IOP reduction were measured by each tonometry method. Corrected IOP parameters using central corneal thickness and mean keratometry values were also analysed. Clustered logistic regression was used to identify variables correlated with progression of glaucoma. Areas under the curve (AUCs) for correlated variables were also compared.ResultsThe mean DCT value (OR 1.36, p=0.024), peak DCT value (OR 1.19, p=0.02) and pattern SD (OR 1.10, p=0.016) were significant risk factors for progression. There was a significant difference in the predictive ability of the mean DCT and GAT values (AUC 0.63 and 0.514, respectively; p=0.01) and of the peak DCT and GAT values (0.646 and 0.503, respectively, p=0.009). The AUCs for corrected IOP did not exceed those of DCT.ConclusionsIOP measurements were more associated with progression of glaucoma when measurements were obtained by DCT than by GAT or correction formulae in eyes with a history of LRS.

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