scholarly journals FEATURES OF THE DYNAMICS OF THE I DEGREE OF SEVERETY BACTERIAL KERATITES IN DIABETIC PATIENTS

2021 ◽  
pp. 15-20
Author(s):  
O. V. Zavoloka
Keyword(s):  
Corneal Ulcer ◽  
Anterior Segment ◽  
Corneal Edema ◽  
Control Group ◽  
Sensitivity Threshold ◽  
Diabetic Patients ◽  
Bacterial Keratitis ◽  
Corneal Sensitivity ◽  
Results Of Treatment ◽  
Degree Of Severity

Summary. Diabetes mellitus (DM) is a risk factor for severe bacterial keratitis, which often leads to complications. The aim was to identify the features of the dynamics of the I degree of severity bacterial keratitis in diabetic patients. Materials and methods. The results of treatment of 15 patients with type 1 DM and bacterial keratitis of the I degree of severity (main group) and 20 patients with bacterial keratitis of the I degree of severity without DM (control group) were analyzed. The severity of bacterial keratitis was determined according to our proposed scheme with a total score of ≤ 14. All patients were treated with instillations of ofloxacin, antiseptics, antioxidants, reparents, artificial tears, mydriatics, systemic anti-inflammatory therapy. In addition to standard, ophthalmic examination methods included bacteriological examination, fluorescein test, OCT of the anterior segment of the eye, non-contact corneal esthesiometry. Results and discussion. In diabetic patients with bacterial keratitis of the I degree of severity the degree of inflammatory reaction in the anterior chamber of the eye and the average threshold of corneal sensitivity at all airflow temperatures at the first visit exceeded the indicators of controls (p<0.05). The degree of the average corneal sensitivity threshold decrease throughout the observation, the degree of pericorneal injection, the size of the corneal ulcer, the depth of corneal infiltration from the 3rd day of observation, the depth of corneal ulcer and corneal edema from the 7th day exceeded indicators of controls (p<0.05). Conclusions. Diabetic patients have features of the dynamics of the I degree of severity bacterial keratitis, which lead to prolongation of the disease and worsening of its consequences.

Corneal Sensitivity in Bacterial Keratitis Patients with or without Diabetes Mellitus

2021 ◽  
pp. 67-72
Author(s):  
O. V. Zavoloka
Keyword(s):  
Diabetes Mellitus ◽  
Anterior Segment ◽  
Control Group ◽  
Sensitivity Threshold ◽  
Diabetic Patients ◽  
Bacterial Keratitis ◽  
Corneal Sensitivity ◽  
Fellow Eye ◽  
Nondiabetic Control

The aim. To identify the features of corneal sensitivity of the sick and the fellow eye in bacterial keratitis patients with or without diabetes mellitus. Materials and methods. The analysis was performed on the basis of survey data of 62 type 1 diabetes patients with bacterial keratitis and 43 nondiabetic control patients with bacterial keratitis. The examination was performed at the first visit. In addition to standard ophthalmic examination, the patients underwent fluorescein test, OCT of the anterior segment of the eye, non-contact corneal aesthesiometry. Results and discussion. The average corneal sensitivity threshold in diabetic patients with bacterial keratitis at the first visit at all air flow temperatures exceeded the corresponding indicators in nondiabetic patients of the control group: by 33.5% at an air temperature of 5 °C, by 30.6% at 15 °C, by 28.8% at 20 °C, by 27% at 30 °C, and by 26.1% at 40 °C (p<0.05). The average corneal sensitivity threshold at a temperature of 20 °C in the fellow eye in diabetic patients with bacterial keratitis exceeded that in nondiabetic patients with bacterial keratitis of the control group by 32.9 % (p<0.05). Conclusions. Corneal sensitivity of the sick and fellow eye in patients with bacterial keratitis depends on the presence of diabetes mellitus. The average threshold of corneal sensitivity of the sick and fellow eye in diabetic patients with bacterial keratitis at the first visit exceeds the corresponding values in nondiabetic patients with bacterial keratitis. Keywords: diabetes mellitus, bacterial keratitis, corneal sensitivity.

scholarly journals FEATURES OF THE DYNAMICS OF THE II DEGREE OF SEVERETY BACTERIAL KERATITES IN DIABETIC PATIENTS AT DIFFERENT STAGES OF DIABETIC POLYNEYROPATHY

2021 ◽  
pp. 5-10
Author(s):  
O. V. Zavoloka
Keyword(s):  
Clinical Symptoms ◽  
Healing Process ◽  
Anterior Segment ◽  
Diabetic Polyneuropathy ◽  
Diabetic Patients ◽  
Bacterial Keratitis ◽  
Results Of Treatment ◽  
Patients With Diabetes ◽  
Type 1 Dm ◽  
Degree Of Severity

Summary. The neuro-trophic condition of the cornea affects the healing process of corneal defects in patients with keratitis, causing the severity, duration and consequences of the disease. The aim was to identify the features of the dynamics of the II degree of severity bacterial keratitis in patients with diabetes mellitus (DM) at different stages of the severity of diabetic polyneuropathy (DPN). Materials and methods. The results of treatment of 19 patients with bacterial keratitis of the II degree of severity and type 1 DM were analyzed. II degree of severity of bacterial keratitis was determined according to our proposed scheme at a sum of points 15-21. All patients were treated with instillations of the antibiotic ofloxacin, antiseptics, antioxidants, reparants, artificial tears, mydriatics, systemic anti-inflammatory therapy. Patients were divided into two groups according to the severity of DPN: with symptomatic (first group) and stage with impaired DPN (second group). In addition to standard, ophthalmic examination methods included bacteriological examination, fluorescein test, OCT of the anterior segment of the eye, non-contact corneal esthesiometry. Results and discussion. In most patients of the second group, corneal sensitivity and depth of edema of the corneal tissues surrounding the ulcer, the size of the ulcer defect and the depth of corneal infiltration, the degree of pericorneal injection, the depth of the corneal ulcer defect from the 1st, 7th, 10th and 14th days of observation, respectively, were higher than in patients of the first group (p<0,05). The consequence of the disease in patients of the second group was more severe than in patients of the first group. Conclusions. In patients with the stage of impaired DPN, bacterial keratitis is characterized by a longer duration and severity of clinical symptoms, as well as worse consequences of the disease than in patients with symptomatic DPN.

scholarly journals CLINICAL PECULIARITIES OF BACTERIAL KERATITIS IN TYPE 1 DIABETIC PATIENTS

2021 ◽  
Vol 1 (7(71)) ◽  
pp. 25-29
Author(s):  
Z. Olesia
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Control Group ◽  
Diabetic Patients ◽  
Corneal Tissue ◽  
Bacterial Keratitis ◽  
Corneal Sensitivity ◽  
Treatment Research

The purpose was to define the clinical peculiarities of bacterial keratitis in patients with type 1 diabetes mellitus (DM1) at visit 1.  Methods. We retrospectively reviewed the results of 62 DM1 patients (62 eyes) with bacterial keratitis and 43 nondiabetic patients (43 eyes) with bacterial keratitis of the control group who were referred for visit 1 (before administering the treatment). Research methods were as follows: visual acuity, tonometry, slit-lamp biomicroscopy of anterior and posterior eye segments, bacteriological studies, fluorescein dye test, anterior eye OCT and non-contact corneal esthesiometry.  Results. Compared to nondiabetic, DM1 patients with bacterial keratitis showed higher degree of inflammatory reaction in the anterior chamber of the eye at visit 1 (p<0.05) as well as 28.8% lower mean corneal sensitivity threshold (p<0.05). At visit 1, the degree of decreasing of corneal sensitivity in DM1 patients with bacterial keratitis was higher than in control group (p<0.05). Localization of bacterial keratitis, the degree of pericorneal injection, corneal ulcer defect size and depth, corneal infiltration as well as edema of the corneal tissue surrounding the ulcer did not depend on the presence of diabetes mellitus (р>0,05) at visit 1. Conclusions. There are clinical peculiarities of bacterial keratitis in patients with type 1 diabetes mellitus at visit 1.  

Clinical Peculiarities of Bacterial Keratitis in Type 1 Diabetic Patients 

2021 ◽  
Author(s):  
Olesia Zavoloka
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Control Group ◽  
Diabetic Patients ◽  
Corneal Tissue ◽  
Bacterial Keratitis ◽  
Corneal Sensitivity ◽  
Treatment Research

Abstract The purpose was to define the clinical peculiarities of bacterial keratitis in patients with type 1 diabetes mellitus (DM1) at visit 1. Methods. We retrospectively reviewed the results of 62 DM1 patients (62 eyes) with bacterial keratitis and 43 nondiabetic patients (43 eyes) with bacterial keratitis of the control group who were referred for visit 1 (before administering the treatment). Research methods were as follows: visual acuity, tonometry, slit-lamp biomicroscopy of anterior and posterior eye segments, bacteriological studies, fluorescein dye test, anterior eye OCT and non-contact corneal esthesiometry. Results. Compared to nondiabetic, DM1 patients with bacterial keratitis showed higher degree of inflammatory reaction in the anterior chamber of the eye at visit 1 (p<0.05) as well as 28.8% lower mean corneal sensitivity threshold (p<0.05). At visit 1, the degree of decreasing of corneal sensitivity in DM1 patients with bacterial keratitis was higher than in control group (p<0.05). Localization of bacterial keratitis, the degree of pericorneal injection, corneal ulcer defect size and depth, corneal infiltration as well as edema of the corneal tissue surrounding the ulcer did not depend on the presence of diabetes mellitus (р>0,05) at visit 1.Conclusions. There are clinical peculiarities of bacterial keratitis in patients with type 1 diabetes mellitus at visit 1.

An in vivo confocal microscopy study of corneal changes in pseudoexfoliation syndrome

2018 ◽  
Vol 29 (5) ◽  
pp. 555-560 ◽  
Author(s):  
Luca Terracciano ◽  
Michela Cennamo ◽  
Eleonora Favuzza ◽  
Litasova Julia ◽  
Orsola Caporossi ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Anterior Segment ◽  
Senile Cataract ◽  
Nerve Plexus ◽  
Pseudoexfoliation Syndrome ◽  
Control Group ◽  
In Vivo Confocal Microscopy ◽  
Corneal Sensitivity ◽  
Corneal Layer

Purpose: To evaluate, through the in vivo confocal microscopy, the pathological changes of each corneal layer in eyes affected by pseudoexfoliation syndrome. Methods: We studied 40 eyes of 40 patients with diagnosis of unilateral senile cataract associated with pseudoexfoliation syndrome and 40 eyes of 40 control subjects with senile cataract without pseudoexfoliation syndrome. All patients underwent a complete ophthalmic examination including best corrected visual acuity, slit-lamp examination, corneal sensitivity measurement using a Cochet-Bonnet nylon thread esthesiometer, and anterior segment optical coherence tomography (Visante OCT, Carl Zeiss Meditec AG, Germany); in vivo confocal microscopy of corneal sections (endothelium, stroma, sub-basal nerve plexus, and superficial and basal epithelium) was performed with the ConfoScan 4.0 (Nidek, Japan). Results: In pseudoexfoliation syndrome group, the mean corneal sensitivity was 44.1 ± 1.3 mm and in the control group was 55.6 ± 4.7 mm. The corneas of the eyes with pseudoexfoliation syndrome were significantly less sensitive than those of control group eyes (p < 0.001). Pseudoexfoliation syndrome eyes had a lower nerve density and less nerve beadings and a higher degree of tortuosity in sub-basal plexus compared to the control group. The cell density of epithelial and endothelial layers was significantly lower in pseudoexfoliation syndrome eyes than controls. In 80% of pseudoexfoliation syndrome eyes, we found activated keratocytes and inflammatory cells in the anterior stroma. Conclusion: Our study demonstrates the morpho-structural corneal alterations in eyes affected by pseudoexfoliation syndrome, using corneal in vivo confocal microscopy as a non-invasive and high-reproducible technique to evaluate pathophysiology of each corneal layer; the sub-basal nerve plexus alterations are correlated with the lower corneal sensitivity.

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 Complex Approach to the Bacterial Corneal Ulcers Treatment

2020 ◽  
Vol 17 (4) ◽  
pp. 796-803
Author(s):  
E. V. Yani ◽  
V. A. Golikova
Keyword(s):  
Corneal Ulcer ◽  
Treatment Time ◽  
Functional Results ◽  
Control Group ◽  
Ophthalmological Examination ◽  
Entire Treatment Period ◽  
Corneal Ulcers ◽  
Results Of Treatment ◽  
Group 2 ◽  
Corticosteroid Drugs

Purpose: Objective: to evaluate the effect of treatment of bacterial corneal ulcers of varying severity using a combination of antibacterial and corticosteroid drugs.Material and methods. 63 patients with bacterial corneal ulcers of varying severity were treated. The study used a quantitative scale to assess the severity of corneal ulcers. Group 1 — patients with mild corneal ulcers (18 patients); Group 2 — patients with moderate corneal ulcer (17 patients); group 3 — severe corneal ulcer (11 patients); control group — patients with mild corneal ulcer (17 patients). Patients of groups 1, 2 and 3, in addition to the conventional treatment, received Dexamethasone 0.1 % — 0.3 ml in parabulbar injections from the first day of treatment for the entire treatment period. Kr). In addition to the standard ophthalmological examination, all patients were assessed for the ulcer defect using measurements on OCT-POG accessing the parameters of the diameter of the corneal ulcer (d) and the depth coefficient (Kr).Results. The patients in the 1st group received antibacterial treatment and the addition of parabulbar injections of a corticosteroid drug (Dexamethasone). It allowed to decrease the treatment time and the period of hospitalization, promoted faster epithelialization and a reduction in the depth of the ulcer, less coarse scarring of the cornea, allowed to increase the functional results of treatment. The proposed treatment for severe corneal ulcers in 55 % of cases allows to use only conservative treatment. It is possible to obtain moderate opacity with vascularization in 60 % cases, which contributes to the preservation and/or improvement of visual acuity, despite the severity of the inflammatory process without the use of surgical intervention.Conclusion. The proposed treatment, involving the use of the corticosteroid drug Dexamethasone 0.1 % in parabulbar injections of 0.3 ml once daily for a bacterial corneal ulcer of mild severity for, average, 15.0 ± 1.4 days, a bacterial corneal ulcer of moderate severity — 18.0 ± 1.3 days, severe bacterial corneal ulcer — 25.0 ± 4.4 days, seems to be effective if the proposed parameters of the diameter and depth of the corneal ulcer are controlled. 

Our Experience in the Treatment of Bacterial Keratitis

2021 ◽  
pp. 27-33
Author(s):  
V. M. Sakovych ◽  
O. V. Aleksieieva
Keyword(s):  
Hyperbaric Oxygenation ◽  
Corneal Edema ◽  
Main Group ◽  
Control Group ◽  
Comprehensive Treatment ◽  
Clinical Parameters ◽  
Bacterial Keratitis ◽  
Bacterial Strains ◽  
Inflammatory Infiltration ◽  
And Control

Introduction. In recent years, the emergence of bacterial strains resistant to antibiotics used in medical practice significantly reduced the effectiveness of chemoprophylaxis and therapy. Following data indicates the need to search for new antibacterial drugs and ways of treating patients with bacterial keratitis. The aim of research is improvement of clinical parameters in patients with bacterial keratitis using hyperbaric oxygenation. Materials and Methods. We observed 68 patients (68 eyes) with bacterial keratitis aged 18 to 75 years. There were 36 men and 32 women. The patients were divided into 2 groups: main group (38 patients) and control group (30 patients). All the patients received antibiotic therapy, mydriatics, tissue-based products, vitamins. In addition, patients of the main group underwent hyperbaric oxygenation. The severity of the inflammatory response was evaluated using objective indicators: the presence and type of discharge into the conjunctival cavity, the severity of the mixed injection, corneal edema, the degree of inflammatory infiltration of the surface layers of the cornea. Results. The changes of clinical parameters in patients of the main and control groups were evaluated and scored (conjunctival discharge in the cavity, the severity of the mixed injection, corneal edema and inflammatory infiltration). The therapy contributed to faster disappearance of discharge into the conjunctival cavity and mixed injection, regression of edema, resorption of infiltrates (p <0.001). Conclusions. Hyperbaric oxygenation in comprehensive treatment of patients with bacterial keratitis is highly efficient, provides stable clinical and functional results in the main group compared with the control group. Keywords: bacterial keratitis, hyperbaric oxygenation, comprehensive treatment, clinical parameters in points.

Corneal optical density in Fuchs endothelial dystrophy determined by anterior segment optical coherence tomography

2020 ◽  
pp. 112067212094479
Author(s):  
Christian M Wertheimer ◽  
Carolin Elhardt ◽  
Andreas Wartak ◽  
Nikolaus Luft ◽  
Stefan Kassumeh ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Optical Density ◽  
Anterior Segment ◽  
Corneal Edema ◽  
Diagnostic Tools ◽  
Control Group ◽  
Distilled Water ◽  
Optical Coherence ◽  
Corneal Surgery ◽  
Disease Characteristics

Purpose: In this study, we propose a method to grade corneal stromal opacity using optical density measurements by anterior segment optical coherence tomography (AS-OCT) and validate the approach in Fuchs endothelial corneal dystrophy (FECD). Methods: A retrospective analysis of human corneal OCT scans was performed on 48 eyes of 32 patients with FECD and 33 control eyes of 21 patients using the Carl Zeiss Cirrus HD-OCT 5000. In addition, corneal edema in fresh rabbit cadaver eyes was artificially induced by distilled water and imaged with the Thorlabs TELESTO-II spectral domain OCT at different time points during saturation. The increase of opacity due to corneal edema was proposed to directly correlate with enhanced reflectivity sites in the OCT images, corresponding to higher optical density. The increase was determined as the image area above a statistically established gray-scale value using ImageJ and correlated with other disease characteristics. Results: Optical densities in human corneas showed significant differences between FECD patients and the control group ( p = 0.002). The increased optical densities determined in FECD corneas correlated well with other disease characteristics such as corneal pachymetry or visual acuity. Likewise, rabbit corneas showed a time dependent increase in thickness and in corneal optical density during soaking in distilled water. Conclusion: This study presents corneal optical density by AS-OCT as an objective value for corneal changes in FECD. Complementing other diagnostic tools in FECD the assessment of corneal optical density may identify progression of FECD, gauge novel therapeutic strategies and support risk and benefit analyses for corneal surgery.

scholarly journals The Effects of Diabetic Duration on Lacrimal Functional Unit in Patients with Type II Diabetes

2019 ◽  
Vol 2019 ◽  
pp. 1-11
Author(s):  
Xiaoyu Zeng ◽  
Ying Lv ◽  
Zhongxiu Gu ◽  
Zhe Jia ◽  
Chen Zhang ◽  
...  
Keyword(s):  
Type Ii Diabetes ◽  
Functional Unit ◽  
Control Group ◽  
Diabetic Patients ◽  
Blink Rate ◽  
Type Ii ◽  
Corneal Sensitivity ◽  
Cross Sectional ◽  
Speed Score ◽  
Schirmer I Test

Purpose. To observe ocular surface changes in Type II diabetic patients with different disease durations and to understand the correlations between clinical parameters and diabetic durations. Methods. In this cross-sectional, prospective study, 51 healthy controls and 91 patients with Type II diabetes were enrolled. The diabetics were divided into 3 subgroups according to the disease duration, including duration <10 y group, 10 to 20 y group, and ≥21 y group. All subjects underwent clinical ocular examinations, including lipid layer thickness (LLT), blinking rate, tear meniscus height (TMH), noninvasive tear film break-up time (NI-BUT), meibography, superficial punctate keratopathy (SPK) scoring, corneal sensitivity, and Schirmer I test. They were also evaluated using the standard patient evaluation of eye dryness (SPEED) questionnaire. Results. SPEED score, meiboscore, SPK score, LLT, Schirmer I test, and corneal sensitivity differed significantly between the diabetic and healthy control groups. Further, SPEED score, Schirmer I test, corneal sensitivity, meiboscore, and blink rate significantly differed among the 3 diabetic subgroups and the control group. In diabetics, the SPEED score correlated with the SPK score, blink rate, TMH, and LLT; NI-BUT with TMH, LLT, and blink rate; TMH with the SPK score; Schirmer I test with the SPK score; and corneal sensitivity with the meiboscore. More importantly, the Schirmer I test, corneal sensitivity, and SPEED score negatively correlated with diabetic duration. Conclusion. Diabetic duration is an important factor that affects functions of the lacrimal functional unit in patients with Type II diabetes. The trends of changes in the ocular parameters vary along the course of diabetes.

Sign in / Sign up

Export Citation Format

Share Document