Evaluation of Ocular Surface Epithelial and Stromal Thicknesses in Psoriasis Using Anterior Segment Optical Coherence Tomography

Purpose: To evaluate the epithelial and stromal thicknesses of conjunctiva and cornea in psoriatic patients with anterior segment optical coherence tomography (AS-OCT),Methods: In this cross-sectional study, 61 patients with psoriasis and 42 age-matched, healthy individuals were enrolled. The epithelial and stromal thicknesses of both inferotemporal bulbar conjunctiva and central cornea were measured using AS-OCT. Results: Both the Tear break-up time and Schirmer-1 test values were significantly lower in the psoriasis group compared with the controls (p<0.05). The epithelial thickness of conjunctiva and cornea did not differ between psoriasis and control groups. (p>0.05) The central corneal stroma was significantly thicker in the psoriasis group (p=0.04). PASI was positively correlated with the thickness of central cornea stroma (r=0.442, p=0.006) in the nail psoriasis group. Conclusions: Psoriasis is not associated with altered epithelial thicknesses of the cornea and conjunctiva. It is accompanied by the stromal thickening of the cornea without conjunctival stromal involvement.

Changes of Corneal Thickness and Intraocular Pressure in Type II Diabetic Patients

Aims. The purpose of the present paper is to present the results of central corneal thickness & intraocular pressure measurements in diabetic patients with or without retinopathy, and compare the results with non-diabetic control patients. Methods. Total number was 152 patients were 152 eyes The study group was divided into 3 groups as following: 50 non diabetic (control). 50 diabetic type II with no diabetic retinopathy. 52 diabetic type II patient with diabetic retinopathy. Correlation analysis was performed to assess the association between glycosylated hemoglobin levels& Intraocular pressures and retinal changes among subgroups. Results. Demographic characteristics of study and control groups were similar (P>0.05). Mean CCT 553.62 with Std deviation (14.47) in control cases and 622.27 with Std deviation (507.09) in diabetic cases which is more than control however the distinction failed to reach applied math significance were (p value= > 0.05). additionally, CCT and diabetic retinopathy association was significant were CCT in diabetic patients with no retinal changes was 563.96 Std deviation (18.85) and in diabetic patients with retinopathy was 670.45 Std deviation (717.2) and P value = 0.004 (significant). There was significant correlation between increased corneal thickness and intraocular pressure were p-value = 0.002. Conclusions. We found that the central cornea of diabetic patients is thicker when compared with non-diabetic patients. Thicker central cornea associated with diabetes mellitus should be taken into consideration while obtaining accurate intraocular pressure measurements in diabetics.

Ocular Surface Temperature: Characterization in a Large Cohort of Healthy Human Eyes and Correlations to Systemic Cardiovascular Risk Factors

Purpose: To characterize ocular surface temperature (OST) in healthy eyes and its association with systemic risk factors of cardiovascular and ischemic heart disease. Methods: This prospective cross-sectional study included consenting subjects who were examined at the Institute for Medical Screening in Sheba Medical Center. A Therm-App™ thermal imaging camera (Opgal LTD, Israel) was used for OST acquisition, and the mean OST of the medial canthal, lateral canthal, and central cornea regions were measured. Room and body temperatures were also recorded. Past medical and ocular history as well as data from various clinical examinations performed at the same visit were obtained. Results: Thermographic images were obtained from 186 subjects, 150 of which were included in the final analysis. OST was significantly higher in the medial canthal, central cornea, and lateral canthal regions in people with a history of ischemic heart disease (p = 0.02, p = 0.02, and p = 0.03, respectively). There were no significant OST differences (ANOVA test) associated with the presence of hypertension, diabetes mellitus, or active smoking status. Conclusions: OST correlated positively with the presence of ischemic heart disease. This correlation, its pathophysiological base, and its clinical application warrants further investigation.

Prescription and Effect of Orthokeratology Lenses

Orthokeratology (OK) is the way to correct the myopia or astigmatism by flattening or the central cornea with specialty lenses. The range of correction is from -2.50 to -4.00 diopters after 10 days of fitting. The designs are constructed with flat base curve radius, steep reverse curve, flat alignment curve, and peripheral curve. This multi-curve design enabled the OK lenses to stay on the cornea stably and effectively. Recently, the application of OK is extending to hyperopia and presbyopia. In the future, the amount of correction and the application of OK will increase more and more.

Assessment of Central Corneal Thickness in Adults With Indications For Kidney Transplantation and Commenting On Some Related Factors

Objectives Central corneal thickness (CCT) is an important biological indicator of eyeball affecting intraocular pressure, which plays a vital role in glaucoma pathology. This study investigated the central corneal thickness in renal failure subjects with indications for kidney transplantation and commented on some related factors. Methods A cross-sectional descriptive study was conducted from January to June 2021 in Hanoi, Vietnam. Ninety-six adult patients with grade 3 and 4 renal failure indicated kidney transplantation had central corneal thickness measured. We investigated the mean value of central corneal thickness in patients with indications for kidney transplantation. The related factors were evaluated by multivariable linear regression. Results The mean thickness of the central cornea in the right eye was 529.3 ± 32 µm, and the left eye was 528.5 ± 32.1 µm, with no difference between the central corneal thickness in the two eyes. Corneal thickness has a positive correlation with IOP after dialysis and smoking habits, adjusted R2 = 0.2405, has a negative correlation with age, adjusted R2 = 0.2405, and with calcium concentration blood, adjusted R2 = 0.032. Conclusion The thickness of the central cornea in patients with renal failure with indications for kidney transplantation in both eyes is similar. Factors related to corneal thickness are age, smoking habits, intraocular pressure after dialysis, and blood calcium levels.

Case Report of Brown McLean Syndrome

Purpose: To report two rare cases of Brown McLean syndrome after cataract surgery in a patient with aphakia.Case summary: (Case 1) A 54-year-old woman with Marfan’s syndrome who had aphakia and peripheral corneal edema after left eye cataract surgery 4 years ago. The patient had an elevated lesion in the peripheral cornea without involving the central cornea, and had symptoms of pain, irritation and tearing. Specular microscopy showed normal endothelial cell density and morphology in the edematous cornea. The peripheral corneal edema improved after use of antibiotics, autoserum eyedrops and 5% NaCl eyedrops. (Case 2) A 61-year-old woman with aphakia in her left eye after bilateral cataract surgery 11 years ago, underwent surgery for a macular hole in both eyes. The patient developed peripheral corneal erosions and edema in the left eye 2 months after the surgery. Specular microscopy showed normal endothelial cell density and morphology. The peripheral corneal edema was static over the years while using 5% NaCl eyedrops and artificial tears, and did not progress to involve the central cornea.Conclusions: Brown McLean syndrome is a rare disease but the possibility should be considered if a patient with aphakia after cataract surgery has peripheral corneal edema for several years.

Corneal Densitometry in Bilateral Keratoconus Patients with Unilateral Corneal Vogt's Striae: A Contralateral Eye Study

BackgroundWe aimed to investigate corneal densitometry and correlations with corneal morphological parameters in bilateral keratoconus (KCN) patients with unilateral Vogt's striae.MethodsOne hundred and-twelve patients (224 eyes) with bilateral KCN and unilateral Vogt's striae were enrolled in this cross-sectional contralateral eye study. Corneal densitometry and morphological parameters were measured using Pentacam HR.ResultsOur study revealed that corneal densitometry values of the anterior 0–2 mm and 2–6 mm, intermediate 0–2 mm and 2–6 mm, posterior 2–6 mm, and total cornea 2–6 mm in eyes with Vogt’s striae were significantly higher than those in eyes without Vogt's striae (P < 0.05). The corneal densitometry values of the anterior 6–10 mm, posterior 0–2 mm, and total cornea 6–10 mm were significantly lower in eyes with Vogt's striae (P < 0.05). The corneal densitometry values in the anterior 0–2 mm and total cornea 2–6 mm were positively correlated with K1, K2, Km, Kmax, ACE, and PCE (P < 0.05) and negatively correlated with CCT and TCT in eyes with Vogt's striae (P < 0.05). K2, Km, and Kmax were significantly correlated with densitometry values of the anterior 0–2 mm and the intermediate 0–2 mm in eyes without Vogt’s striae (P < 0.05). Corneal densitometry values of the anterior and intermediate layers in the central cornea were higher in KCN eyes with Vogt's striae than in eyes without Vogt's striae, and the densitometry values of the anterior corneal stroma in the central region of the cornea were higher than those of the peripheral cornea in KCN eyes with and without Vogt's striae.ConclusionsIn conclusion, these results indicate that Vogt's striae mainly occur on the anterior and intermediate layers during the progression of KCN.

A Comparative Study between Air Bubble Tamponade Alone versus Air Bubble Tamponade with Internal Fluid Aspiration for Nonplanar Descemet’s Membrane Detachment after Phacoemulsification

Purpose. To compare the efficacy of air bubble tamponade alone versus air bubble tamponade with internal fluid aspiration for nonplanar Descemet’s membrane detachment after clear corneal incision phacoemulsification. Methods. This study is a prospective, intervention, comparative randomised clinical trial, conducted at a private eye centre, Ismailia, Egypt, from March 2019 to March 2020. It contained 30 eyes of 24 patients who had postphacoemulsification nonplanar Descemet’s membrane detachment involving the periphery and the central area of the cornea (>50% of the cornea) with corneal oedema. The patients were divided into two groups: group A: patients with nonplanar DMD affecting the central cornea treated by air bubble tamponade only and group B: patients with nonplanar DMD affecting the central cornea treated by air bubble tamponade augmented by internal fluid aspiration. Trial Registration: This trial was registered at www.pactr.org and the identification number for the registry is PACTR202006612296119. Results. During the 12-month study period, this study included 30 eyes (24 patients) out of 1356 phaco surgeries with postphacoemulsification nonplanar Descemet’s membrane detachment. Six patients had DMD in both eyes, eight patients had DMD in the right eye, and ten patients had DMD in the left eye. All patients have successful surgeries without complications. The calculated incidence rate for visually significant DMD was 2.2% per year. The mean ± SD time interval from cataract surgery to the primary intervention was 4.2 ± 1.1 days. Descemet’s membrane was attached in 56.25% of patients in group A (9 out of 16 eyes) and 92.6% of patients in group B (13 out of 14 eyes) with a minimum of one-month follow-up. Conclusion. Air descemetopexy combined with the internal fluid aspiration demonstrated to be more efficient than air descemetopexy only to treat Descemet’s membrane detachment following phacoemulsification. It should be tried before planning other major surgeries in patients with severe Descemet’s membrane detachment.

Multifocal Femto-PresbyLASIK in Pseudophakic Eyes

Background: Presbyopia treatment in pseudophakic patients with a monofocal IOL is challenging. This study investigates the refractive results of femto-PresbyLASIK and analyzes presbyopia treatment in pseudophakic eyes. Methods: 14 patients with 28 pseudophakic eyes were treated with femto-PresbyLASIK. The dominant eye was targeted at a distance and the non-dominant eye at −0.5 D. The presbyopic algorithm creates a steepness in the cornea center by using an excimer laser that leads to corneal multifocality. Results: 6 months after surgery a refraction of −0.11 ± 0.13 D (p = 0.001), an uncorrected distance visual acuity of 0.05 ± 1.0 logMAR (p < 0.001) and an uncorrected near visual acuity of 0.15 ± 0.89 logMAR (p = 0.001) were achieved in the dominant eye. For the non-dominant eye, the refraction was −0.28 ± 0.22 D (p = 0.002), the uncorrected distance of visual acuity was 0.1 ± 1.49 logMAR, and the uncorrected near visual acuity was 0.11 ± 0.80 logMAR (p < 0.001). Spherical aberrations (Z400) were reduced by 0.21–0.3 µm in 32% of eyes, and by 0.31–0.4 µm in 26% of eyes. Conclusion: By steepening the central cornea while maintaining spherical aberrations within acceptable limits, PresbyLASIK created a corneal multifocality that safely improved near vision in both eyes. Thus, femto-PresbyLASIK can be used to treat presbyopia in pseudophakic eyes without performing intraocular surgery.

Atopic triad (allergic rhinitis, eczema, and asthma) and eye rubbing as risk factors for keratoconus: a systematic review and meta-analysis

Keratoconus (KN), is an eye disorder, characterized by progressive thinning and protrusion of central cornea. A number of conditions such as such as allergy, asthma, eczema, and eye rubbing has been shown to be associated with the development of KN. However, there is a disagreement regarding some of risk factors and their strength so we conducted systematic review and meta-analysis to determine how strongly risk factors such as eye rubbing, and atopic triad associate with KN development and progression. We systematically searched the literature for related studies using specific keywords and key phrases. The studies were scrutinized based on inclusion and exclusion criteria. Finally, we extracted relevant qualitative and quantitate information from studies. For meta-analysis we used odds ratio (OR) and their 95% CI were used to draw forest plots. 35 studies were selected in final meta-analysis. Our meta-analysis yielded the combined effect of risk factors with OR of 2.20 and a 95% CI of 1.84–2.64. Furthermore, we found that eye rubbing-related studies had effect size of OR 2.09 with a 95% CI of 1.76–2.49 and a p value of 0.00001. For atopic triad (allergic rhinits, asthma and eczema) related studies, the meta-analysis yielded overall effect size of OR 2.34 with 95% CI of 2.06-2.66. Eye rubbing and atopic triad (allergic rhinitis, eczema, and asthma) are important risk factors for KC development with statistically strong association.