Epidemiology of Corneal Neovascularization and Its Impact on Visual Acuity and Sensitivity: A 14-Year Retrospective Study

Purpose: To quantify the severity and location of corneal neovascularization (cNV) and its impact on the visual acuity and corneal sensitivity in a cohort of the patients referred to a specialist cornea clinic and also to describe the etiology of cNV in the cohort.Methods: We retrospectively evaluated the charts of 13,493 subjects referred to the San Raffaele Cornea Unit between January 2004 and December 2018 to search for cNV diagnosis. The corneal neovascularization severity was measured in the quadrants (range: 1–4) and location was defined as superficial, deep, or both. Best spectacle corrected visual acuity (BSCVA) was measured in logMar. We used the multiple regression analysis to identify the independent predictors of logMAR, after adjusting for age, gender, keratoconus, herpes keratitis, penetrating keratoplasty, trauma, and cataract surgery.Results: Corneal neovascularization was diagnosed in 10.4% of the patients analyzed. The most prevalent etiology of cNV in our population was non-infectious corneal dystrophies/degenerations followed by herpes simplex virus infection. cNV affected OD, OS, or both eyes in 35.6, 40.2, and 24.2 of cases, respectively. Mean BSCVA (SD) was 0.59 (0.76), 0.74 (0.94), and 1.24 (1.08) in cNV one, two, and three or four of the quadrant groups. Superficial, deep, or mixed cNV occurred in 1,029, 348, and 205 eyes. Severe cNV (three or four of the quadrants) was a significant predictor of low visual acuity (p < 0.001) and reduced corneal sensitivity (p < 0.05). cNV location and its severity were associated (p < 0.05). In addition, corneal anesthesia was associated with lower BSCVA (p < 0.001).Conclusion: Severe and deep cNV are associated with the reduced visual acuity and corneal sensitivity. Our data strongly support the relevance of appropriate follow-up as cNV is a major risk factor for graft rejection.

Cytomegalovirus Keratitis in Acute Myeloblastic Leukemia Report of a Case

Objectives: Here, we report a rare case of acute myeloblastic leukemia (AML) developed a bilateral dendritic epithelial keratitis without retinitisCase presentation: A 58-year-old woman presented to the emergency department of Baqiyatallah Hospital in Tehran due to dyspnea and dry cough along with weakness, lethargy and weight loss resulting from acute myeloblastic leukemia. She was treated for systemic problem. In a while after developing pain, burning, redness of the eyes and ocular mucopurulent discharge, ocular symptoms began. The patient was initially treated with oral acyclovir with a possible diagnosis of Herpes simplex virus Keratitis. Polymerase Chain Reaction (PCR) was performed on ocular discharge specimens collected by soft-tipped applicators reported as CMV. Then, acyclovir was discontinued and bilateral CMV keratitis treated with IV Ganciclovir and her epithelial lesions gradually disappeared. Conclusions: CMV is capable of generating corneal epithelial engagement without corneal endothelium and retina involvement and demonstrated that CMV keratitis can be a rare cause but an emergent problem of acute myeloblastic leukemia (AML). Therefore, in any cases with bilateral corneal herpes keratitis, the patient should be evaluated for immune system deficiency.

Early Stage Diagnosis of Eye Herpes (NAGIN) by Machine Learning and Image Processing Technique

Eyes are very important parts of the body. Automatic eye detection is must to diagnose various eye disease including Herpes (Nagin) in early stages. Type 1 Herpes Simplex Virus (HSV) may damaging the eye and causing permanent eyesight problems. Herpes keratitis, commonly known as eye herpes, is an inflammation of the cornea, the clear dome that covers the front part of the eye. The proposed method potentially reduce workload on eye doctors and increase the efficiency of limited healthcare resources.

Prospective study of the sensitivity of the Wood’s lamp for common eye abnormalities

ObjectiveThe Wood’s lamp, a handheld instrument that uses long-wave ultraviolet (UV) light with magnification of 2–3 times, is commonly used by non-ophthalmologists for examining patients with eye complaints. The goal of current research was to determine the sensitivity and specificity of the Wood’s lamp for common eye abnormalities.Study designWe examined a convenience sample of patients, 18 years of age and older, who presented for eye complaints to an urgent clinic of a large ophthalmology practice. This prospective observational trial was performed from December 2016 until July 2017. An ophthalmologist examined the patient’s eyes with a Wood’s lamp, followed by examination of the eyes using a slit lamp. The Wood’s lamp was compared with the slit lamp, which served as the gold standard.ResultsThere were 73 patients recruited. The mean age of study subjects (29 female and 44 male) was 49 years. The overall sensitivity of the Wood’s lamp was 52% (38/73; 95% CI 40% to 64%). Based on the principal final diagnosis made with the slit lamp, the Wood’s lamp only detected 9 of 16 corneal abrasions, 5 of 10 corneal ulcers, 5 of 9 corneal foreign bodies, 0 of 4 cases of non-herpetic keratitis, 1 of 2 cases of herpes keratitis, 1 of 5 rust rings and 18 of 28 other diagnoses.Conclusions and relevanceExamination using the Wood’s lamp fails to detect many common eye abnormalities. Our findings support the need for a slit lamp examination of patients with eye complaints whenever possible.