|Year : 2017 | Volume
| Issue : 4 | Page : 326-329
R. K. Eye Care Centre, Rasipuram, Namakkal Dist, Tamil Nadu, India
|Date of Web Publication||25-Apr-2018|
Dr R Vasumathi
18/A, G V R Mill Street, Rasipuram, Namakkal Dist, Tamil Nadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Vasumathi R. Journal scan. TNOA J Ophthalmic Sci Res 2017;55:326-9
Mittal V, Jain R, Mittal R, Vashist U, Narang P. Successful management of severe unilateral chemical burns in children using simple limbal epithelial transplantation (SLET). Br J Ophthalmol 2016;100:1102-8.
Aim: The aim of this study is to study the outcomes of simple limbal epithelial transplantation (SLET) for unilateral total limbal stem cell deficiency (LSCD) secondary to severe ocular surface burns in children. Methods: Retrospective interventional case series was performed at a private referral tertiary care center. Children <15 years of age who underwent autologous SLET for total LSCD and had a minimum follow-up of 6 months were included in the study. Demographic and clinical data were recorded in a predesigned form. All patients underwent SLET with a standardized technique. The outcome was defined as a complete success (completely epithelialized, avascular corneal surface), partial success (focal recurrence of symblepharon not involving the visual axis) and failure (unstable ocular surface with persistent epithelial defects/symblepharon recurrence involving the visual axis). Results: The mean age was 5.75 years (range 2–12). The male-to-female ratio was 3:1. All eyes (four) presented in the acute phase, had grade 6 chemical injury (Dua classification) and underwent amniotic membrane transplantation at presentation. The mean interval between initial injury and SLET was 6 months (range 4.5–8). The outcome was complete success and partial success in one-fourth and three-fourths of cases, respectively. The overall follow-up was 12–60 months. Pre-SLET visual acuities were hand motions (one eye) and perception of light (three eyes). Post-SLET visual acuities were counting fingers close to face (one eye), 6/36 (two eyes), and 6/18 (one eye) at final follow-up. Cases with partial success underwent repeat SLET with conjunctival autograft, after which the outcome was complete success in all cases at varied follow-up intervals (13–36 months). Conclusions: SLET appears to be a promising technique for the treatment of LSCD secondary to ocular surface burns in children.
Zhong J, Deng Y, Tian B, Wang B, Sun Y, Huang H, et al. Hyaluronate acid-dependent protection and enhanced corneal wound healing against oxidative damage in corneal epithelial cells. J Ophthalmol 2016;2016:6538051.
Purpose: The purpose of this study is to evaluate the effects and mechanism of exogenous hyaluronate (HA) in promoting corneal wound healing. Methods: Human corneal epithelial cells (HCECs) were incubated with different concentrations of HA to evaluate their efficiency in promoting cell migration and their modulation of repair factors. After inducing hyperosmolar conditions, the cell morphologies, cell apoptosis, and expression levels of tumor necrosis factor-α (TNF-α) and matrix metallopeptidase 9 (MMP-9) were detected to assess the protective role of HA. Corneal epithelium-injured rat models were established to test the therapeutic effects of 0.3% HA. Then, the wound healing rates, the RNA expression levels of inflammatory cytokines, and repair factors were examined. Results: HCECs in the 0.03% and 0.3% HA groups showed fewer morphological alterations and lower rates of cell apoptosis following preincubation with HA under hyperosmolar conditions, as well as the expression levels of MMP-9 and TNF-α. In the rat model, the areas of fluorescein staining in the corneas of 0.3% HA group were significantly smaller than the control group. The expression levels of interleukin-1 β and MMP-9 were decreased, while CD44 and FN were increased in the 0.3% HA group. Conclusion: HA-enhanced corneal epithelial cell wound healing by promoting cell migration, upregulating repair responses, and suppressing inflammatory responses.
Zeng J, Liu H, Liu X, Ding C. The relationship between Helicobacter pylori on and open-angle glaucoma: A Meta-analysis. Invest Ophthalmol Vis Sci 2015;56:5238-45.
Purpose: The hypothesis of the correlation between Helicobacter pylori infection and open-angle glaucoma (OAG) originated from the role of H. pylori in inducing a systemic autoimmune response and the release of a large number of inflammatory substances, and in influencing the trabecular meshwork cell apoptotic process. More importantly, H. pylori antibodies are considered to cross react with ciliary body epithelial antigens. A meta-analysis was performed to evaluate the effects of H. pylori infection on OAG risk. Methods: Relevant studies that reported the associations between H. pylori infection and OAG were identified through an extensive search of the Excerpta Medica Database, Web of Science, and PubMed databases in English and Chinese National Knowledge Infrastructure, VIP, and Wan Fang databases in Chinese, and by reviewing the reference lists of the key articles. The summary odds ratio (OR) and 95% confidence interval (CI) were calculated using the random-effects model. Results: This meta-analysis involved 695 glaucoma patients and 1580 control individuals. The overall combined ORs showed a significant correlation between H. pylori infection and OAG (OR = 2.08, 95% CI = 1.42–3.04). The subgroup analysis showed the association of H. pylori infection with primary open-angle glaucoma (POAG; OR = 3.06, 95% CI = 1.27–2.46) and normal tension glaucoma (NTG; OR = 1.77, 95% CI = 1.76–5.34), but not with pseudoexfoliation glaucoma (PXFG; OR = 1.46, 95% CI = 0.40-5.30). Conclusions: The result of this meta-analysis suggested a statistically significant association between H. pylori infection and OAG. Further analysis showed that this positive relation is observed only in POAG and NTG patients, but not in the PXFG patients.
Sengupta S, Venkatesh R, Krishnamurthy P, Nath M, Mashruwala A, Ramulu PY, et al. Intraocular pressure reduction after phacoemulsification versus manual small-incision cataract surgery: A Randomized controlled trial. Ophthalmology 2016;123:1695-703.
Purpose: The purpose of this study is to compare reduction in intraocular pressure (IOP) and change in anterior chamber angle configuration between eyes undergoing phacoemulsification versus those undergoing manual small-incision cataract surgery (MSICS). Methods: Prospective, randomized, double-masked, parallel assignment clinical trial was done involving five hundred eyes of 500 participants 40–70 years of age with normal IOP, gonioscopically open angles, and age-related cataract. Eyes underwent phacoemulsification or MSICS after a 1:1 randomization and allocation code. Best-corrected vision, IOP, comprehensive slit-lamp evaluation, and anterior segment (AS) optical coherence tomography (OCT) were performed at baseline and at 1, 3, and 6 months follow-up. Change in IOP (ΔIOP) and AS OCT parameters between baseline and 6 months after surgery were measured. Results: At 6 months, similar IOP reduction was observed in eyes undergoing phacoemulsification (ΔIOP = 2.7 ± 2.9 mmHg) and MSICS (ΔIOP = 2.6 ± 2.6 mmHg; P = 0.70). Widening of the angle opening distance (AOD) 500 μm from the scleral spur (median ΔAOD500 = 103 μm; interquartile range = 39–179 μm) was also similar in both groups (P = 0.28). Multivariate linear regression analysis showed that eyes with higher baseline IOP experienced significantly greater reduction in IOP at 6 months (ΔIOP = 0.46-mmHg reduction for every 1-mmHg increment in baseline IOP; 95% confidence interval (CI), 0.4-0.5 mmHg; P < 0.001). After adjusting for covariates, the magnitude of widening of AOD500 was not associated significantly with reduction in IOP (1.33-mmHg reduction for every 1-mm increment in AOD500; P = 0.07). Baseline AOD500 (β = −0.60-mm change/1-mm increment of baseline AOD; 95% CI, −0.67 to − 0.53 mm) and anterior chamber depth (β = 0.07-mm change/1-mm increment of baseline anterior chamber depth; 95% CI, 0.04–0.1 mm) were significant predictors of AOD500 widening at 6 months. Conclusions: Both phacoemulsification and MSICS led to significant and similar IOP reductions 6 months after surgery, and both surgeries produced similar changes in anterior chamber and angle parameters. Higher baseline IOP was associated with greater IOP reduction; IOP reduction also can be attributed partly to changes in angle and anterior chamber configuration, although these parameters were unable to significantly predict IOP drop at 6 months.
Shoughy SS, Kozak I, Tabbara KF. Associations of systemic diseases with intermediate uveitis. Ophthalmic Epidemiol 2016;23:27-31.
Purpose: The purpose of this study is to determine the associations of systemic diseases with intermediate uveitis. Methods: The medical records of 50 consecutive cases with intermediate uveitis referred to The Eye Center in Riyadh, Saudi Arabia, were reviewed. Age-and sex-matched patients without uveitis served as controls. Patients had complete ophthalmic and medical examinations. Results: There were 27 male and 23 female patients. Mean age was 29 years with a range of 5–62 years. Overall, 21 cases (42%) had systemic disorders associated with intermediate uveitis, and 29 cases (58%) had no associated systemic disease. A total of 11 patients (22%) had asthma, 4 (8%) had multiple sclerosis, 3 (6%) had presumed ocular tuberculosis, 1 (2%) had inflammatory bowel disease, 1 (2%) had nonHodgkin lymphoma, and 1 (2%) had sarcoidosis. Evidence of systemic disease was found in 50 (5%) of the 1,000 control subjects. Bronchial asthma was found in 37 patients (3.7%), multiple sclerosis in 9 patients (0.9%), inflammatory bowel disease in 3 patients (0.3%), and tuberculosis in 1 patient (0.1%). None of the control patients had sarcoidosis or lymphoma. There were statistically significant associations between intermediate uveitis and bronchial asthma (P = 0.0001), multiple sclerosis (P = 0.003) and tuberculosis (P = 0.0005). Conclusion: Bronchial asthma and multiple sclerosis were the most frequently encountered systemic diseases associated with intermediate uveitis in the patient population studied. Patients with intermediate uveitis should undergo careful history-taking and investigations to rule out associated systemic illness.
Sen D, Ghosh S, Roy D. Correlation of C-reactive protein and body mass index with diabetic retinopathy in Indian population. Diabetes Metab Syndr 2015;9:28-9.
Aim: This study aims o study the association of C-reactive protein (CRP) and body mass index (BMI) with diabetic retinopathy (DR). Methods: Sixty diabetes patients each with DR (Group A), no DR (Group B) and 60 healthy volunteers (control, Group C) were studied. CRP was measured. BMI was calculated and the results were analyzed. Results: Significant difference in CRP was observed between Groups A and B (P = 0.000) and A and C (P = 0.007). No significant difference in BMI was observed. Central macular thickness correlated positively with CRP and negatively with BMI. Conclusion: Strong association of CRP with DR was observed and no significant relationship between DR and BMI was found.
Bu SC, Kuijer R, van der Worp RJ, Postma G, Renardel de Lavalette VW, Li XR, et al. Immunohistochemical evaluation of idiopathic epiretinal membranes and in vitro studies on the effect of TGF-β on müller cells. Invest Ophthalmol Vis Sci 2015;56:6506-14.
Purpose: The purpose of this study was to investigate the presence of type VI collagen and glial cells in idiopathic epiretinal membrane (iERM) and the role of transforming growth factor-β1 (TGF-β) in the expression of collagens and α-smooth muscle actin (α-SMA) in retinal Müller cells. Methods: Idiopathic ERM samples from vitrectomy were analyzed for glial acidic fibrillary protein (GFAP), cellular retinaldehyde-binding protein (CRALBP), α-SMA, and type VI collagen using flat-mount immunohistochemistry. To study intracellular collagen expression in relation to cellular phenotype, spontaneously immortalized human Müller cells (MIO-M1) were treated with TGF-β1 for 48 h, and the expression of α-SMA and intracellular type I, II, IV, and VI collagens was studied using immunocytology. Findings in Müller cells were compared with those in fetal lung fibroblasts and newborn skin fibroblasts. Results: A colocalization of GFAP/CRALBP and GFAP/α-SMA was found in iERM, indicating a dynamic process of activation of retinal Müller cells in vivo. TGF-β induced upregulation of α-SMA stress fibers in retinal Müller cells and both types of fibroblasts in vitro. The intracellular staining intensity of type I, II, and VI collagens was decreased in retinal Müller cells containing α-SMA stress fibers, whereas the intracellular staining intensity of type I and VI collagens in both types of fibroblasts was not affected. Conclusions: Type VI collagen and activated retinal Müller cells are present in iERM. TGF-β induces an upregulation of α-SMA stress fibers in retinal Müller cells and fibroblasts and appears to have a cell-specific effect on intracellular collagen expression.
Chu CJ, Johnston RL, Buscombe C, Sallam AB, Mohamed Q, Yang YC, et al. Risk factors and incidence of macular edema after cataract surgery: A Database study of 81984 eyes. Ophthalmology 2016;123:316-23.
Purpose: The purpose of this study is to define the incidence of pseudophakic macular edema (PME) after cataract surgery and to identify contributory risk factors. Methods: Structured clinical data mandated by the Elecronic medical record (EMR) were anonymized and extracted for each eye undergoing cataract surgery including perioperative visual acuity, copathologic features, simultaneous surgical procedures, and the presence or absence of a specified list of intraoperative complications. Diabetic status with matched early treatment diabetic retinopathy study (ETDRS) grading also was mandated by the EMR. Eyes receiving prophylactic nonsteroidal anti-inflammatory drugs were excluded. Diagnosis of cystoid macular edema or new-onset macular edema in patients with diabetes was recorded by a healthcare professional within 90 days of surgery. Results: Baseline incidence of PME in eyes without operative complications, diabetes, or risk factors was 1.17%. Eyes in which PME developed were more likely to be male, older, and to demonstrate risk factors. The relative risk (RR) was increased in eyes with capsule rupture with or without vitreous loss (RR, 2.61; 95% confidence interval [CI], 1.57–4.34), a previous diagnosis of epiretinal membrane (RR, 5.60; 95% CI, 3.45–9.07), uveitis (RR, 2.88; 95% CI, 1.50–5.51), retinal vein occlusion (RR, 4.47; 95% CI, 2.56–5.92), or retinal detachment repair (RR, 3.93; 95% CI, 2.60–5.92). High myopia, age-related macular degeneration, or prostaglandin analog use were not shown to increase risk. Eyes with PME on average had poorer postoperative visual acuity, which persisted to the latest time point assessed, up to 24 weeks. Eyes from patients with diabetes, even in the absence of retinopathy, had an increased RR (RR, 1.80; 95% CI, 1.36–2.36) of new macular edema after surgery. The risk was higher in the presence of any diabetic retinopathy (DR; RR, 6.23; 95% CI, 5.12–7.58) and rose proportionately with increasing severity of DR. Conclusions: PME occurs commonly after phacoemulsification cataract surgery, even in the absence of complications and risk factors. This large retrospective study using structured EMR data quantified the RRs of PME and the risk with increasing ETDRS severity of DR. It highlights the need for prophylactic therapy, especially in those groups of eyes with the highest RRs.
Chen SN, Yang CM. Lens capsular flap transplantation in the management of refractory macular hole from multiple etiologies. Retina 2016;36:163-70.
Purpose: The purpose of this study is to report the clinical results of lens capsular flap transplantation in refractory macular hole (MH). Methods: This retrospective, interventional, consecutive case series included 20 eyes with persistent MH after previous standard MH surgery. All eyes underwent vitrectomy, lens anterior or posterior capsule transplantation into the MH, gas tamponade, and a 1-week postoperative head down. Structural and functional changes were evaluated. Results: The predisposing conditions to surgical failure included high myopia with MH and retinal detachment in four eyes, MH after myopic foveoschisis surgery in one eye, high myopia with a large MH in one eye, proliferative diabetic retinopathy with MH in three eyes, MH with severe retinal detachment in one eye, retinal detachment with concurrent peripheral breaks and MH in one eye, and large or chronic MH in nine eyes. MH was closed in all the 10 eyes receiving anterior capsular flap transplantation. In the 10 eyes with posterior capsular flap transplantation, MH was closed in 5, partially closed in 3, and not closed in 2. Visual acuity in logarithm of minimal angle of resolution improved from 1.53 ± 0.39 preoperatively to 1.07 ± 0.35 postoperatively. Conclusion: Lens capsular flap transplantation may close the MH and improve visual outcome in the majority cases of refractory MH.
Erke MG, Bertelsen G, Peto T, Sjølie AK, Lindekleiv H, Njølstad I, et al. Cardiovascular risk factors associated with age-related macular degeneration: The Tromsø study. Acta Ophthalmol 2014;92:662-9.
Purpose: The purpose of this study is to examine associations between cardiovascular risk factors and age-related macular degeneration (AMD). Methods: A population-based, cross-sectional study of Caucasians aged 65–87 years was conducted in Norway in 2007/2008. Retinal photographs were graded for AMD. Multivariable logistic regression analyzes were performed based on questionnaires addressing habits of smoking, alcohol consumption, physical activity, health and medication; and physical examination comprising anthropometric measurements, blood pressure and blood sampling. Cardiovascular disease status was obtained from a validated end-point registry. Results: Gradable photographs were available for 2631 participants, of whom 92 (3.5%) participants had late AMD. In the multivariable analysis of late AMD, significant interactions were found between sex and the variables age, triglyceride level, use of lipid-lowering drugs and physical exercise. Current daily smoking was significantly related to late AMD in both sexes (odds ratio [OR] 4.06, 95% confidence interval [CI] 1.69–9.76 and OR 3.59, 95% CI 1.17–11.04, women and men, respectively) compared with never smokers. Higher number of pack years was associated with the presence of large drusen (>125 μm) (OR 1.04, 95% CI 1.01–1.09/5 years). Higher systolic blood pressure (OR 1.06, 95% CI 1.01–1.12/5 mmHg), overweight (OR 2.87, 95% CI 1.13–7.29), and obesity (OR 2.92, 95% CI 1.06–8.03), physical exercise duration (OR 0.41, 95% 0.18–0.96 for 30 min or more compared with less) and frequency (OR 0.46, 95% CI 0.23–0.92 for weekly or more often compared to less) were associated with late AMD in women only. Conclusions: Smoking was strongly associated with AMD, in line with results from other populations. In addition, late AMD was related to higher systolic blood pressure, physical inactivity, overweight, and obesity in women.
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