Search

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim To compare the efficacy of cord blood and peripheral adult donor blood serum eyedrops, controlled for growth factor content, in the treatment of severe dry eye diseases (DED) resistant to conventional therapy. Methods This was a multicentre randomised, double masked, cross-over clinical trial. Sixty patients diagnosed as severe DED, associated to persistent corneal epithelial defects were randomised and equally assigned to group A (treated with cord blood serum (CBS)) or group B (treated with PBS), eyedrops administered eight times/day for 1 month. Primary outcome was the pretreatment and post-treatment change in corneal fluorescein staining. Secondary outcomes included the pretreatment and post-treatment change in Ocular Surface Disease Index (OSDI) questionnaire and Visual Analogue Score (VAS) of subjective symptoms, Schirmer I test, tear breakup time and conjunctival staining. Patients with relapse in signs or symptoms after further 2 months switched to the remaining group for one additional month. Data were statistically analysed (p<0.05). Results Corneal staining was more significantly reduced after the CBS treatment, both VAS and OSDI score reduction was observed in both groups, but group A reported significantly less grittiness and pain. Nineteen patients shifted in the crossover period, the within individual comparison confirmed a better recovery in the CBS treatment period. Reduction in epithelial damage was positively associated with epidermal growth factor, transforming growth factor α and platelet-derived growth factor content. Levels of interleukins (IL-13) were positively associated with symptom decrease. Conclusions Overall, DED signs improved after both CBS and PBS treatments, with potential advantages of CBS for subjective symptoms and corneal damage reduction. [ABSTRACT FROM AUTHOR]

Objectives: To investigate longitudinally corneal sub-basal nerve plexus (SNP) by means of in vivo confocal microscopy (IVCM) in the contralateral eye (CE) of patients with unilateral neurotrophic keratitis (NK) secondary to central nervous system (CNS) diseases who underwent different treatments. Methods: Ten patients with NK and 10 matched controls were included. In 7 NK patients, conservative treatment maintained unchanged the clinical picture over the 1-year follow-up (Group 1), while NK progressed in 3 patients who underwent direct corneal neurotization (Group 2). IVCM scans of SNP of NK patients were acquired in CE at baseline (V0) ad after 1-year follow-up (V1). All images were analyzed with the automated software "ACCMetrics" and compared with controls. The following IVCM corneal nerve parameters were calculated at V0 and V1 with ACCMetrics: fiber density (CNFD), branch density (CNBD), fiber length (CNFL), total branch density (CTBD), fiber area (CNFA), fiber width (CNFW), and fractal dimension (CNFrD). Results: At V0, significantly lower mean values of CNFD and CNBD, and higher values of CNFW were detected in CE of NK patients compared to controls (respectively, 16.9 ± 8.7 vs 25.0 ± 8.3 n/mm2, P=.029; 19.3 ± 13.8 vs 33.8 ± 18.9 n/mm2, P=.023; 0.022 ± 0.002 vs 0.020 ± 0.001 mm/mm2, P<.001). From V0 to V1, all IVCM metrics of CE remained unchanged in Group 1, while they improved in Group 2. Conclusions: Contralateral eye of patients with unilateral NK secondary to CNS disease showed lower CNFD and CNBD and higher CNFW compared to controls. Unlike conservative treatment, direct corneal neurotization was able to improve SNP metrics also in CE. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess the effect of long-lasting botulinum A toxin injections on ocular surface parameters and to further investigate the relationship between these parameters and the duration of the treatment.Methods: In this retrospective study, patients with unilateral hemifacial spasm who were receiving botulinum A toxin injections for at least 1 year were analyzed. Healthy contralateral eyes acted as controls. The ocular surface examination included Ocular Surface Disease Index questionnaire, Schirmer test type I, tear film break-up time (TFBUT), tear osmolarity, corneal sensitivity, and corneal fluorescein staining.Results: Twenty-six patients (6 males and 20 females; mean age 76.4 ± 8.9 years) were included in the study. The mean duration of the treatment was 7.2 ± 5.4 years, and the mean frequency of injections was of one every 3.3 ± 0.4 months. TFBUT, Schirmer test, and corneal sensitivity were significantly lower in the eye homolateral to hemifacial spasm compared with the contralateral one (5.9 ± 3.2 vs 7.5 ± 4.2 s, P = 0.001; 6.2 ± 3.4 vs 9.2 ± 6.6 mm, P = 0.031; 50.8 ± 3.7 mm vs 52.3 ± 2.9 mm, P = 0.048, respectively). One month after the last injection, TFBUT further decreased from 5.9 ± 3.2 to 2.3 ± 1.2 s (P = 0.028). A significant positive correlation was found between the duration of treatment and tear osmolarity (ρ = 0.542, P = 0.025).Conclusion: Patients with hemifacial spasm under long-lasting treatment with serial botulinum A toxin injections showed a reduction in tear film production and stability, as well as corneal sensitivity in the treated eye compared with the contralateral one. Tear film stability further decreased 1 month after the last injection. [ABSTRACT FROM AUTHOR]

Purpose: A red eye is common in the ophthalmic practice, and redness is one out of four cardinal signs of inflammation. The correlation between the conjunctival bulbar redness (CBR) and ocular surface parameters, including tear cytokine levels, was investigated, in patients suffering from Dry Eye (DE). Methods: Thirty five patients diagnosed as suffering from DE and fifteen age and sex matched healthy volunteers and were analyzed with respect to: 1. subjective symptoms of discomfort with the Ocular Surface Disease Index (OSDI ranging 0‐100), and Visual Analogue Score (VAS, ranging 0‐100 mm) ; 2.Tear Film Break Up Time (TFBUT, seconds); 3. Corneal vital and conjunctival vital staining scored by the NEI system (score 0‐15, and 0‐18, respectively); 4. Tear levels of exudated serum albumin (ALBU, mg/ml), and of the following Interleukins (IL): IL1b. IL‐6. IL‐17A. and Tumor Necrosis Factor (TNF)a (pg/ml), detected by the Luminex Technology Multiplex Assays; 5. the quantification of CBR analyzed on slit lamp digital images by using image processing of relative Red‐channel activity with the free Image J software (NIH). Parameters were statistically analyzed in the two groups of subjects by using t‐test and Mann‐Whitney U test for parametric and nonparametric variables respectively. Relationship between variables was investigated using Spearman r correlation tests (significance p < 0.05). Results: CBR was higher in DE as compared to controls (49.6 ± 3.5 vs 41.1 ± 2.4. p < 0.001). Tear IL‐6 level was higher in DE patients vs controls (25.5 ± 15.5 vs 5.9 ± 3.1, p < 0.0001), whereas IL1b, IL‐17A, and TNFa were detected in only the DE patients (median 5.73, 5.74, and 13.88 respectively) A significant correlation was found between CBR and IL‐6 (r = 0.524), TNFa (0.571) TFBUT (‐0.561), VAS score (0.832), and ALBU (0.628), p always <0.001. Conclusions: Data suggests that digitized CBR analysis may be a useful tool to quantify inflammation in the clinical setting. [ABSTRACT FROM AUTHOR]