Transepithelial High-Intensity Cross-Linking for the Treatment of Progressive Keratoconus: 2-year Outcomes

WOS: 000393881100004PubMed: 27249007Purpose: To report 2-year outcomes of transepithelial high-intensity cross-linking (CXL) procedure in the treatment of patients with progressive keratoconus.Methods: Forty-eight eyes of 48 consecutive progressive keratoconus patients who underwent transepithelial accelerated CXL procedure were enrolled in the study. Each patient underwent pre- and postoperative comprehensive ophthalmologic examinations including determination of refractive error as spherical equivalent (SE) and corrected distant visual acuity (CDVA), slit lamp biomicroscopic examination, fundoscopy, and a detailed analysis on a Scheimplug+Placido device (Sirius, CSO, Florence, Italy). the riboflavin solution, which was composed of riboflavin 0.25% with hydroxypropyl methylcellulose (HPMC) and benzalkonium chloride (BAC) (ParaCel, Avedro), was used in the procedure. the cornea was exposed to ultraviolet A light (KXL System, Avedro Inc., Waltham, MS, USA) for 2 minutes and 40 seconds at an irradiance of 45 mW/cm(2).Results: the mean age of the patients was 25.9 4.0 (ranging from 18 to 33) years. No significant changes were observed in the mean CDVA, SE, and topographic indices at year 1 and year 2 visits compared to preoperative examination. the mean corneal thickness at the thinnest point was significantly higher at year 1 and year 2 visits than at preoperative examination (p1 = 0.014 and p2 = 0.017, respectively). No intra- or postoperative complications or adverse reactions were observed.Conclusions: Transepithelial high-intensity (irradiance of 45 mW/cm(2) for 2 minutes and 40 seconds) CXL using 0.25% riboflavin solution was a safe and effective method to halt the progression of keratoconus for a 2-year follow-up period

Evaluation of Peripapillary Retinal Nerve Fiber Layer Thickness in Patients With Vitamin B12 Deficiency Using Spectral Domain Optical Coherence Tomography

WOS: 000318646600009PubMed: 23317171Purpose: To compare peripapillary retinal nerve fiber layer (RNFL) thicknesses measured by Cirrus HD optical coherence tomography (OCT) of patients with vitamin B12 deficiency with healthy controls and to evaluate the correlation between the peripapillary RNFL thickness and plasma vitamin B12 levels. Materials and Methods: Forty-five patients (19 male and 26 female) with a diagnosis of vitamin B12 deficiency (patient group) and 45 age-and sex-matched healthy subjects (control group) were consecutively enrolled in this study. Average, temporal, nasal, inferior, and superior quadrant peripapillary RNFL thicknesses of each subject were obtained using the Cirrus HD OCT. Disc area (DA) and rim area (RA), central subfield thickness (CST), cube volume (CV), and cube average thickness (CAT) were also measured. Results: Mean age of each group was 33.1 +/- 6.5 years (range: 21-45 years). Mean plasma vitamin B12 level was 114.8 +/- 34.0 pg/mL in the patient group and was 405.1 +/- 20.0 pg/mL in the control group (p < 0.001). the patient and control groups were similar regarding axial length, plasma folate levels, DA, RA, CST, CV, CAT, and RNFL thicknesses in superior, nasal, and inferior quadrants. However, average RNFL and RNFL in temporal quadrant were significantly thinner in the patient group than in the control group (p = 0.013 and p < 0.001, respectively). in addition, temporal (r = 0.356, p = 0.001) and average (r = 0.212, p = 0.045) peripapillary RNFL thicknesses were correlated with plasma vitamin B12 levels. Conclusion: We have shown that, as in other non-glaucomatous optic neuropathies, temporal quadrant RNFL thickness was thinner in patients with vitamin B12 deficiency and it was correlated with plasma vitamin B12 levels. Further studies are warranted to clarify the clinical relevance of these findings and the effects of vitamin B12 replacement therapy

Investigation of tear osmolarity in early rheumatoid arthritis: relation to disease activity

WOS: 000331148900021PubMed: 23931459Objective: To investigate the frequency of dry eye (DE) by measuring tear osmolarity (TO) with the recently introduced TearLab system (TearLab Corp, San Diego, Calif.) in patients with early rheumatoid arthritis (ERA) and the relationship between the severity of DE and ERA disease activity. Design: Prospective study Participants: Sixty-four eyes of 64 newly diagnosed and untreated patients with ERA were enrolled in this study. Methods: TO measurements, tear break-up time (TBUT), and Schirmer tests were performed. ERA disease activity was evaluated according to the disease activity score 28 (DAS28). the patients were divided into 3 groups according to DAS28 scores as follows: mild (DAS28 5.1). Results: DE was identified in 46 (71.8%) patients with ERA according to the TO values. There were significant differences among these groups concerning TO (p = 0.001) and TBUT (p = 0.005) scores, whereas there was no significant difference between these groups regarding Schirmer scores (p = 0.200). in addition, DAS28 values were positively correlated with TO values (r = 0.710, p < 0.001), negatively correlated with Schirmer scores, (r = -0.251, p = 0.045), and negatively correlated with TBUT scores (r = -0.335, p = 0.007) among all patients. Conclusions: Our study demonstrated a relationship between the ERA disease activity and severity of DE by using TO measurements with the TearLab system. Therefore, TO measurement could be added to other classical DE tests for diagnosing DE and for assessing the degree of disease activity of ERA

Effect of axial length on retinal nerve fiber layer thickness in children

WOS: 000335377100021PubMed: 23918073Purpose: To investigate the effect of axial length on peripapillary retinal nerve fiber layer (RNFL) thickness in myopic, hyperopic, and emmetropic eyes in children by Cirrus HD spectral-domain optical coherence tomography (OCT). Methods: Subjects were divided into 3 groups according to their refractive status: myopic (n = 36), emmetropic (n = 30), and hyperopic (n = 28) eyes. the RNFL thickness measurements were taken from the superior, inferior, nasal, and temporal quadrants in the peripapillary region by Cirrus HD OCT. Axial length was also determined for each patient. Results: the myopic eyes had thinner average RNFL and RNFLs of temporal, superior, nasal, and inferior quadrants than the hyperopic eyes (p1 0.05). Conclusions: We have shown that axial length and accordingly refractive status influenced peripapillary RNFL thickness measurements by Cirrus HD OCT in children. Therefore, to make a correct diagnosis of glaucoma or other optic neuropathies in children, either axial length-induced magnification effect should be corrected by ophthalmologists or the current Cirrus HD OCT database should be revised taking axial length into consideration

Plasma Homocysteine Levels in Dry Eye Patients

WOS: 000317467300009PubMed: 23132455Purpose: To compare plasma homocysteine levels between patients with dry eye disease and normal control subjects. Methods: Plasma homocysteine (enzyme immunoassay), vitamin B12, and folate levels were determined in 38 patients with dry eye and in 38 controls. Results: Characteristics of the dry eye and control groups were similar. the mean plasma homocysteine level was 16.38 +/- 6.98 mmol/L in the dry eye group and 14.39 +/- 5.11 mu mol/L in the control group (P = 0.10, t test). Hyperhomocysteinemia was present in the 43.9% of the dry eye patients and 33.3% of the controls (P = 0.43, chi(2) test). There were no statistical differences between dry eye and control groups regarding plasma vitamin B12 and folate levels (P = 0.72 and P = 0.69, respectively, t test). Conclusions: Plasma homocysteine levels in dry eye patients may be inadequate to give homocysteine a role in pathogenesis. However, in ocular diseases like glaucoma, plasma homocysteine levels are significantly higher, and associated dry eye disease may cause an additional increase in plasma homocysteine levels

Assessment of peripapillary retinal nerve fiber layer thickness in children with vitamin B-12 deficiency

Cure, Medine Cumhur/0000-0001-9253-6459WOS: 000327894900020PubMed: 23677174Vitamin B-12 deficiency is a worldwide problem. It affects all ages, including children. It is one of the most common nutritional disorders and can cause harmful effects on the nervous system. in this study, we compared the peripapillary retinal nerve fiber layer thickness (RNFLT) in a healthy control group with children with vitamin B-12 deficiency. in our study, we aimed to evaluate the effect of vitamin B-12 deficiency on the RNFLT in children with the optical coherence tomography (OCT) method. Sixty-six children with a diagnosis of vitamin B-12 deficiency (patient group) and 66 age- and sex-matched healthy children (control group) were enrolled in this prospectively designed study. Blood counts, vitamin B-12 levels, folate levels, and full biochemical parameters were obtained for all the subjects in each group. Peripapillary RNFLT measurements were performed with Cirrus HD spectral domain OCT. the thickness of the superior retinal nerve fiber layer (RNFL) in the vitamin B-12 deficiency group was significantly lower than that of the control group (p = 0.037). Although the average thickness of the RNFL was lower in the patient group, there was no statistically significant differences (p = 0.216). in the vitamin B-12 deficiency group, the average RNFL thickness and the superior RNFL thickness were significantly correlated with vitamin B-12 levels (r (1) = 0.353, p (1) < 0.004 and r (2) = 0.416, p (2) = 0.001, respectively). Our study showed that a deficiency in vitamin B-12, elsewhere it is important for the development of the central nervous system, is associated with a reduction in the thickness of the superior RNFL

The relationship between retinal nerve fiber layer thickness and carotid intima media thickness in patients with type 2 diabetes mellitus

WOS: 000346060800038PubMed: 25315984Aims: the aim of the present study was to investigate retinal nerve fiber layer (RNFL) thickness in patients with type 2 diabetes mellitus (T2D) using spectral-domain optical coherence tomography and to evaluate the relationship between RNFL thickness and carotid intima media thickness (CIMT). Methods: This study included 171 patients with T2D (53.2+/-8.8 years) and age matched 61 healthy controls (51.9+/-8.1 years). We evaluated anthropometric and metabolic parameters as well as RNFL and CIMT measurements in patients with T2D and controls. the MannWhitney U test was used to compare the continuous variables and the Chi-square test was used to compare categorical variables. Spearman's rank correlation test was used for calculation of associations between variables. Results: the average RNFL thickness was 84.82+/-11.22 mm in patients with T2D and 92.35+/-8.45 mm in healthy controls (p < 0.001). Mean CIMT values were higher in patients with T2D (0.80+/-0.1 mm) than the healthy subjects (0.72+/-0.1 mm) (p < 0.001). A significant negative correlation was found between age and all quadrants of RNFL. There was a negative correlation between average RNFL thickness and HbA1c (r =-0.176), uric acid (r = -0.145), CIMT (r = -0.190) and presence of carotid plaque (r = -0.193). the superior RNFL thickness was negatively associated with HbA1c (r = -0.175), CIMT (r = -0.207) and carotid plaque (r = -0.176). There was also an inverse correlation between the inferior RNFL thickness and HbA1c (r = -0.187) and carotid plaque (r = -0.157). Conclusion: Thinning of RNFL might be associated with atherosclerosis in patients with T2D. (C) 2014 Elsevier Ireland Ltd. All rights reserved

The impact of hypertension on retinal nerve fiber layer thickness and its association with carotid intima media thickness

WOS: 000354191800007PubMed: 25658169Objective. Our aim was to investigate retinal nerve fi ber layer (RNFL) thickness in hypertensive patients using spectraldomain optical coherence tomography (SD-OCT) and to evaluate the relationship between RNFL thickness and carotid intima media thickness (CIMT). Methods. This study included 59 patients with hypertension (HT) (53.6 +/- 10.7 years) and 54 age-matched healthy controls (51.0 +/- 8.1 years). We evaluated anthropometric and metabolic parameters as well as RNFL and CIMT measurements in patients with hypertension and controls. Results. the average RNFL thickness was 86.60 +/- 10.86 mu m in hypertensive patients and 93.63 +/- 7.30 mu m in healthy controls (p < 0.001). Selective thinning of the RNFL was found in the superior and inferior quadrants. Mean CIMT values were higher in patients with HT (0.80 +/- 0.15 mm) than the healthy subjects (0.71 +/- 0.1 mm) (p < 0.001). the average, inferior and nasal RNFL thickness were negatively associated with diastolic blood pressure respectively (r= 0.112, r= 0.210, r= 0.225). There was an inverse correlation between RNFL thickness in the average and superior retinal quadrant and CIMT (r- =0.201, r= -0.185). There were no correlations between RNFL thickness and age, body mass index, fasting plasma glucose, lipid parameters, high-sensitive C-reactive protein and microalbuminuria. Conclusion. RNFL thickness is reduced in hypertensive patients and may be associated with atherosclerosis

The impact of hypertension on retinal nerve fiber layer thickness and its association with carotid intima media thickness

WOS: 000354191800007PubMed: 25658169Objective. Our aim was to investigate retinal nerve fi ber layer (RNFL) thickness in hypertensive patients using spectraldomain optical coherence tomography (SD-OCT) and to evaluate the relationship between RNFL thickness and carotid intima media thickness (CIMT). Methods. This study included 59 patients with hypertension (HT) (53.6 +/- 10.7 years) and 54 age-matched healthy controls (51.0 +/- 8.1 years). We evaluated anthropometric and metabolic parameters as well as RNFL and CIMT measurements in patients with hypertension and controls. Results. the average RNFL thickness was 86.60 +/- 10.86 mu m in hypertensive patients and 93.63 +/- 7.30 mu m in healthy controls (p < 0.001). Selective thinning of the RNFL was found in the superior and inferior quadrants. Mean CIMT values were higher in patients with HT (0.80 +/- 0.15 mm) than the healthy subjects (0.71 +/- 0.1 mm) (p < 0.001). the average, inferior and nasal RNFL thickness were negatively associated with diastolic blood pressure respectively (r= 0.112, r= 0.210, r= 0.225). There was an inverse correlation between RNFL thickness in the average and superior retinal quadrant and CIMT (r- =0.201, r= -0.185). There were no correlations between RNFL thickness and age, body mass index, fasting plasma glucose, lipid parameters, high-sensitive C-reactive protein and microalbuminuria. Conclusion. RNFL thickness is reduced in hypertensive patients and may be associated with atherosclerosis

A case of suture-related bacterial keratitis and its treatment with topical imipenem

[No abstract available