A novel in vivo corneal trans-epithelial electrical resistance measurement device

Purpose: To develop a device that is capable of easily measuring corneal transepithelial electrical resistance (TER) and changes in the corneal barrier function. Methods: We had previously developed an in vivo method for measuring corneal TER using intraocular electrode. This method can be used to precisely measure the decline of the corneal barrier function after instillation of benzalkonium chloride (BAC). In order to lessen the invasiveness of that procedure, we further refined the method for measuring the corneal TER by developing electrodes that could be placed on the cornea and in the conjunctival sac instead of inserting them into the anterior chamber. TER was then calculated by subtracting the electrical resistance, which lacked the corneal epithelial input, from the whole electrical resistance that was measured between the electrodes. Slit lamp examination and scanning electron microscopy (SEM) were used to determine safety of the new device. Corneal TER changes after exposure to 0.02% BAC were determined using the new device as well as SEM and transmission electron microscopy (TEM). Results: Slit lamp examination before and after exposure of rabbits\u27 corneas to the sensor confirmed safety of the device. SEM examination revealed no difference of the corneal epithelium which exposed to the new device with normal corneas. SEM and TEM pictures revealed damaged microvilli and tight junctions after instillation of 0.02% BAC. TER change after treatment with 0.02%BAC was similar to those determined by the established anterior chamber method. Conclusion: We succeeded to develop a less invasive device for corneal TER measurement in vivo in animals. This new device may be applicable in the future for clinical use in humans

Polyoxyethylene hydrogenated castor oil modulates benzalkonium chloride toxicity: comparison of acute corneal barrier dysfunction induced by travoprost Z and travoprost.

To determine the element that modulates benzalkonium chloride (BAC) toxicity by using a new electrophysiological method to evaluate acute corneal barrier dysfunction induced by travoprost Z with sofZia (Travatan Z(®)), travoprost with 0.015% BAC (Travatan(®)), and its additives

Reversible visual disturbance due to cryptococcal uveitis in a non-HIV individual.

A 52-year-old man without underlying diseases visited a local hospital with symptoms of memory deficit and mild headache. Radiological examination of the brain with computed tomography (CT) revealed hydrocephalus. Etiology was not revealed by cerebrospinal fluid (CSF) analysis and a ventricular-atrial (V-A) shunt was installed. The patient had congestion and dacryorrhea of the right eye and uveitis was diagnosed three months after placement of the V-A shunt. The serum cryptococcal antigen (CrAg) tested positive at a titration of 64 times. Additionally, samples of the right eye anterior chamber aqueous humor (ACAH), cerebrospinal fluid (CSF) and prostate fluid were positive for Cryptococcus antigen at a titration of 128 times. In addition, Cryptococcus neoformans var. grubii was isolated from the peripheral blood, CSF and ACAH, resulting in a diagnosis of disseminated cryptococcosis. Fluconazole (FLCZ) at 800 mg/day was administered for the first two days, followed by a 400 mg/day maintenance dose. After six months of treatment, his visual power recovered. This is a rare case of disseminated cryptococcosis involving uveitis, which was successfully treated by FLCZ. Disseminated cryptococcosis should be considered in cases with mild symptoms and V-A shunt installation for hydrocephalus

Conjunctival Sac Microbiome in Infectious Conjunctivitis

Acute bacterial conjunctival infections are common, and this study identified the conjunctival bacterial community in infectious conjunctivitis cases seen at the outpatient clinic of Khanh Hoa General Hospital in Nha Trang, Vietnam from October 2016 through December 2017. Conjunctival swabs were collected and tested using conventional culture, PCR, and 16S ribosomal RNA sequencing. The study included 47 randomly selected patients. More than 98% of all DNA reads represented five bacterial phyla. Three of these phyla constituted 92% of all sequences (Firmicutes (35%), Actinobacteria (31%), and Proteobacteria (26%)). At the genus level, there were 12 common genera that constituted about 61% of all sequence reads. Seven of those genera were common (Streptococcus (10%), Cutibacterium (10%), Staphylococcus (7%), Nocardioides (7%), Corynebacterium 1 (5%), Anoxybacillus (5%), and Acinetobacter (5%)), which encompassed 49% of all reads. As for diversity analysis, there was no difference on PERMANOVA analysis (unweighted UniFrac) for sex (p = 0.087), chemosis (p = 0.064), and unclassified eyedrops (p = 0.431). There was a significant difference in cases with bilateral conjunctivitis (p = 0.017) and for using antibiotics (p = 0.020). Of the predominant phyla, Firmicutes had the highest abundance in bacterial conjunctivitis in this study. Pseudomonas as a resident commensal microbiota may have an important role in the prevention of infection

Comparison of Corneal Safety and Intraocular Pressure?Lowering Effect of Tafluprost Ophthalmic Solution with Other Prostaglandin Ophthalmic Solutions

Purpose: The benzalkonium chloride (BAK) content of tafluprost ophthalmic solution (TaprosR: tafluprost) has been reduced to balance corneal safety and preservative effectiveness (old formulation: 0.01%; new formulation: 0.001%). However, no reports have been published on its clinical effect. Therefore, we conducted a clinical research study to compare the safety of BAK-reduced tafluprost on the ocular surface with other prostaglandin ophthalmic solutions. Methods: This clinical study included 28 glaucoma patients (28 eyes) with a treatment history of latanoprost ophthalmic solution (XalatanR) or travoprost ophthalmic solution (Travatan Z R), who presented with corneal epithelial disorders. The subjects were switched to BAK-reduced tafluprost, and its effect on the ocular surface was examined after 1 and 2 months of treatment [using fluorescein staining score, hyperemia, tear film breakup time, and intraocular pressure (IOP) lowering]. Results: In all analyzed subjects (N=27), the fluorescein staining score was significantly improved after switching to BAK-reduced tafluprost (P<0.0001). Conversely, the IOP-lowering effect was not notably changed. The subjects switched from latanoprost (n=10) showed significant improvement in fluorescein staining score (P<0.05) as well as in IOP lowering (P<0.01). The subjects switched from travoprost (n=17) also showed significant improvement in fluorescein staining score (P<0.001), but without a significant change in IOP lowering. Conclusions: Tafluprost with reduced BAK has potential as a superior antiglaucoma drug, not only for its IOP-lowering effect, but also for its good corneal safety profile

Thyroid ultrasound findings in a follow-up survey of children from three Japanese prefectures: Aomori, Yamanashi, and Nagasaki

We conducted ultrasound thyroid screening in cohort of 4,365 children aged between 3 to 18 years in three Japanese prefectures (Aomori, Yamanashi, and Nagasaki) using the same procedures as used in the Fukushima Health Survey. Forty-four children had nodules ? 5.1 mm in diameter or cysts ? 20.1 mm in diameter detected at the first screening, and 31 of these children underwent the second follow-up survey. We collected information from thyroid ultrasound examinations and final clinical diagnoses and re-categorized the thyroid findings after the second examination. Twenty children had nodules ? 5.1 mm in diameter or cysts ? 20.1 mm in diameter at the second examination; of these, one child was diagnosed with a thyroid papillary carcinoma and the remaining 19 children were diagnosed with possibly benign nodules such as adenomas, adenomatous nodules, and adenomatous goiters. A further 11 children were re-categorized as "no further examinations were required." Our results suggest that ultrasound thyroid findings in children may change with a relatively short-term passing period, and that thyroid cancer may exist at a very low but certain frequency in the general childhood population

Thyroid Ultrasound Findings in Children from Three Japanese Prefectures: Aomori, Yamanashi and Nagasaki

Due to the likelihood of physical and mental health impacts following the unprecedented accident at the Fukushima Daiichi Nuclear Power Plant, the Fukushima prefectural government decided to conduct the Fukushima Health Management Survey to assist in the long-term health management of residents. This included thyroid ultrasound examination for all children in Fukushima. For appropriate evaluation of ultrasound screening of the thyroid, it is important to understand its reference data of thyroid findings in children in general. In order to analyze the frequencies of specific thyroid findings, we conducted ultrasound screening of the thyroid by the same procedures as used in Fukushima in 4,365 children, aged 3 to 18 years, from three Japanese prefectures. Overall, thyroid cysts were identified in 56.88% and thyroid nodules in 1.65% of the participants. Thyroid cysts and nodules with a maximum diameter of more than 5 mm were identified in 4.58% and 1.01%, respectively, and age-adjusted prevalences were 3.82% and 0.99%, respectively. Although the prevalence of cysts and nodules varied among the examination areas, no significant differences were observed among the three examination areas in the prevalence of cysts and nodules with a maximum diameter of more than 5 mm. Also, the prevalence of thyroid cysts and nodules, especially those with a maximum diameter of more than 5 mm, significantly increased with age, and showed a female predominance. We also identified ectopic thymus (1.95%), diffuse goiter (1.40%), ultimobranchial body (0.73%), lymph node swelling (0.21%) and thyroid agenesis (0.05%). This is the first ultrasound description of the age-adjusted prevalence of thyroid cysts and nodules, or of the prevalence of abnormalities other than cysts and nodules, such as ectopic thymus, in relation to age, in the general Japanese child population. We contend that this can provide relevant information for the Fukushima Health Management Survey and future population studies

Predictive factors for postoperative visual acuity following multifocal diffractive intraocular lens implantation using corneal topography and tomography

Purpose: To identify predictive factors for postoperative uncorrected visual acuity (UCVA) following diffractive multifocal intraocular lens implantation. Subject and Method: Forty five eyes of 28 patients who underwent cataract surgery with diffractive multifocal intraocular lens TECNIS® ZMB00 (AMO) implantation from January 2015 to March 2018 were included. We formed two groups randomly with 18 eyes of 11 patients defined as the training set for preoperative factors and 27 eyes of 17 patients defined as the validation set for postoperative effects. All eyes had undergone superior corneal incisions of 2.4 mm. The predictive factors included age, mean corneal refractive power, corneal astigmatism, spherical equivalent, coma and spherical aberration of cornea, depth of angle recess, mesopic and photopic pupil diameters, PDist and MDist (distances from the alignment light to the photopic and the mesopic pupil centers, respectively). The good-UCVA group was defined as patients who had logMAR ≦ 0 one month after the surgery. Independent-related factors were identified by stepwise logistic regression analyses. Results: Only PDist was adopted (P = 0.0108) in the training set. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was 0.91. In the validation set, it had a sensitivity of 66%, a specificity of 100% and a cut-off value of 0.23. Conclusions: It is supposed that distances from the alignment light to the PDist influence the postoperative UCVA following multifocal diffractive intraocular lens implantation

Predictive factors for postoperative visual acuity following multifocal diffractive intraocular lens implantation using corneal topography and tomography

Purpose: To identify predictive factors for postoperative uncorrected visual acuity (UCVA) following diffractive multifocal intraocular lens implantation. Subject and Method: Forty five eyes of 28 patients who underwent cataract surgery with diffractive multifocal intraocular lens TECNISR ZMB00 (AMO) implantation from January 2015 to March 2018 were included. We formed two groups randomly with 18 eyes of 11 patients defined as the training set for preoperative factors and 27 eyes of 17 patients defined as the validation set for postoperative effects. All eyes had undergone superior corneal incisions of 2.4 mm. The predictive factors included age, mean corneal refractive power, corneal astigmatism, spherical equivalent, coma and spherical aberration of cornea, depth of angle recess, mesopic and photopic pupil diameters, PDist and MDist (distances from the alignment light to the photopic and the mesopic pupil centers, respectively). The good-UCVA group was defined as patients who had logMAR ≦ 0 one month after the surgery. Independent-related factors were identified by stepwise logistic regression analyses. Results: Only PDist was adopted (P = 0.0108) in the training set. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was 0.91. In the validation set, it had a sensitivity of 66%, a specificity of 100% and a cut-off value of 0.23. Conclusions: It is supposed that distances from the alignment light to the PDist influence the postoperative UCVA following multifocal diffractive intraocular lens implantation