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1.
Ho Sik Hwang Yilu Xie Elena Koudouna Kyung-Sun Na Young-Sik Yoo Suk-Woo Yang Donald J. Brown James V. Jester 《The ocular surface》2018,16(4):448-453
Purpose
While meibography has proven useful in identifying structural changes in the meibomian gland (MG), little is known regarding the MG spectral transmission and absorption characteristics. The purpose of this study was to measure the transmission/absorption spectra of the MG compared to other eyelid tissues.Methods
Human and rabbit eyelids were fixed in paraformaldehyde, serial sectioned (50?μm) using a cryotome and imaged by brightfield and reflectance microscopy. Eyelid regions (MG, muscle, tarsus and dermis) were then illuminated by a 100?μm spot using a infrared enhanced white light source. Transmission spectra over a 550–950?nm range were then measured using a spectrometer and differences compared using two-way analysis of variance.Results
Brightfield microscopy of both human and rabbit eyelid tissue showed a marked decrease in light transmission for MG acini compared to other eyelid tissues. In rabbit, the dermis showed 5× and the muscle showed 2× more light transmission compared to MG (P?<?.001 and P?<?.001, respectively). For human, the muscle showed 14× and the tarsus showed 84× more light transmission compared to MG (P?<?.01 and P?<?.001, respectively). No specific spectral region of light absorption could be detected in either rabbit or human MG. Loss of light transmission in MG was localized to acini containing small lipid droplets, averaging 2.7?±?0.8?μm in diameter.Conclusions
The data suggest that light transmission is dramatically reduced in the acini due to light scattering by small lipid droplets, suggesting that Meibography detects active lipid synthesis in differentiating meibocytes. 相似文献2.
Shao Dan Zhang Jing Na He Tong Tong Niu Shan Shan Liu Chiu Yeung Chan Chun Yang Ren Chi Liu Chi Pui Pang Yang Qu Ruo Xi Li Hai Lin Wang 《The ocular surface》2018,16(1):70-76
Objective
To investigate the bacterial profile in the conjunctiva and meibomian glands in patients before penetrating ocular surgeries, and to compare the anti-bacterial efficacy of 0.5% levofloxacin and its combination with meibomian gland massage.Design
Hospital-based, case-control study.Participants
Two hundred and twenty-six eyes from 226 patients with non-infective ocular diseases and scheduled for penetrating ocular surgeries.Methods
Tested eyes were administered topical 0.5% levofloxacin (4 times daily) for 2 days. Among them, 91 eyes received meibomian gland massage before levofloxacin application. Samples from the conjunctival sac and meibomian glands were collected for aerobic and anaerobic cultures.Main outcome measures
Culture-positivity and bacterial strains.Results
Before treatment, aerobes and anaerobes were cultured from 38.5% and 11.0% of the conjunctival samples respectively, compared with 38.5% and 8.8% in the meibomian secretions respectively. Staphylococcus epidermidis and Propionibacterium acnes were the commonest isolated aerobe and anaerobe. Two-day application of levofloxacin reduced aerobic growth to 29.6% in the conjunctiva and 19.3% in the meibomian glands. It had no effect on the anaerobes in these regions (13.3% in the conjunctiva and 10.4% in the meibomian glands). Combined levofloxacin with meibomian gland massage further reduced aerobic growth to 19.8% in the conjunctiva and 11.0% in the meibomian glands. It also drastically decreased anaerobic growth in the meibomian glands (1.1%).Conclusions
Meibomian glands carrying considerable bacteria should be considered as a potential source of contamination in ocular surgery. Meibomian gland massage shows additional anti-bacterial effects to topical levofloxacin and could be recommended as a complementary preoperative prophylaxis. 相似文献3.
Purpose
To evaluate the effect of 3% diquafosol ophthalmic solution on tear film lipid layer thickness (LLT) in normal human eyes by tear interferometry.Methods
Forty-seven healthy men (mean age of 42.4 years) randomly received one drop of artificial tears in one eye and one drop of 3% diquafosol ophthalmic solution in the other. LLT of each eye was quantified by tear interferometry before and 15, 30, and 60 min after instillation. Ocular symptoms were assessed before and 30 min after instillation. Baseline LLT, tear film breakup time (TBUT), meibomian gland area (meiboscore) of the upper and lower eyelids, and Schirmer test value were evaluated on a different day before treatment.Results
LLT before and 15, 30, and 60 min after diquafosol instillation was 62.3 ± 31.1, 77.0 ± 39.5, 79.3 ± 40.5, and 77.7 ± 43.6 nm, respectively, with the diquafosol-induced increase in LLT being significant at each time point. Artificial tears did not result in a significant increase in LLT. TBUT (ρ = 0.32, P = 0.026), meiboscore of the lower eyelid (ρ = ?0.33, P = 0.022), and the maximum difference in LLT between before and after diquafosol instillation (ΔLLTmax) (ρ = 0.35, P = 0.016) were significantly correlated with baseline LLT in the diquafosol group. Age was not significantly related to baseline LLT or ΔLLTmax. Symptoms did not differ significantly between the two groups.Conclusions
Topical instillation of 3% diquafosol ophthalmic solution increased LLT for up to 60 min in normal human eyes regardless of age. 相似文献4.
Therapeutic efficacy of intense pulsed light in patients with refractory meibomian gland dysfunction
Purpose
To evaluate the efficacy and safety of intense pulsed light (IPL) combined with meibomian gland expression (MGX) for treatment of refractory meibomian gland dysfunction (MGD).Methods
Ninety eyes of 45 patients were randomly assigned to receive either the combination of IPL and MGX or MGX alone (control). Each eye underwent eight treatment sessions at 3-week intervals. Parameters were evaluated before and during treatment as well as at 3–11 weeks after the last treatment session. Measured parameters included the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire score, noninvasive breakup time (NIBUT), fluorescein breakup time (BUT), lipid layer grade, lipid layer thickness (LLT), lid margin abnormalities, corneal and conjunctival fluorescein staining (CFS) score, meibum grade, and meiboscore.Results
A significant improvement in lipid layer grade was apparent in the IPL-MGX group from 6 to 32 weeks after treatment onset (adjusted P?<?0.001) but was not observed in the control group. The IPL-MGX group also showed significant improvements in LLT, NIBUT, BUT, lid margin abnormalities, and meibum grade compared with the control group at 24 and 32 weeks (adjusted P?<?0.001) as well as significant improvements in the SPEED score at 32 weeks (adjusted P?=?0.044) and in CFS score at 24 (adjusted P?=?0.015) and 32 (adjusted P?=?0.006) weeks.Conclusions
The combination of IPL and MGX improved homeostasis of the tear film and ameliorated ocular symptoms in patients with refractory MGD and is thus a promising modality for treatment of this condition. 相似文献5.
Michael T.M. Wang Leslie Tien Alicia Han Jung Min Lee Dabin Kim Maria Markoulli Jennifer P. Craig 《The ocular surface》2018,16(4):424-429
Purpose
To investigate the influence of blinking on tear film parameters, ocular surface characteristics, and dry eye symptomology.Methods
A total of 154 participants were recruited in an age, gender and ethnicity-matched cross-sectional study, of which 77 exhibited clinically detectable incomplete blinking, and 77 did not. Blink rate, dry eye symptomology, tear film parameters, and ocular surface characteristics were assessed in a single clinical session.Results
Overall, a higher proportion of participants exhibiting incomplete blinking fulfilled the TFOS DEWS II dry eye diagnostic criteria (64% versus 44%, p?=?0.02), with an odds ratio (95% CI) of 2.2 (1.2–4.2) times. Participants exhibiting incomplete blinking had higher Ocular Surface Disease Index scores (18?±?13 versus 12?±?9, p?=?0.01), and greater levels of meibomian gland dropout (41.3?±?15.7% versus 27.5?±?14.1%, p?<?0.001). Furthermore, poorer tear film lipid layer thickness, non-invasive tear film stability, expressed meibum quality, eyelid notching, and anterior blepharitis grades were also observed in those exhibiting incomplete blinking (all p?<?0.05). Blink frequency did not correlate significantly with any ocular surface parameters (all p?>?0.05).Conclusions
Incomplete blinking was associated with a two-fold increased risk of dry eye disease. The greater levels of meibomian gland dropout, as well as poorer expressed meibum quality and tear film lipid layer thickness, observed would suggest that incomplete blinking may predispose towards the development of evaporative dry eye. 相似文献6.
Aaron B.C. Wong Michael T.M. Wang Kevin Liu Zak J. Prime Helen V. Danesh-Meyer Jennifer P. Craig 《The ocular surface》2018,16(3):289-293
Purpose
To assess tear film parameters, ocular surface characteristics, and dry eye symptomology in patients receiving topical anti-glaucoma medications.Methods
Thirty-three patients with a diagnosis of open angle glaucoma or ocular hypertension, receiving unilateral topical anti-glaucoma medication for at least 6 months, were recruited in a cross-sectional, investigator-masked, paired-eye comparison study. Tear film parameters, ocular surface characteristics, and dry eye symptomology of treated and fellow eyes were evaluated and compared.Results
The mean?±?SD age of the participants was 67?±?12 years, and the mean?±?SD treatment duration was 5.3?±?4.4 years. Treated eyes had poorer non-invasive tear film breakup time (p?=?0.03), tear film osmolarity (p?=?0.04), bulbar conjunctival hyperaemia (p?=?0.04), eyelid margin abnormality grade (p?=?0.01), tear meniscus height (p?=?0.03), and anaesthetised Schirmer value (p?=?0.04) than fellow eyes. There were no significant differences in dry eye symptomology, meibomian gland assessments, and ocular surface staining between treated and fellow eyes (all p?>?0.05).Conclusions
Adverse changes in tear film stability, tear osmolarity, conjunctival hyperaemia, and eyelid margins were observed in treated eyes. This suggests that inflammatory mechanisms may be implicated in the development of dry eye in patients receiving long term topical anti-glaucoma therapy. 相似文献7.
Sun Woong Kim Yilu Xie Paul Q. Nguyen Vickie T. Bui Kelly Huynh Jonathan S. Kang Donald J. Brown James V. Jester 《The ocular surface》2018,16(4):463-469
Purpose
To evaluate the role of PPARγ in regulating meibocyte differentiation and lipid synthesis in a human meibomian gland epithelial cell line (hMGEC).Methods
HMGEC were exposed to the PPARγ agonist, Rosiglitazone, from 10-50?μM. Cultures were also exposed to specific PPARγ antagonist, T0070907, to block PPARγ receptor signaling. Cells were then stained with Ki-67 and LipidTox to determine the effects on cell cycling and lipid synthesis, respectively. Expression of meibocyte differentiation related proteins, ADFP, PPARγ, ELOVL4, and FABP4, were evaluated by quantitative PCR and western blotting. A human corneal epithelial cell line (hTCEpi) was used as a control.Result
Rosiglitazone significantly decreased Ki-67 staining within 2 days in a dose-dependent manner (P?=?0.003) and increased lipid accumulation in hMGEC in a dose dependent manner. T0070907 suppressed both lipid droplet synthesis and cell cycle exit. Rosiglitazone significantly upregulated expression of ADFP, PPARγ, ELOVL4, and FABP4 by 9.6, 2.7, 2.6, and 3.3 fold on average (all P?<?0.05 except for FABP4, P?=?0.057) in hMGEC. T0070907 significantly abrogated rosiglitazone-induced upregulation of these genes when treated prior to rosiglitazone treatment (all P?<?0.05). The observed lipogenic differentiation response was not duplicated in hTCEpi after exposure to rosiglitazone.Conclusion
Rosiglitazone induced cell cycle exit and upregulation of lipogenic gene expression leading to lipid accumulation in hMGEC. These effects were suppressed by PPARγ antagonist indicating that PPARγ signaling specifically directs lipogenesis in hMGEC. These findings suggest that PPARγ plays a critical role in meibocyte differentiation. 相似文献8.
Hamid-Reza Moein Ahmad Kheirkhah Rodrigo T. Muller Andrea C. Cruzat Deborah Pavan-Langston Pedram Hamrah 《The ocular surface》2018,16(2):218-225
Purpose
To evaluate the long-term alterations of corneal nerves in patients with herpes simplex virus (HSV) keratitis using in vivo confocal microscopy (IVCM).Design
Prospective, longitudinal, cross sectional.Methods
This study included 16 patients with a history of HSV keratitis and 15 age-matched normal controls. Slit-scanning IVCM was performed in all subjects at baseline and then after a mean follow-up of 37.3?±?1.7 months in the patient group. Corneal subbasal nerve density and corneal sensation were compared between groups at baseline and follow-up.Results
At baseline, the mean subbasal nerve density was significantly lower in both affected eyes (1.4?±?0.6?mm/mm2) and contralateral unaffected eyes (6.4?±?0.7?mm/mm2) compared with the controls (14.1?±?1.6?mm/mm2; all P?<?.001). At the end of follow-up, the mean nerve density in affected eyes increased to 2.8?±?0.7?mm/mm2 (P?=?.006), with no significant change in contralateral unaffected eyes (6.5?±?1.0?mm/mm2, P?=?.72). However, both eyes had lower nerve density than controls (all P?<?.001). Corneal sensation was significantly lower in affected eyes (2.6?±?0.6?cm) than in the control group (6.0?±?0.0, P?<?.001) and showed no significant change at the end of follow-up (2.5?±?0.6?cm, P?=?.80). Corneal sensation in contralateral unaffected eyes was not different in comparison with controls at both baseline and follow up (all p?>?.05).Conclusions
Our results demonstrate that although corneal nerve regeneration occurs in patients with HSV keratitis, this change is not clinically significant and does not results in changes of corneal sensation. Therefore, these patients need to be followed closely for complications of neurotrophic keratopathy and might benefit from neuro-regenerative therapies. 相似文献9.
Shao Dan Zhang Jing Na He Tong Tong Niu Chiu Yeung Chan Chun Yang Ren Shan Shan Liu Yang Qu Kam Lung Chong Hai Lin Wang Jun Tao Chi Pui Pang 《The ocular surface》2017,15(2):242-247
Purpose
To compare the bacteriological profile of meibomian gland secretion and conjunctival cul-de-sac in subjects with and without meibomian gland dysfunction (MGD).Methods
This hospital-based study enrolled 201 eyes from 201 MGD patients and 84 eyes from 84 age- and gender-matched controls. Samples from the conjunctivae and meibomian gland secretion were obtained. Both aerobic and anaerobic cultures were performed. Differences in the culture-positivity and bacterial strains between two groups were compared.Results
36.9% and 10.7% of the control meibomian gland secretion recovered aerobes and anaerobes, respectively. A higher rate of aerobic (44.0%) and similar rate of anaerobic (10.7%) bacteria were isolated from the conjunctival cul-de-sac in these controls. Patients with MGD showed significantly higher positive culture rates from both the meibomian gland secretion (75.6% for aerobes and 34.3% for anaerobes) and conjunctival cul-de-sac (64.7% for aerobes and 30.8% for anaerobes). All p values were ≤ 0.001. In both groups and at either location, the predominant species isolated were Staphylococcus epidermidis (aerobes) and Propionibacterium acnes (anaerobes). Of note, the MGD patients harbor a much more complex bacterial profile than the controls.Conclusion
Both aerobic and anaerobic bacteria can be isolated from the ocular surface of healthy subjects. Patients with MGD demonstrate significantly higher culture positivity and more complex bacterial profiles than the controls. Bacterial related cytotoxicity and/or inflammation may contribute to the pathological process of MGD. 相似文献10.
Shin Mizoguchi Hiroki Iwanishi Masahide Kokado Takayoshi Sumioka Geraint J. Parfitt Yilu Xie Reiko Arita Rika Shirakawa Osamu Yamanaka Yuka Okada James V. Jester Shizuya Saika 《The ocular surface》2017,15(4):713-722
Purpose
To examine effects of alkali injury of the ocular surface on meibomian gland pathology in mice.Methods
Three μL of 1 N NaOH were applied under general anesthesia to the right eye of 10-week-old BALB/c (n = 54) mice to produce a total ocular surface alkali burn. The meibomian gland morphology was examined at days 1, 2, 5, 10, and 20 by stereomicroscopy and non-contact infrared meibography. Mice were then sacrificed and eyelids processed for histology with hematoxylin-eosin and immunohistochemistry for ELOVL4, PPARγ, myeloperoxidase (a neutrophil marker) and F4/80 macrophage antigen, as well as TUNEL staining. Another set of specimens was processed for cryosectioning and Oil red O staining.Results
Alkali injury to the ocular surface produced cellular apoptosis, infiltration of neutrophils and macrophages, degeneration of the meibomian gland, and ductal dilation. Inflammation in and destruction of acunal stricture seemed more prominent in the lower eyelid, while duct dilation was more frequently observed in the upper eyelid during healing. Surviving acinar cells were labeled for ELOVL4 and PPARγ. Oil red O staining showed that the substance in the dilated duct contained predominantly neutral lipid.Conclusions
Alkali injury to the ocular surface results in damage and destruction of the eyelid meibomian glands. The pattern of the tissue damage differs between glands of the upper and lower eyelids. 相似文献11.
Di Chen Afsun Sahin Wendy R. Kam Yang Liu Raheleh Rahimi Darabad David A. Sullivan 《The ocular surface》2018,16(3):382-389
Purpose
Lipopolysaccharide (LPS), a bacterial endotoxin, is known to stimulate leuokotriene B4 (LTB4) secretion by human corneal (HCECs), conjunctival (HConjECs) and meibomian gland (HMGECs) epithelial cells. We hypothesize that this LTB4 effect represents an overall induction of proinflammatory gene expression in these cells. Our objective was to test this hypothesis.Methods
Immortalized HCECs, HConjECs and HMGECs were cultured in the presence or absence of LPS (15?μg/ml) and ligand binding protein (LBP; 150?ng/ml). Cells were then processed for RNA isolation and the analysis of gene expression by using Illumina BeadChips, background subtraction, cubic spline normalization and GeneSifter software.Results
Our findings show that LPS induces a striking increase in proinflammatory gene expression in HCECs and HConjECs. These cellular reactions are associated with a significant up-regulation of genes associated with inflammatory and immune responses (e.g. IL-1β, IL-8, and tumor necrosis factor), including those related to chemokine and Toll-like receptor signaling pathways, cytokine-cytokine receptor interactions, and chemotaxis. In contrast, with the exception of Toll-like signaling and associated innate immunity pathways, almost no proinflammatory ontologies were upregulated by LPS in HMGECs.Conclusions
Our results support our hypothesis that LPS stimulates proinflammatory gene expression in HCECs and HConjECs. However, our findings also show that LPS does not elicit such proinflammatory responses in HMGECs. 相似文献12.
Miki Uchino Motoko Kawashima Yuichi Uchino Natume Suzuki Hiroto Mitamura Miki Mizuno Yuichi Hori Norihiko Yokoi Kazuo Tsubota 《The ocular surface》2018,16(4):430-435
Purpose
To evaluate the usefulness of a dry eye mobile application (app) for screening dry eye disease (DED) at educational tear events in Japan.Methods
In this cross-sectional study, Japanese subjects visiting a “Tears Day” event were selected randomly. They completed questionnaires and underwent ophthalmic evaluations for DED (using Japanese revised diagnostic criteria) including a functional visual acuity (FVA) test. The app calculated FVA using the average of the continuous VA over 30?s.Results
Sixty-three general-population subjects were included: 25 men and 38 women (average age, 50.8?±?15.9 years). The prevalence of DED was 66.7% (42 subjects); age was significantly higher among subjects with DED (55.2?±?3.4 vs. 48.1?±?2.7 years, p?=?0.04; men, 54.0?±?7.3 vs. 47.0?±?3.0 years, p?=?0.36; women, 55.5?±?3.9 vs. 50.6?±?3.8 years, p?=?0.4). The prevalence of DED was significantly higher in women (p?=?0.04). Tear film breakup time was significantly shorter (3.8?±?2.4 vs. 8.7?±?2.0, p?=?0.04) and the meibum score was significantly higher (p?=?0.02) among subjects with DED. Regarding the tear film breakup pattern, line and random breaks were most prevalent among DED. FVA showed a significant negative correlation with DED (r?=??0.25, p?=?0.047).Conclusions
The app might motivate people to perform quick tests with the expectation of getting easy DED screening. The number of subjects diagnosed with DED was relatively high. 相似文献13.
Young-Sik Yoo Kyung-Sun Na Yong-Soo Byun Jun Geun Shin Byeong Ha Lee Geunyoung Yoon Tae Joong Eom Choun-Ki Joo 《The ocular surface》2017,15(1):130-138.e1
Purpose
To elucidate the anatomic details of gland dropout detected on two-dimensional infrared (IR) meibography in cases of dry eye associated with meibomian gland dysfunction (MGD) by using three-dimensional optical coherence tomography (OCT) meibography.Methods
In this cross-sectional, observational case series, we enrolled gland dropout detected on IR meibography; the condition was then examined using a real-time swept-source OCT system. Accordingly, a series of 500 raster B-scan OCT images, with the gland dropout site (observed on IR imaging) at the center, were obtained and rendered as three-dimensional volume images. The OCT images were classified based on the anatomic details, including acini and ducts, at the meibomian glands (Group I, constricted acini; II, atrophic acini; III, no acini).Results
The percentage of disagreement between IR and OCT images for dropout detected on IR imaging was 49.45% (43 and 93 cases in group I and II, respectively). Loss of the meibomian glands on both IR and OCT imaging (Group III) was observed in 50.55% cases (133 and 6 cases of gland dropout at the partial and whole eyelid on IR imaging, respectively). The proportion of disagreement between IR and OCT images (Group I and II) was higher in the middle area (63/119, 53.39%), as compared to that in the nasal (34/73, 46.58%) or temporal areas of the eyelid (26/65, 40%).Conclusions
The loss of the meibomian glands, as observed on IR imaging, should be carefully interpreted, and OCT images may be useful to confirm the anatomic details of the meibomian glands. 相似文献14.
Swapna S. Shanbhag Hajirah N. Saeed Eleftherios I. Paschalis James Chodosh 《The ocular surface》2018,16(3):272-281
Purpose
To systematically review the published literature on outcomes of Boston keratoprosthesis type 1 for the treatment of limbal stem cell deficiency secondary to severe chemical corneal injury.Methods
Literature searches were conducted in MEDLINE (Ovid), Embase, Web of Science, and the Cochrane Central Register. The main outcome measures assessed were the proportion of eyes with best-corrected visual acuity (BCVA)?≥?20/200 and the proportion retaining their original keratoprosthesis, both at the last recorded visit.Results
We identified 9 reports in which outcomes of Boston keratoprosthesis type I implantation after severe chemical injury could be determined, encompassing a total of 106 eyes of 100 patients. There were no randomized controlled studies. The median pre-operative BCVA was hand motion. Vision improved to ≥20/200 in 99/106 (93.4%) eyes after implantation. With a mean follow-up of 24.99?±?14 months, 68/106 (64.1%) eyes retained BCVA?≥?20/200?at the last examination. Therefore, 68/99 (68.7%) of those who improved to?>?20/200 maintained at least this acuity. The originally implanted device was retained in 88/99 (88.9%) recipients for whom retention was reported. The mean time to failure was 22.36?±?17.2 months. Glaucomatous optic neuropathy was the most common cause for BCVA <20/200 in eyes that retained the keratoprosthesis (18/27, 66.7%)..Conclusions
Implantation of a Boston keratoprosthesis type I in eyes with corneal blindness after severe chemical ocular injury leads to functional vision in the majority of recipients. Evidence was limited by variability in outcome reporting and an absence of controlled studies.. 相似文献15.
Purpose
To investigate the feasibility of remote assessment and follow-up of dry eye symptoms using electronic versions of two validated questionnaires.Methods
We conducted a prospective study of consecutive patients with dry eye disease (DED). Patients were enrolled during a clinical visit and were explained how to respond electronic versions of the Ocular surface Disease Index (OSDI) and the Symptom Assessment in Dry Eye (SANDE) questionnaires using a computer in the presence of investigators. A secure link to both questionnaires was sent to each patient every 2 weeks in order to respond and submit their symptoms over a 3-month period.We analyzed the number of patients who responded to both questionnaires, the recurrence, and the symptoms scores reported.Results
A total of 1121 questionnaires were collected; 103 patients (85%) reported their symptoms at least once during the 3-month study duration. The majority of participants who completed the study (71.6%) responded remotely at least once per month during the 3-month duration of the study. The mean OSDI and SANDE scores from the total of remote evaluations were 34.9?±?21.9 (range 0–97.5) and 50.3?±?24.9 (range 0–100), respectively. There was a statistically significant correlation between the total scores collected with the two questionnaires (R?=?0.67, P?<?0.001).Conclusions
Patients are motivated to report DED symptoms while away from the clinic. Distance-based evaluation of DED symptoms is both feasible and convenient, and can be implemented to follow symptoms in large populations with chronic dry eye. 相似文献16.
Jennifer P. Craig Joevy Lim Alicia Han Leslie Tien Ally L. Xue Michael T.M. Wang 《The ocular surface》2019,17(1):83-88
Purpose
To investigate the ethnic differences in tear film quality, ocular surface parameters, and dry eye symptomology between co-located Asian and Caucasian populations.Methods
Two hundred and six participants (103 East Asian and 103 Caucasian) were recruited in an age and gender-matched cross-sectional study. Dry eye symptomology, ocular surface parameters, and tear film quality were evaluated for each participant within a single clinical session.Results
The mean?±?SD age of the 206 participants (82 male, 124 female) was 45?±?16 years. Overall, a greater proportion of Asian participants were symptomatic of dry eye and fulfilled the TFOS DEWS II dry eye diagnostic criteria than Caucasian participants (74% versus 51%, p?=?0.002), with an odds ratio (95% CI) of 2.7 (1.5–4.8) times. Poorer OSDI scores, tear film stability, lipid layer quality, tear osmolarity, lid wiper epitheliopathy, meibomian gland dropout, and expressed meibum quality were observed in the Asian group (all p?<?0.05). A significantly higher proportion of participants exhibited incomplete blinking in the Asian group than the Caucasian group (81% versus 45%, p?<?0.001).Conclusions
Asian participants exhibited more severe dry eye signs and symptoms than Caucasian participants. The poorer meibomian gland function and higher degree of incomplete blinking observed among Asian participants may potentially contribute towards the ethnic predisposition towards dry eye development. 相似文献17.
Purpose
To study the clinical and microbiological profile of microbial keratitis in Stevens-Johnson syndrome (SJS).Study design
Case series.Participants
Patients with SJS who developed microbial keratitis.Methods
Medical records and microbiological data of patients with SJS who developed microbial keratitis from January 1991 to December 2012 were reviewed. We analysed the type of causative organisms and their antibiotic susceptibility along with the clinical pattern and responses to medications in this group of patients.Main outcome measure
Clinical and microbiological profile of microbial keratitis.Results
We reviewed 65 eyes of 60 patients seen between January 1991 and December 2012. Positive microbiological culture results were obtained in 45 eyes (69.2%). Isolated bacterial infections were noted in 27 eyes (60%) while isolated fungal growth was seen in 1/45 eyes (2.2%). Polymicrobial infections were noted in 17/45 eyes (37.8%). The most common bacteria isolated were Staphylococcus species (35%). The median duration of SJS before presentation was 5 months (IQR, 2 months to 7 years) with 50% presenting within four months of the onset of SJS. Twenty-eight eyes (43%) needed treatment in addition to antibiotics for resolution of tarsorraphy, epilation, tissue adhesive application, and amniotic membrane grafting or punctal cautery. The average time for resolution was 25 days.Conclusion
Microbial keratitis in SJS patients is different from patients without SJS in presentation and the response to medications. It requires a multi-disciplinary approach for healing. 相似文献18.
Purpose
To investigate the differences in ocular surface characteristics, tear film parameters, and dry eye symptomology between co-located pediatric populations of Asian and Caucasian ethnicity.Methods
Seventy New Zealand-born pediatric participants, aged between 5 and 18 years, were recruited in an age and environmentally controlled cross-sectional study. Participants were classified into three groups according to ethnicity and eyelid morphology: Asian single lid (ASL), Asian double lid (ADL), and Caucasian double lid (CDL). Ocular biometry, tear film parameters, ocular surface characteristics, and dry eye symptomology were evaluated in a single clinical session.Results
Overall, no significant intergroup differences were observed in tear film quality, dry eye symptomology, and meibomian gland dropout. A higher proportion of ASL and ADL participants exhibited incomplete blinking than the Caucasian group (both p?<?0.001). Meibomian gland shortening was more frequently observed among the two Asian groups (both p?<?0.05), while gland tortuosity was more common in the Caucasian group (both p?<?0.001). ASL participants exhibited greater inferior lid wiper epitheliopathy grades than ADL participants (p?=?0.01), and corneal astigmatism was more pronounced in the ASL than CDL group (p?=?0.02).Conclusions
Ethnic differences in meibomian gland morphological patterns were observed in the current pediatric cohort, although overall meibomian gland dropout did not differ between groups. Asian participants exhibited a higher degree of incomplete blinking, and more marked inferior lid wiper epitheliopathy and corneal astigmatism were observed in the ASL group. These findings would suggest that eyelid anatomy and tension may potentially be implicated in the development of ethnic differences in dry eye disease later in life. 相似文献19.
Jingjing Wang Mindy Call Maureen Mongan Winston Whei-Yang Kao Ying Xia 《The ocular surface》2017,15(4):704-712