Effect of corneal epithelium on ultraviolet-A and riboflavin absorption

Bottós, Kátia Mantovani; Schor, Paulo; Dreyfuss, Juliana Luporini; Nader, Helena B.; Chamon, Wallace

doi:10.1590/s0004-27492011000500008

Cited by 60 publications

(52 citation statements)

References 29 publications

(40 reference statements)

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“…15 Bu nedenle KÇB uygulamadan önce kornea epitelini bir spatül yardımıyla kaldırdık ve bu işlemi tüm hasta grubumuzda uyguladık. Ancak tedavinin uzun sürmesi ve epitel kaldırma işlemi sırasıda ağrı duyulması özellikle pediatrik yaş grubunda KÇB uygulamasını zorlaştırmaktadır.…”

Section: Discussionunclassified

Keratokonus Hastalarının Korneal Çapraz Bağlama Tedavisinde Yaş Faktörünün Etkisi

...

2012

tjo

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ÖzetAmaç: Keratokonuslu hastalarda korneal çapraz bağlama tedavisinin yaşa bağlı etkisini ortaya koymak. Ge reç ve Yön tem: İlerleyici keratokonus nedeniyle korneal çapraz bağlama tedavisi uyguladığımız 45 hastanın 49 gözü geriye dönük incelendi. Hastalar pediatrik, orta ve erişkin olmak üzere üç gruba ayrıldı. Birinci grup (25 yaş) 17 gözden oluştu. Ameliyat öncesi düzeltilmiş en iyi görme keskinliği (log-MAR-EİDGK), santral kornea kalınlığı (SKK) ve maksimum kornea dikliği (MKD) kaydedilip ameliyat sonrası ortalama 13,8±3,83 aylık takip değerleriyle karşılaştırıldı. Sonuçlar: Tedavi öncesine göre, 1. grupta istatistiksel olarak anlamlı bir şekilde görme artışı (p <0,05) saptandı, 2. ve 3. gruptaki görme artışı ise istatistiksel olarak anlamlı değildi (p=0,434, p=0,21, sırasıyla). Gruplar kendi aralarında karşılaştırıldığında log-MAR-EİDGK farkı istatiksel olarak anlamlı değildi (p=0,182). Hiçbir grupta, tedavi öncesine göre SKK'da istatistiksel olarak anlamlı değişiklik saptanmadı (p=0,353, p=0,308, p=0,692, sırasıyla). Gruplar kendi aralarında karşılaştırıldığında da MKD açısından istatistiksel olarak anlamlı fark saptanmadı (P=0,856) Tedavi öncesine göre, MKD değerlerindeki değişiklik de tüm gruplarda istatistiksel olarak anlamlı değildi (p=0,605, p=0,574, p=0,266, sırasıyla). Korneal düzleşme, en fazla grup 3'te elde edilirken, bu değer istatiksel olarak anlamlı değildi (P=0,282). Tar t›fl ma: Keratokunusta korneal çapraz bağlama tedavisi sonuçlarının görme keskinliği, SKK ve MKD değerleri açısından yaş grupları arasında anlamlı bir fark göstermediği saptandı. ( Sum maryPur po se: To evaluate the effect of age on corneal cross-linking treatment in keratoconus patients. Ma te ri al and Met hod:We retrospectively evaluated forty-nine eyes of 45 patients with keratoconus that were applied corneal cross-linking treatment. The patients were divided into three groups; pediatric, adolescent and adult. The first group (25 years old) consisted of 17 eyes. Preoperative best-corrected visual acuity (BCVA log-MAR), central corneal thickness (CCT), and maximum corneal steepness (MCS) were compared with postoperative 13.8±3.83-month follow-up values. Re sults: After the treatment, a statistically significant improvement in visual acuity was found in group 1 (p<0.50).Visual acuity improvement was not statistically significant in group 2 and group 3 (p=0.434, p=0.21, respectively). Log-MAR-visual acuity differences were not statistically significant among the groups (p=0.182). No statistically significant change was found in postoperative CCT values in all groups (p=0. 353, p=0.308, p=0.692, respectively). MCS values did not change statistically significantly at the postoperative evaluation (p=0.605, p=0.574, p=0.266, respectively). There was no statistically significant difference when comparing the three groups (p=0.856). Maximum corneal flattening was observed in group 3, but it was not statistically significant (p=0.282). Dis cus si on: It was determined that the results of corneal cross-linking treatment in keratoco...

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Section: Discussionunclassified

Keratokonus Hastalarının Korneal Çapraz Bağlama Tedavisinde Yaş Faktörünün Etkisi

...

2012

tjo

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“…Bottоs и соавт., проводивших флуоресцентную микроскопию свиных ро-говиц, корнеальный эпителий может быть существен-ным препятствием на пути рибофлавина, предотвращая проникновение препарата в строму, не ограничивая при этом пропускания УФ-А. В свою очередь, недостаточная интрастромальная концентрация фотосенсибилизатора может привести к снижению эффекта кросслинкинга [52]. По данным оптической когерентной томографии, эффективность стромального проникновения рибофла-вина in vivo при CXL зависит от характера и степени де-эпителизации роговицы [53].…”

Section: стандартный протокол уф-кросслинкингаunclassified

“…Bottos и соавт. на свиных глазах ex vivo продемон-стрировали эффективность внутрикамерной инъекции рибофлавина, легко преодолевающего эндотелиальный барьер [52].…”

Section: трансэпителиальный уф-кросслинкингunclassified

Ultraviolet Corneal Crosslinking

Бикбов¹,

Khalimov²,

Usubov³

2016

Annals RAMS

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Во всем мире ежегодно отмечается значительный рост заболеваний роговицы, сопровождающихся деструктив-ными изменениями коллагена в ее составе, что связывают с ухудшением экологии, интенсификацией глазной хи-рургии, травмами глаза, а также с увеличившимся числом офтальмоинфекций [1]. В Российской Федерации на больных с заболеваниями роговицы приходится до 18% общего числа слепых и слабовидящих [2].В основе кератоэктазий, в частности кератоконуса, лежит прогрессирующая деградация коллагеновой струк-туры роговицы и, соответственно, снижение ее прочност-но-механических свойств, приводящие к помутнению, нередко рубцеванию и значительному снижению остроты зрения. Как правило, это билатеральный патологический процесс, чаще наблюдаемый у лиц молодого трудоспо-собного возраста. Качественные и количественные из-менения состава коллагена органа зрения, отрицательно сказываясь на его структуре, проявляются в различных сочетаниях симптоматики болезни.Этиология кератоконуса считается многофакторной и наряду с вышеуказанными причинами включает также наследственную, эндокринную, аллергическую, имму-нологическую и другие теории, среди которых наиболее признанной у специалистов считается генетическая ги-потеза [3]. Несомненно, в пользу этого свидетельствуют семейные случаи заболевания, а также их сочетание с некоторыми наследственными синдромами. Так, по дан-ным мультицентрового проспективного исследования CLERK (США), генетические формы кератоконуса были выявлены в 13,5% случаев [4].В последнее десятилетие так называемый инжини-ринг тканей, базирующийся на процессах фотополи-меризации, стали использовать для лечения широкого спектра заболеваний. В частности, с целью укрепления роговой оболочки глаза при хронических дегенеративных процессах успешно применяется ультрафиолетовый (УФ) кросслинкинг роговицы (UV Corneal Crosslinking, CXL), основанный на ее облучении при длине волны 370 нм с использованием светочувствительного рибофлавина [5].Кросслинкинг (перекрестное связывание, или сши-вание) способствует стабилизации биомеханических свойств роговицы за счет увеличения количества свя-зей между фибриллами стромального коллагена, кера-тоцитами и белками межклеточной адгезии посредством рибофлавин-УФ-индуцируемых фотохимических реак-ций [5−8]

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“…In a study of basic research, evaluating a promising anti-inflammatory drug for intravitreal use, Rassi et al (6) demonstrated that infliximab can be used repeatedly for two or three times, with minimal retinal toxicity in rabbits. In another study comparing the action of the ranibizumab and bevacizumab "in vitro", Souto et al (7) showed greater effect than the first in cultured endothelial cells from human umbilical cord vein.Bottós and colleagues (8) addressed, through novel basic research, a very important subject related to the promotion of corneal collagen crosslinking (CXL): the influence of the corneal epithelium in maintaining the effectiveness of CXL. In this novel approach the authors found that the maintenance of epithelium does not interfere in the transmission of ultraviolet light to the corneal stroma, but interferes with the absorption of riboflavin for the same.…”

mentioning

confidence: 99%

“…Bottós and colleagues (8) addressed, through novel basic research, a very important subject related to the promotion of corneal collagen crosslinking (CXL): the influence of the corneal epithelium in maintaining the effectiveness of CXL. In this novel approach the authors found that the maintenance of epithelium does not interfere in the transmission of ultraviolet light to the corneal stroma, but interferes with the absorption of riboflavin for the same.…”

mentioning

confidence: 99%

Neste fascículo do ABO

Chamon¹

2011

Arq. Bras. Oftalmol.

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This issue of ABO brings interesting articles in epidemiology, basic research, new technologies and randomized clinical trials.Kara-Júnior and his colleagues (1) presented the results of a questionnaire administered to more than 600 patients treated in a campaign to perform cataract surgery in São Paulo. The study showed a sad reality for patients excluded from the comprehensive eye care. Almost half of all patients interviewed were unable to gain access to cataract surgery before the campaign, because they have abandoned the free public service as a result of the long waiting lists or for failing to schedule their surgeries (19%), or did not have the resources to afford the costs associated with surgeries performed by health insurance or private care (29%). The costs reported by patients who had not sought public service ranged from R$ 1,000 to over R$ 4,000.00. Authors rightly emphasized in their conclusions "the need to continue to carry out community campaigns to meet people who would not have access to surgery by conventional means." I also believe it is important to consider that, despite the campaigns being indispensable at the present time the Brazilian public health, we must keep in mind that, ideally, access to health care should be possible for the whole population without the need to create specific campaigns.Patients with anophthalmic cavities were evaluated in two articles (2,3) . Narikawa and colleagues (2) retrospectively analyzed the epidemiological profile of 107 patients with anophthalmic cavity in a reference service in the state of São Paulo, detecting trauma as the most frequent etiology, especially in men. In another study conducted in the Federal District, Goulart and colleagues (3) assessed the psychosocial aspects involved in the rehabilitation of patients with anophthalmic cavity. In their study, which evaluated 44.4% of patients with anophthalmic cavity since 2004, the trauma was also nominated as the most frequent cause. In this sample, one third of patients said that the eye loss negatively influenced their daily routine.Several epidemiological, clinical and basic research articles focused on retinal aspects. In another epidemiological study, evaluating patients with sickle cell disease, Freitas and colleagues (4) demonstrated that routine eye examination may, in specific cases, establish clinical suspicion of systemic diseases. Gil and colleagues (5) conducted a randomized double-blind clinical trial to compare, through morphological and functional assessment, the treatment of diffuse diabetic macular edema with intravitreal triamcinolone and with laser phototherapy. Twenty-one eyes of 14 patients were randomly assigned to each group. Although intravitreal injection have led to the decrease in retinal thickness measured by OCT, the study showed no functional differences between the initial examination after three months of treatment in either group. In a study of basic research, evaluating a promising anti-inflammatory drug for intravitreal use, Rassi et al. (6) demonstrated that...

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Effect of corneal epithelium on ultraviolet-A and riboflavin absorption

Cited by 60 publications

References 29 publications

Keratokonus Hastalarının Korneal Çapraz Bağlama Tedavisinde Yaş Faktörünün Etkisi

Keratokonus Hastalarının Korneal Çapraz Bağlama Tedavisinde Yaş Faktörünün Etkisi

Ultraviolet Corneal Crosslinking

Neste fascículo do ABO

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