Comparison of corneal biomechanical properties of patients with dry eye secondary to Sjögren's syndrome and healthy subjects

Borrego-Sanz, Lara; Baldomero, Federico Sáenz-Francés San; Valle, David Díaz; Santos-Bueso, E.; Jean, R. Sánchez; Martinez-de-la-Casa, José M.; Castillo, José Manuel Benítez del; Feijoó, Julián García; Rodríguez, L. Rodríguez

doi:10.1016/j.jfo.2018.02.015

“…Conflicting results are available in the literature regarding central corneal thickness in DED. Although few studies showed similar values between DED patients and normal subjects[24–27], we found significantly lower values in patients with oGVHD compared to controls, in agreement with others. [32–34] The corneal thinning in DED is attributed to the increased osmolarity of the tear film that induces the activation of the inflammatory cascade and stimulate the production of high levels of the cytokine and MMP-9 by the distressed epithelial cells.…”

Section: Discussionsupporting

confidence: 92%

“…To date, few previous studies have investigated corneal biomechanics in patients with DED owing to different etiologies, but not oGVHD, by means of both ORA and CorVis ST.[24–27] The former is a non-contact tonometer that provides the measure of two parameters of corneal biomechanics: CRF that reflects the overall resistance of the cornea, and CH that measures the viscoelastic properties of the corneal tissue detecting the changes in the organization of collagen lamellae. CorVis ST is a device that employs an ultrahigh speed Scheimpflug camera to record dynamic deformation of the cornea.…”

Section: Discussionmentioning

confidence: 99%

“…CorVis ST is a device that employs an ultrahigh speed Scheimpflug camera to record dynamic deformation of the cornea. Impaired values of corneal biomechanics have been reported in DED patients with and without Sjögren’s syndrome[24–26]; conversely, Firat et al[27] reported no alterations of corneal biomechanical parameters in patients with DED. However, this study did not evaluate comprehensively ocular surface parameters, and did not stratify patients according to the severity of DED.…”

Section: Discussionmentioning

confidence: 99%

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Corneal biomechanical alterations in patients with chronic ocular Graft Versus-Host Disease

Giannaccare

¹

,

Pellegrini

²

,

Taroni

³

et al. 2019

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Purpose To compare corneal biomechanics between patients with ocular graft versus-host disease (oGVHD) and healthy subjects (controls), and to further correlate these values with ocular and hematological characteristics. Materials and methods The following procedures were performed in oGVHD patients and controls: Schirmer test (ST), break-up time (BUT), corneal and conjunctival staining, tear matrix metalloproteinase-9 (MMP-9) assay (InflammaDry test, Rapid Pathogen Screening, Inc, Sarasota, FL). Corneal biomechanics were calculated by using ocular response analyzer (ORA, Reichert Instruments, Depew, New York, USA). The Mann-Whitney U test was used to compare continuous variables between oGVHD patients and controls. Correlations of corneal biomechanics with ocular and hematological parameters were examined using Spearman's correlation. Results A total of 45 oGVHD patients (mean age ± SD, 51.5 ± 7.1 years) and 34 controls (47.8 ± 6.1 years) were included. Patients with oGVHD showed significantly lower values of corneal hysteresis (CH) and corneal resistance factor (CRF) compared to controls (respectively, 9.4 ± 1.8 mmHg vs 11.6 ± 1.6 and 9.7 ± 1.4 mmHg vs 12.3 ± 1.3; always p< 0.001). Twenty-nine of the oGVHD eyes (64.4%) were strong-positive for MMP-9, while 16 (35.6%) were weak-positive. Conversely, only 4 of the control eyes (11.8%) were weak-positive for MMP-9. In patients with oGVHD, CH was significantly correlated with corneal staining ( Rs = -0.316, p = 0.035), conjunctival staining ( Rs = -0.437, p = 0.003), ST ( Rs = 0.390, p = 0.008), BUT ( Rs = 0.423, p = 0.004), oGVHD severity grade (Rs = -0.383, p = 0.009), and MMP-9 positivity grade ( Rs = -0.429, p = 0.003), while CRF was correlated only with corneal staining ( Rs = -0.317, p = 0.034). Conclusions Corneal biomechanics are reduced in patients with oGVHD, and CH is negatively correlated with disease severity grade and MMP-9 tear levels.

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“…Conflicting results are available in the literature regarding central corneal thickness in DED. Although few studies showed similar values between DED patients and normal subjects[24–27], we found significantly lower values in patients with oGVHD compared to controls, in agreement with others. [32–34] The corneal thinning in DED is attributed to the increased osmolarity of the tear film that induces the activation of the inflammatory cascade and stimulate the production of high levels of the cytokine and MMP-9 by the distressed epithelial cells.…”

Section: Discussionsupporting

confidence: 92%

“…CorVis ST is a device that employs an ultrahigh speed Scheimpflug camera to record dynamic deformation of the cornea. Impaired values of corneal biomechanics have been reported in DED patients with and without Sjögren’s syndrome[24–26]; conversely, Firat et al[27] reported no alterations of corneal biomechanical parameters in patients with DED. However, this study did not evaluate comprehensively ocular surface parameters, and did not stratify patients according to the severity of DED.…”

Section: Discussionmentioning

confidence: 99%

Corneal Biomechanical Alterations in Patients with Chronic Ocular Graft Versus-host Disease

Giannaccare

¹

,

Pellegrini

²

,

Taroni

³

et al. 2019

Preprint

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22Purpose: To compare corneal biomechanics between patients with ocular graft versus-host 23 disease (oGVHD) and healthy subjects (controls), and to further correlate these values with 24 ocular and hematological characteristics. 25 Materials and Methods: The following procedures were performed in oGVHD patients and 26 controls: Schirmer test (ST), break-up time (BUT), corneal and conjunctival staining, tear 27 matrix metalloproteinase-9 (MMP-9) assay (InflammaDry test, Rapid Pathogen Screening, 28 Inc, Sarasota, FL). Corneal biomechanics were calculated by using ocular response analyzer 29 (ORA, Reichert Instruments, Depew, New York, USA). The Mann-Whitney U test was used 30 to compare continuous variables between oGVHD patients and controls. Correlations of 31 corneal biomechanics with ocular and hematological parameters were examined using 32Spearman's correlation. 33Results: A total of 45 oGVHD patients (mean age ± SD, 51.5 ± 7.1 years) and 34 controls 34 (47.8 ± 6.1 years) were included. Patients with oGVHD showed significantly lower values of 35 corneal hysteresis (CH) and corneal resistance factor (CRF) compared to controls 36 (respectively, 9.4 ± 1.8 mmHg vs 11.6 ± 1.6 and 9.7 ± 1.4 mmHg vs 12.3 ± 1.3; always 37 p<0.001). Twenty-nine of the oGVHD eyes (64.4%) were strong-positive for MMP-9, while 38 16 (35.6%) were weak-positive. Conversely, only 4 of the control eyes (11.8%) were weak-39 positive for MMP-9. In patients with oGVHD, CH was significantly correlated with corneal 40 staining (Rs = -0.316, p = 0.035), conjunctival staining (Rs = -0.437, p = 0.003), ST (Rs = 41 0.390, p = 0.008), BUT (Rs = 0.423, p = 0.004), oGVHD severity grade (Rs = -0.383, p = 42 0.009), and MMP-9 positivity grade (Rs = -0.429, p = 0.003), while CRF was correlated only 43 with corneal staining (Rs = -0.317, p = 0.034). 44Conclusions: Corneal biomechanics are reduced in patients with oGVHD, and CH is 45 negatively correlated with disease severity grade and MMP-9 tear levels. 46 47 51 Allogeneic hematopoietic stem cell transplantation (HSCT) is an established and potentially 52 curative treatment for a variety of malignant and non-malignant hematological disorders. 53 Graft versus-host disease (GVHD) is a multi-organ systemic disease caused by complex 54 interactions between donor and recipient immune systems and represents the leading cause of 55 morbidity following HSCT.[1] Chronic ocular GVHD (oGVHD) develops in 40 to 60% of 56 patients undergoing HSCT, and dry eye disease (DED) represents the hallmark of this 57 condition.[2-4] The disease is thought to be the result of the progressive immune-mediate 58 inflammatory damage of ocular surface structures, which may lead to lacrimal and meibomian 59 glands dysfunction, conjunctival keratinization, corneal epitheliopathy, eyelid laxity and 60 scarring, and in more severe cases even corneal melting and perforation.[5-7] 61 Recent proteomic studies evaluated the various constituent compositions of tears 62 inflammatory mediators in eyes with oGVHD and detected increased levels of...

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Evaluation of ocular surface epithelial and stromal thicknesses in psoriasis using anterior segment optical coherence tomography

Erşan

¹

,

Kılıç

²

,

Işık

³

2022

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Purpose: To evaluate the epithelial and stromal thicknesses of conjunctiva and cornea in psoriatic patients with anterior segment optical coherence tomography (AS-OCT), Methods: In this cross-sectional study, 61 patients with psoriasis and 42 age-matched, healthy individuals were enrolled. The epithelial and stromal thicknesses of both inferotemporal bulbar conjunctiva and central cornea were measured using AS-OCT.Results: Both the Tear break-up time and Schirmer-1 test values were signi cantly lower in the psoriasis group compared with the controls (p<0.05). The epithelial thickness of conjunctiva and cornea did not differ between psoriasis and control groups. (p>0.05) The central corneal stroma was signi cantly thicker in the psoriasis group (p=0.04). PASI was positively correlated with the thickness of central cornea stroma (r=0.442, p=0.006) in the nail psoriasis group. Conclusions: Psoriasis is not associated with altered epithelial thicknesses of the cornea and conjunctiva. It is accompanied by the stromal thickening of the cornea without conjunctival stromal involvement.

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Comparison of corneal biomechanical properties of patients with dry eye secondary to Sjögren's syndrome and healthy subjects

Cited by 5 publications

References 26 publications

Corneal biomechanical alterations in patients with chronic ocular Graft Versus-Host Disease

Corneal biomechanical alterations in patients with chronic ocular Graft Versus-Host Disease

Corneal Biomechanical Alterations in Patients with Chronic Ocular Graft Versus-host Disease

Evaluation of ocular surface epithelial and stromal thicknesses in psoriasis using anterior segment optical coherence tomography

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