Long term observation of ocular surface alkali burn in rabbit models: Quantitative analysis of corneal haze, vascularity and self-recovery

Kethiri, Abhinav Reddy; Damala, Mukesh; Basu, Sayan; Rao, Ch. Mohan; Bokara, Kiran Kumar; Singh, Vivek

doi:10.1016/j.exer.2021.108526

Cited by 14 publications

(11 citation statements)

References 34 publications

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“…This plausibility can explain the favorable graft survival in the four eyes of three patients without the application of allogenic/cadaveric stem cell transplantation in these eyes and the clinical observation of clear central cornea despite severe limbal hypertrophic changes in some eyes with chronic and recurrent VKC. In our recent study[ 13 ] in the rabbit limbal stem cell deficiency model, we observed that despite all clinical features suggestive of limbal stem cell deficiency for several months, the limbal region showed self-renewal without any surgical intervention, lending support to the observations discussed in this study.…”

Section: Discussionsupporting

confidence: 87%

Clinical, histological and immunohistochemistry characteristics of cornea in the sequelae stage of chronic vernal keratoconjunctivitis

Jaffet

Singh²,

Chaurasia³

et al. 2021

Indian Journal of Ophthalmology

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Purpose: To report the clinical outcomes and histopathological and immunohistochemistry (IHC) features in eyes with the sequelae stage of vernal keratoconjunctivitis (VKC). Methods: Investigative study of corneal samples obtained following surgical intervention for vision restoration in four eyes of three patients with VKC. Patient 1 (an 11-year-old boy) had deep anterior lamellar keratoplasty in both eyes, Patient 2 (a 24-year-old male) underwent superficial keratectomy followed by penetrating keratoplasty, and Patient 3 (a 22-year-old male) underwent penetrating keratoplasty. The corneal samples retrieved after surgical intervention were assessed for histology features and immunohistochemistry (IHC) studies. Results: The grafts were clear till the follow-up of 2–18 months. Histopathology of all four corneal samples showed epithelial hyperplasia, absent Bowman layer, thick hyalinized stromal lamellae, vascularization, and chronic inflammatory cells such as lymphocytes and plasma cells. IHC showed strong expression of CK 3 in both eyes of Patient 1 and no expression in Patients 2 and 3. The marker for limbal stem cells, ABCG2, was absent in all four samples; however, p63α was expressed strongly in Patients 2 and 3, moderately in the right eye of Patient 1, and marginally expressed in the left eye of Patient 1. Conclusion: The eyes in the sequelae stage of VKC (having corneal scarring and 360° hypertrophied limbus) can be managed favorably with keratoplasty and amniotic membrane transplantation without allogenic/cadaveric stem cell transplantation. The expression of transient progenitor cells in the scarred corneas of VKC patients in the sequelae stage suggests that the limbal stem cell dysfunction is more likely partial and self-renewal of limbal stem cells is a plausibility in these eyes.

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Section: Discussionsupporting

confidence: 87%

Clinical, histological and immunohistochemistry characteristics of cornea in the sequelae stage of chronic vernal keratoconjunctivitis

Jaffet

Singh²,

Chaurasia³

et al. 2021

Indian Journal of Ophthalmology

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“…However, a comprehensive assessment of the progressive changes in corneal biomechanical properties associated with burn may necessitate more repeated measurements conducted in shorter time intervals over a more extended period. Such a long-term study may provide better temporal resolution of corneal stiffness change during collagen remodeling, which may not be complete even after several months [7,63]. Second, it is understood that the dose and function of ketamine anesthesia affects the IOP [64,65], which was shown to affect the stiffness of the cornea significantly [66].…”

Section: Discussionmentioning

confidence: 99%

Longitudinal assessment of the effect of alkali burns on corneal biomechanical properties using optical coherence elastography

Mekonnen

Lin

Zevallos-Delgado

et al. 2022

Journal of Biophotonics

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Eye injury due to alkali burn is a severe ocular trauma that can profoundly affect corneal structure and function, including its biomechanical properties. Here, we assess the changes in the mechanical behavior of mouse corneas in response to alkali‐induced injury by conducting longitudinal measurements using optical coherence elastography (OCE). A non‐contact air‐coupled ultrasound transducer was used to induce elastic waves in control and alkali‐injured mouse corneas in vivo, which were imaged with phase‐sensitive optical coherence tomography. Corneal mechanical properties were estimated using a modified Rayleigh–Lamb wave model, and results show that Young's modulus of alkali‐burned corneas were significantly greater than that of their healthy counterparts on days 7 (p = 0.029) and 14 (p = 0.026) after injury. These findings, together with the changes in the shear viscosity coefficient postburn, indicate that the mechanical properties of the alkali‐burned cornea are significantly modulated during the wound healing process.

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“…Injury to the ocular surface via chemical or thermal burns, radiation, or ocular surgery is a serious and vision-threatening cause of LSCD. Chemical and thermal burns to the ocular surface, classified under chemical insults, are the leading cause of LSCD [ 54 ] and produce corneal edema and limbal ischemia, resulting in corneal neovascularization and conjunctivalization. One chemical noted to cause delayed LSCD is total body exposure to sulfur mustard [ 55 ].…”

Section: Etiologies and Additional Treatmentsmentioning

confidence: 99%

“…One chemical noted to cause delayed LSCD is total body exposure to sulfur mustard [ 55 ]. Progression of a corneal burn leads to increased vascularization and disruption of the limbal layer, resulting in LSCD [ 54 ]. The severity of the burn to the ocular surface depends upon the degree of surface contact and penetration [ 56 ].…”

Section: Etiologies and Additional Treatmentsmentioning

confidence: 99%

The Multifold Etiologies of Limbal Stem Cell Deficiency: A Comprehensive Review on the Etiologies and Additional Treatment Options for Limbal Stem Cell Deficiency

Moshirfar,

Masud,

Harvey

et al. 2023

JCM

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Given the various ocular manifestations of limbal stem cell insufficiency, an awareness of the genetic, acquired, and immunological causes and associated additional treatments of limbal stem cell deficiency (LSCD) is essential for providers. We performed a comprehensive review of the literature on the various etiologies and specific therapies for LSCD. The resources utilized in this review included Medline (PubMed), Embase, and Google Scholar. All English-language articles and case reports published from November 1986 through to October 2022 were reviewed in this study. There were collectively 99 articles on these topics. No other exclusion criteria were applied. Depending on the etiology, ocular manifestations of limbal stem cell deficiency range from dry eye syndrome and redness to more severe outcomes, including corneal ulceration, ocular surface failure, and vision loss. Identifying the source of damage for LSCD is critical in the treatment process, given that therapy may extend beyond the scope of the standard protocol, including artificial tears, refractive surgery, and allogeneic stem cell transplants. This comprehensive review of the literature demonstrates the various genetic, acquired, and immunological causes of LSCD and the spectrum of supplemental therapies available.

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Long term observation of ocular surface alkali burn in rabbit models: Quantitative analysis of corneal haze, vascularity and self-recovery

Cited by 14 publications

References 34 publications

Clinical, histological and immunohistochemistry characteristics of cornea in the sequelae stage of chronic vernal keratoconjunctivitis

Clinical, histological and immunohistochemistry characteristics of cornea in the sequelae stage of chronic vernal keratoconjunctivitis

Longitudinal assessment of the effect of alkali burns on corneal biomechanical properties using optical coherence elastography

The Multifold Etiologies of Limbal Stem Cell Deficiency: A Comprehensive Review on the Etiologies and Additional Treatment Options for Limbal Stem Cell Deficiency

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