Ocular surface inflammation and ectatic corneal disorders

Abstract

Purpose of review Inflammatory mediators are a focus of recent corneal ectasia (CE) research and are a profound, modifiable contributor to CE in general and keratoconus (KC) in particular, opening a path to explore new methods of control. As advanced imaging technology and expanded population screening allow for earlier detection, the possibility of early intervention can profoundly change the prognosis of CE. Recent findings Significant increases in the inflammatory mediators and immune components have been observed in the cornea, tear fluid, and blood of ectasia patients, while inflammation dampeners such as vitamin D and their receptors are reduced. Atopy and allergy have a strong association with KC, known to increase itch factors and stimulate eye rubbing, a risk factor in ectasia pathogenesis. Management of atopy or allergic conditions and topical anti-inflammatories has helped stabilize CE disease. Summary Strategies such as monitoring inflammatory factors and using immune or inflammatory modulators, including managing subclinical inflammation, may be clinically beneficial in stabilizing the disease and improving outcomes. The detected factors are biomarkers, but as yet unproven to be sensitive or specific enough to be considered biomarkers for early detection of CE. The establishment of such biomarkers could improve the therapeutic outcome.

The Role of Vitamin D3 in Ocular Diseases

“…People suffering from this disease have the tendency to have lower serum levels of 25-hydroxyvitamin D than healthy ones [ 18 ]. Elevated levels of inflammatory mediators and immune elements have been noted in the cornea, tear fluid, and bloodstream of individuals suffering from this ailment, while anti-inflammatory agents such as vitamin D and their receptors were diminished [ 19 ]. The presence of vitamin D receptor polymorphism has been linked to the onset of keratoconus.…”