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Cureus Sep 2021Pterygium is a common ocular disease caused by abnormal cellular proliferation leading to abnormal fibrovascular growth of the conjunctiva. The main treatment is... (Review)
Review
Pterygium is a common ocular disease caused by abnormal cellular proliferation leading to abnormal fibrovascular growth of the conjunctiva. The main treatment is surgical removal; however, despite the improvement of surgical techniques and development of adjuvant therapies, postoperative recurrence, which can be as high as 89%, remains a challenge. Currently, pterygium excision with conjunctival autograft remains the preferred surgical technique, although there is no gold standard technique to prevent pterygium recurrence. We have conducted a thorough and comprehensive review of the scientific literature regarding the use of PRF membranes in pterygium surgery. We aim to assess the safety, effectiveness, and applicability of platelet-rich fibrin membrane for primary pterygium surgery and assess its possible benefits in resource-limited settings.
PubMed: 34660083
DOI: 10.7759/cureus.17884 -
International Journal of Ophthalmology 2023Pterygium is a prevalent ocular disease that can cause discomfort and vision impairment. Early and accurate diagnosis is essential for effective management. Recently,...
Pterygium is a prevalent ocular disease that can cause discomfort and vision impairment. Early and accurate diagnosis is essential for effective management. Recently, artificial intelligence (AI) has shown promising potential in assisting clinicians with pterygium diagnosis. This paper provides an overview of AI-assisted pterygium diagnosis, including the AI techniques used such as machine learning, deep learning, and computer vision. Furthermore, recent studies that have evaluated the diagnostic performance of AI-based systems for pterygium detection, classification and segmentation were summarized. The advantages and limitations of AI-assisted pterygium diagnosis and discuss potential future developments in this field were also analyzed. The review aims to provide insights into the current state-of-the-art of AI and its potential applications in pterygium diagnosis, which may facilitate the development of more efficient and accurate diagnostic tools for this common ocular disease.
PubMed: 37724272
DOI: 10.18240/ijo.2023.09.04 -
Asia-Pacific Journal of Ophthalmology... 2019
Topics: Humans; Ophthalmologic Surgical Procedures; Pterygium
PubMed: 31789641
DOI: 10.1097/APO.0000000000000269 -
Drug Discovery Today Jan 2023Pterygium is a fibrovascular tissue growth invading the cornea. Adjunctive treatment post-surgery includes conventional immunosuppressants as well as antiviral drugs.... (Review)
Review
Pterygium is a fibrovascular tissue growth invading the cornea. Adjunctive treatment post-surgery includes conventional immunosuppressants as well as antiviral drugs. The use of large- and small-molecule antivascular endothelial growth factor (VEGF) agents remains an integral part of pterygium treatment as well as other neovascular conditions of the eye. Naturally occurring polyphenolic compounds have favorable characteristics for treating neovascular and inflammatory eye conditions, including good efficacy, stability, cost-effectiveness, and the versatility of their chemical synthesis. In this review, we discuss pharmacological treatments of pterygium. Natural products, such curcumin, ellagic acid, and chalcones, are reviewed, with emphasis on their potential as future pterygium treatments.
Topics: Humans; Pterygium; Biological Products; Conjunctiva; Cornea
PubMed: 36280041
DOI: 10.1016/j.drudis.2022.103416 -
Cornea Feb 2020To test the hypothesis that pterygium presents with both refractive and anatomical changes, especially short axial length.
PURPOSE
To test the hypothesis that pterygium presents with both refractive and anatomical changes, especially short axial length.
METHODS
A retrospective, hospital-based cross-sectional study included 521 eyes from 521 patients who were enrolled through a community survey by Shanghai Heping Eye Hospital was conducted. Patients with primary pterygium in at least 1 eye were considered the pterygium group, and those with normal eyes were considered the nonpterygium group. The prevalence and length of pterygium, refractive characteristics including spherical power, astigmatism, corneal curvature, and anatomical parameters including axial length, anterior chamber depth, endothelial cell density, and corneal thickness were compared between groups.
RESULTS
Five hundred twenty-one eyes of 521 patients (214 men and 307 women) with a mean age of 70.5 ± 7.6 years were included in the study. The prevalence of hyperopia (81.6%, 65.1%, P = 0.001), axial length (23.1 ± 1.2 mm, 24.2 ± 2.4 mm, P < 0.001), anterior chamber depth (2.9 ± 0.3 cm, 3.1 ± 0.4 cm, P = 0.001), flat K value (42.94 ± 2.16 diopters, 43.73 ± 1.48 diopters, P = 0.002), Kmax (51.13 ± 7.74 diopters, 47.49 ± 5.62 diopters, P < 0.001), and spherical power (0.97 ± 2.40 diopters, -0.82 ± 4.40 diopters, P < 0.001) were statistically different between the pterygium and nonpterygium groups. Age (r = -0.21, P = 0.025), corneal astigmatism (r = -0.41, P < 0.001), flat K value (r = -0.39, P < 0.001), and endothelial cell density (r = -0.33, P = 0.001) were all negatively correlated with the length of pterygium. The prevalence of pterygium and severe pterygium over 3 mm were statistically different according to the severity of hyperopia (P < 0.001) and axial length (P < 0.001). Stratified χ analysis showed that axial length, rather than hyperopia, was a related factor to pterygium (odds ratio = 5.23, 95% confidence interval: 2.50-10.93).
CONCLUSIONS
We conclude from our study that the prevalence of pterygium is related to small eye size. SDF-1/CXCR4 signaling may play a vital role in pterygium and shorter axial length. Further study focused on SDF-1/CXCR4 signaling will be needed.
Topics: Aged; Axial Length, Eye; Biometry; Cross-Sectional Studies; Female; Humans; Hyperopia; Male; Middle Aged; Pterygium; Refraction, Ocular; Retrospective Studies; Vision Tests; Visual Acuity
PubMed: 31714404
DOI: 10.1097/ICO.0000000000002200 -
International Journal of Oncology May 2019Human papillomavirus (HPV) infection has been implicated as a primary cause of lesions in the anogenital region, skin, oropharynx and respiratory tract. Additionally,... (Review)
Review
Human papillomavirus (HPV) infection has been implicated as a primary cause of lesions in the anogenital region, skin, oropharynx and respiratory tract. Additionally, the role of HPV in the pathogenesis of ocular surface disease has also been extensively studied. Conjunctival papilloma development has been strongly associated with the HPV infection of certain subtypes. On the other hand, the role of HPV in conjunctival pterygium, conjunctival intraepithelial neoplasia (CIN) and ocular surface squamous neoplasia (OSSN) remains controversial. Genetic predisposition and environmental factor is important in HPV hosts as regards the pathogenesis of ocular surface disease. Several studies have indicate a synergic role of HPV with ultraviolet radiation in pterygium establishment. A higher recurrence risk rate and more aggressive disease of ophthalmic pterygium is observed in cases of HPV infection. The purpose of this review was to provide a systematic review of the literature and to assist in a better understanding of the role of HPV in ocular surface disease.
Topics: Carcinoma in Situ; Carcinoma, Squamous Cell; Conjunctiva; Conjunctival Neoplasms; Eye Neoplasms; Humans; Papillomavirus Infections; Pterygium
PubMed: 30896784
DOI: 10.3892/ijo.2019.4755 -
PeerJ 2020Pterygium results from a variety of biological pathways that are involved in the formation of ocular surface diseases. However, the exact pathogenesis of pterygium is...
PURPOSE
Pterygium results from a variety of biological pathways that are involved in the formation of ocular surface diseases. However, the exact pathogenesis of pterygium is still unclear. Our study focused on gene expression profiles to better understand the potential mechanisms of pterygium.
METHODS
RNA sequencing experiments were performed on clinical pterygium tissues and normal conjunctival tissues. To identify the hub genes for the development of pterygium, we further conducted weighted gene co-expression network analysis (WGCNA). qRT-PCR was utilized to validate the dysregulation of the most significant differentially expressed genes (DEGs) and key hub genes in the independent subjects.
RESULTS
A total of 339 DEGs (P-adjusted < 0.05 and log2 fold change [log2FC] ≥ 1.0) were obtained that reached statistical significance with p-values < 0.05. Among them, 200 DEGs were upregulated; these genes were mainly associated with the extracellular matrix and with cell adhesion or migration. In contrast, the 139 downregulated genes were enriched for endocrine and inflammation pathways. With regard to WGCNA, five modules were assigned based on the DEG profiles, and the biological functions of each module were verified with previously published GO terms. The functions included ECM-receptor interactions, the PI3K-Akt signalling pathway and an endoplasmic reticulum (ER)-related pathway. The five hub genes with the highest connectivity in each module and the five most significant DEGs showed dysregulated expression in the independent cohort samples.
CONCLUSIONS
RNA sequencing and WGCNA provided novel insights into the potential regulatory mechanisms of pterygium. The identified DEGs and hub genes, which were classified into two groups according to different functions or signalings, may provide important references for further research on the molecular biology of pterygium.
PubMed: 32411530
DOI: 10.7717/peerj.9056 -
International Ophthalmology Dec 2023Hypoxia-inducible factors (HIFs) are considered to play a significant role in the pathogenesis of pterygium. The aim of this study was to investigate the relative...
PURPOSE
Hypoxia-inducible factors (HIFs) are considered to play a significant role in the pathogenesis of pterygium. The aim of this study was to investigate the relative expression or immunoreactivity of HIF1α and HIF2α in the epithelium of primary pterygium, recurrences and healthy conjunctiva.
METHODS
Immunohistochemical staining was performed with antibodies against HIF1α and HIF2α, respectively, on 55/84 primary pterygium specimens, 6/28 recurrences and 20/20 control tissues (healthy conjunctiva).
RESULTS
Immunohistochemical staining revealed lower epithelial immunoreactivity of HIF1α and HIF2α in both primary pterygium (11% and 38%) and recurrences (18% and 21%) when compared to healthy conjunctival tissue (46% and 66%). Differences between immunoreactivity of HIF1α and of HIF2α in primary pterygium and controls were each highly significant (p < .001). Within the group of primary pterygium, epithelial immunoreactivity of HIF2α (38%) was significantly higher than that of HIF1α (11%). In recurrent pterygium and healthy conjunctiva, immunoreactivity levels of HIF2α were higher than those of HIF1α as well; however, differences between both isoforms were not significant.
CONCLUSION
Our study shows evidence that the higher expressed epithelial HIF2α, rather than HIF1α, and the balance between both HIF isoforms might be relevant factors associated with pathogenesis of primary pterygium. Modulation of HIF2α levels and activity may thus offer a new therapeutic approach to the treatment of advancing pterygium where the initial stage with its HIF1-peak has already passed.
Topics: Humans; Pterygium; Epithelium; Conjunctiva; Protein Isoforms
PubMed: 37684398
DOI: 10.1007/s10792-023-02855-3 -
Romanian Journal of Ophthalmology 2016Pterygium is characterized by the thickening of the bulbar conjunctiva and the invasion of the cornea from the sclerocorneal limbus to the central portion of the cornea....
Pterygium is characterized by the thickening of the bulbar conjunctiva and the invasion of the cornea from the sclerocorneal limbus to the central portion of the cornea. Pterygium produces corneal deformation, which extends toward the central portion of the cornea. The visual disorders depend on the corneal extent. The treatment goal is the removal of the corneal and conjunctival portion of the pterygium and the coverage of the resulting conjunctival defect. The association of the pterygium surgical excision was assessed with conjunctival autograft. For this purpose, a retrospective study was performed on 68 patients and was extended over 7 years (2009-2015). Patients with recurrent pterygium were excluded. The time for corneal re-epithelization and for the pain and photophobia disappearance was followed. The incidence of recurrence was also observed. Pain levels were assessed by using a 10-point visual analog linear scale (VAS). The mean time for ocular pain and photophobia disappearance was of 48 hours. The mean pain score was 3.38 at 24 hours after surgery. Corneal re-epithelialization was achieved in 60 hours after surgery. Recurrence occurred in 6 patients. It was concluded that pterygium surgical excision with conjunctival autograft is effective in pterygium surgery.
Topics: Adult; Autografts; Conjunctiva; Epithelium, Corneal; Female; Humans; Male; Middle Aged; Ophthalmologic Surgical Procedures; Pterygium; Re-Epithelialization; Retrospective Studies; Transplantation, Autologous; Treatment Outcome
PubMed: 29450343
DOI: No ID Found -
Frontiers in Medicine 2022Pterygium is a common ocular surface disease. When pterygium significantly invades the cornea, it limits eye movement and impairs vision, which requires surgery to...
Pterygium is a common ocular surface disease. When pterygium significantly invades the cornea, it limits eye movement and impairs vision, which requires surgery to remove. It is medically recognized that when the width of the pterygium that invades the cornea is >3 mm, the patient can be treated with surgical resection. Owing to this, this study proposes a system for diagnosing and measuring the pathological progress of pterygium using deep learning methods, which aims to assist doctors in designing pterygium surgical treatment strategies. The proposed system only needs to input the anterior segment images of patients to automatically and efficiently measure the width of the pterygium that invades the cornea, and the patient's pterygium symptom status can be obtained. The system consists of three modules, including cornea segmentation module, pterygium segmentation module, and measurement module. Both segmentation modules use convolutional neural networks. In the pterygium segmentation module, to adapt the diversity of the pterygium's shape and size, an improved U-Net++ model by adding an Attention gate before each up-sampling layer is proposed. The Attention gates extract information related to the target, so that the model can pay more attention to the shape and size of the pterygium. The measurement module realizes the measurement of the width and area of the pterygium that invades the cornea and the classification of pterygium symptom status. In this study, the effectiveness of the proposed system is verified using datasets collected from the ocular surface diseases center at the Affiliated Eye Hospital of Nanjing Medical University. The results obtained show that the Dice coefficient of the cornea segmentation module and the pterygium segmentation module are 0.9620 and 0.9020, respectively. The Kappa consistency coefficient between the final measurement results of the system and the doctor's visual inspection results is 0.918, which proves that the system has practical application significance.
PubMed: 35237630
DOI: 10.3389/fmed.2022.819971