-
International Journal of Ophthalmology 2021To investigate the retinal vascular network alterations in eyes of patients with pterygium.
AIM
To investigate the retinal vascular network alterations in eyes of patients with pterygium.
METHODS
Totally 18 left eyes from 18 female pterygium patients and 18 left eyes from 18 female healthy control subjects were enrolled. Optical coherence tomography angiography (OCTA) images were generated of the superficial retinal layer and deeper retinal layer of the macular retina for each eye. The microvascular (MIR) and macrovascular (MAR) densities were calculated and MIR, MAR, and total microvascular (TMI) density was compared in the healthy control and pterygium groups.
RESULTS
In pterygium group, in the superficial retinal layer, the vascular density in superficial MIR, superior right (SR), inferior right (IR), right (R), superficial central annuli (SC)1, SC2, and SC3 decreased significantly in the macular area (<0.05). Furthermore, the vascular density in all those decreased regions except R, was significantly and negatively correlated with the disease course (=-0.6038 to -0.7762, =0.0008), and the area size of pterygium (=-0.6043 to -0.9508, <0.05). For the deeper retinal layer, the density of deep total microvessel (DTMI), deeper MIR, SR, IR, R, DC2, and DC3 decreased significantly in macular area of pterygium patients (<0.05). Furthermore, the vascular density in all those decreased regions was significantly and negatively correlated with the disease course (=-0.6901 to -0.7795, =0.0015), and the area size of pterygium (=-0.6043 to -0.9563, <0.05). No statistically significant differences and correlation was found in other region density (|r|<0.47, >0.05).
CONCLUSION
OCTA findings suggest that pterygium patients present with decreased retinal MIR density, and the major vascular alterations occurr mainly on the bitamporal side. The vascular density of the superficial SC1, SC2, SC3 adjacent to the foveal and deep layer of DC2, DC2 regions, significantly decreased.
PubMed: 34926200
DOI: 10.18240/ijo.2021.12.08 -
Cornea May 2022The purpose of this study was to evaluate the presence and pattern of autofluorescence and its related cytological changes in pterygium.
PURPOSE
The purpose of this study was to evaluate the presence and pattern of autofluorescence and its related cytological changes in pterygium.
METHODS
Eighty-six patients with unilateral pterygium and 76 controls were recruited. We graded pterygium, looked for autofluorescence, performed cytology of the nasal conjunctiva, repeated evaluation after 6 months, compared findings with controls, and assessed the progression of pterygium from photographs with the help of ImageJ software.
RESULTS
Autofluorescence was present in 51% of cases with pterygium. Autofluorescence at the leading edge (65.9%) was the predominant pattern seen. In total, 83.3% of grade 3 pterygia, 64.7% of grade 2 pterygia, and 28.9% of grade 1 pterygia (P value <0.0005) had autofluorescence. Impression cytology showed conjunctival epithelial cells in 60% of cases, significant squamous metaplasia in grade 3 pterygia (45%) compared with grade 2 pterygia (11.8%), and normal conjunctival epithelial cells in grade 1 pterygia (P value < 0.0005).
CONCLUSIONS
The presence and pattern of conjunctival autofluorescence and cytological changes, especially squamous metaplasia, are linked to the severity or grade of pterygium.
Topics: Conjunctiva; Epithelial Cells; Humans; Metaplasia; Pterygium
PubMed: 34469339
DOI: 10.1097/ICO.0000000000002820 -
The Ocular Surface Jan 2021To evaluate any correlation between pterygium laterality and patient handedness. (Observational Study)
Observational Study
PURPOSE
To evaluate any correlation between pterygium laterality and patient handedness.
METHODS
Our study represents a retrospective observational study of a series of consecutive pterygium patients recruited from two centres. Each patient was assessed for their handedness which was compared to the laterality of their presenting pterygium. Patients that possessed bilateral disease comparisons between pterygium size and handedness were made. Correlation statistics were performed to compare patient handedness and pterygium location (right or left). For patients possessing bilateral disease only, the pre-surgical differences between lengths and areas of pterygium were calculated and compared.
RESULTS
A total of 219 patients were recruited into our study. 172 patients possessed unilateral disease and in 47 patients, the disease was bilateral. A significant association was identified between handedness and pterygium laterality (p < 0.001). Patients with right-sided pterygia were more likely to be right-handed (OR 2.327) and left-sided presentations who were more likely to be left-handed (OR 5.717). For bilateral presentations, patients were found to have longer (mean increase 3.50 ± 0.47 mm) and larger (mean increase 4.38 ± 0.48 mm) pterygia in the eye ipsilateral to their dominant hand.
CONCLUSIONS
A new insight of handedness as a contributing factor to pterygium laterality is consistent with evidence relating to the asymmetrical development of cortical cataract as well as to theories underlying the geometry of ocular UV exposure. A more complete understanding of factors contributing to ocular insolation may further inform as to improved protective measures and provides further evidence for the role of peripheral light focusing in pterygium pathogenesis.
Topics: Conjunctiva; Functional Laterality; Humans; Pterygium; Retrospective Studies
PubMed: 33309855
DOI: 10.1016/j.jtos.2020.12.001 -
Seminars in Ophthalmology Nov 2023To evaluate risk factors for pterygium and prevalence of periocular and systemic diseases among patients with pterygium. (Review)
Review
PURPOSE
To evaluate risk factors for pterygium and prevalence of periocular and systemic diseases among patients with pterygium.
METHODS
A retrospective case-control study was conducted among members of Clalit Health Services (CHS) in Israel, from 2001 to 2022. A total of 13,944 patients diagnosed with pterygium were included. For each case, three controls were matched among all CHS patients according to year of birth, sex, and ethnicity. Mixed models were used to assess differences in demographic characteristics, ocular and systemic diseases between the groups. Generalized estimating equation (GEE) logistic regression was used to estimate the odds ratios (OR) and adjust for confounders.
RESULTS
The average age of pterygium patients was 49 ± 17 years; 51% were male. The results showed significant associations between pterygium and risk factors of vernal kerato-conjunctivitis (OR 2.52, 95% confidence interval [CI]: [1.96-3.24]), chronic allergic conjunctivitis (OR 1.98, 95% CI: [1.65-2.39]), blepharitis (OR 1.91, 95% CI: [1.78-2.04]), chalazion (OR 1.47, 95% CI: [1.30-1.67]) and unspecified systemic allergy (OR 1.21, 95% CI [1.09-1.34]), after adjusting for rural residency status. Glaucoma (OR 0.74, 95% CI [0.64-0.85]) and smoking (OR 0.70, 95% CI [0.66-0.75]) were protective factors against pterygium.
CONCLUSION
Systemic and periocular inflammatory and allergic diseases are risk factors for pterygium.
Topics: Humans; Male; Adult; Middle Aged; Aged; Female; Pterygium; Retrospective Studies; Case-Control Studies; Risk Factors; Prevalence; Conjunctivitis, Allergic
PubMed: 37303165
DOI: 10.1080/08820538.2023.2223266 -
International Journal of Environmental... Sep 2022The search for the "gold standard" in the surgical treatment of pterygium has been ongoing for over two decades. Despite the development of various surgical techniques,... (Review)
Review
The search for the "gold standard" in the surgical treatment of pterygium has been ongoing for over two decades. Despite the development of various surgical techniques, recurrence rates range from 6.7% to 88% depending on the method used. This review discusses the latest and most commonly used methods for the surgical removal of pterygium, primarily focusing on efficacy and safety. Moreover, this review includes articles that either evaluated or compared surgical methods and clinical trials for primary and recurrent pterygium. Limited data are available on combined methods as well as on the efficacy of adjuvant treatment. The use of adjuvant intraoperative mitomycin C (MMC) and conjunctival autografting (CAU) are the two most highly recommended options, as they have the lowest rates of postoperative recurrence.
Topics: Conjunctiva; Follow-Up Studies; Humans; Mitomycin; Pterygium; Recurrence; Treatment Outcome
PubMed: 36141628
DOI: 10.3390/ijerph191811357 -
International Ophthalmology Oct 2019The aim of the study was to measure amino acid levels with the metabolomics analysis in pterygium tissue and normal conjunctiva tissue.
PURPOSE
The aim of the study was to measure amino acid levels with the metabolomics analysis in pterygium tissue and normal conjunctiva tissue.
MATERIALS AND METHODS
In this prospective, randomized, clinical study, a comparison of the amino acid profile of pterygium tissue and normal conjunctiva tissue taken during autograft pterygium surgery was made. After homogenization of the tissues, amino acid levels were measured with chromatography-mass spectrometry (LC-MS/MS) in the biochemistry laboratory. Statistical analysis was made using the Wilcoxon signed-rank test.
RESULTS
Evaluation of pterygium and normal conjunctiva tissues of 29 patients, comprising 16 females and 13 males with a mean age of 54.75 ± 11.25 years (range 21-78 years) was made. While a dramatic increase was observed in all the amino acid levels in the pterygium tissue compared to the normal conjunctiva (p > 0.05), only the increases in arginine, methionine, glycine and tyrosine amino acids were determined to be statistically significant (p < 0.01), (p = 0.028), (p = 0.038), (p = 0.046).
CONCLUSION
Pterygium is known to be degenerative inflammatory fibrovascular tissue. When the aetiology is examined in depth, several metabolic processes are seen to have an effect. Further studies of the amino acid profile with more extensive patient series could confirm the data obtained in the current study and contribute to the clarification of the pathogenesis of pterygium.
Topics: Adult; Aged; Amino Acids; Conjunctiva; Female; Humans; Male; Metabolomics; Middle Aged; Prospective Studies; Pterygium; Young Adult
PubMed: 30617855
DOI: 10.1007/s10792-018-01069-2 -
Environmental Science and Pollution... Aug 2022Pterygium, one of the most common eye disorders, is an abnormal fibrovascular proliferation extending from the conjunctiva to the cornea. The mechanism of development in...
Pterygium, one of the most common eye disorders, is an abnormal fibrovascular proliferation extending from the conjunctiva to the cornea. The mechanism of development in pterygium has not been fully elucidated; however, oxidative stress is suggested to be one of the major causes. Heavy metals such as lead (Pb), cadmium (Cd), and mercury (Hg) enter the human body and induce oxidative stress. However, no study has investigated the association of these heavy metals with pterygium. Therefore, this study aimed to evaluate the associations of environmental exposures to Pb, Cd, and Hg with pterygium in the Korean general adults. We analyzed data from 6,587 adults (≥ 20 years of age) who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) 2008-2011. Pterygium was diagnosed as the presence of a wing-shaped fibrovascular growth. The exposures of Pb, Cd, and Hg were estimated by measuring blood concentrations. The prevalence of pterygium in this study population was 4.0% (348 subjects). After adjusting for potential confounders, the Pb level in blood was found to have a significant dose-dependent association with pterygium (p for trend = 0.001), and its highest quintile (vs. the lowest) had an odds ratio (OR) of 2.22 (95% CI: 1.30, 3.78) for pterygium. The Hg level in blood in the second quintile (vs. the lowest) had an OR of 1.64 (95% CI: 1.04, 2.59) for pterygium. In conclusion, this study suggests that environmental exposures to Pb and Hg in the Korean general adults may be related to the development of pterygium.
Topics: Adult; Cadmium; Conjunctiva; Environmental Exposure; Humans; Lead; Mercury; Metals, Heavy; Nutrition Surveys; Pterygium; Republic of Korea
PubMed: 35314935
DOI: 10.1007/s11356-022-19250-7 -
Computational and Structural... 2023There is limited knowledge about the impact of circulating lipids and lipid-modifying drugs on pterygium development, with conflicting results reported. Our study aimed...
There is limited knowledge about the impact of circulating lipids and lipid-modifying drugs on pterygium development, with conflicting results reported. Our study aimed to address these questions by applying the Mendelian randomization (MR) approach. A two-step MR model was developed. In the first step, bidirectional two-sample MR was employed to establish the causal relationship between circulating lipids and pterygium risk. In the second step, drug-target MR analysis was conducted to assess the causal effect of proprotein convertase subtilisin/kexin type 9 (PCSK9) and 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) inhibitors on pterygium outcomes. Genetically predicted low-density lipoprotein cholesterol (LDL-c) levels were found to be significantly associated with an increased risk of pterygium (Inverse variance weighted [IVW] odds ratio [OR] = 2.227; = 1.53 × 10). Similarly, higher total cholesterol (TC) levels exhibited a suggestive association with greater susceptibility to pterygium (IVW OR = 1.806; = 1.70 × 10). Through drug-target MR, a positive causal association was noted between HMGCR-mediated LDL-c levels and pterygium (IVW OR = 6.999; = 0.016), suggesting that statins may be effective in reducing pterygium risk. The present findings suggest that circulating TC and LDL-c are risk factors for pterygium. Additionally, the results indicate that HMGCR inhibitors, which lower LDL-c levels, have a potential protective effect on pterygium outcomes. Further research is warranted to elucidate the underlying mechanisms involved in pterygium pathogenesis, with a particular focus on cholesterol metabolism.
PubMed: 38022695
DOI: 10.1016/j.csbj.2023.11.002 -
Journal of Healthcare Engineering 2022A two-category model and a segmentation model of pterygium were proposed to assist ophthalmologists in establishing the diagnosis of ophthalmic diseases. A total of 367...
A two-category model and a segmentation model of pterygium were proposed to assist ophthalmologists in establishing the diagnosis of ophthalmic diseases. A total of 367 normal anterior segment images and 367 pterygium anterior segment images were collected at the Affiliated Eye Hospital of Nanjing Medical University. AlexNet, VGG16, ResNet18, and ResNet50 models were used to train the two-category pterygium models. A total of 150 normal and 150 pterygium anterior segment images were used to test the models, and the results were compared. The main evaluation indicators, including sensitivity, specificity, area under the curve, kappa value, and receiver operator characteristic curves of the four models, were compared. Simultaneously, 367 pterygium anterior segment images were used to train two improved pterygium segmentation models based on PSPNet. A total of 150 pterygium images were used to test the models, and the results were compared with those of the other four segmentation models. The main evaluation indicators included mean intersection over union (MIOU), IOU, mean average precision (MPA), and PA. Among the two-category models of pterygium, the best diagnostic result was obtained using the VGG16 model. The diagnostic accuracy, kappa value, diagnostic sensitivity of pterygium, diagnostic specificity of pterygium, and F1-score were 99%, 98%, 98.67%, 99.33%, and 99%, respectively. Among the pterygium segmentation models, the double phase-fusion PSPNet model had the best results, with MIOU, IOU, MPA, and PA of 86.57%, 78.1%, 92.3%, and 86.96%, respectively. This study designed a pterygium two-category model and a pterygium segmentation model for the images of the normal anterior and pterygium anterior segments, which could help patients self-screen easily and assist ophthalmologists in establishing the diagnosis of ophthalmic diseases and marking the actual scope of surgery.
Topics: Humans; Pterygium; Deep Learning; Research; Universities
PubMed: 36451763
DOI: 10.1155/2022/3942110 -
European Journal of Ophthalmology Sep 2022Pterygium is defined as overgrowth of abnormal conjunctival tissue on the cornea. Many proinflammatory cytokines and various growth factors have been implicated in the...
PURPOSE
Pterygium is defined as overgrowth of abnormal conjunctival tissue on the cornea. Many proinflammatory cytokines and various growth factors have been implicated in the pathogenesis of pterygium. Cyclophilin A (CyPA) is a protein that is used by cyclosporin A (CsA) as the intracellular receptor and is secreted in response to inflammatory stimuli. Vascular endothelial growth factor (VEGF) is the most important angiogenic factor. This study aimed to assessment CyPA and VEGF immunoreactivity in pterygium specimens.
MATERIAL AND METHODS
In this cross-sectional study, 32 primary pterygium samples, 25 recurrent pterygium samples and 25 normal bulbar conjunctiva samples were included. The histopathological features, CyPA and VEGF immunoreactivity of surgically excised pterygium specimens were compared with control conjunctiva specimens obtained from normal bulbar conjunctiva.
RESULTS
CyPA immunoreactivity in vascular endothelial cells, epithelial cells, and stromal cells was remarkably higher in pterygium specimens than control conjunctiva specimens ( = 0.004, = 0.012, = 0.001, respectively). Morever, VEGF immunoreactivity in endothelial cells was remarkably higher in pterygium specimens than control conjunctiva specimens (< 0.001). When recurrent and primary pterygium specimens were compared, CyPA and VEGF immunoreactivity was remarkably higher in recurrent pterygium ( = 0.001, = 0.001, respectively). Pearson correlation showed that CyPA immunoreactivity correlated with stromal vascularity, stromal inflammation, and mast cell count in pterygium specimens.
CONCLUSION
This study aimed to assess CyPA and VEGF may have a important function in the pathogenesis and recurrence of pterygium.
PubMed: 36147022
DOI: 10.1177/11206721221128664