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La Tunisie Medicale Jul 2023Pterygium surgery is a closed globe surface surgery. Although it is perfectly standard and followed by excellent results, it is not exempt from the general rule that...
INTRODUCTION
Pterygium surgery is a closed globe surface surgery. Although it is perfectly standard and followed by excellent results, it is not exempt from the general rule that there is no surgery without risk. It therefore seems important to integrate simulation as a pedagogical tool for training ophthalmology residents in pterygium surgery.
AIM
To evaluate the effectiveness of procedural simulation as a training tool for pterygium surgery.
RESULTS
During the study period, eight residents participated in the three workshops. The global assessment of residents' knowledge showed a mean score of 3/5 [1.5/5-4/5] and 4.1/5 [3.25/5-5/5] before and after the training respectively. There was a significant negative correlation between the initial score on the pre-test and the improvement of this score on the post-test, with an r'=-0.87 and a p=0.005. We noted a significant improvement in the global performance score (p<0.001) and even a significant improvement in the specific performance score (p=0.02) between the 3 workshops. The average training satisfaction score was 13.87/16 [10/16-16/16]. We noted a significant positive correlation with r=0.838 and p=0.009 between knowledge improvement and learner satisfaction.
CONCLUSION
The training of fundus examination using an ophthalmoscopic simulator can improve the skills and knowledge of ophthalmic learners. This type of training can be an innovative addition to traditional learning methods.
Topics: Humans; Pterygium; Fundus Oculi; Knowledge; Ophthalmology; Ophthalmoscopy
PubMed: 38445419
DOI: No ID Found -
Molecular Genetics & Genomic Medicine Mar 2024The MYH3-associated myosinopathies comprise a spectrum of rare neuromuscular disorders mainly characterized by distal arthrogryposis with or without other features like...
BACKGROUND
The MYH3-associated myosinopathies comprise a spectrum of rare neuromuscular disorders mainly characterized by distal arthrogryposis with or without other features like pterygia and vertebrae fusion. CPSKF1B (contractures, pterygia, and spondylocarpotarsal fusion syndrome1B) is the only known autosomal recessiveMYH3-associated myosinopathy so far, with no more than two dozen cases being reported.
MATERIALS AND METHODS
A boy with CPSKF1B was recruited and subjected to a comprehensive clinical and imaging evaluation. Genetic detection with whole-exome sequencing (WES) was performed on the patient and extended family members to identify the causative variation. A series of in silico and in vitro investigations were carried out to verify the pathogenicity of the two variants of the identified compound heterozygous variation.
RESULTS
The patient exhibited moderate CPSKF1B symptoms including multiarticular contractures, webbed neck, and spondylocarpotarsal fusion. WES detected a compound heterozygous MYH3 variation consisting of two variants, namely NM_002470.4: c.3377A>G; p. (E1126G) and NM_002470.4: c.5161-2A>C. It was indicated that the NM_002470.4: c.3377A>G; p. (E1126G) variant mainly impaired the local hydrogen bond formation and impacted the TGF-B pathway, while the NM_002470.4: c.5161-2A>C variant could affect the normal splicing of pre-mRNA, resulting in the appearance of multiple abnormal transcripts.
CONCLUSIONS
The findings of this study expanded the mutation spectrum of CPSKF1B, provided an important basis for the counseling of the affected family, and also laid a foundation for the functional study of MYH3 mutations.
Topics: Humans; Male; Arthrogryposis; Conjunctiva; Contracture; Family; Pterygium
PubMed: 38444278
DOI: 10.1002/mgg3.2401 -
European Journal of Ophthalmology Mar 2024To assess the clinical outcomes of symblepharon release in patients with ocular surface chemical injury using Gore-Tex as a novel treatment option.
PURPOSE
To assess the clinical outcomes of symblepharon release in patients with ocular surface chemical injury using Gore-Tex as a novel treatment option.
METHODS
This was a retrospective analysis of 23 eyes of 22 chemical injury patients done during a period of January 2014 to December 2021 at a tertiary eye care centre in South India. All patients underwent symblepharon lysis along with Gore-Tex application over the sclera with minimum 1 year follow up. The patients were assessed for demographic details, visual acuity, intraocular pressure, anterior and posterior segment details, photographic documentation, preoperative diagnosis, previous surgical details in recurrent cases, surgical procedures, final visual acuity, surgical outcomes, and complications. The clinical outcomes were assessed and outcomes were defined as success, partial success, or failure.
RESULTS
The median age was 17 years (IQR, 12-39 years). Among them 10 eyes with symblepharon had grade 3 length, 12 eyes grade 3 width and 12 eyes had grade 3 loss of palisades of Vogt. The success was achieved in 52.2% of the patients; partial success in 34.8% and 13.3% had failure. The mean duration of recurrence was 6.75 ± 3.6 months. Failure was noted in young patients with mean age 9.75years and with grade 3c symblepharon. There was no sight threatening complications noted.
CONCLUSION
The study showed very good results with Gore-Tex as a novel treatment option for chemical injury patient with symblepharon formation. It can be easily employed to prevent the symblepharon recurrence of various ocular surface disorders.
PubMed: 38444229
DOI: 10.1177/11206721241238302 -
Health Science Reports Mar 2024Vernal Keratoconjunctivitis (VKC) has been determined to be highly prevalent in countries within the tropical climate region. However, little evidence from studies...
BACKGROUND
Vernal Keratoconjunctivitis (VKC) has been determined to be highly prevalent in countries within the tropical climate region. However, little evidence from studies conducted within this region has been put forward to support this claim.
AIM
To determine the prevalence and risk factors of VKC among a Ghanaian clinical cohort.
METHODS
A 3-year case-control study was conducted in a tertiary eye care institution, and medical records of patients who had been diagnosed of VKC between 2018 and 2021 were reviewed.
RESULTS
Medical records of 3800 patients were reviewed. Some cases of VKC were identified, with a population prevalence rate of . Males comprised of the population with VKC, with a male-to-female ratio of . The disease was more prevalent (40.8%) in children (17 years), and the overall odds of incidence decreased by 10% for a unit increase in age. Age and sex-adjusted models revealed significant positive associations between Keratoconus [aOR = 40.760, 95% CI -5.948 to 339.937], Rhinitis [cOR = 5.183, 95% CI -2.074 to 12.022] and VKC. However, the incidence of VKC was relatively less expressive among pterygium cases [cOR = 0.315, 95% CI -0.077 to 0.846].
CONCLUSION
VKC is highly prevalent among children and is often associated with comorbidities of atopic origin that exacerbate the impact of the disease among this vulnerable population. It is imperative that clinicians provide holistic care for children with VKC.
PubMed: 38440260
DOI: 10.1002/hsr2.1957 -
The Ocular Surface Jul 2024Chronic inflammation is a predisposing factor for metaplastic changes and ultimately dysplasia. We describe cases of OSSN occurring in the setting of chronic ocular...
PURPOSE
Chronic inflammation is a predisposing factor for metaplastic changes and ultimately dysplasia. We describe cases of OSSN occurring in the setting of chronic ocular surface inflammation.
METHODS
Sixteen eyes from 14 individuals were included from one ocular oncology clinic between 2010 and 2023. Patients presented with ocular surface squamous neoplasia (OSSN) in the setting of chronic inflammation. The diagnosis of OSSN was made using anterior segment high-resolution optical coherence tomography (HR-OCT) and confirmed by histopathological analysis in all cases.
RESULTS
Median age on presentation was 61 [IQR 47.5-69.2] years. Eleven (86%) individuals were male and five (36%) identified as White Hispanic. Ten eyes were referred with ocular surface diagnoses including pannus (n = 4), scarring (n = 3), pterygium (n = 2), and herpetic keratitis (n = 1). Only six eyes were referred as possible neoplasia. All individuals had a history of ocular surface inflammation. The most common inflammatory conditions were ocular rosacea (seven individuals) and atopic keratoconjunctivitis (AKC) (five individuals). Two individuals were found to have bilateral OSSN, one in the setting of ocular rosacea and the other in the setting of AKC. All 16 eyes from 14 individuals were suspected to have OSSN based on HR-OCT findings which guided the location of the incisional biopsies that subsequently confirmed histopathological diagnosis in all cases.
CONCLUSION
OSSN may arise in the setting of chronic inflammation on the ocular surface. Identification of the tumor can be challenging in these cases, and HR-OCT can be a key diagnostic tool in detecting OSSN.
Topics: Humans; Male; Middle Aged; Female; Aged; Risk Factors; Tomography, Optical Coherence; Chronic Disease; Retrospective Studies; Carcinoma, Squamous Cell; Eye Neoplasms; Inflammation; Conjunctival Neoplasms; Corneal Diseases
PubMed: 38432640
DOI: 10.1016/j.jtos.2024.02.006 -
In Vivo (Athens, Greece) 2024In the literature, the studies about the role of matrix metalloproteinase-2 (MMP-2) in pterygium diagnosis are mainly based on its protein expression. The role of MMP-2...
BACKGROUND/AIM
In the literature, the studies about the role of matrix metalloproteinase-2 (MMP-2) in pterygium diagnosis are mainly based on its protein expression. The role of MMP-2 variants has never been examined. The aim of this study was to examine the association of MMP-2 genotypes with pterygium risk.
MATERIALS AND METHODS
MMP-2 rs243865 and rs2285053 were genotyped in 140 pterygium cases and 280 non-pterygium controls by typical polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) genotyping technology.
RESULTS
The genotypic frequency of MMP-2 rs243865 CC, CT and TT were 86.4%, 12.9% and 0.7% in the pterygium group and 81.1%, 17.1% and 1.8% in the non-pterygium group (p for trend=0.3389). The variant CT and TT carriers had a 0.70- and 0.38-fold pterygium risk (95%CI=0.39-1.26 and 0.04-3.25, p=0.2982 and 0.6686, respectively). As for MMP-2 rs2285053, the genotypic frequency of CC, CT and TT were 67.1%, 28.6% and 4.3% in the pterygium group, non-significantly different from those in non-pterygium group (p for trend=0.7081). The CT and TT carriers had a 0.88- and 0.71-fold pterygium risk (95%CI=0.56-1.38 and 0.27-1.88, p=0.6612 and 0.6456, respectively). The allelic analysis results showed that MMP-2 rs243865 variant T allele was not associated with pterygium risk (7.1% versus 10.4%, OR=0.67, 95%CI=0.39-1.13, p=0.1649). As for MMP-2 rs2285053, the T allele was not associated with pterygium risk either (18.6% versus 21.1%, OR=0.85, 95%CI=0.59-1.23, p=0.4136).
CONCLUSION
The genotypes at MMP-2 rs243865 or rs2285053 played minor role in determining individual susceptibility for pterygium among Taiwanese.
Topics: Humans; Case-Control Studies; Conjunctiva; Gene Frequency; Genetic Predisposition to Disease; Genotype; Matrix Metalloproteinase 2; Matrix Metalloproteinase 7; Polymorphism, Single Nucleotide; Pterygium; Taiwan
PubMed: 38418145
DOI: 10.21873/invivo.13472 -
The American Journal of Case Reports Feb 2024BACKGROUND Infectious keratitis after pterygium surgery is a rare but potentially devastating complication. The present study presents 5 cases of herpes simplex... (Review)
Review
BACKGROUND Infectious keratitis after pterygium surgery is a rare but potentially devastating complication. The present study presents 5 cases of herpes simplex keratitis (HSK) after pterygium surgery. CASE REPORT This study was conducted in our clinic in a 5-year period from February 2017 to September 2021. The 5 patients were men, aged between 42 and 73 years, with no prior history of herpes simplex virus (HSV) infections. Symptoms appeared near 1 month (median 30 days, range 10 to 70 days) after primary pterygium surgery. Diagnosis was based on clinical symptoms and laboratory test results, such as tear HSV-sIgA, corneal tissue polymerase chain reaction, and next-generation sequencing of metagenomics. The epithelial (1/5) and stromal (4/5) subtypes of HSK were identified. The patients received topical ganciclovir gel, immunosuppressive eyedrops, and oral acyclovir tablets, along with additional surgical interventions if necessary. Three were healed with conservative therapy, 1 eye required amniotic membrane transplantation due to corneal melt, and 1 was perforated and followed by corneal grafting. Finally, a literature review of previous publications on HSK after ocular surgeries was conducted. CONCLUSIONS HSK is a rare but serious complication that can arise after uneventful pterygium surgery. It is worthy of attention that both epithelial and stromal forms can occur. Timely diagnosis and treatment are crucial to prevent unfavorable outcomes. Consequently, routine corneal fluorescein staining, tear sIgA examination, and corneal scraping for polymerase chain reaction or next-generation sequencing of metagenomics should be performed in any suspected cases.
Topics: Male; Humans; Adult; Middle Aged; Aged; Female; Antiviral Agents; Pterygium; Keratitis, Herpetic; Acyclovir; Immunoglobulin A, Secretory
PubMed: 38400535
DOI: 10.12659/AJCR.942401 -
Cells Feb 2024Conjunctival fibrosis is a serious clinical concern implicated in a wide spectrum of eye diseases, including outcomes of surgery for pterygium and glaucoma. It is mainly...
Conjunctival fibrosis is a serious clinical concern implicated in a wide spectrum of eye diseases, including outcomes of surgery for pterygium and glaucoma. It is mainly driven by chronic inflammation that stimulates conjunctival fibroblasts to differentiate into myofibroblasts over time, leading to abnormal wound healing and scar formation. Soluble guanylate cyclase (sGC) stimulation was found to suppress transforming growth factor β (TGFβ)-induced myofibroblastic differentiation in various stromal cells such as skin and pulmonary fibroblasts, as well as corneal keratocytes. Here, we evaluated the in vitro effects of stimulation of the sGC enzyme with the cell-permeable pyrazolopyridinylpyrimidine compound BAY 41-2272 in modulating the TGFβ1-mediated profibrotic activation of human conjunctival fibroblasts. Cells were pretreated with the sGC stimulator before challenging with recombinant human TGFβ1, and subsequently assayed for viability, proliferation, migration, invasiveness, myofibroblast marker expression, and contractile properties. Stimulation of sGC significantly counteracted TGFβ1-induced cell proliferation, migration, invasiveness, and acquisition of a myofibroblast-like phenotype, as shown by a significant downregulation of , , , , , , , and mRNA levels, as well as by a significant reduction in α-smooth muscle actin, N-cadherin, COL1A1, and FN-EDA protein expression. In addition, pretreatment with the sGC stimulator was capable of significantly dampening TGFβ1-induced acquisition of a contractile phenotype by conjunctival fibroblasts, as well as phosphorylation of Smad3 and release of the proinflammatory cytokines IL-1β and IL-6. Taken together, our findings are the first to demonstrate the effectiveness of pharmacological sGC stimulation in counteracting conjunctival fibroblast-to-myofibroblast transition, thus providing a promising scientific background to further explore the feasibility of sGC stimulators as potential new adjuvant therapeutic compounds to treat conjunctival fibrotic conditions.
Topics: Humans; Soluble Guanylyl Cyclase; Fibroblasts; Myofibroblasts; Transforming Growth Factor beta; Corneal Keratocytes
PubMed: 38391973
DOI: 10.3390/cells13040360 -
Cornea Jun 2024
Topics: Humans; Pterygium; Recurrence; Ophthalmologic Surgical Procedures; Conjunctiva; Treatment Outcome
PubMed: 38391351
DOI: 10.1097/ICO.0000000000003499 -
Journal of Ocular Pharmacology and... Apr 2024This study aimed to explore the effects of elevated KDM4D expression and potential therapeutic effects of Lycium barbarum polysaccharide (LBP) on pterygium. The...
This study aimed to explore the effects of elevated KDM4D expression and potential therapeutic effects of Lycium barbarum polysaccharide (LBP) on pterygium. The expression levels of KDM4D in the primary pterygium ( = 29) and normal conjunctiva ( = 14) were detected by immunohistochemistry. The effects of KDM4D on pterygium fibroblasts were detected by the CCK-8 assay, liquid chromatography-mass spectrometry assay, flow cytometry, and scratch wound healing assay. The relative expression of KDM4D in pterygium fibroblasts stimulated by interleukin (IL)-1β, IL-6, IL-8, and LBP was detected by quantitative real-time PCR and Western blot. The effects of LBP on pterygium fibroblasts were detected using flow cytometry and scratch wound healing assays. The expression level of KDM4D in pterygium was higher than that in normal conjunctiva. KDM4D increased the cell viability of pterygium fibroblasts. The differentially expressed genes identified in the LM-MS assay enriched in "actin filament organization" and "apoptosis." KDM4D promoted migration and inhibited apoptosis of pterygium fibroblasts . Inflammatory cytokines, including IL-1β, IL-6, and IL-8, enhanced the expression of KDM4D in pterygium fibroblasts. LBP inhibited the expression of KDM4D in pterygium fibroblasts and decreased their cell viability. Moreover, LBP attenuated the KDM4D effects on migration and apoptosis of pterygium fibroblasts. Elevated KDM4D expression is a risk factor for pterygium formation. LBP inhibits the expression of KDM4D in pterygium fibroblasts and may be a potential drug for delaying pterygium development.
Topics: Humans; Pterygium; Interleukin-6; Interleukin-8; Drugs, Chinese Herbal; Conjunctiva; Jumonji Domain-Containing Histone Demethylases
PubMed: 38386983
DOI: 10.1089/jop.2023.0130