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International Journal of Molecular... Nov 2021Solar damage due to ultraviolet radiation (UVR) is implicated in the development of two proliferative lesions of the ocular surface: pterygium and pinguecula. Pterygium...
Solar damage due to ultraviolet radiation (UVR) is implicated in the development of two proliferative lesions of the ocular surface: pterygium and pinguecula. Pterygium and pinguecula specimens were collected, along with adjacent healthy conjunctiva specimens. RNA was extracted and sequenced. Pairwise comparisons were made of differentially expressed genes (DEGs). Computational methods were used for analysis. Transcripts from 18,630 genes were identified. Comparison of two subgroups of pterygium specimens uncovered evidence of genomic instability associated with inflammation and the immune response; these changes were also observed in pinguecula, but to a lesser extent. Among the top DEGs were four genes encoding tumor suppressors that were downregulated in pterygium: , , and ; and were also downregulated in pinguecula. Ingenuity Pathway Analysis overwhelmingly linked DEGs to cancer for both lesions; however, both lesions are clearly still benign, as evidenced by the expression of other genes indicating their well-differentiated and non-invasive character. Pathways for epithelial cell proliferation were identified that distinguish the two lesions, as well as genes encoding specific pathway components. Upregulated DEGs common to both lesions, including and , provide a further insight into pathophysiology. Our findings suggest that pterygium and pinguecula, while benign lesions, are both on the pathological pathway towards neoplastic transformation.
Topics: Biomarkers; Case-Control Studies; Genomic Instability; Humans; Inflammation; Pinguecula; Pterygium; RNA-Seq; Transcriptome; Ultraviolet Rays
PubMed: 34769520
DOI: 10.3390/ijms222112090 -
Clinical Ophthalmology (Auckland, N.Z.) 2021Everybody is exposed to ultraviolet radiation and the natural source of ultraviolet radiation is sunlight. The objective of this study was to determine the prevalence of...
BACKGROUND
Everybody is exposed to ultraviolet radiation and the natural source of ultraviolet radiation is sunlight. The objective of this study was to determine the prevalence of solar keratopathy, pterygium and cataract and further to evaluate other factors that cause blindness to the inhabitants of the Northern Red Sea Zone islands of Eritrea.
METHODS
It was a community-based cross-sectional study of all people aged 40 years and above, with a census sampling method. Study participants were screened for presence of solar keratopathy and other ocular diseases, and data were collected by a checklist from March 20 to April 20, 2021. Data were entered on an Excel sheet and transported to SPSS version 21. Results were presented with frequencies and percentages and chi-squared bivariable analysis was carried. -value less than 0.05 was considered significant.
RESULTS
The prevalence of solar keratopathy and cataract was 19.6% and 15.8%, respectively. Pterygium (40%) and pinguecula (32.1%) were also commonly found in the community. Participants aged 70 years and above (<0.001), fishermen (<0.001), housewife (<0.001) and females (<0.001) had a higher rate of blindness. The prevalence of solar keratopathy was higher with increased age and work experience (<0.001). Fishermen and housewives had higher rates of solar keratopathy (44.6%) and cataract (30.2%), respectively, (<0.001). Respondents aged 40 to 49 years had the highest prevalence of pterygium (44.1%) and pinguecula (39.1%) (<0.001).
CONCLUSION
The prevalence of solar keratopathy, cataract, pterygium and pinguecula was high in the community. Fishermen with increased work experience were having the highest prevalence of blindness and solar keratopathy. Age, occupation, work experience, sex, vision problems and history of eye operations had showed significant association with visual acuity, solar keratopathy, cataract, pterygium, and pinguecula. Community awareness about the preventive aspects of these diseases is highly recommended.
PubMed: 34285465
DOI: 10.2147/OPTH.S321413 -
Therapeutic Advances in Ophthalmology 2021This study aimed to determine the relationship between clinical symptoms and findings of patients diagnosed with conjunctivochalasis in our clinic and the risk factors...
OBJECTIVE
This study aimed to determine the relationship between clinical symptoms and findings of patients diagnosed with conjunctivochalasis in our clinic and the risk factors reported in the literature, to determine new possible etiological factors, and to compare routine tear assessment methods with novel strip meniscometry in these patients.
MATERIALS AND METHODS
The study included patients who presented to our clinic between March 2019 and June 2019 and were diagnosed with conjunctivochalasis. The Ocular Surface Disease Index was used to assess ocular surface symptoms. Anterior segment examination included tear break-up time, corneal staining, localization of conjunctivochalasis, and the presence of pinguecula or pterygium. For each patient, tears were measured using both Schirmer and strip meniscometry. Patients with conjunctivochalasis were evaluated as lid-parallel conjunctival folds grade 1, 2, or 3.
RESULTS
There was a total of 57 participants, including 31 women (54.4%) and 26 men (45.6%). Lid-parallel conjunctival folds grade was found to be statistically significantly associated with dust exposure ( = 0.034). Multiple regression analysis revealed that dust exposure was an independent predictor of being diagnosed with lid-parallel conjunctival folds grade 2 lid-parallel conjunctival folds grade 1 (odds ratio = 3.515, = 0.029). Moreover, Schirmer's test and strip meniscometry results were positively correlated in patients with conjunctivochalasis ( = 0.302 and = 0.022).
CONCLUSION
We conclude that external factors are prominent in patients with conjunctivochalasis, especially dust exposure. In addition, strip meniscometry may be preferred as a more practical and noninvasive alternative to investigate dry eye symptoms in patients with conjunctivochalasis.
PubMed: 34263137
DOI: 10.1177/25158414211027757 -
BMJ Case Reports May 2021Diagnosis of rare disorders requires heightened clinical acumen. When such disorders present with atypical or novel features, it adds to the diagnostic challenge. A...
Diagnosis of rare disorders requires heightened clinical acumen. When such disorders present with atypical or novel features, it adds to the diagnostic challenge. A 9-month-old female infant who had received a diagnosis of neonatal hepatitis due to cytomegalovirus infection at 2 months of age presented to our institute with developmental delay, fever, vomiting, feeding difficulty, breathlessness and features of elevated intracranial pressure due to hydrocephalus. Key examination findings with cholestatic jaundice as an early manifestation led to suspicion of type 4 Farber disease. Observation of hydrocephalus, hypertension, bilateral pinguecula and Erlenmeyer flask deformity of the femur were unusual findings for Farber disease. The child had few features (pinguecula, Erlenmeyer flask deformity and hydrocephalus) overlapping with Gaucher disease. Alternatively, prosaposin deficiency (Farber disease type 7) was another differential diagnosis. Diagnosis of Farber disease was confirmed by detection of foamy macrophages on skin biopsy and two homozygous missense variants in gene.
Topics: Child; Farber Lipogranulomatosis; Female; Femur; Gaucher Disease; Humans; Infant; Infant, Newborn; Mutation, Missense; Skin
PubMed: 34045195
DOI: 10.1136/bcr-2020-240742 -
Clinical Optometry 2021Ultraviolet radiation is electromagnetic radiation or light having a wavelength of less than 400 nm but greater than 100 nm. Ultraviolet radiation, majorly from...
BACKGROUND
Ultraviolet radiation is electromagnetic radiation or light having a wavelength of less than 400 nm but greater than 100 nm. Ultraviolet radiation, majorly from sunlight, can potentially damage any organ that is exposed to any part of its spectrum. Aside from the skin, the organ most susceptible to sunlight-induced damage is the eye. Ultraviolet radiation is reported to be the cause of multiple ocular problems ranging from benign conditions like pterygium and pinguecula to ocular malignancies such as basal cell carcinoma which finally leads to visual impairment and blindness. Protection practice is mandatory to avoid the burden of diseases caused by ultraviolet exposure and maximizing the protection measures implementation is important. To maximize this, it is essential to know the current practice and the associated factors affecting the usage of protective devices in the study area.
METHODS
Community-based cross-sectional study was conducted from April to May 2019 on 453 study participants. The study participants were selected through a systematic random sampling method. Data were collected using a pretested structured questionnaire. The analyzed result was summarized and presented using texts, tables and charts. A Chi-square test was applied to assess the significant association.
RESULTS
A total of 430 study subjects were participated and completed the questionnaire with a response rate of 94.92%. The mean age of the study participants was 35.3 (SD±6.68). Two hundred forty-three (56.5%) study participants were males. About 228 (53%) of participants were married, and 356 (82.8%) were Christian in religion. From the total study participants, 173 (40.23%) had good practice in protecting the eye from ultraviolet radiation damages while the remaining 59.77% had poor practice. A significant association was found between sex and protection practice of the eye from ultraviolet radiation damages.
CONCLUSION
The majority of the study participants had poor protection practice of the eye from ultraviolet radiation damages. Improving awareness and protection practice are vital to reduce the burden of ocular abnormalities due to excessive exposure to ultraviolet radiation.
PubMed: 33519252
DOI: 10.2147/OPTO.S291916 -
BMC Ophthalmology Dec 2019To determine the repeatability of measurements of ocular surface vessel density in normal and diseased eyes using optical coherence tomography angiography (OCTA).
BACKGROUND
To determine the repeatability of measurements of ocular surface vessel density in normal and diseased eyes using optical coherence tomography angiography (OCTA).
METHODS
Ten normal eyes, 10 pinguecula eyes, and 10 pterygium eyes of 30 volunteers were subjected to OCTA (AngioVue Imaging System, Optovue, Inc.). For scanning, we used the corneal adapter module. Each eye was scanned three times in the nasal and temporal directions, separately. AngioVue software was used to generate the ocular surface vessel density. Ocular surface vessel density was defined as the proportion of vessel area with blood flow to the total measurement area (3 × 3 mm). Intersession repeatability of the measurement was summarized as the coefficient of variation (CV), and intraclass correlation coefficients (ICC) were calculated by variance component models.
RESULTS
The CVs were less than 5% in all subjects, and the ICCs exceeded 0.9; thus, all measurements showed good repeatability. The nasal vessels densities differed significantly between healthy eyes and eyes with pterygium (P < 0.05); however, there was no significant difference between healthy eyes and eyes with pinguecula (P = 0.466).
CONCLUSIONS
These results suggest that measurement of ocular surface vessel density by OCTA in normal eyes and eyes with pterygium and pinguecula is repeatable. This preliminary research describes a quantitative and visual method for assessing vessel density of the ocular surface with a high level of consistency.
Topics: Adult; Blood Vessels; Conjunctiva; Cornea; Diagnostic Techniques, Ophthalmological; Female; Fluorescein Angiography; Humans; Male; Middle Aged; Pinguecula; Pterygium; Reproducibility of Results; Tomography, Optical Coherence
PubMed: 31823755
DOI: 10.1186/s12886-019-1255-2 -
Journal of Ophthalmology 2019To evaluate the association between pinguecula excision and subsequent improvement in dry eye syndrome.
PURPOSE
To evaluate the association between pinguecula excision and subsequent improvement in dry eye syndrome.
METHODS
We included 30 consecutive patients with primary nasal pinguecula and dry eye symptoms undergoing ocular surgery for the first time. Criteria for pinguecula excision surgery were nasal location, yellowish color, and protrusion of conjunctiva at least 2 times thicker than adjacent normal conjunctiva as measured by anterior segment optical coherence tomography. Our primary outcomes were 3-month postoperative changes in tear film breakup time (TBUT), Schirmer test, and a dry eye symptom score.
RESULTS
30 eyes from 30 different patients (12 men and 18 women) underwent pinguecula excision and conjunctival autografting using fibrin glue. The mean age was 42.5 ± 8.35 (range 28-63) years. The preoperative protrusion ratio of pinguecula was 2.33 ± 0.28 (range 2.00-2.90). Mean preoperative TBUT, Schirmer test, and dry eye symptom scores were 5.10 ± 1.27 seconds, 6.07 ± 2.27 mm, and 2.80 ± 0.76 points. Mean postoperative 3-month TBUT, Schirmer test, and dry eye symptom scores were 7.80 ± 1.13 seconds, 7.27 ± 2.02 mm, and 0.30 ± 0.47 points, respectively. The median pre- and postoperative changes were found to be statistically significant by Wilcoxon signed-rank tests for TBUT, Schirmer test score, and dry eye symptom score.
CONCLUSION
Surgical excision of pinguecula and conjunctival autograft using fibrin glue is an effective and safe method to improve symptoms of dry eye syndrome.
PubMed: 31281668
DOI: 10.1155/2019/6438157 -
Eye and Vision (London, England) 2019A number of risk factors have been evaluated in ocular surface squamous neoplasia, but few studies have assessed risk factors specific to the armed forces veteran...
BACKGROUND
A number of risk factors have been evaluated in ocular surface squamous neoplasia, but few studies have assessed risk factors specific to the armed forces veteran population.
METHODS
We conducted a retrospective case-control study on 55 patients and 55 age-matched controls with biopsy-proven ocular surface squamous neoplasia from the Miami Veterans Administration Hospital Eye Clinic to investigate potential risk factors encountered by veterans, including service-specific exposures. Veteran-specific risk factors included ionizing radiation exposure, Agent Orange exposure, deployment to Southwest Asia, and exposure to the series of biochemical warfare tests known as Project Shipboard Hazard and Defense. Data was analyzed with SPSS (SPSS Inc., Chicago, IL) using t-tests, chi-squared, and logistic regression analysis, with a -value of < 0.05 considered statistically significant.
RESULTS
The strongest risk factor for ocular surface squamous neoplasia was lifetime sun exposure both directly assessed via historical quantification of exposure by dermatology practitioners (Odds Ratio (OR) 5.4, 95% Confidence Interval (CI) 2.27-12.847, < 0.005), and using the surrogate markers of basal cell carcinoma (OR 3.157, 95% CI 1.286-7.748, = 0.010) and pingueculae (OR 5.267, 95% CI 2.104-13.186, < 0.005). Of the veteran-specific risk factors, Agent Orange exposure and Southwest Asia deployment were not associated with an increased risk of ocular surface squamous neoplasia. Exposure to ionizing radiation and involvement in Project Shipboard Hazard and Defense were not documented among any cases or controls.
CONCLUSIONS
The results of our study are consistent with prior established risk factors, namely highlighting the important role of sun exposure in ocular surface squamous neoplasia among veterans.
PubMed: 31131286
DOI: 10.1186/s40662-019-0138-1 -
Clinical & Experimental Optometry Mar 2020It was the author's (LWH) observation that pterygium was frequently misdiagnosed by general practitioners that led to this study. The aim was to identify the rate of...
BACKGROUND
It was the author's (LWH) observation that pterygium was frequently misdiagnosed by general practitioners that led to this study. The aim was to identify the rate of misdiagnosis of pterygium by optometrists and general practitioners based upon assessing referral accuracy to a single ophthalmologist (LWH).
METHODS
This study involved a prospective case series from 25 March 2015 to 18 December 2018 in a tertiary referral practice specialising in pterygium. The accuracy of diagnosis of pterygium, based upon the content of the clinical referral, was undertaken for optometrists and general practitioners. The benchmark for diagnostic accuracy was the diagnosis made by the author (LWH) during a consultation in person by the author (LWH) using a hand-light examination and confirmed by slitlamp examination.
RESULTS
A total of 1,511 consecutive patients were included in the study with 90/549 incorrectly diagnosed (16 per cent) by general practitioners and 14/962 (1.4 per cent) by optometrists. General practitioners were 13.28 times more likely to incorrectly diagnose a pterygium than optometrists (95% CI 7.48-23.57). Almost exclusively, the incorrect diagnosis made by general practitioners was naming a pinguecula, a pterygium. The same misdiagnosis was made by optometrists but far less frequently.
CONCLUSION
General practitioners misdiagnosed pterygium far more often than optometrists which may reflect a reduction in training in eye health.
Topics: Australia; Clinical Competence; Follow-Up Studies; General Practitioners; Humans; Optometrists; Prospective Studies; Pterygium; Reproducibility of Results
PubMed: 31060100
DOI: 10.1111/cxo.12916 -
Journal of Ophthalmology 2018In this study, we evaluated corneal epithelial integrity and tear film parameters in patients with inflamed pinguecula and compared these findings with their fellow eyes...
PURPOSE
In this study, we evaluated corneal epithelial integrity and tear film parameters in patients with inflamed pinguecula and compared these findings with their fellow eyes and with healthy controls.
METHODS
We evaluated the fluorescein staining properties and performed the tear break-up time (TBUT) test and Schirmer 2 test (ST2) measurements of 32 patients who had symptomatic unilateral inflamed pinguecula and compared the results with their fellow eyes and also with an age- and sex-matched control group.
RESULTS
Twenty-three eyes (72%) in the inflamed pinguecula group and 1 eye (3.1%) in the fellow eyes group had punctate epithelial staining (PES) or epithelial defect on the nasal cornea ( < 0.001). There was no PES or epithelial defect in the control group. Eyes with inflamed pinguecula ( = 32) had lower TBUT and ST2 values compared to the control group ( 32) ( < 0.001 for both). Fellow eyes ( 32) also had lower TBUT and ST2 values compared to the control group (=0.003 for both). There was no difference in the TBUT and ST2 results between the eyes with inflamed pinguecula and fellow eyes (=0.286 and =0.951, respectively).
CONCLUSION
A high percentage of eyes with inflamed pinguecula had nasal corneal epithelial staining or epithelial defect. We also found lower TBUT and ST2 results in eyes with inflamed pinguecula and the fellow eyes compared to the control group. These findings may be important in pathogenesis of pinguecula and pterygium and also in uncovering their relation.
PubMed: 30515317
DOI: 10.1155/2018/2474173