scholarly journals Corneal Backscatters as an Objective Index for Assessing Fuchs’ Endothelial Corneal Dystrophy: A Pilot Study

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Hsueh-Yen Chu ◽  
Ching-Hsi Hsiao ◽  
Phil Yeong-Fong Chen ◽  
David Hui-Kang Ma ◽  
Chee-Jen Chang ◽  
...  
Keyword(s):  
Pilot Study ◽  
Corneal Thickness ◽  
Corneal Edema ◽  
Normal Subjects ◽  
Corneal Dystrophy ◽  
Retrospective Case ◽  
Area Density ◽  
Scheimpflug Imaging ◽  
Membrane Density ◽  
Morphological Patterns

Purpose. To provide an objective, quantitative approach for monitoring Fuchs’ endothelial corneal dystrophy (FECD), with Scheimpflug imaging. Design. This is a retrospective case-control pilot study. Methods. The study group consisted of 53 eyes in 27 patients diagnosed with FECD, with normal subjects paired as control. Main outcome measures were corneal thickness, morphological patterns on densitograms, and indices of corneal density including the average area density (mean AD) and the average ratio of Descemet’s membrane density versus area density (DM/AD) in Pentacam Scheimpflug images. Results. There were no significant differences in age and corneal thickness between FECD and normal groups. Morphologically, hanging-hammock patterns were noted on the densitograms of FECD patients, which were different from the high-back chair patterns in normal subjects. Quantitatively, mean AD and DM/AD were both elevated in FECD patients as compared with normal subjects (P=0.01 and 0.025, resp.). In addition, FECD patients with corneal edema had significantly higher mean AD (P=0.018) than those without corneal edema. Conclusions. This pilot study shows that Pentacam system provides an objective, quantitative way to approach FECD corneas. It can assist ophthalmologists in detecting the early change and in monitoring disease progression of FECD. Further studies are needed to consolidate the findings.

scholarly journals Еfficacy of Combined Treatment of Epithelial and Endothelial Corneal Dystrophy Using Corneal Crosslinking and Automated Posterior Lamellar Keratoplasty

2019 ◽  
Vol 16 (1S) ◽  
pp. 102-107
Author(s):  
L. R. Marvanova
Keyword(s):  
Surgical Treatment ◽  
Combined Treatment ◽  
Corneal Thickness ◽  
Corneal Edema ◽  
Corneal Dystrophy ◽  
Main Group ◽  
Stage I ◽  
Lamellar Keratoplasty ◽  
Control Group ◽  
Posterior Lamellar Keratoplasty

The purpose: to establish a combined approach to the treatment of patients with epithelial and endothelial cornea dystrophy (EED) based on a comparative study of the results of one-step and two-step methods. Patients and methods. The study included 75 patients (81 eyes) with corneal EED, who underwent surgical treatment at the Ufa Eye Research Institute from 2011 to 2016. The patients were divided into two groups — the main group consisted of 43 (46 eyes, 57 %) patients, who underwent the first stage of the CC before surgical treatment of EED, the second stage after 1–12 months — automated posterior lamellar keratoplasty (APLK). In the control group, isolated APLK was performed in 32 (35 eyes, 43 %) patients. Results. After CC (1–10 days) in the main group an increase in corneal thickness due to edema enhancement in the cornea stroma was observed in patients with stage I–III of the corneal EED. After 3 months, a decrease in corneal thickness was recorded in patients of the main group with I-II stages of the disease (p < 0.05), after 6 months — in all stages of the corneal EED compared with the control group (p < 0.05). According to optical coherence tomography (OCT), a decrease in the total cornea thickness in both зфешутеы groups was noted within 12 months after APLK: in the main group from 667 ± 65 μm initially to 594 ± 31 μm, in the control group, where there was a pronounced corneal edema from 787 ± 56 to 612 ± 67 μm. Conclusion. Corneal cross-linking in patients with I–III stages of corneal EED provides improvement of the cornea, manifested in reducing edema and its thickness. It allows to delay the implementation of the automated posterior lamellar keratoplasty without corneal deterioration in patients with stage I up to 6–12 months, in patients with stage II–III up to 3–6 months.

scholarly journals Deep Anterior Lamellar Keratoplasty and Phototherapeutic Keratectomy for Management of Thiel-Behnke Corneal Dystrophy

2017 ◽  
Vol 1 (1) ◽  
pp. oapoc.0000005
Author(s):  
Gaspare Monaco ◽  
Antonio Scialdone ◽  
Mariangela Gari ◽  
Marco Messina ◽  
Craig Wilde ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Corneal Thickness ◽  
Anterior Segment ◽  
Corneal Dystrophy ◽  
Early Recurrence ◽  
Lamellar Keratoplasty ◽  
Deep Anterior Lamellar Keratoplasty ◽  
Retrospective Case ◽  
Phototherapeutic Keratectomy ◽  
Anterior Lamellar Keratoplasty

Background To evaluate the outcome of surgical options in the management of Thiel-Behnke corneal dystrophy (TBCD). This is a retrospective case report. Methods A 52-year-old female with TBCD with a visual acuity of 0.50 LogMAR in both eyes underwent deep anterior lamellar keratoplasty (DALK) in her left eye (LE) and, 8 months later, phototherapeutic keratectomy (PTK) in her right eye (RE). Postoperatively, the presence of recurrence, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), central corneal thickness (CCT), and spherical equivalent (SE) were assessed. Spectralis domain anterior segment optical coherence tomography was also performed to evaluate corneal morphology and reflectivity. Results At 1 year, the LogMAR UCVA and BCVA were +0.80 and +0.24, respectively, in the LE and +0.70 and +0.24 in the RE, respectively. CCT and SE were 741 microns (μm) and +4.25 diopters (D) in the LE, respectively, and 339 μm and +6.00 D in the RE, respectively. The cornea was clear in the LE. There was early recurrence of the TBCD and corneal haze in the RE. Conclusions The visual outcome of both DALK and PTK were similar for TBCD. No episodes of rejection or recurrence of dystrophy were noted in the eye that underwent DALK. However, postoperative hyperopic shift, persistent haze, and early recurrence were noted after PTK.

Ultrasound Biomicroscopy Documented Anterior Uveal Melanoma Regression after Ruthenium-106 Plaque Therapy

2021 ◽  
pp. 1-9
Author(s):  
Biljana Kuzmanović Elabjer ◽  
Mladen Bušić ◽  
Andrej Pleše ◽  
Mirjana Bjeloš ◽  
Daliborka Miletić ◽  
...  
Keyword(s):  
Uveal Melanoma ◽  
Tumor Regression ◽  
Corneal Thickness ◽  
Case Series ◽  
Ultrasound Biomicroscopy ◽  
Close Monitoring ◽  
Single Institution ◽  
Retrospective Case ◽  
Caucasian Patients

<b><i>Introduction:</i></b> Ultrasound biomicroscopy (UBM) is the only widely used method for the evaluation of anterior uveal melanoma (AUM). <b><i>Objective:</i></b> Documentation of regression of AUM treated with ruthenium-106 (Ru-106) plaque types CCB and CCC using UBM. <b><i>Methods:</i></b> This single institution-based retrospective case series involved 10 Caucasian patients with AUM followed after brachytherapy with UBM from January 2014 until February 2019. The largest prominence of the tumor perpendicular to the sclera or the cornea (including scleral/corneal thickness) (<i>D</i>) and the largest basal dimension (<i>B</i>) were measured in millimeters with UBM for all patients prior to the brachytherapy and at 4-month interval follow-up. Tumor regression was calculated as a percentage of decrease in the initial <i>D</i> and <i>B</i> values. <b><i>Results:</i></b> The study involved 10 patients with a mean age of 64.4 years (yr) (range 46–80 yr). <i>D</i> ranged from 1.82 to 5.5 mm (median 2.99 mm) and <i>B</i> from 2.32 to 12.38 mm (median 4.18 mm). The apical radiation dose in all patients was 100 Gy. The median follow-up was 42.02 months. Regression for <i>D</i> was 21.11 ± 13.66%, 31.09 ± 14.66%, and 34.92 ± 19.86% at 1st, 2nd, and 3rd year of the follow-up, respectively, while for <i>B</i> it was 21.58 ± 16.05%, 28.98 ± 17.71%, and 32.06 ± 18.96%, respectively. Tumor recurrence was documented in 2/10 patients. <b><i>Conclusion:</i></b> The major regression of AUM, treated with Ru-106 plaque types CCB and CCC, was documented in the first 2 years after brachytherapy in our study group. In the following years, only minimal regression was documented that warns of the need for close monitoring and active search for local recurrences.

scholarly journals A pilot study investigating the use of 4D flow MRI for the assessment of splanchnic flow in patients suspected of mesenteric ischaemia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pauline Hall Barrientos ◽  
Katrina Knight ◽  
Douglas Black ◽  
Alexander Vesey ◽  
Giles Roditi
Keyword(s):  
Blood Flow ◽  
Pilot Study ◽  
Splenic Vein ◽  
Normal Subjects ◽  
Mesenteric Ischaemia ◽  
4D Flow Mri ◽  
4D Flow ◽  
Flow Mri ◽  
Mesenteric Vessels ◽  
Flow Changes

AbstractThe most common cause of chronic mesenteric ischaemia is atherosclerosis which results in limitation of blood flow to the gastrointestinal tract. This pilot study aimed to evaluate 4D flow MRI as a potential tool for the analysis of blood flow changes post-prandial within the mesenteric vessels. The mesenteric vessels of twelve people were scanned; patients and healthy volunteers. A baseline MRI scan was performed after 6 h of fasting followed by a post-meal scan. Two 4D flow datasets were acquired, over the superior mesenteric artery (SMA) and the main portal venous vessels. Standard 2D time-resolved PC-MRI slices were also obtained across the aorta above the coeliac trunk, superior mesenteric vein, splenic vein and portal vein (PV). In the volunteer cohort there was a marked increase in blood flow post-meal within the PV (p = 0.028), not seen in the patient cohort (p = 0.116). Similarly, there were significant flow changes within the SMA of volunteers (p = 0.028) but not for the patient group (p = 0.116). Our pilot data has shown that there is a significant haemodynamic response to meal challenge in the PV and SMA in normal subjects compared to clinically apparent CMI patients. Therefore, the interrogation of mesenteric venous vessels exclusively is a feasible method to measure post-prandial flow changes in CMI patients.

scholarly journals Refractive outcome and tomographic changes after Descemet membrane endothelial keratoplasty in pseudophakic eyes with Fuchs’ endothelial dystrophy

2021 ◽  
Author(s):  
Bishr Agha ◽  
Nura Ahmad ◽  
Daniel G. Dawson ◽  
Thomas Kohnen ◽  
Ingo Schmack
Keyword(s):  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Corneal Astigmatism ◽  
Endothelial Keratoplasty ◽  
Descemet Membrane Endothelial Keratoplasty ◽  
Corneal Densitometry ◽  
Scheimpflug Imaging ◽  
Fuchs Endothelial Dystrophy ◽  
Posterior Corneal Astigmatism

Abstract Purpose To analyze refractive and topographic changes secondary to Descemet membrane endothelial keratoplasty (DMEK) in pseudophakic eyes with Fuchs’ endothelial dystrophy (FED). Methods Eighty-seven pseudophakic eyes of 74 patients who underwent subsequent DMEK surgery for corneal endothelial decompensation and associated visual impairment were included. Median post-operative follow-up time was 12 months (range: 3–26 months). Main outcome measures were pre- and post-operative manifest refraction, anterior and posterior corneal astigmatism, simulated keratometry (CASimK) and Q value obtained by Scheimpflug imaging. Secondary outcome measures included corrected distance visual acuity (CDVA), central corneal densitometry, central corneal thickness, corneal volume (CV), anterior chamber volume (ACV) and anterior chamber depth (ACD). Results After DMEK surgery, mean pre-operative spherical equivalent (± SD) changed from + 0.04 ± 1.73 D to + 0.37 ± 1.30 D post-operatively (p = 0.06). CDVA, proportion of emmetropic eyes, ACV and ACD increased significantly during follow-up. There was also a significant decrease in posterior corneal astigmatism, central corneal densitometry, central corneal thickness and corneal volume over time (p = 0.001). Only anterior corneal astigmatism and simulated keratometry (CASimK) remained fairly stable after DMEK. Conclusion Despite tendencies toward a hyperopic shift, changes in SE were not significant and refraction remained overall stable in pseudophakic patients undergoing DMEK for FED. Analysis of corneal parameters by Scheimpflug imaging mainly revealed changes in posterior corneal astigmatism pointing out the relevance of posterior corneal profile changes during edema resolution after DMEK.

scholarly journals Fuchs endothelial corneal dystrophy and small eyes

2020 ◽  
Vol 17 (1) ◽  
pp. 35-40
Author(s):  
Nicole Shao-Yuen Lim ◽  
John Males
Keyword(s):  
Cohort Study ◽  
Outcome Measures ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Strong Association ◽  
Corneal Thickness ◽  
Anterior Chamber Depth ◽  
Corneal Dystrophy ◽  
T Test ◽  
Corneal Decompensation

Aim: To determine whether there is an association between Fuchs endothelial corneal dystrophy (FECD) and shorter axial length (AL), shallower anterior chamber depth (ACD) and higher spherical equivalent (SE). In addition, to evaluate whether there is a correlation between AL and severity of corneal decompensation in FECD, using corneal thickness as a proxy. Design: Retrospective cohort study. Methods: This was a single-centre study conducted in a cornea clinic in Sydney, Australia. Detailed clinical measurements of 91 eyes of 50 FECD patients were compared with 110 eyes of 55 controls. Main outcome measures included AL, ACD and SE. Other outcome measures included central corneal thickness, visual acuity, intraocular pressure and keratometry. Results: Mean AL of FECD patients was 23.6 mm (standard deviation [SD] ±0.9 mm), compared with 24.7 mm (SD ±1.8 mm) for controls (1.1 mm difference [95% confidence interval [CI] 0.5-1.6], p < 0.001, independent sample t-test); corresponding means for ACD were 3.0 and 3.3 mm (0.32 mm difference [95%CI 0.2-0.5], p < 0.001, independent t-test). Eleven out of the 22 FECD patients with available refraction data had hypermetropic refraction compared with 16 out of 36 controls (p = 0.68, chi-squared test). The mean SE of FECD patients (+0.10D) was higher than controls (−1.33D) (1.4D difference [0.1-2.8], p = 0.04, independent t-test). No statistically significant correlation was found between AL and corneal thickness (p = 0.28, linear regression). Conclusion: In this retrospective cohort study, a strong association was established between FECD and small eyes, with shorter AL and shallower ACD, compared with controls. These results have important implications for surgical planning, as shorter AL and ACD in FECD patients likely contribute to their high risk of corneal decompensation following cataract surgery.

scholarly journals Long-term Follow-up of Pachymetric and Topographic Alterations after Corneal Collagen Cross-Linking for Keratoconus

2012 ◽  
Vol 1 (1) ◽  
pp. 22-25
Author(s):  
Paraskevi G Zotta ◽  
Diamantis D Almaliotis ◽  
George D Kymionis ◽  
Vasilios F Diakonis ◽  
Kostas A Moschou ◽  
...  
Keyword(s):  
Corneal Thickness ◽  
Case Series ◽  
Cross Linking ◽  
Retrospective Case ◽  
Time Intervals ◽  
Long Term Follow Up ◽  
Collagen Cross Linking ◽  
Corneal Collagen

ABSTRACT Purpose To determine the long-term alterations of corneal thickness, along with topographic outcomes, after corneal collagen cross-linking treatment (CXL) for keratoconus. Materials and methods In this retrospective case series, 46 patients (52 eyes), 32 males and 14 females, with progressive keratoconus were included. All eyes underwent CXL in accordance with the standard protocol (Dresden) for the treatment of their ectatic corneal disorder between January 2006 and June 2007. Pachymetric and topographic outcomes were evaluated preoperatively and at 1, 3, 6, 12, 24 and 36 months postoperatively. Results Mean follow-up was 28.08 ± 8.39 months (range, from 12 to 36 months). A statistically significant decline in corneal pachymetric values (at the thinnest location) when compared with preoperative values (467.65 ± 41.08 µm) was demonstrated at 1 (437.63 ± 50.57 µm), 3 (439.08 ± 52.27 µm), 6 (449.37 ± 52.73 µm), 12 (449.63 ± 83.53 µm) and 24 (459.97 ± 47.32 µm) months after CXL (p < 0.05, for all mentioned time intervals). Return to preoperative pachymetric values (469.52 ± 40.52 µm) was revealed 36 months post-CXL (p > 0.05). With respect to topographic (flat and steep keratometric values, keratoconus index), no statistically significant differences between preoperative and all postoperative intervals were found (p > 0.05, for all values for all time intervals). Conclusion Corneal pachymetric values reduce significantly up to 24 months after CXL treatment, while a return to preoperative values was revealed 36 months after the procedure. No significant changes’ concerning topographic outcomes was demonstrated after CXL, indicating stability of these parameters. How to cite this article Zotta PG, Almaliotis DD, Kymionis GD, Diakonis VF, Moschou KA, Karampatakis VE. Long-term Follow-up of Pachymetric and Topographic Alterations after Corneal Collagen Cross-Linking for Keratoconus. Int J Keratoco Ectatic Corneal Dis 2012;1(1):22-25.

scholarly journals Correlation between Corneal Elevation Topography and Perimetric Changes in Patients with Primary Open Angle Glaucoma

2020 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Visual Field ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Cross Sectional Study ◽  
Visual Field Examination ◽  
Cross Sectional ◽  
Control Subjects ◽  
Scheimpflug Imaging ◽  
Average Maximum ◽  
Grading Scale

Aim: The aim of this study is to assess Scheimpflug topographic elevation maps in patients with POAG and correlate the results with their perimetric changes. Methods: This was an analytical observational cross-sectional study. The study included 130 eyes of 70 subjects which were divided into 78 eyes of 44 patients diagnosed with POAG and 52 eyes of 26 control subjects. Measurement of IOP, visual field examination in patients with POAG using Humphrey Field Analyzer (2003 Carl Zeiss Meditec), Germany were done. Subjects were scanned using TMS-5 topographer (Topographic Modeling System, version 5. Tomey Corp. Nagoya, Japan) to measure central corneal thickness, mean anterior keratometry, maximum anterior and posterior topographic elevation maps in the central 3, 5, and 7 mm. Results: 78 patients with POAG classified according to visual field deterioration using Hodapp-Anderson-Parrish grading scale into mild glaucoma 33 eyes, moderate glaucoma 19 eyes, severe glaucoma 26 eyes, and 52 eyes control were included in the study. The mean age of the patients with POAG was 57.82 ± 7.78 years; 22 eyes (50%) were male and 22 eyes (50%) were female. The average age of control subjects was 56.62 ± 8.48 years; 12 eyes (46.2%) were male and 14 eyes (53.8%) were female, average CCT was 530.3 ± 23.58 µm, average mean anterior keratometry (MAK) was 42.97 ± 1.42 D, average maximum anterior elevation (MAE) in 3,5 and 7mm zone was 5.31 ± 2.28, 12.10 ± 6.94 and 44.04 ± 21.99 µm respectively and average maximum posterior elevation (MPE) in 3,5 and 7mm zone was 8.46 ± 2.10, 19.90 ± 9.39 and 62.72 ± 28.82 µm respectively in patients with POAG, whereas average CCT was 543.0 ± 31.02µm, average MAK was 43.11 ± 1.73 D, average MAE in 3,5 and 7mm zone was 4.52 ± 1.97, 5.90 ± 2.71 and 27.19 ± 8.55 µm respectively. Conclusion: Evaluation of corneal elevation topography by scheimpflug imaging showed forward shifting of the anterior and posterior corneal surfaces in POAG.

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