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Article ; Online: Systemic diseases and the cornea.

Shah, Ruchi / Amador, Cynthia / Tormanen, Kati / Ghiam, Sean / Saghizadeh, Mehrnoosh / Arumugaswami, Vaithi / Kumar, Ashok / Kramerov, Andrei A / Ljubimov, Alexander V

Experimental eye research

2021 Volume 204, Page(s) 108455

Abstract: There is a number of systemic diseases affecting the cornea. These include endocrine disorders ... an insight to underlying systemic diseases and can act as the first indicator of an undiagnosed systemic ... systemic diseases and also discuss underlying molecular mechanisms, as well as current and emerging treatments. ...

Abstract	There is a number of systemic diseases affecting the cornea. These include endocrine disorders (diabetes, Graves' disease, Addison's disease, hyperparathyroidism), infections with viruses (SARS-CoV-2, herpes simplex, varicella zoster, HTLV-1, Epstein-Barr virus) and bacteria (tuberculosis, syphilis and Pseudomonas aeruginosa), autoimmune and inflammatory diseases (rheumatoid arthritis, Sjögren's syndrome, lupus erythematosus, gout, atopic and vernal keratoconjunctivitis, multiple sclerosis, granulomatosis with polyangiitis, sarcoidosis, Cogan's syndrome, immunobullous diseases), corneal deposit disorders (Wilson's disease, cystinosis, Fabry disease, Meretoja's syndrome, mucopolysaccharidosis, hyperlipoproteinemia), and genetic disorders (aniridia, Ehlers-Danlos syndromes, Marfan syndrome). Corneal manifestations often provide an insight to underlying systemic diseases and can act as the first indicator of an undiagnosed systemic condition. Routine eye exams can bring attention to potentially life-threatening illnesses. In this review, we provide a fairly detailed overview of the pathologic changes in the cornea described in various systemic diseases and also discuss underlying molecular mechanisms, as well as current and emerging treatments.
MeSH term(s)	Autoimmune Diseases/diagnosis ; Autoimmune Diseases/epidemiology ; COVID-19/epidemiology ; Comorbidity ; Cornea/pathology ; Humans ; SARS-CoV-2
Language	English
Publishing date	2021-01-21
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	80122-7
ISSN	1096-0007 ; 0014-4835
ISSN (online)	1096-0007
ISSN	0014-4835
DOI	10.1016/j.exer.2021.108455
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Article: Systemic Associations with Keratoconus.

Unni, Prasida / Lee, Hyunjoo Jean

Life (Basel, Switzerland)

2023 Volume 13, Issue 6

Abstract: ... of the cornea and subsequent vision loss. It nearly always presents as a bilateral disease, suggesting ... Keratoconus is a disease of the cornea that results in progressive steepening and thinning ... keratoconus and systemic diseases are abundant in the literature, and the list of possible associations is ...

Abstract	Keratoconus is a disease of the cornea that results in progressive steepening and thinning of the cornea and subsequent vision loss. It nearly always presents as a bilateral disease, suggesting that there is an underlying abnormality of the corneas that becomes manifest with time. However, the mechanisms underlying the development of keratoconus are largely unknown. Associations reported between keratoconus and systemic diseases are abundant in the literature, and the list of possible associations is very long. We found that atopy, Down syndrome, and various connective tissue diseases were the most frequently cited associations in our broad literature search. Additionally, Diabetes Mellitus has been increasingly studied as a possible protective factor against keratoconus. In this review, we have summarized the evidence for and against these particular systemic conditions and keratoconus and have discussed some of the implications of keratoconus patients having these conditions.
Language	English
Publishing date	2023-06-10
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662250-6
ISSN	2075-1729
ISSN	2075-1729
DOI	10.3390/life13061363
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Article ; Online: Peripheral hypertrophic subepithelial corneal opacification - Role of tear secretion, medication and systemic diseases.

Riedl, Jana C / Misirkhanova, Aminat / Wasielica-Poslednik, Joanna / Schuster, Alexander K / Schmidtmann, Irene / Beutel, Manfred E / Pfeiffer, Norbert / Gericke, Adrian

Acta ophthalmologica

2024

Abstract: ... secretion, medication and systemic diseases are associated with PHSCO.: Methods: This is a retrospective ... Systemic diseases or medication did not differ markedly between PHSCO and healthy controls.: Conclusion: Reduced ... PHSCO and dry eye disease. The results of the study do not support our hypothesis that PHSCO is ...

Abstract	Background: Peripheral hypertrophic subepithelial corneal opacification (PHSCO) is a corneal disease that may severely affect vision. The major goal of this study was to test the hypothesis that tear secretion, medication and systemic diseases are associated with PHSCO. Methods: This is a retrospective, case-control study conducted at the Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz. We analysed medical records of patients diagnosed with PHSCO. Sex, age, Schirmer's test II, general medication and medical history were assessed and compared to an age- and sex-matched control group from the Gutenberg Health Study (GHS). Results: One hundred ninety-five eyes of 112 patients with PHSCO were included. Eighty-eight patients were female with a mean age of 55.3 ± 14.7 years (23-89 years) and 24 patients were male with a mean age of 59.3 ± 12.6 years (38-84 years). In 83 patients (74.1%) both eyes were involved. The Schirmer's test II was significantly reduced in patients with PHSCO compared to the GHS control group (p < 0.001). Patients with PHSCO were more frequently administered artificial tears and steroid eye drops (p < 0.001) and were more hyperopic than healthy controls (p = 0.01). Systemic diseases or medication did not differ markedly between PHSCO and healthy controls. Conclusion: Reduced tear secretion and more frequent use of artificial tears in patients with PHSCO suggest a link between PHSCO and dry eye disease. The results of the study do not support our hypothesis that PHSCO is associated with systemic diseases. Interestingly, patients with PHSCO were less frequently on β-blockers than control subjects.
Language	English
Publishing date	2024-03-27
Publishing country	England
Document type	Journal Article
ZDB-ID	2408333-1
ISSN	1755-3768 ; 1755-375X
ISSN (online)	1755-3768
ISSN	1755-375X
DOI	10.1111/aos.16680
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Article ; Online: Systemic Associations with Keratoconus

Prasida Unni / Hyunjoo Jean Lee

Life, Vol 13, Iss 1363, p

2023 Volume 1363

Abstract	Keratoconus is a disease of the cornea that results in progressive steepening and thinning of the cornea and subsequent vision loss. It nearly always presents as a bilateral disease, suggesting that there is an underlying abnormality of the corneas that becomes manifest with time. However, the mechanisms underlying the development of keratoconus are largely unknown. Associations reported between keratoconus and systemic diseases are abundant in the literature, and the list of possible associations is very long. We found that atopy, Down syndrome, and various connective tissue diseases were the most frequently cited associations in our broad literature search. Additionally, Diabetes Mellitus has been increasingly studied as a possible protective factor against keratoconus. In this review, we have summarized the evidence for and against these particular systemic conditions and keratoconus and have discussed some of the implications of keratoconus patients having these conditions.
Keywords	keratoconus ; associations ; atopy ; Science ; Q
Subject code	610
Language	English
Publishing date	2023-06-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
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Article ; Online: Corneal Nerve Abnormalities in Ocular and Systemic Diseases.

Patel, Sneh / Hwang, Jodi / Mehra, Divy / Galor, Anat

Experimental eye research

2020 Volume 202, Page(s) 108284

Abstract: ... functional evaluation of corneal nerves in health and disease. Through application of these technologies ... and systemic disorders, including dry eye disease (DED), glaucoma, migraine, and fibromyalgia ... to functional abnormalities. This review will discuss instruments used to evaluate corneal nerves and summarize ...

Abstract	The trigeminal nerve gives rise to the corneal subbasal nerve system, which plays a crucial role in sensations of touch, pain, and temperature and in ocular healing processes. Technological advancements in instruments, in particular in vivo confocal microscopy and aethesiometry, have allowed for the structural and functional evaluation of corneal nerves in health and disease. Through application of these technologies in humans and animal models, structural and functional abnormalities have been detected in several ocular and systemic disorders, including dry eye disease (DED), glaucoma, migraine, and fibromyalgia. However, studies across a number of conditions have found that structural abnormalities do not always relate to functional abnormalities. This review will discuss instruments used to evaluate corneal nerves and summarize data on nerve abnormalities in a number of ocular and systemic conditions. Furthermore, it will discuss potential treatments that can alleviate the main manifestations of nerve dysfunction, namely ocular surface pain and persistent epithelial defects.
MeSH term(s)	Animals ; Cornea/innervation ; Corneal Diseases ; Dry Eye Syndromes/diagnosis ; Dry Eye Syndromes/etiology ; Fibromyalgia/diagnosis ; Fibromyalgia/etiology ; Glaucoma/diagnosis ; Glaucoma/etiology ; Humans ; Microscopy, Confocal ; Migraine Disorders/diagnosis ; Migraine Disorders/etiology ; Ophthalmic Nerve/abnormalities
Language	English
Publishing date	2020-10-10
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S. ; Review
ZDB-ID	80122-7
ISSN	1096-0007 ; 0014-4835
ISSN (online)	1096-0007
ISSN	0014-4835
DOI	10.1016/j.exer.2020.108284
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Article ; Online: Neurotrophic Keratopathy in Systemic Diseases

Alessandro Meduri / Giovanni William Oliverio / Antonio Valastro / Claudia Azzaro / Umberto Camellin / Francesco Franchina / Leandro Inferrera / Anna Roszkowska / Pasquale Aragona

Frontiers in Medicine, Vol

A Case Series on Patients Treated With rh-NGF

2022 Volume 9

Abstract: ... severe neurotrophic keratopathy (NK) caused by systemic diseases and treated with rh-NGF ... years) with moderate and severe NK caused by systemic diseases were enrolled. The VAS questionnaire was ... PurposeTo evaluate the prevalence, clinical ocular presentation and corneal healing in moderate and ...

Abstract	PurposeTo evaluate the prevalence, clinical ocular presentation and corneal healing in moderate and severe neurotrophic keratopathy (NK) caused by systemic diseases and treated with rh-NGF.SettingDepartment of Biomedical and Dental Sciences and Morphofunctional Imaging, Ophthalmology Clinic, University of Messina, Italy.DesignRetrospective observational study of case series.Materials and MethodsIn this retrospective observational study 11 patients (five female and six males) aged from 24 to 88 years (55.4 ± 21.3 years) with moderate and severe NK caused by systemic diseases were enrolled. The VAS questionnaire was dispensed. The ocular examination comprised slit lamp evaluation, ocular surface assessment with Keratograph 5M (Oculus, Germany), corneal sensitivity with Cochet-Bonnet esthesiometer (Lunneaux, France) and corneal thickness measurement with AC-OCT (DRI, Triton, Topcon, Japan). The underlying systemic causes of NK were determined.ResultsThe main cause of NK was post-neuroma surgery (36%), followed by diabetes (18%). The remaining causes were rheumatoid arthritis (9%), post-traumatic (9%), post-surgery (9%), atopia (9%), Graves' disease (9%). Seven eyes presented severe grade of NK with corneal ulcer and in four a moderate grade was registered. The rh-NGF (Cenegermin) was administered with a standard protocol one drop six times daily for 8 weeks. The complete healing of all corneal defects was registered at the end of the treatment.ConclusionsThe post-neuroma surgery was the most common cause of NK and severe grade was clinically more represented. The rh-NGF proved effective to promote corneal recovery with all defects healed after the treatment.
Keywords	neurotrophic keratopathy ; rh-NGF ; neurotrophic keratitis ; Cenegermin ; nerve growing factor ; Medicine (General) ; R5-920
Subject code	616 ; 610
Language	English
Publishing date	2022-05-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
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Article ; Online: Systemic Lupus Erythematosus and Risk of Dry Eye Disease and Corneal Surface Damage: A Population-Based Cohort Study.

Tseng, Ching-Han / Tai, Ying-Hsuan / Hong, Chien-Tai / Dai, Ying-Xiu / Chen, Tzeng-Ji / Cherng, Yih-Giun / Lai, Shih-Chung

International journal of environmental research and public health

2023 Volume 20, Issue 5

Abstract: ... including the lacrimal glands and the cornea. The present study sought to assess the risk of aqueous ... deficient dry eye disease (DED) and corneal surface damage in patients with SLE. We conducted a population ... of DED and corneal surface damage between subjects with and without SLE. Proportional hazard ...

Abstract	Systemic lupus erythematosus (SLE) potentially involves multiple parts of the ocular system, including the lacrimal glands and the cornea. The present study sought to assess the risk of aqueous-deficient dry eye disease (DED) and corneal surface damage in patients with SLE. We conducted a population-based cohort study using Taiwan's National Health Insurance research database to compare the risks of DED and corneal surface damage between subjects with and without SLE. Proportional hazard regression analyses were used to calculate the adjusted hazard ratio (aHR) and 95% confidence interval (CI) for the study outcomes. The propensity score matching procedure generated 5083 matched pairs with 78,817 person-years of follow-up for analyses. The incidence of DED was 31.90 and 7.66 per 1000 person-years in patients with and without SLE, respectively. After adjusting for covariates, SLE was significantly associated with DED (aHR: 3.30, 95% CI: 2.88-3.78,
MeSH term(s)	Humans ; Female ; Aged ; Cohort Studies ; Risk Factors ; Lupus Erythematosus, Systemic/complications ; Dry Eye Syndromes/complications ; Corneal Injuries ; Taiwan/epidemiology
Language	English
Publishing date	2023-02-21
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2175195-X
ISSN	1660-4601 ; 1661-7827
ISSN (online)	1660-4601
ISSN	1661-7827
DOI	10.3390/ijerph20053776
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Article ; Online: Corneal biomechanical parameters in systemic autoimmune diseases.

Ozarslan Ozcan, Deniz / Ozcan, Sait Coskun / Kimyon, Gezmis

Clinical & experimental optometry

2021 Volume 105, Issue 1, Page(s) 61–64

Abstract: Clinical relevance: The relationship between the cornea and systemic autoimmune diseases has been ... This study aims to evaluate corneal biomechanical changes in patients with systemic autoimmune diseases using ... demonstrated in prior studies. Corneal Visualisation Scheimpflug Technology (Corvis ST) provides a specific and ...

Abstract	Clinical relevance: The relationship between the cornea and systemic autoimmune diseases has been demonstrated in prior studies. Corneal Visualisation Scheimpflug Technology (Corvis ST) provides a specific and detailed assessment of corneal biomechanical features, such as stiffness and elasticity. Background: This study aims to evaluate corneal biomechanical changes in patients with systemic autoimmune diseases using Corvis ST. Methods: This prospective study included 36 patients with ankylosing spondylitis (AS), 38 patients with rheumatoid arthritis (RA), and 36 age- and sex-matched healthy subjects. After ophthalmologic examinations Pentacam HR and Corvis ST was performed on all eyes. The mean keratometric and pachymetric data, corneal biomechanical parameters, biomechanical intraocular pressure (bIOP) were analysed. Results: There was no statistically significant differences among the groups regarding age, gender, refraction, visual acuity, IOP, pachymetry and keratometry. Compared to healthy controls, the mean velocity values of applanation 1 (A1V) and 2 (A2V), deformation amplitude (DA), and corvis biomechanical index (CBI) were statistically significantly higher and stiffness parameter at first applanation (SPA1) was statistically significantly lower in AS and RA patients (all p < 0.05). In both AS and RA groups, disease duration was found to be negatively correlated with SPA1 (p = 0.043, 0.027, respectively) and positively correlated with CBI (p = 0.022, 0.020, respectively). Conclusion: AS and RA patients have a decreased corneal stiffness compared to healthy subjects. Disease duration seems to be correlated with these changes.
MeSH term(s)	Autoimmune Diseases ; Biomechanical Phenomena ; Cornea ; Corneal Pachymetry ; Humans ; Intraocular Pressure ; Prospective Studies ; Tonometry, Ocular
Language	English
Publishing date	2021-03-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	639275-1
ISSN	1444-0938 ; 0816-4622
ISSN (online)	1444-0938
ISSN	0816-4622
DOI	10.1080/08164622.2021.1896335
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Article ; Online: Systemic treatment and surgical intervention in inflammatory Terrien disease.

Arnalich-Montiel, Francisco

Taiwan journal of ophthalmology

2024 Volume 14, Issue 1, Page(s) 108–111

Abstract: ... corneal thinning vascularization, and a pseudopterygium, the patient experienced recurrent photophobia ... of both Terrien marginal degeneration (TMD) and Fuchs' superficial marginal keratitis. Characterized by peripheral ... redness, and tearing over 15 years. This case challenges the traditional distinction between TMD and ...

Abstract	This case report presents a unique instance of a 55-year-old male patient exhibiting features of both Terrien marginal degeneration (TMD) and Fuchs' superficial marginal keratitis. Characterized by peripheral corneal thinning vascularization, and a pseudopterygium, the patient experienced recurrent photophobia, redness, and tearing over 15 years. This case challenges the traditional distinction between TMD and Fuchs' superficial marginal keratitis, suggesting a potential common underlying disorder. Mycophenolate mofetil provided a partial response, while pseudopterygium removal led to sustained remission, emphasizing its therapeutic significance. This case highlights the first documented use of mycophenolate in TMD and supports the notion of shared vasculitic origins between TMD and Fuchs' keratitis, raising intriguing questions about targeted therapeutic interventions.
Language	English
Publishing date	2024-03-15
Publishing country	India
Document type	Case Reports
ZDB-ID	2652841-1
ISSN	2211-5072 ; 2211-5072
ISSN (online)	2211-5072
ISSN	2211-5072
DOI	10.4103/tjo.TJO-D-23-00176
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Article ; Online: Conjunctival microcirculation in ocular and systemic microvascular disease.

Asiedu, Kofi / Krishnan, Arun V / Kwai, Natalie / Poynten, Ann / Markoulli, Maria

Clinical & experimental optometry

2023 Volume 106, Issue 7, Page(s) 694–702

Abstract: ... a relationship between conjunctival microcirculatory haemodynamics and many diseases such as dry eye disease ... insight into overall conjunctival health, as well as in ocular and systemic disease. These algorithms ... reflectance spectroscopy and corneal confocal microscopy. Furthermore, several studies have demonstrated ...

Abstract	The conjunctival microcirculation is an accessible complex network of micro vessels whose quantitative assessment can reveal microvascular haemodynamic properties. Currently, algorithms for the measurement of conjunctival haemodynamics use either manual or semi-automated systems, which may provide insight into overall conjunctival health, as well as in ocular and systemic disease. These algorithms include functional slit-lamp biomicroscopy, laser doppler flowmetry, optical coherence tomography angiography, orthogonal polarized spectral imaging, computer-assisted intravitral microscopy, diffuse reflectance spectroscopy and corneal confocal microscopy. Furthermore, several studies have demonstrated a relationship between conjunctival microcirculatory haemodynamics and many diseases such as dry eye disease, Alzheimer's disease, diabetes, hypertension, sepsis, coronary microvascular disease, and sickle cell anaemia. This review aims to describe conjunctival microcirculation, its characteristics, and techniques for its measurement, as well as the association between conjunctival microcirculation and microvascular abnormalities in disease states.
MeSH term(s)	Humans ; Blood Flow Velocity ; Microcirculation ; Conjunctiva/blood supply ; Hemodynamics ; Slit Lamp Microscopy
Language	English
Publishing date	2023-01-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	639275-1
ISSN	1444-0938 ; 0816-4622
ISSN (online)	1444-0938
ISSN	0816-4622
DOI	10.1080/08164622.2022.2151872
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