Break-up Time Research Articles

Effects of full-thickness wedge resection on ocular surface and in vivo confocal microscopy findings in floppy eyelid syndrome patients.

To evaluate the effect of full-thickness wedge resection (FTWR) on ocular surface and in vivo confocal microscopy (IVCM) findings in patients with floppy eyelid syndrome (FES). The study included two groups: a surgical treatment (ST) group (26 eyes) consisting of patients who underwent FTWR surgery, and a conservative treatment (CT) group (30 eyes). Pre-treatment and post-treatment ocular surface disease index (OSDI), tear break-up time (TBUT), corneal fluorescein staining (CFS), IVCM findings along with the body mass index (BMI), FES grade, the presence and the treatment of obstructive sleep apnea syndrome (OSAS) were recorded and compared between the groups. The groups were comparable in terms of BMI, FES grade, and OSAS data. After six months, TBUT in the ST group significantly increased to 12.92 ± 1.15, compared to 8.10 ± 1.60 in the CT group (p = 0.000). The CFS and OSDI scores were significantly lower in the ST group (0.15 ± 0.37, 18.0 ± 8.3, respectively) compared to the CT group (0.90 ± 0.61, 27.3 ± 9.3, respectively) (p = 0.000). IVCM analysis revealed a significant decrease in dendritic cell count (ST: 22.0 ± 12.4, CT: 39.5 ± 15.1, p = 0.000) and nerve tortuosity (ST: 1.38 ± 0.64, CT: 2.00 ± 0.59, p = 0.000), with a significant increase in total nerve density (ST: 4.27 ± 0.83, CT: 3.57 ± 0.90, p = 0.002) in the ST group compared to the CT group after six months. In our retrospective cohort, FTWR surgery was shown to be an effective and reliable surgical treatment for FES, improving both ocular surface and IVCM findings. Patients with moderate to severe stages of FES not responding to conservative treatment may benefit from eyelid tightening.

Analysis on the changes of objective indicators of dry eye after implantable collamer lens (ICL) implantation surgery.

To explore whether implantable collamer lens implantation has any effect on the postoperative objective indicators of dry eye and to determine the severity of its influence on each indicator. This prospective observational trial was performed in the Department of Ophthalmology of West China Hospital and was approved by the Biomedical Ethics Sub-Committee of the West China Hospital of Sichuan University. A total of 89 non-dry eye patients (178 eyes in total) who received ICL implantation surgery at West China Hospital of Sichuan University were enrolled. The noninvasive keratograph tear film breakup time (NIKBUT), noninvasive keratograph tear meniscus height (NIKTMH), score of lipid layer, score of meibomian gland function, and hyperemia index were obtained via the OCULUS Keratograph for all subjects before surgery and at 1week, 1month, and 3months after surgery. The fluorescein tear film breakup time (FBUT), corneal fluorescein staining score (CFS), and Schirmer test I were also measured at the same time. A total of 178 eyes completed the 1-week and 1-month follow-up, and 40 eyes completed the 3-month follow-up. Compared with the preoperative baseline, there was no significant difference in the NIKBUT or the corneal fluorescein staining score at each follow-up time point (P > 0.05, P > 0.05, P > 0.05). The FBUT and Schirmer test I at 1week, 1month, and 3months after surgery were significantly higher than the preoperative baseline (P < 0.01, P < 0.01, P < 0.01). The NIKTMH and the score of lipid layer were significantly lower than the preoperative baseline at 1week, 1month, and 3months after surgery (P < 0.01, P < 0.01, P < 0.05). The score of meibomian gland function and hyperemia index were significantly lower than the preoperative baseline 1week after surgery (P < 0.01). ICL implantation has no adverse effect on the occurrence of postoperative dry eye, but it reduces the basal tear secretion of patients after surgery and has adverse effects on the indices of meibomian gland function in the short term postoperatively.

Agreement between invasive and noninvasive measurement of tear film breakup time

The agreement between fluorescein breakup time (FBUT) estimates and noninvasive breakup time (NIBUT) estimates automatically acquired using two videokeratoscopes was assessed. Small-cone (E300, Medmont) and large-bowl (K5M, OCULUS) Placido-ring–based videokeratoscopes were utilized for automated NIBUT estimation and fluorescein strip method was used for FBUT estimation. 33 subjects completed the study. Clear instructions were given regarding the blink before measurements. Bland–Altman analysis was used to test the agreement between tear film breakup time estimates and repeated measure analysis of variance was used to test the differences between measurement types. In comparison to FBUT, E300 NIBUT estimate was shorter (− 0.6 ± 2.6 s), whereas K5M NIBUT estimate was longer (3.3 ± 2.4 s). Limits of agreement for FBUT vs. E300 was 29.8 s, for FBUT vs. K5M 26.4 s, and 31.4 s for E300 vs. K5M. There were significant differences between tear film breakup times (F = 3.59, df = 2, P = 0.032). E300 and K5M NIBUT measurements have poor agreement with FBUT, even when blinking is precisely clarified. Agreement was better for shorted break up times than that for longer ones but in general NIBUT measurements are not interchangeable.

Effectiveness and safety of Jiejing Runmu decoction in treatment of dry eye disease

ObjectiveTo investigate the effectiveness and safety of Jiejing Runmu decoction in relieving the clinical manifestations of dry eye disease (DED). Design and interventionsThis single-arm prospective intervention study was conducted at the Peking University Third Hospital and People's Hospital of Yongqing. Of the 211 patients recruited, 200 completing the follow-up were included in the analysis. Patients received Jiejing Runmu decoction once a day for 4 weeks continuously, without any change in eye care habits. Individuals were evaluated at four time points: pretreatment (baseline), 2 weeks, 1 month, and 3 months (2 months after completion of treatment), using the Ocular Surface Disease Index (OSDI), tear film breakup time (TBUT), corneal fluorescein staining, Schirmer test I and meibomian gland assessments. Adverse effects were evaluated at each follow-up visit and systematic examinations were performed during the first and last visits. ResultsOSDI, TBUT, corneal fluorescein staining, Schirmer test I, meibomian gland expressibility, and quality of secretions improved at 2 weeks, 1 month and 3 months compared to baseline (P < 0.0001). No significant differences were found between the sexes. Patients above 45 years showed worse subjective symptoms and objective signs, and greater improvements in corneal fluorescein staining, meibomian gland expressibility, and quality of secretions were observed in this group. No obvious adverse effects were detected during any follow-up visit. ConclusionJiejing Runmu decoction significantly improved both the subjective symptoms and objective signs of DED, with favorable tolerance.

Impact of removing soft contact lenses 1day versus 1month before surgery on the outcomes of microkeratome laser in situ keratomileusis.

To compare the outcomes, safety, efficacy, and predictability of microkeratome laser in situ keratomileusis (LASIK) 24h and one month or more after removing soft contact lenses. ULTRALASIK Eye Center, Dubai, United Arab Emirates. The patients were divided based on the time of discontinuation of the soft contact lenses before LASIK (Group 1 at 24h and Group 2 at one month or longer), and the two groups were well matched. Schirmer's testing, tear break-up time, corrected distance visual acuity, uncorrected distance visual acuity, manifest refraction spherical equivalent, and infection rate were evaluated preoperatively and at one week, one month, and six months after treatment. Group 1 (G1) comprised 1025 eyes, and group 2 (G2) had 1052 eyes. The groups were comparable preoperatively. The overall-mentioned outcomes were comparable between groups with uncorrected distance visual acuity of - 0.084 ± 0.12 logMAR in G1 and - 0.078 ± 0.17 logMAR in the G2 at 6months (P = 0.322). Tear break-up time as well as Schirmer's testing results was also comparable with no evidence of increased risk of dry eyes or non-inflammatory complications in any of the groups on follow-up visits at 1week (P = 0.421), 1month (P = 0.101), and 6months (P = 0.399) postoperatively. Finally, no infectious complications were recorded in either of the groups. With the absence of corneal warpage, no statistical or clinical difference in microkeratome LASIK outcomes and safety was spotted between the groups despite the difference in SCL discontinuation time before the procedure.

Changes in Ocular Surface Parameter After Intense Pulsed Light Therapy in Ocular Demodicosis: A Case Report

Introduction : Demodex infestation may manifest as blepharitis and dry eye syndrome. Intense Pulsed Light (IPL) therapy is an emerging option for managing ocular demodicosis.&#x0D; Case Illustration : A 77-years-old woman complained of itch and watery eyes since four years ago. Meibomian pouting, telangiectasias, foamy secretions, and sleeves were identified in both eyelids. Right eye examination showed 52% and 42% meibomian dropout in the superior and inferior eyelid, respectively, Schirmer test 6 mm, lipid layer thickness (LLT) 43 nm, tear meniscus height (TMH) 0.36 mm, and non-invasive tear break-up time (NIBUT) 9.6 seconds. Left eye examination showed 65% and 56% meibomian dropout in the superior and inferior eyelid, respectively, Schirmer test 5 mm, LLT 66 nm, TMH 0.16 mm, and NIBUT 5.8 seconds. Demodex mites were identified during eyelash wet mount examination. She underwent four sessions of IPL. At the two-month follow-up, complaints were alleviated. Signs of blepharitis were subsided. Right eye examination showed 36% and 34% meibomian dropout in the superior and inferior eyelid, respectively, Schirmer's test 9 mm, LLT 68 nm, TMH 0.49 mm, and NIBUT 10.7 seconds. Left eye examination showed 25% and 35% meibomian dropout in the superior and inferior eyelid, respectively, Schirmer's test 9 mm, LLT &gt;100 nm, TMH 0.9 mm, and NIBUT 6.2 seconds.&#x0D; Discussion : IPL has a role in managing ocular demodicosis by local inflammation control, meibum liquefaction, and meibomian glands photomodulation. IPL is also thought to directly eradicate Demodex mites.&#x0D; Conclusion : Improvement of ocular surface parameters was observed after IPL therapy in ocular demodicosis.

The impact of prolonged face mask use on ocular surface health during COVID-19 pandemic: a clinical, and conjunctiva impression cytology study.

To investigate the relationship between prolonged face mask use and ocular surface health utilizing conjunctival impression cytology, the Schirmer test, the tear break-up time (TBUT) test, and the ocular surface disease index (OSDI) questionnaire. In this cross-sectional prospective study, individuals who used face masksfor at least eight hours per day for at least six months were compared to healthy volunteers who used face masks for no more than one hour per day. Each participant completed an OSDI questionnaire. The Schirmer test (under anesthesia), the TBUT test, and conjunctiva impression cytology analysis according to the Nelson classification method were performed on each participant. This study included 102 (49 male, 53 female) face mask users with an average age of 33.29 ± 7.71years and 110 (60 male, 50 female) healthy controls with an average age of 32.96 ± 7.10years (p = 0.746). The total OSDI score was significantly higher in face mask users than the control group (25.18 ± 3.54 vs 9.46 ± 2.13, p < 0.001). The mean Schirmer test value and TBUT were significantly lower in the study group than the control group (p < 0.001, p < 0.001). There was a statistically significant difference between the two groups in total score and stage of the Nelson classification system (p < 0.001, and p = 0.024, respectively). All conjunctiva impression cytology assessments, including cellularity, cell-cell contact, nucleus/cytoplasma ratio, goblet cell amount, and metaplasia, revealed statistically significant deterioration in the study group compared to the control group (p < 0.001, p = 0.025, p < 0.001, p < 0.001, and p < 0.001, respectively). The prolonged useof face masks leads to dry eyes. The findings of conjunctiva impression cytology indicate the role of inflammation in the pathogenesis of mask associateddry eye.

BOTULINUM TOXIN A FOR BLEPHAROSPASM WITH DRY EYE: A SYSTEMATIC REVIEW

Introduction &amp; Objectives : Essential blepharospasm is a neurological condition that is defined by uncontrolled and abnormal eyelid closure from a central cerebral disorder. Between 40%-85% of blepharospasm occurs in conjunction with dry eye symptoms. Botulinum neurotoxin (BoNT) injections are commonly used treatment for reducing spasms in blepharospasm. Furthermore, it is often suggested for dry eye therapy due to their ability to reduce lacrimal drainage. The purpose of this review is to assess the effectiveness of BoNT treatment for blepharospasm with dry eye symptoms.&#x0D; Methods : A literature research was conducted on online databases such as PubMed, Cochrane library and Google scholar. All studies of BoNT and dry eye with full-text journals published in English within the last 10 years were included. We assessed Tear Breakup Time (TBUT), Schirmer Test, and Blepharospasm Disability Index (BSDI).&#x0D; Results : 204 patients from 6 publications were analyzed. In five trials, the BoNT treatment statistically significant increased TBUT (p&lt;0,5), with mean final TBUT 5,7 ±1.1 s. Furthermore, the Schirmer test also increased with the mean final score 6,29 ± 4,6 mm. The mean BSDI score dropped by 6,05 ± 3,7 in two studies.&#x0D; Conclusion : It is confirmed that BoNT injection is an effective treatment for essential blepharospasm with dry eye symptoms. Clinicians should be screened for dry eye in all blepharospasm patients prior to BoNT treatment.

Understanding Ocular Surface Disease in Glaucoma: A Comparative Analysis of Symptoms and Objective Parameters.

Background Glaucoma is a progressive optic neuropathy that may result in irreversible visual impairment and can diminish quality of life. Lowering intraocular pressure (IOP) through topical eyedrops is usually the primary approach to managing glaucoma. However, long-term treatment poses a risk to ocular surface health, leading to ocular surface disease (OSD). Preservative-containing eyedrops are implicated in OSD development due to their detrimental effects on the tear film and goblet cell density. OSD symptoms may impact patient compliance due to local side effects. This study aims to assess OSD in glaucoma patients receiving topical treatment, quantify symptoms and objective ocular surface parameters, and compare them to a control group not using topical glaucoma medications. Methodology Patients diagnosed with primary open-angle glaucoma receiving topical treatment and a control group were included in this study. To assess OSD, patients completed the Ocular Surface Disease Index (OSDI) questionnaire to evaluate symptoms and underwent objective measurements of ocular surface parameters using a keratograph. These parameters included assessments of bulbar redness and non-invasive keratograph tear break-up time (NIKTBUT). Results A cohort of 92 patients was subjected to examination, comprising 66 individuals diagnosed with glaucoma and 26 controls. Within the glaucoma patient subset, the mean number of IOP-lowering drugs administered was 2.42 ± 0.18, with 22.7% exclusively utilizing preservative-free eye drops. Our investigations unveiled a substantial prevalence of OSD symptoms, manifesting not only within the glaucoma cohort but also among the control group, with 72.7% and 53.8%, respectively (p = 0.224), reporting moderate-to-severe symptoms (OSDI > 23). Remarkably, OSDI scores exhibited higher values among female participants (p = 0.039) and glaucoma patients using prostaglandins (p<0.001) and were negatively correlated to the number of IOP-lowering drugs used (-0.448; p < 0.001). Furthermore, employing keratograph assessment, we discerned heightened bulbar redness (1.86 ± 0.07) in the glaucoma group compared to the control group (1.58 ± 0.07; p = 0.008). Glaucoma subgroup analyses further unveiled higher bulbar redness among glaucoma patients employing carbonic anhydrase inhibitors (p = 0.035) and applying medication preservatives (p = 0.045) but lower among individuals using beta-blockers (p = 0.018). However, the NIKTBUT did not show significant variance between the two groups (glaucoma group: 10.19 ± 0.85 seconds; control group: 10.96 ± 1.37 seconds; p = 0.499). Conclusions Our study revealed a significant prevalence of OSD in our sample, with the OSDI questionnaire showing limited specificity. The notable increase in bulbar redness pointed to an elevated prevalence of OSD among glaucoma patients, emphasizing the considerable impact of preservatives on ocular surface damage. Recognizing the potential damage to the tear film and ocular surface is crucial for glaucoma experts, who must employ comprehensive therapeutic strategies to mitigate symptoms, advocating for the preferential use of preservative-free medications, when possible, for optimizing long-term treatment.

Incidence of Dry Eye Syndrome After Cataract Surgery with Phacoemulsification Technique in Padang Eye Center Hospital

Introduction &amp; Objectives : Dry eyes is one of the most common ophthalmological problems. The etiology of dry eyes is usually multifactorial, such as medication, aging, systemic disease, allergy, computer usage, environmental factors, meibomian gland dysfunction and ophthalmic surgery. Cataract is still one of the leading causes of vision impairment globally. No medical treatment is effective to remove cataract. Thus, the only option is cataract removal surgery. The most common technique of cataract surgery in Padang Eye Center Hospital is phacoemulsification. This study aims to assess the incidence of dry eye syndrome after phacoemulsification surgery without complication in patients with no previous history of dry eye syndrome.&#x0D; Methods : This study was conducted using a prospective study. The evaluation uses Ocular Surface Disease Index ( OSDI ) questionnaire and tear break-up time ( TBUT ) test performed preoperatively and three times postoperatively at one week, one month and three months follow-up after surgery.&#x0D; Results : 110 eyes of 96 patients diagnosed with cataracts who had undergone phacoemulsification surgery were enrolled in this study. The mean age of patients is 62.46 ± 6.14 years, and 59,09% were men. After one week of surgery, only 9,09% had results 0-12 on the OSDI scale, and 43,63% represented moderate dry eye disease ( OSDI score 23-32 ) and TBUT test results from 61,82% of patients had dry eyes, which improved gradually after time.&#x0D; Conclusion : The incidence of dry eye syndrome significantly increased after one-week post-surgery. But after one month postoperative, the patients’ condition gradually improved and returned to normal after three months postoperatively.

TEAR FILM CHANGES FOLLOWING PHACOEMULSIFICATION SURGERY IN PRIMARY EYE CARE CENTER

Abstract&#x0D; Introduction &amp; Objectives : Dry eye disease (DED) is one of the most commonly encountered problem in daily ophthalmology practice. One of many risk factors for DED is cataract surgery. Cataract surgery is known to modify tear film and ocular surface through corneal incision and ocular toxicity of peri- and postoperative medications. The aim of this study is to analyze tear film before and after phacoemulsification in primary eye care facility by measuring tear break-up time (TBUT), fluorescein staining, Schirmer I test (ST-I), and ocular surface disease index (OSDI) score.&#x0D; Methods : This was a longitudinal observational study with prospective cohort design, which included patients diagnosed with senile cataract and underwent uncomplicated phacoemulsification surgery at primary eye care center Sawangan Eye Clinic within period of June to December 2022. Friedman, Wilcoxon, and Cochran tests were used to analyze the data.&#x0D; Results : Thirty nine eyes from 39 patients met the inclusion criteria and were followed up to 3-month postoperatively. Mean age of the patients was 61.1±10.54 years, which consited of 53.8% males and 46.2% females. Mean preoperative OSDI score, corneal staining, TBUT, and ST-I were 24.94±10.24, 1.38±1.99, 2.94±2.17, and 15.46±8.80 respectively; while 3-month postoperative, these parameters’ means were 11.22±13.15 (p=0.0001), 1.38±2.56 (p=0.118), 3.13±1.79 (p=0.192), and 13.31±9.45 (p=0.006) respectively. OSDI was the only parameter which showed statistically significant changes from preoperative to postoperative follow ups (p&lt;0.05).&#x0D; Conclusion : Phacoemulsification did not alter corneal staining and TBUT significantly after 3 months postoperatively, even though both of these parameters' preoperative value were already lower; yet OSDI score improved over time after surgery.

Tear Break Up Time Pattern in Medical Students After COVID-19 Pandemic

Introduction &amp; ObjectivesCOVID-19 pandemic makes most activities are carried out online with using the VDT. Tear Break UpTime (TBUT) examination is a short and fast examination and is able to determine damage to thetear film and subjective examination using the OSDI Questionnaire. This study aimed to assess TBUTpattern in medical students after COVID-19 pandemic regarding VDT used for online learningactivities.&#x0D; MethodsThis study is an observational analytic study with a cross-sectional approach. The difference inproportion between TBUT results based on gender was analyzed using chi-square test. Statisticalanalysis was carried out using a multivariate test based on the results of data normality. The onewayANOVA test is used for normally distributed data, while Kruskall-Wallis is used if the data is notnormally distributed.&#x0D; ResultsA total of 75 subjects were included in the study, consisting of 53 females (70,7%) and 22 males(29.3%). Average use of VDT 8 hours per day. The average TBUT in both eyes were &lt; 10 secondsand random breaks was the most common pattern seen in this study (61,3% OD and 62,7% OS).There was no significant difference between TBUT and gender but there was statistically significantdifference between OSDI score and TBUT.&#x0D; ConclusionLongterm use of VDT may be affect TBUT and subjective symptoms shown by OSDI score. Randombreak was the most common pattern seen in young adults in relation with VDT use.

Ocular Surface Characteristics in Pugs with Pigmentary Keratitis in the Canary Islands, Spain.

This study investigated the prevalence of pigmentary keratitis (PK) in Pug-breed dogs and described the ocular surface characteristics associated with this disease. A total of 219 eyes from 110 dogs were examined, with 94.5% of them affected by PK. Age, previous ocular diseases, corneal vascularization, and corneal sensitivity were significantly associated with the presence of PF and the severity of corneal pigmentation. The study also found that low tear production and blinks incomplete with tear signs, as well as reduced corneal sensitivity, were linked to more severe forms of corneal pigmentation. The Tear Ferning Test (TFT) was identified as a valuable tool for evaluating tear quality in dogs, with worse test results indicating a higher risk of severe PK. A lower mean Tear Break-Up Time (TBUT) test was observed in dogs with PK. Additionally, the study observed a statistically significant difference in corneal thickness between the nasal and temporal zones, with the nasal zone being thicker. It was also suggested that sex and fertility status may influence the incidence of PK and the severity of corneal pigmentation. Overall, these findings provide insight into the underlying causes of PK in Pugs and can inform future treatment strategies for this breed.

Cornea-SELEX for aptamers targeting the surface of eyes and liposomal drug delivery.

Cornea is the major barrier to drug delivery to the eye, which results in low bioavailability and poor efficacy of topical eye treatment. In this work, we first select cornea-binding aptamers using tissue-SELEX on pig cornea. The top two abundant aptamers, Cornea-S1 and Cornea-S2, could bind to pig cornea, and their K d values to human corneal epithelial cells (HCECs) were 361 and 174 nм, respectively. Aptamer-functionalized liposomes loaded with cyclosporine A (CsA) were developed as a treatment for dry eye diseases. The K d of Cornea-S1- or Cornea-S2-functionalized liposomes reduces to 1.2 and 15.1 nм, respectively, due to polyvalent binding. In HCECs, Cornea-S1 or Cornea-S2 enhanced liposome uptake within 15 min and extended retention to 24h. Aptamer CsA liposomes achieved similar anti-inflammatory and tight junction modulation effects with ten times less CsA than a free drug. In a rabbit dry eye disease model, Cornea-S1 CsA liposomes demonstrated equivalence in sustaining corneal integrity and tear break-up time when compared to commercial CsA eye drops while utilizing a lower dosage of CsA. The aptamers obtained from cornea-SELEX can serve as a general ligand for ocular drug delivery, suggesting a promising avenue for the treatment of various eye diseases and even other diseases.

The Efficacy and Safety of Chinese Eye Exercise of Acupoints in Dry Eye Patients: A Randomized Controlled Trial

Introduction: Dry eye disorder (DED) is a growing global issue linked to excessive digital screen time. Chinese eye exercise of acupoint (CEA), a set of self-massages on shared Chinese acupuncture (CA), has been used to reduce visual-related ocular symptoms and possibly as an alternative treatment for DED. This study aimed to assess the efficacy and safety of CEA. Methods: A single-blind randomized controlled trial was conducted at Thammasat University Hospital in Thailand, recruiting 56 participants aged 20–60 years, equally divided into two groups: the treatment group with CEA and the control group with standard lid hygiene treatment (STD). The intervention program lasted 12 weeks. Main outcome measures: Ocular Surface Disease Index (OSDI), tear break-up time (TBUT), Schirmer-I test (SIT), corneal surface staining (CSS), and self-recorded forms for safety and adverse effects were measured at baseline, week 4, and week 12. An independent sample t test, paired t test, and repeated measures (ANOVA) were used to compare results between both groups, study visits, and primary and secondary outcome measurements, respectively. The p values <0.05 were considered statistically significant. Results: The characteristics were not statistically different between both groups at the baseline. The mean OSDI scores were significantly reduced in both groups at week 4 and week 12 compared to baseline (p value <0.05). Additionally, both CEA and STD showed significant improvement in TBUT and SIT (p value <0.05). CSS was significantly improved only in the CEA groups (p value <0.05). No significant differences were observed between the study groups, except for SIT at week 12 (p value <0.05). For the safety, there were no adverse side effects in either group. Conclusion: CEA seemed to be as effective as STD in improving the OSDI, TBUT, and SIT of DED without causing any side effects.

Evaluation of the effect of intravitreal injections on corneal epithelial, scleral and limbal region changes in diabetic retinopathy by AS-OCT.

The aim of the study is to evaluate the effects of diabetic retinopathy and intravitreal injections on the corneal, limbal and scleral areas. Patients with diabetes mellitus at different diagnosis and treatment levels were compared among themselves and with the control group in terms of corneal, limbal and scleral aspects with the help of anterior segment optical coherence tomography. In addition, clinical tests such as tear break-up time, Schirmer test-I and ocular surface disease index questionnaire were applied to the patients and the difference between the groups was investigated. When the groups were examined in terms of BUT, SCH-I and OSDI, there was a statistically significant difference between control group and diabetic group(p < 0.05). In the limbal region, all measurements are higher than in patients with diabetic eye involvement. Thinning was detected in the scleral area with intravitreal injection (p < 0.05). It should be known that DM may cause undesirable changes in the limbal region, and the importance of non-invasive detection with AS-OCT should not be forgotten. Since intravitreal injections for DME cause thinning of the sclera, it can cause various complications, and it may be recommended to change the quadrant in repetitive injection applications.

Evaluation of dry eye disease and corneal epithelial mapping in patients with lower eyelid ectropion.

To evaluate the corneal epithelial mapping, ocular surface parameters and their relationship with each other in lower eyelid ectropion patients according to severity. This retrospective study included 48 lower eyelid ectropion patients and 63 healthy individuals as control group. Ocular surface and tear functions were evaluated with ocular surface staining score, tear film break-up time (BUT), non-invasive tear break-up time (NIBUT) and ocular surface disease index (OSDI). Meibography scores and corneal epithelial thickness (CET) mapping were evaluated. The lower eyelid ectropion was classified and divided into subgroups as follows: mild, moderate and severe. There was no significant differences between the groups for age and gender. Compared to controls, CET was significantly thinner at inferior (p = 0.047) and inferior nasal quadrants (p = 0.023) in the ectropion patients. Lower BUT and NIBUT, higher OSDI scores and higher ocular surface staining were observed in the ectropion patients. In the subgroups determined according to the severity of ectropion, ocular surface damage was found to be significantly higher as the severity of ectropion increased (p < 0.05). Patients with lower eyelid ectropion had worse ocular surface findings and more ocular complaints. Furthermore, the inferior and inferior nasal CETs were thinner in patients with lower ectropion.

Duration of Sturtian “Snowball Earth” glaciation linked to exceptionally low mid-ocean ridge outgassing

Abstract The Sturtian “Snowball Earth” glaciation (ca. 717–661 Ma) is regarded as the most extreme interval of icehouse climate in Earth’s history. The exact trigger and sustention mechanisms for this long-lived global glaciation remain obscure. The most widely debated causes are silicate weathering of the ca. 718 Ma Franklin large igneous province (LIP) and changes in the length and degassing of continental arcs. A new generation of two independent Neoproterozoic full-plate tectonic models now allows us to quantify the role of tectonics in initiating and sustaining the Sturtian glaciation. We find that continental arc length remains relatively constant from 850 Ma until the end of the glaciation in both models and is unlikely to play a role. The two plate motion models diverge in their predictions of the timing and progression of Rodinia break-up, ocean-basin age, ocean-basement depth, sea-level evolution, and mid-ocean ridge (MOR) carbon outflux. One model predicts MOR outflux and ocean basin volume–driven sea level lower than during the Late Cenozoic glaciation, while the other predicts outgassing and sea level exceeding those of the Late Cretaceous hothouse climate. The second model would preclude a major glaciation, while the first model implies that the trigger for the Sturtian glaciation could have been a combination of an extremely low MOR outflux (~9 Mt C/yr) and Franklin LIP weathering. Such minimal outflux could have maintained an icehouse state for 57 m.y. when silicate weathering was markedly reduced, with a gradual build-up of MOR CO2 in the atmosphere paired with terrestrial volcanism leading to its termination.

Efficacy of the combination of cyclosporine and sodium hyaluronate eye drops on dry eye syndrome

Purpose: To investigate the efficacy and adverse effect of cyclosporine combined with sodiumhyaluronate (SH) eye drops on dry eye syndrome (DES).Methods: 148 patients with DES treated in Nanjing Drum Tower Hospital Group Suqian Hospital,Jiangsu Province, China between January 2022 and February 2023 were randomly assigned to control(70 cases) and study groups (78 cases). Control group was treated with SH eye drop (1 drop each onboth eyes 5 - 6 times a day, for 2 months), while study group was treated with both SH (the samedosage and use with control group) and cyclosporine eye drop (1 - 2 drops each for both eyes, 4 - 6times a day, for two months). Tear film stability indices such as schirmer I test (SIT), tear break-up time(BUT) and corneal fluorescein stain (FL) of both groups were analyzed before and after therapy.Results: There was no significant difference in BUT, SIT and FL score between the two groups beforetreatment. Compared with before treatment, BUT and SIT increased significantly (p &lt; 0.05), while FLscore dropped significantly in both groups after treatment (p &lt; 0.05). After treatment, study groupshowed significantly higher BUT and SIT levels, and significantly lower FL score than control group (p &lt;0.05).Conclusion: The combination of cyclosporine eye drops with SH eye drops is effective in treating DES.This combination regimen protects tear film stability, effectively alleviates DES symptoms, improvesocular surface and meibomian gland function, and also increases lacrimal river height, withoutincreasing adverse reactions. Further studies will be required, to provide more evidence for clinicalapplication of this combination regimen.

Evaluation of tear film in patients with AIDS without opportunistic ocular infections in the era of COVID-19: A case-control study.

The assessment of tear film and ocular surface conditions in patients with acquired immunodeficiency syndrome (AIDS) has been poorly studied thus far. We aim to assess tear film parameters, ocular surface characteristics, and dry eye disease (DED) symptoms of patients with AIDS who did not undergo highly active antiretroviral treatment (HAART). This case-control study included 154 age-, sex-, and ethnicity-matched healthy controls and patients with AIDS. All participants underwent comprehensive ocular surface assessment and subjective DED symptomology evaluation. Data were collected between March 2022 and July 2022. HAART-naïve patients with AIDS had a shorter noninvasive tear film breakup time (median 3.76 vs. 8.54 s), thinner tear film lipid layer thickness (median 73.00 vs. 91.00 nm), and lower Schirmer I test values (median 5.00 mm/5 min vs. 12.00 mm/5 min) (all P < 0.001). Moreover, higher corneal fluorescein staining scores (median 1.00 vs. 0.00) and higher upper, lower, and total meibomian gland grades were observed in AIDS patients (all P < 0.05). Negative correlations between the blood viral load and the Ocular Surface Disease Index score ( r = -3.50, P = 0.027) and the Schirmer I test score ( r = -0.374, P = 0.017) were detected in patients with AIDS. Altered tear film status was observed in individuals with HAART-naïve AIDS, even when there were no other ocular symptoms present. Therefore, patients with AIDS should be encouraged to undergo comprehensive ocular surface examinations to detect any subclinical tear film alterations occurring.