Dry eye disease (DED) has evolved into a major public health concern with ocular discomfort and pain being responsible for significant morbidity associated with DED. However, the etiopathological factors contributing to ocular pain associated with DED are not well understood. The current IVCM based study investigated the association between corneal dendritic cell density (DCD), corneal subbasal nerve plexus (SBNP) features, and serum vitamin D and symptoms of evaporative dry eye (EDE). The study included age and sex matched 52 EDE patients and 43 heathy controls. A significant increase in the OSDI scores (discomfort subscale) was observed between EDE (median, 20.8) and control (median, 4.2) cohorts (P < 0.001). Similarly, an increase in DCD was observed between EDE (median, 48.1 cells/mm2) patients and controls (median, 5.6 cells/mm2) (P < 0.001). A significant decrease in SBNP features (corneal nerve fiber length, fiber density, fiber width, total branch density, nerve branch density, and fiber area) was observed in EDE patients with OSDI score >23 (P < 0.05). A positive correlation was observed between DCD and OSDI discomfort subscale (r = 0.348; P < 0.0003) and SBNP features. An inverse correlation was observed between vitamin D and OSDI scores (r = −0.332; P = 0.0095) and DCD with dendritic processes (r = −0.322; P = 0.0122). The findings implicate DCD, SBNP features, and vitamin D with EDE symptoms.
The main aim of this review is to update the reader with practical knowledge concerning the relationship between diabetes mellitus and periodontal diseases. Exclusive data is available on the association between these two chronic diseases till date. Articles published on this relationship often provide the knowledge of definitions of diabetes mellitus and periodontal diseases, prevalence, extent, severity of periodontal disease, complications of diabetes along with the possible underlying mechanisms. The authors reviewed human epidemiological studies, cross-sectional observations and longitudinal cohort, case control that evaluated variables exclusively over the past 30 years and the predominant findings from the “certain” articles are summarized in this review. This review clarifies certain queries such as 1) Do periodontal diseases have an effect on the metabolic control of diabetes? 2) Does diabetes act as a risk factor of periodontitis? 3) What are the possible underlying mechanisms relating the connection between these two chronic diseases? 4) What is the effect of periodontal intervention on metabolic control of diabetes? After a thorough survey of literature, it was observed that diabetes acts as a risk factor in development of periodontitis as periodontitis is significantly aggravated in patients suffering from diabetes having long term hyperglycemia. Different mechanisms underlying the association between the accelerated periodontal disease and diabetes are emerging but still more work is required. Major efforts are required to elucidate the impact of periodontal diseases on diabetes. At the same time, patients are needed to be made aware of regular periodontal maintenance schedule and oral hygiene.
TCAT and WFO ablation provided essentially equivalent outcomes after myopic LASIK, with induction of fewer lower order aberrations and higher order aberrations following TCAT ablation. [J Refract Surg. 2017;33(1):6-10.].
Background: Vitamin D deficiency is associated with a range of systemic diseases including ocular disorders. The objective of this study is to measure tear vitamin D levels and investigate the correlation between serum and tear vitamin D levels. Methods: A total of 48 healthy volunteers without any systemic and ocular disease were recruited for this observational cohort study. Serum was collected using clot activator coated Vacutainer® Plus tubes. Tear fluid was collected using Schirmer's strips. Serum and tear total 25-hydroxyvitamin D levels were measured by competitive chemiluminescent ELISA and the correlation between the levels were studied. Results: The measured serum 25-hydroxyvitamin D level ranged between 3.3 and 27.5 ng/ml (Mean ± SEM, 9.4 ± 0. 7 ng/ml; Median 8.4 ng/ml). Significantly (p < 0.0001) higher level of 25-hydroxyvitamin D was detected in the tears (Mean ± SEM, 17.0 ± 1.6 ng/ml; Range 3.2-45.8 ng/ml; Median, 16.3 ng/ml) compared to serum. An average of~2 fold (Mean ± SEM, 1.9 ± 0.2; Range 0.4-5.8; Median, 1.7) higher 25-hydroxyvitamin D was observed in tears compared to serum in the subjects. In addition, a positive correlation was observed between serum and tear 25-hydroxyvitamin D levels (r = 0.5595; p < 0.0001). Conclusions: A higher level of 25-hydroxyvitamin D was observed in the tear fluid compared to that of the serum. It would be beneficial to consider tear vitamin D levels to study its role with reference to ocular surface diseases.
BackgroundMigraine is a multifactorial disorder with complex neuronal and vascular mechanisms that encompasses a wide clinical spectrum of symptoms, including ocular manifestations. Dry eye disease and dysfunction of ocular somatosensory pathways have been implicated in the pathogenesis. The current study investigates the association between a dysfunctional tear film and ocular aberrations with migraine.MethodsSixty eyes of 30 patients with migraine and 60 eyes of 30 controls were studied. Dry eye evaluation included Schirmer’s test, tear film break-up time, corneal esthesiometry and lipid layer analysis using Lipiview® interferometer. Wavefront aberrations were measured using Optical Path Difference before performing the dry eye evaluation. The intraocular light scatter was quantified using the objective scatter index (OSI) of the optical quality analysis system. Measured parameters were compared between the migraine and the control group using independent sample t-test. Statistical analysis was performed using commercial software. A p value of ≤ 0.05 was considered statistically significant.ResultsThere were 19 females and 11 males in each group. Statistically significant difference was found between the two groups with respect to total aberrations (p = 0.049), higher order aberrations (p = 0.009), coma (p = 0.03), spherical aberrations (p = 0.018), Lipiview interferometric coloric units (p < 0.001) and OSI (p < 0.001). Trefoil (p = 0.26) and TBUT (p = 0.398) were not significantly different between both groups.ConclusionsOcular aberrations are higher in patients with migraine as compared with controls. Tear film abnormalities add to the aberrations in otherwise asymptomatic patients and may also be associated with migraineous attacks. Treating the ocular surface to obtain a healthy tear film might introduce a potential modifiable factor in the prevention of migraneous attacks.
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