Conjunctivochalasis: a systematic review

Marmalidou, Anna; Kheirkhah, Ahmad; Dana, Reza

doi:10.1016/j.survophthal.2017.10.010

Cited by 40 publications

(54 citation statements)

References 84 publications

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“…31 Numerous factors, including aged conjunctiva, ocular inflammation, mechanical friction, tear film instability, and delayed tear clearance, are involved in the pathogenesis of CCH. 2,21,32 However, the exact pathogenesis remains largely unknown. In this study, we revealed the important role of cellular senescence in the development of CCH and explored the underlying mechanism.…”

Section: Discussionmentioning

confidence: 99%

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P38-Mediated Cellular Senescence in Conjunctivochalasis Fibroblasts

Xiang

Zhan

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Conjunctivochalasis (CCH) is a common ocular disease and has received extensive attention recently. However, its exact pathogenesis remains largely unknown. Owing to the high morbidity of CCH in older people, this study aimed to investigate whether cellular senescence contributes to CCH progression and the underlying mechanism. METHODS. Loose conjunctival tissues from CCH patients (n ¼ 13) and normal conjunctival tissues from age-matched persons (n ¼ 12) were obtained and the fibroblasts were separately induced and obtained. Cellular senescence, and the expression of senescence-associated genes (p53 and p21) and p38 in CCH conjunctival tissues and normal controls, were determined by senescence-associated b-galactosidase (SA-b-Gal) staining and quantitative (q)RT-PCR, respectively. To explore the effects of p38 on cellular senescence in CCH fibroblasts, small interfering RNA (siRNA) targeting p38 (siP38) and p38-specific inhibitor SB203580 was performed in CCH fibroblasts. Then, cellular senescence, cell viability, reactive oxygen species (ROS) production, and gene expression were detected according to the corresponding methods. RESULTS. CCH conjunctival tissues had significantly more senescent cells, evidenced by more SA-b-Gal-positive cells, and higher expression of senescence-associated genes (p53 and p21) and p38. CCH fibroblasts transfected with siP38 or treated with SB203580 had obviously reduced numbers of senescent cells, decreased ROS production, and increased cell viability, as well as reduced expression of senescence-associated genes. Meanwhile, blocking p38 signaling decreased the expression of p53 and p21. CONCLUSIONS. Therefore, these findings indicate that cellular senescence might be a causative factor for CCH. P38 signaling might play an important role in the progress of cellular senescence in CCH fibroblasts via manipulation of p53/p21 signaling.

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Section: Discussionmentioning

confidence: 99%

“…19,20 Aging is the most important risk factor for CCH. 21 Based on these studies, we speculated that cellular senescence may contribute to the development of CCH. However, the role of cellular senescence in CCH is still largely unknown.…”

mentioning

confidence: 99%

P38-Mediated Cellular Senescence in Conjunctivochalasis Fibroblasts

Xiang

Zhan

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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“…The average density of collagen III were 0.17 ± 0.01 and 0.18 ± 0.01 in control group and treatment group (Fig.6). In our study, both of the average optical density of collagen I and collagen III have no significantly (P >0.05) increased after treatment with riboflavin and UVA light of 45mW/cm 2 (Fig.7).…”

Section: Expression Of Collagen I and Collagen Iii In The Rabbit Conjmentioning

confidence: 45%

“…Conjunctivochalasis(CCh) is a common age-related eye disease and characterized by progressive thinning and accumulation in the lower eyelid causing foreign body sensation, tears and other symptoms [1] . Conjunctivochalasis wasassociated with the biomechanical properties of conjunctival [1,2] . As we know, the reduction in the size of a single collagen fiber and the reduction in the number of conjunctival collagen fibers are the main pathogenic factors of progressive CCh.…”

Section: Introductionmentioning

confidence: 99%

The change of collagen in rabbit conjunctiva after conjunctiva cross-linking

Wang

et al. 2019

Preprint

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Background We aimed to determine the ultrastructural changes of collagen fibrils in the rabbit conjunctiva after conjunctiva cross-linking using riboflavin and UVA light of 45mW / cm 2 irradiation intensity. Conjunctiva cross-linking may increase conjunctiva stiffness. Methods The super-temporal quadrant of the right eyes of twenty-four adult rabbits were treated with topical riboflavin solution (0.25%) followed by irradiation with UVA light (45mW/cm 2 ) for 4 min. After 3 weeks, the collagen fibrils in fibril bundles were examined with electron microscopy. Immunohistochemical staining was applied to detect the expression of collagen I and III in the rabbits’ conjunctiva. Results The diameter of collagen fibrils in the fibril bundles varied slightly and ranged from 30 to 60 nm in control group conjunctival stroma. While in the treatment group, the diameter of collagen fibrils ranged from 60 to 90 nm. Thickest collagen fibrils were observed in the treatment group (fibril diameters up to 90 nm), whereas thickest collagen fibrils in control group conjunctival stroma are considerable smaller (up to 60 nm in diameter). However, both of the thickness of collagen fibrils displayed a unimodal distribution. Collagen I and collagen III were increased after treatment with riboflavin and UVA light of 45 mW/cm 2 .Conclusions The data indicate that in rabbits, conjunctiva cross-linking with riboflavin and UVA light of 45 mW/cm 2 for 4 min is relatively safe and does not induce ultrastructural alterations of conjunctiva cells. The conjunctiva cross-linking riboflavin and UVA light of 45 mW/cm 2 can increase the diameter of collagen fibrils, but the average density of collagen I and collagen III have no statistical significance.

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“…The exact pathological mechanism of CCh remains unclear, but several alterations of OS have been postulated. The first alteration is the senile degradation of the subconjunctival connective tissue, reducing attachment of the bulbar conjunctiva to the sclera and conjunctival laxity 2,14 . A recent transcriptome analysis of human conjunctiva with CCh demonstrated that reduced gene expression could cause decreased cell viability, which is related to the aging process 26 .…”

Section: Discussionmentioning

confidence: 99%

The correction of conjunctivochalasis using high-frequency radiowave electrosurgery improves dry eye disease

Seong

Lee

et al. 2021

Sci Rep

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We aimed to determine the clinical impact of conjunctivochalasis (CCh) and its correction using high-frequency radiowave electrosurgery (HFR-ES), for signs and symptoms of dry eye disease (DED). Forty patients diagnosed with symptomatic CCh were prospectively enrolled. As a result, patients with CCh had moderate to severe DED and most of them exhibited meibomian gland dysfunction (MGD). Corneo-conjunctival fluorescein staining score (CFS) and all lid-parallel-conjunctival-folds scores (LIPCOFs) were positively correlated. Nasal LIPCOF significantly correlated with symptoms and tear volume. Central, temporal, and total LIPCOF significantly correlated with MG loss, MGD stage, and lipid layer thickness. Independent significant factors associated with total LIPCOF included CFS, tear break-up time, and MGD stage. One month following HFR-ES, CCh was completely resolved in all cases. Patient age and preoperative nasal LIPCOF were determinants of outcomes associated with postoperative improvements in symptoms. Ocular surface parameters significantly improved, but MGD-related signs did not. Collectively, CCh associated with MGD severity deteriorates not only tear film stability and reservoir capacity, leading to DED exacerbation. Therefore, CCh should be corrected in patients with DED and MGD. Younger patients with nasal CCh are likely to experience more symptomatic relief after HFR-ES. Particularly, management for MGD should be maintained after CCh correction.

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Conjunctivochalasis: a systematic review

Cited by 40 publications

References 84 publications

P38-Mediated Cellular Senescence in Conjunctivochalasis Fibroblasts

P38-Mediated Cellular Senescence in Conjunctivochalasis Fibroblasts

The change of collagen in rabbit conjunctiva after conjunctiva cross-linking

The correction of conjunctivochalasis using high-frequency radiowave electrosurgery improves dry eye disease

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