Effect of Pseudoexfoliation on Corneal Transparency

Cankaya, Ali Bulent; Tekin, Kemal; İnanç, Merve

doi:10.1097/ico.0000000000000852

Cited by 17 publications

(5 citation statements)

References 28 publications

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“…12,13 Corneal endotheliopathy could also lead to changes in CCT, as supposed by several authors in the literature. 14 In agreement with current knowledge, 15,16 the conflicting results about the changes of CCT in eyes affected by PEX could be interpreted either as the consequence of reduced corneal cell density and morphological changes due to hypesthesia or as the expression of corneal swelling due to endothelial dysfunction. In our study, however, we did not find any significant changes in CCT between the two study groups, so the relationship between presence of PEM and stromal/endothelium alterations is not yet currently clear.…”

Section: Discussionsupporting

confidence: 82%

An in vivo confocal microscopy study of corneal changes in pseudoexfoliation syndrome

Terracciano

Cennamo

Favuzza

et al. 2018

European Journal of Ophthalmology

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Purpose: To evaluate, through the in vivo confocal microscopy, the pathological changes of each corneal layer in eyes affected by pseudoexfoliation syndrome. Methods: We studied 40 eyes of 40 patients with diagnosis of unilateral senile cataract associated with pseudoexfoliation syndrome and 40 eyes of 40 control subjects with senile cataract without pseudoexfoliation syndrome. All patients underwent a complete ophthalmic examination including best corrected visual acuity, slit-lamp examination, corneal sensitivity measurement using a Cochet-Bonnet nylon thread esthesiometer, and anterior segment optical coherence tomography (Visante OCT, Carl Zeiss Meditec AG, Germany); in vivo confocal microscopy of corneal sections (endothelium, stroma, sub-basal nerve plexus, and superficial and basal epithelium) was performed with the ConfoScan 4.0 (Nidek, Japan). Results: In pseudoexfoliation syndrome group, the mean corneal sensitivity was 44.1 ± 1.3 mm and in the control group was 55.6 ± 4.7 mm. The corneas of the eyes with pseudoexfoliation syndrome were significantly less sensitive than those of control group eyes (p < 0.001). Pseudoexfoliation syndrome eyes had a lower nerve density and less nerve beadings and a higher degree of tortuosity in sub-basal plexus compared to the control group. The cell density of epithelial and endothelial layers was significantly lower in pseudoexfoliation syndrome eyes than controls. In 80% of pseudoexfoliation syndrome eyes, we found activated keratocytes and inflammatory cells in the anterior stroma. Conclusion: Our study demonstrates the morpho-structural corneal alterations in eyes affected by pseudoexfoliation syndrome, using corneal in vivo confocal microscopy as a non-invasive and high-reproducible technique to evaluate pathophysiology of each corneal layer; the sub-basal nerve plexus alterations are correlated with the lower corneal sensitivity.

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Section: Discussionsupporting

confidence: 82%

An in vivo confocal microscopy study of corneal changes in pseudoexfoliation syndrome

Terracciano

Cennamo

Favuzza

et al. 2018

European Journal of Ophthalmology

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“…This indicated that the severity of keratoconus may be correlated with the elevation of the corneal densitometry values, especially in the anterior layer. Elevated corneal densitometry also has been reported in the pathogenesis of various ocular surface disorders, which may compromise the corneal transparency, including keratitis,17 endothelial abnormality,18 and pseudoexfoliation syndrome 19. Misalignment of the corneal collagen has been noted in keratoconus 4.…”

Section: Discussionmentioning

confidence: 97%

Correlation Between Corneal Topographic, Densitometry, and Biomechanical Parameters in Keratoconus Eyes

Shen

Han

Jhanji

et al. 2019

Trans. Vis. Sci. Tech.

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Purpose To investigate the correlation between corneal densitometry, corneal topographic parameters, and corneal biomechanical properties in keratoconus. Methods A total of 76 eyes of 76 keratoconus patients were enrolled in this cross-sectional study. Corneal densitometry and topography were measured using Pentacam HR. Corneal biomechanical properties were measured using CorVis ST. Results The corneal densitometry values of the anterior 0 to 2 and 2 to 6 mm layers significantly correlated with the maximum keratometry values ( R = 0.373, P = 0.001 and R = 0.276, P = 0.016, respectively), thinnest corneal thickness values ( R = −0.331, P = 0.003 and R = −0.234, P = 0.042, respectively), anterior corneal elevation ( R = 0.392, P < 0.001 and R = 0.323, P = 0.004, respectively), and posterior corneal elevation ( R = 0.450, P < 0.001 and R = 0.367, P = 0.001, respectively). The stiffness parameter-applanation time 1 (SP-A1) significantly correlated with the corneal densitometry values for the anterior 0 to 2 mm ( R = −0.397, P < 0.001), anterior 2 to 6 mm ( R = −0.331, P = 0.004), central 0 to 2 mm ( R = −0.306, P = 0.007), central 2 to 6 mm ( R = −0.228, P = 0.048), posterior 2 to 6 mm ( R = −0.243, P = 0.035), total 0 to 2 mm ( R = −0.291, P = 0.011), and total 2 to 6 mm ( R = −0.295, P = 0.010) layers. Conclusions The corneal densitometry values correlated with the severity of keratoconus and the SP-A1 values. Translational Relevance Corneal densitometry values may serve as markers to predict the severity of keratoconus.

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“…Increased optical density of the corneal epithelium in PEX has not yet been reported in the literature. However, Cankaya et al observed that the presence of pseudoexfoliation material decreased the transparency of the cornea as a whole [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The optical density of the cornea in patients with PEX has received little research attention. Recently, Cankaya et al confirmed that the presence of pseudoexfoliation material can decrease the transparency of the cornea [ 11 ]. However, Sekeroglu et al reported contradictory results, as corneal clarity was similar in patients with bilateral PEX and healthy controls [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Scheimpflug Camera Measurement of Optical Density of the Corneal Epithelium, Stroma, and Endothelium in Patients with Pseudoexfoliation Syndrome

et al. 2018

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BackgroundThe present study evaluated the optical density of particular layers of the cornea and anterior lens capsule in patients with pseudoexfoliation syndrome (PEX).Material/MethodsSixty patients with cataract and PEX (mean age 76.6±5.6 years, range 62–88 years) were compared to 55 controls with cataract without PEX syndrome (mean age 76.3±6.09 years, range 62–90 years; P>0.05). The anterior segment of one eye was examined in each patient using Pentacam HR by Oculus before the planned cataract surgery.ResultsThe average optical density of the corneal epithelium, stroma, and endothelium was 25.3±6.09% and 19.9±3.41% (P<0.001), 23.1±5.5% and 19.2±3.6% (P<0.0001), and 14.6±3.4% and 12.3±2.1% (P<0.0001) in the PEX and control groups, respectively. The optical density of the anterior lens capsule was 13.6±4.2% in the PEX group and 9.74± 2.23% in the control group (P<0.0001). The average thickness of the cornea was 555 μm and 556 μm and the average optical density of endothelial cells 2240/mm2 and 2323/mm2 in the PEX and control groups, respectively (P<0.05).ConclusionsIn patients with PEX, increased optical density was observed not only in the structures with pseudoexfoliative material detectable by a slit-lamp), but also in the corneal epithelium and stroma. The increased optical density was not associated with reduced endothelial cell density or increased central cornea thickness.

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Effect of Pseudoexfoliation on Corneal Transparency

Abstract: This research demonstrates that the presence of pseudoexfoliation material can cause decrease in the transparency of clear cornea.

Cited by 17 publications

References 28 publications

An in vivo confocal microscopy study of corneal changes in pseudoexfoliation syndrome

An in vivo confocal microscopy study of corneal changes in pseudoexfoliation syndrome

Correlation Between Corneal Topographic, Densitometry, and Biomechanical Parameters in Keratoconus Eyes

Scheimpflug Camera Measurement of Optical Density of the Corneal Epithelium, Stroma, and Endothelium in Patients with Pseudoexfoliation Syndrome

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