In vivo confocal microscopy study of climatic droplet keratopathy

Urrets-Zavalía, Julio A; Croxatto, J. Oscar; Holopainen, Juha M.; Cafaro, Thamara A.; Espósito, F.; Neira, Waldir; Serra, Horacio M.

doi:10.1038/eye.2012.79

Cited by 11 publications

(7 citation statements)

References 5 publications

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“…Many individuals also received a test of visual acuity with a Snellen chart and Landolt rings or E for illiterate individuals, objective refraction determination using an autorefractometer (RK1, Canon Inc., Tokyo, Japan). Three representative cases of patients with different grades of CDK were also studied using in vivo confocal laser scanning microscopy (IVCM) as previously described [ 38 ].…”

Section: Methodsmentioning

confidence: 99%

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Climatic Droplet Keratopathy in Argentina: Involvement of Environmental Agents in Its Genesis Which Would Open the Prospect for New Therapeutic Interventions

Suárez

Correa

Crim

et al. 2015

BioMed Research International

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Climatic droplet keratopathy (CDK) is a degenerative corneal disease of unknown etiology. We described CDK for the first time in Latin America in the Argentinean Patagonia (El Cuy). A deeper knowledge of CDK pathogenic mechanisms will provide new therapeutic strategies. For that reason we investigated the prevalence of CDK in El Cuy and its existence in other 3 provinces with similar climate. Patients eyes were examined, habits throughout lives were inquired about, and serum ascorbate (sAA) was determined. All individuals work outdoors for most of the day. All regions had normal O3 levels. Individuals from regions 1, 2, and 3 had very low consumption of vegetables/fruits and low sAA levels. Conversely, region 4 individuals had balanced diet and higher sAA concentrations. CDK was only found in region 3 where individuals had partial deficiency of sAA and did not use eye protection. No CDK was found in regions 1 and 2 where individuals had similar work activities and dietary habits to those in region 3 but wear eye protection. No disease was found in region 4 where individuals work outdoors, have balanced diet, and use eye protection. To summarize, the CDK existence was related not only to climate but also to the dietary habits and lack of protection from sunlight.

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Section: Methodsmentioning

confidence: 99%

“…Although globular deposits in the anterior layer of the corneas with CDK were described many years ago using optical and electron microscopy [ 36 , 37 ], more recently, these anomalies have been further characterized by us using in vivo confocal microscopy (IVCM) [ 38 ].…”

Section: Introductionmentioning

confidence: 99%

Climatic Droplet Keratopathy in Argentina: Involvement of Environmental Agents in Its Genesis Which Would Open the Prospect for New Therapeutic Interventions

Suárez

Correa

Crim

et al. 2015

BioMed Research International

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“…Although corneal degenerations and dystrophies have already been studied by means of CLSM, it was not until very recently that corneal abnormalities in patients with CDK were described by us using this technique (Urrets‐Zavalia et al. ).…”

Section: Recent Findings In the Pathogenesis Of Cdkmentioning

confidence: 99%

“…The progression of the disease was accompanied with an increment of the dendritic cells in the limbal area (87 ± 7 cells/mm 2 in grade 1, 101 ± 7 cells/mm 2 in grade 2 and 237 ± 8 cells/mm 2 in grade 3 CDK), and with a compromise of the epithelium (inclusion bodies) and the basal architecture (vacuoles) which may be secondary to fibrosis and hypo‐esthesia (Urrets‐Zavalía et al. ). The deep corneal stroma and corneal endothelium were not affected in CDK (data not shown).…”

Section: Recent Findings In the Pathogenesis Of Cdkmentioning

confidence: 99%

Climatic droplet keratopathy: an old disease in new clothes

Serra

Holopainen

Beuerman

et al. 2015

Acta Ophthalmologica

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ABSTRACT.Climatic droplet keratopathy (CDK) is an acquired and potentially handicapping cornea degenerative disease that is highly prevalent in certain rural communities around the world. It predominantly affects males over their forties. It has many other names such as Bietti's band-shaped nodular dystrophy, Labrador keratopathy, spheroidal degeneration, chronic actinic keratopathy, oil droplet degeneration, elastoid degeneration and keratinoid corneal degeneration. CDK is characterized by the haziness and opalescence of the cornea's most anterior layers which go through three stages with increasing severity. Globular deposits of different sizes may be histopathologically observed under the corneal epithelium by means of light and electron microscopy. The coalescence and increased volume of these spherules may cause the disruption of Bowman's membrane and the elevation and thinning of the corneal epithelium. The exact aetiology and pathogenesis of CDK are unknown, but they are possibly multifactorial. The only treatment in CDK advanced cases is a corneal transplantation, which in different impoverished regions of the world is not an available option. Many years ago, the clinical and histological aspects of this disease were described in several articles. This review highlights new scientific evidence of the expanding knowledge on CDK's pathogenesis which will open the prospect for new therapeutic interventions.

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“…Although globular deposits in the anterior layer of the corneas with CDK were described many years ago using optical and transmission electron microscopy, [16,17] more recently, these anomalies have been further characterized by us using CLSM. [18] As CDK is an ocular surface disease and the analysis of the tear proteins may result in further understanding of this disease, we studied tears glycoproteins in CDK patients using glycopeptide capture techniques and proteomics. Our results suggest that the enzymatic glycosylation may also be involved in the formation of deposits in CDK, since altered levels of Nglycosylation of certain proteins were observed in the tears of patients with CDK [19].…”

Section: Discussionmentioning

confidence: 99%

Clinical, Functional and Structural Studies of Humans and Merino Sheep Corneas from Two Different Regions of Argentina

Fern¹,

Suárez²,

Crim³

et al. 2015

J Clin Exp Ophthalmol

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Objective: The purpose of our work was to study and compare the cornea and tear film of people and sheep inhabiting in a region of Argentinean Patagonia (PATG), and in a geographically and climatically different region in the Argentinean Pampa (CAPT). Methods:Using cross sectional study, corneal examinations were performed in people and Merino sheep inhabiting PATG and CAPT regions, respectively. All people completed a questionnaire related to work activity, diet, and the use of hats or sunglasses during their life. Eyes from all participants were examined with a portable handheld slitlamp biomicroscope (BM) to evaluate corneal appearance, epithelium integrity, and transparency. Later on, in a subgroup of participants we studied eyeblinking frequency (EBF), ocular surface staining (FS), breakup time (BUT), Schirmer Tear Test (STT), corneal structure using confocal laser scanning microscopy (CLSM) and light microscopy (LM), and concentrations of serum ascorbate (sAA).Results: BM studies revealed numerous cases of Climatic Droplets Keratopathy (CDK) only in people inhabiting the PATG region. CLSM studies confirmed typical punctiform deposits at the Bowman´s layer in CDK patients living in that region. CLSM images from sheep did not show any abnormalities at the Bowman´s layer but exhibited small hyper reflective dots at the epithelium only in animals pasturing in the PATG region. FS and EBF mean values were significant higher in sheep grazing in the PATG region (p <0.05). No differences were found in surface eye tests when people from both regions were analyzed. Low sAA levels were found only in CDK people living in PATG region.Conclusions: CDK is a multi-factorial disease not only associated to harsh climate. We provide data that low sAA levels can play a role in its genesis in Patagonia patients'... Sheep pasturing in this region with a high prevalence of CDK have high concentration of sAA and did not present any sub epithelial corneal abnormalities.At initiation of the study people from both regions answered to a questionnaire related to diet, work activity, and the wear of eye protection from their early adulthood until that day, and their eyes were examined with a portable handheld slitlamp biomicroscope (Led Slit Lamp XL1, Shin Nipon, Ohira Co., Niigata, Japan) by specialists.Next, ocular surface tests were performed on 20 CDK patients from PATG region and 20 individuals from the CAPT region selected at random. The first test measured eye blink frequency (EBF) for 1 minute immediately prior to the other test. A second test was fluorescein staining (FS) to evaluate epithelium integrity, followed by breakup time (BUT); those were evaluated as previously described. [5] FS was recorded on a 4point subjective scale Citation: Suárez MF, Crim N, Monti R, Espósito E, Urrets-Zavalía JA, et al. (2015) Clinical, Functional and Structural Studies of Humans and Merino Sheep

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In vivo confocal microscopy study of climatic droplet keratopathy

Cited by 11 publications

References 5 publications

Climatic Droplet Keratopathy in Argentina: Involvement of Environmental Agents in Its Genesis Which Would Open the Prospect for New Therapeutic Interventions

Climatic Droplet Keratopathy in Argentina: Involvement of Environmental Agents in Its Genesis Which Would Open the Prospect for New Therapeutic Interventions

Climatic droplet keratopathy: an old disease in new clothes

Clinical, Functional and Structural Studies of Humans and Merino Sheep Corneas from Two Different Regions of Argentina

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