Keratoconus Progression in Patients With Allergy and Elevated Surface Matrix Metalloproteinase 9 Point-of-Care Test

Mazzotta, Cosimo; Traversi, Claudio; Mellace, Pierfrancesco; Bagaglia, Simone Alex; Zuccarini, S.; Mencucci, Rita; Jacob, Soosan

doi:10.1097/icl.0000000000000432

Cited by 35 publications

(36 citation statements)

References 27 publications

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“…In another study, an increase in MMP-9 protein level was also detected in the blood of KC patients compared with controls 43 . Higher levels of MMP-9 were found in tears of KC patients with allergies compared with KC patients without allergies, with the disease significantly progressing only in the first group of patients at a 12 month follow up 44 . However, other studies found no significant difference in the…”

Section: Ecm and Mmp Alterations In Keratoconusmentioning

confidence: 87%

Matrix metalloproteinases in keratoconus – Too much of a good thing?

Martino

Ali

Inglehearn

2019

Experimental Eye Research

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Section: Ecm and Mmp Alterations In Keratoconusmentioning

confidence: 87%

Matrix metalloproteinases in keratoconus – Too much of a good thing?

Martino

Ali

Inglehearn

2019

Experimental Eye Research

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“…So far, the most reliable approach to the estimate of the biomechanical effects of CXL must be based on numerical analysis using realistic geometrical and material models of the cornea, e.g., the finite element analysis (FEA) 84,103,104 , that accounts for the exact geometry, the complex microstructure of the stroma, and furthermore for the presence of the fluids filling the anterior chamber 105,106,107 . Numerical approaches must be combined with experimental testing conducted with advanced devices conceived to provide accurate information on the variability of the material parameters of the stroma, such as the ones based on Bruilloin microscopy 27 .…”

Section: Discussionmentioning

confidence: 99%

The meaning of the demarcation line after riboflavin-UVA corneal collagen crosslinking

Mazzotta

Wollensak

Raiskup³

et al. 2019

Expert Review of Ophthalmology

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Since at least two decades, corneal cross-linking by riboflavin and UV-A irradiation stands as an established treatment option of progressive corneal ectasia. More than ten years ago, the histological evaluation of animal corneas and later of human corneas by means of in vivo biomicroscopy and scanning laser confocal microscopy demonstrated in corneas treated with cross-linking procedure the occurrence of a demarcation line running almost parallel to the corneal surface. The feature is a direct consequence of the cross-linking-induced photooxidative modification of the stromal tissue due to riboflavin stromal concentration, light distribution within the corneal stroma, riboflavin activation, oxygen availability and diffusion in the corneal stroma, radicals release, and UV-A exposure time. In this study, the general role of the demarcation line observed after a corneal cross-linking process, in particular its mechanical relevance, clinical consequences, and other various findings in the numerous nowadays available modalities of this treatment, are reviewed objectively.

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“…Furthermore, recent studies have identified eye rubbing, itchy eyes, and AC as risk factors for KC [6,7]. In addition, AC has also been proven to exacerbate KC conditions [5,8]. Mazzotta et al [8] found that KC progression occurred more rapidly and to a greater extent in patients with concomitant allergy, eye rubbing and elevated matrix metalloproteinase 9 (MMP9) levels in tears and that KC progression was closely related to the severity of allergy.…”

Section: Introductionmentioning

confidence: 99%

“…KC is a degenerative disorder of the cornea that was first described as a noninflammatory ectatic disease, but recent studies have implicated that the action of inflammatory mediators are involved in KC development and progression [8][9][10]. Corneal injury and elevated inflammatory mediator release caused by excessive eye rubbing in AC patients have been proposed as possible mechanisms of KC development.…”

Section: Introductionmentioning

confidence: 99%

Corneal biomechanical changes in allergic conjunctivitis

Wang

Deng

et al. 2021

Eye and Vis

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Background To explore corneal biomechanical changes, identify related factors and determine early indicators of keratoconus (KC) development risk in allergic conjunctivitis (AC) patients. Methods A total of 50 patients, including 20 eyes without AC and 30 eyes with AC were enrolled in this study. All patients underwent a complete ocular examination, including evaluations of clinical manifestations of AC, corneal tomography and densitometry by Pentacam, corneal biomechanics by Corvis ST, and corneal and epithelial thickness mapping by RTvue optical coherence tomography (OCT). Results The index of surface variance (ISV), index of vertical asymmetry (IVA), keratoconus index (KI), index of height decentration (IHD) and Belin/Ambrosio enhanced ectasia total deviation index (BAD-D) were significantly higher in the AC group than in the non-allergic conjunctivitis (NAC) group (P < 0.05). The tomography and biomechanical index (TBI) was also significantly higher in the AC group (P = 0.04). The average epithelial thickness in the 2–7 mm annulus was significantly thinner in the AC group than in the NAC group (P < 0.05). The average densitometry of the total cornea and the anterior layer were higher in the AC group than in the NAC group (P < 0.001). The ISV, IVA, KI, IHD and BAD-D were significantly correlated with the TBI and changes in corneal epithelial thickness in AC patients (P < 0.05). The changes in epithelial thickness were closely related to the eye rubbing frequency and allergic sign scores (P < 0.05). Conclusions AC patients should be advised to routinely undergo corneal tomographic and biomechanical measurements, and the TBI could be used as an indicator of KC development risk in AC patients. Trial registration Corneal Biomechanical Changes of Allergic Conjunctivitis, NCT04299399. Registered March 3, 2020 - Retrospectively registered.

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Keratoconus Progression in Patients With Allergy and Elevated Surface Matrix Metalloproteinase 9 Point-of-Care Test

Abstract: The study demonstrated a statistically significant progression of KC in patients with concomitant allergies, positive to MMP-9 point-of-care test versus negative. A high correlation between severity of allergy and KC progression was documented.

Cited by 35 publications

References 27 publications

Matrix metalloproteinases in keratoconus – Too much of a good thing?

Matrix metalloproteinases in keratoconus – Too much of a good thing?

The meaning of the demarcation line after riboflavin-UVA corneal collagen crosslinking

Corneal biomechanical changes in allergic conjunctivitis

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