Ocular Surface Microbiota in Naïve Keratoconus: A Multicenter Validation Study

Rocha-de-Lossada, Carlos; Mazzotta, Cosimo; Gabrielli, Federico; Papa, Filomena Tiziana; Gómez-Huertas, Carmen; García-López, Celia; Urbinati, Facundo; Rachwani-Anil, Rahul; García-Lorente, María; Sánchez-González, José-María; Rechichi, Miguel; Rubegni, Giovanni; Borroni, Davide

doi:10.3390/jcm12196354

Cited by 12 publications

(9 citation statements)

References 46 publications

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Section: It Is Time For a Turning Point In Keratoconusmentioning

confidence: 99%

“…6 The Journal of Keratoconus and Ectatic Corneal Diseases has the honor and task of hosting present and future innovations in clinical and surgical research, in keratoconus diagnostics and in everything relating to genetic, hormonal, inflammatory, environmental and biochemical aspects, including new research topic in ocular microbiota. 7,8 All ophthalmologists of good will are invited to contribute with their studies to the success of the IJKECD, owned and managed by Jaypee Brothers Medical Publishers (P) LTD.In recent years we have witnessed and contributed to a revolution in the knowledge of the pathophysiology of keratoconus, of the clinic and of pathophysiological optics, thanks to machines such as Scheimpflug-based and now OCT-based tomography. Furthermore, the biomechanics of the cornea is increasingly closer, especially motion-tracking Brillouin Microscopy, surely it will contribute to many new discoveries and increasingly earlier diagnoses of ectatic diseases.…”

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It is time for a Turning Point in Keratoconus

Mazzotta

2024

International Journal of Keratoconus and Ectatic Corneal Diseases

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It is time for a Turning Point in KeratoconusKeratoconus (KC) is no longer a rare disease 1 , especially in certain geographical areas it reaches peaks of endemic value. The therapies and innovations of the last years', starting with crosslinking, have drastically changed the prognosis and quality of life of our patients.New combined therapies, minimally invasive refractive enhancement treatments, have changed and are changing history. 2 Increasingly sophisticated diagnoses, intelligent CT scanners, machine learning and artificial intelligence are at the service of ophthalmologists who are passionate about the subject and of patients for higher, refined and early diagnoses. 3 This has made keratoconus a subspecialty of modern ophthalmology and poses ever new and exciting challenges in the clinical, diagnostic, and therapeutic fields. There was a need for an international society dedicated to this disease, distinct and separate, but which is open to dialogue with the most important international societies of refractive and anterior segment eye surgery.Thus, the IKS (International Keratoconus Society) was finally born, the home of ophthalmologists who deal with keratoconus and of all those who want to dedicate themselves to this fascinating sector of ophthalmology.Such an important Society could not fail to have an equally important scientific Journal, and we have the honor of having the International Journal of Keratoconus and Ectatic Corneal Diseases (IJKECD) as our official IKS scientific Journal. 3 I cannot hide a certain emotion, because it was precisely in this Journal that the M nomogram 4,5 for the standardized treatment of individualized crosslinking of ectatic corneas of all thicknesses was born, as awarded in the ESCRS Congress in 2019 in Paris with the "Joseph Colin Prize" for innovating therapies in the field of Keratoconus. 4,5 The "M nomogram" allows safe and effective setting of CXL parameters based on thickness minimum preoperative corneal membrane, also allowing the standardized treatment of thin and ultrathin ectatic corneas with a minimum thickness between 250 and 400 µm, keeping the fluence standardized in the Dresden Protocol constant (5.4 J/cm 2 ). 4,5 Actually, the preliminary results on new epithelium-on accelerated CXL protocols with progressively higher fluence and pulsed light show that a new pachymetry-based PFPL M Epi-on ACXL nomogram stabilizes ectasia progression. 6 Higher fluence Epi-on ACXL increases CXL penetration, with better functional outcomes in the absence of complications, thus paving the way to a replacement of epithelium-off crosslinking treatments. From a clinical and practical perspective, a safer and faster transepithelial crosslinking treatment with an efficacy profile comparable to Epi-off CXL, with no adverse events and capable of quickly rehabilitating patients with progressive KC to resume their school or work activities, represents a great challenge and a highly interesting goal. The early evidence of my recent studies will allow surgeons to extend the indication...

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Section: It Is Time For a Turning Point In Keratoconusmentioning

confidence: 99%

mentioning

confidence: 99%

It is time for a Turning Point in Keratoconus

Mazzotta

2024

International Journal of Keratoconus and Ectatic Corneal Diseases

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“…Keratitis is an inflammatory disease of the eye, studies have found that the diversity of ocular surface flora changes when bacterial keratitis occurs [59,60], and intestinal commensal bacteria can affect the susceptibility to ocular keratitis by affecting sIgA levels [61]. Animal models have shown that gut microbiota can provide protection against Pseudomonas aeruginosa-induced keratitis by regulating mature neutrophils.…”

Section: Bacterial Keratitis (Bk)/ Fungal Keratitis (Fk)mentioning

confidence: 99%

What is the impact of microbiota on dry eye: a literature review of the gut-eye axis

Song,

Dong,

Wang

et al. 2024

BMC Ophthalmol

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Background Dry eye is a chronic and multifactorial ocular surface disease caused by tear film instability or imbalance in the microenvironment of the ocular surface. It can lead to various discomforts such as inflammation of the ocular surface and visual issues. However, the mechanism of dry eye is not clear, which results in dry eye being only relieved but not cured in clinical practice. Finding multiple environmental pathways for dry eye and exploring the pathogenesis of dry eye have become the focus of research. Studies have found that changes in microbiota may be related to the occurrence and development of dry eye disease. Methods Entered the keywords “Dry eye”, “Microbiota”, “Bacteria” through PUBMED, summarised the articles that meet the inclusion criteria and then filtered them while the publication time range of the literature was defined in the past 5 years, with a deadline of 2023.A total of 13 clinical and 1 animal-related research articles were screened out and included in the summary. Results Study found that different components of bacteria can induce ocular immune responses through different receptors present on the ocular surface, thereby leading to an imbalance in the ocular surface microenvironment. Changes in the ocular surface microbiota and gut microbiota were also found when dry eye syndrome occurs, including changes in diversity, an increase in pro-inflammatory bacteria, and a decrease in short-chain fatty acid-related bacterial genera that produce anti-inflammatory effects. Fecal microbiota transplantation or probiotic intervention can alleviate signs of inflammation on the ocular surface of dry eye animal models. Conclusions By summarizing the changes in the ocular surface and intestinal microbiota when dry eye occurs, it is speculated and concluded that the intestine may affect the occurrence of eye diseases such as dry eye through several pathways and mechanisms, such as the occurrence of abnormal immune responses, microbiota metabolites- intervention of short-chain fatty acids, imbalance of pro-inflammatory and anti-inflammatory factors, and release of neurotransmitters, etc. Analyzing the correlation between the intestinal tract and the eyes from the perspective of microbiota can provide a theoretical basis and a new idea for relieving dry eyes in multiple ways in the future.

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“…A healthy surface microbiota is important for proper interaction between the CL and the ocular surface, as well as to reduce the potential occurrence of serious issues during CL wear. [9][10][11] One factor that affects ocular discomfort is lid wiper epitheliopathy (LWE), whose prevalence ranges from 67% to 80% in symptomatic CL wearers, but is less than 32% in asymptomatic wearers. 12 LWE results from the friction of the eyelid over the ocular surface when the tear film thins.…”

Section: Introductionmentioning

confidence: 99%

Assessing neophyte response to daily disposable silicone hydrogel contact lenses: A randomised clinical trial investigation over one month

Garcia‐Queiruga,

Pena‐Verdeal,

Ferreiro‐Figueiras

et al. 2024

Ophthalmic Physiologic Optic

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ObjectiveThis randomised clinical trial assessed the impact on symptoms, tear film dynamics and ocular surface integrity of daily disposable silicone‐hydrogel contact lenses (CLs) over a month, paying special attention to lid wiper epitheliopathy (LWE) and its implications for CL discomfort.MethodsNeophyte CL wearers (n = 44, 21.09 ± 5.00 years old) were randomly assigned to either the experimental (n = 24) or control group (n = 20). Participants assigned to the experimental group were required to wear daily disposable CLs for 1 month for at least 8 h/day and 6 days/week. All participants were healthy subjects (no history of ocular surgery or active ocular disease) with spherical refractive errors between −8.00 and +5.00 D and cylindrical power <0.75 D. At the baseline and 1‐month sessions, the Dry Eye Questionnaire 5 (DEQ‐5) was completed, together with the measurement of tear film osmolarity with the TearLab osmometer, tear meniscus height (TMH) and lipid layer pattern (LLP) using a slit‐lamp with Tearscope Plus attached, fluorescein break‐up time (FBUT), maximum blink interval (MBI), corneal staining with fluorescein under cobalt blue light and LWE with lissamine green under slit lamp and halogen white light.ResultsAt the baseline session, LWE showed a negative correlation with DEQ‐5 (r = −0.37, p = 0.02). Significant differences in FBUT and LWE (p = 0.04) and a positive correlation between LWE and DEQ‐5 (r = 0.49, p = 0.007) were observed at 1 month. Intrasession analysis at 1 month showed significant differences between the experimental and control groups in DEQ‐5, FBUT and LWE (all p ≤ 0.02). Intersession analysis in the experimental group showed variations in DEQ‐5, FBUT and LWE (all p ≤ 0.02) but no significant variation in the control group (all p ≥ 0.11).ConclusionThe presence of LWE was significantly correlated with higher symptom values in the DEQ‐5. Also, participants in the experimental group presented higher values of LWE after 1 month of CL wear, in comparison with the control group.

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Ocular Surface Microbiota in Naïve Keratoconus: A Multicenter Validation Study

Cited by 12 publications

References 46 publications

It is time for a Turning Point in Keratoconus

It is time for a Turning Point in Keratoconus

What is the impact of microbiota on dry eye: a literature review of the gut-eye axis

Assessing neophyte response to daily disposable silicone hydrogel contact lenses: A randomised clinical trial investigation over one month

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