Significance of Fuchs Flecks in Patients With Pterygium/Pinguecula

Ip, Matthew H.; Chui, Jeanie; Tat, Lien; Coroneo, Minas T.

doi:10.1097/ico.0000000000000621

Cited by 18 publications

(11 citation statements)

References 13 publications

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“…There are, however, significant limitations to the precision of recall bias. A recent report suggested that pinguecula developing in the limbus cornea as a result of UV exposure could be an index for the UV exposure dose a person has received [43]. Because pterygium is also an index for high UV exposure, it could also be effective to conduct future investigations using the presence/absence and extent of pinguecula and pterygium as indexes for the ocular UV exposure level.…”

Section: Resultsmentioning

confidence: 99%

Association between ultraviolet radiation exposure dose and cataract in Han people living in China and Taiwan: A cross-sectional study

et al. 2019

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Purpose We investigated associations between ocular ultraviolet (UV) radiation exposure dose and cataract opacities among Han people living in China and Taiwan, to assess the effects of UV exposure intensity. Methods This cross-sectional study included Han people aged ≥40 years (1,801 individuals, 450 in Sanya, 636 in Taiyuan, and 715 in Taichung) as subjects who completed a questionnaire including items about diabetes, smoking, steroid use, work history, and time spent outdoors, and underwent an ophthalmic examination. Right eye axial length was measured using A-mode ultrasonography or IOLMaster. Slit-lamp imaging under maximum mydriasis was used to classify cataracts into three major types [cortical (COR), nuclear (NUC), and posterior subcapsular cataracts (PSC)] and two subtypes [retrodots (RD) and waterclefts (WC)] by one ophthalmologist. COR was divided into opacity presence (CEN+) or absence (CEN-) in the central 3-mm diameter area of the pupil. COR was also subdivided into three groups according to opacity shape: axle-shaped opacity concomitant with WC, wedge-shaped opacity around the pupil to the eye center, and ring-shaped opacity in the lens equator along the pupillary margin. The cumulative ocular UV exposure (COUV) was calculated. A logistic regression analysis was used for multivariate analysis. Results Cataract odds ratios in high COUV eyes were 5.35 for NUC, 1.87 for PSC, and 1.35 for RD. In eyes with WC, risk of COR ring-shaped opacity significantly increased but that of wedge-shaped opacity (CEN+) significantly decreased. In eyes without WC, risk of COR axle-shaped opacity (CEN–) and ring-shaped opacity significantly increased but that of wedge-shaped opacity (CEN+) significantly decreased. Conclusions Increased COUV level among Han people may be a risk factor for the development of nuclear cataracts, PSC, retrodots and ring-shaped cortical cataract. Risk of ocular UV exposure for cortical cataract may differ by opacity shape.

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Section: Resultsmentioning

confidence: 99%

Association between ultraviolet radiation exposure dose and cataract in Han people living in China and Taiwan: A cross-sectional study

et al. 2019

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“…At the same time, UV damage of other cell types residing in the LESC niche, including limbal fibroblasts, may compromise the stem cell phenotype and functionality. We have provided evidence that perhaps the earliest evidence of UV damage may be in vivo evidence of corneal invasion of Fuchs' fleck-like lesions at the head of primary and recurrent pterygia, pinguecula, and even in clinically normal nasal and temporal limbus in sun-damaged individuals [ 113 ].…”

Section: Effects Of Uv Irradiation To the Limbal Niche: Pterygium mentioning

confidence: 99%

The Role of Limbal Epithelial Stem Cells in Regulating Corneal (Lymph)angiogenic Privilege and the Micromilieu of the Limbal Niche following UV Exposure

Notara

Lentzsch

Coroneo

et al. 2018

Stem Cells International

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The cornea is a clear structure, void of blood, and lymphatic vessels, functioning as our window to the world. Limbal epithelial stem cells, occupying the area between avascular cornea and vascularized conjunctiva, have been implicated in tissue border maintenance, preventing conjunctivalisation and propagation of blood and lymphatic vessels into the cornea. Defects in limbal epithelial stem cells are linked to corneal neovascularisation, including lymphangiogenesis, chronic inflammation, conjunctivalisation, epithelial abnormalities including the presence of goblet cells, breaks in Bowman's membrane, persistent epithelial defects and ulceration, ocular surface squamous neoplasia, lipid keratopathy, pain, discomfort, and compromised vision. It has been postulated that pterygium is an example of focal limbal deficiency. Previous reports showing changes occurring in limbal epithelium during pterygium pathogenesis suggest that there is a link to stem cell damage. In this light, pterygium can serve as a model disease of UV-induced stem cell damage also characterised by corneal blood and lymphangiogenesis. This review focuses on the role of corneal and limbal epithelial cells and the stem cell niche in maintaining corneal avascularity and corneal immune privilege and how this may be deregulated following UV exposure. We present an overview of the PUBMED literature in the field as well as recent work from our laboratories.

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“…Patients suffering from pterygium can sometimes simultaneously be troubled with pinguecula [38]. Pinguecula is a common benign sun-related disorder [38], characterized by the elastotic degeneration of collagen [39] and squamous proliferation and metaplasia [40]. As both the histology and etiology are comparable between pterygium and pinguecula, these conditions are often linked or even mistaken for one another.…”

Section: Introductionmentioning

confidence: 99%

Pterygium Pathology: A Prospective Case-Control Study on Tear Film Cytokine Levels

Acker

Haagdorens

Roelant

et al. 2019

Mediators of Inflammation

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Pterygium is a common eye disease, linked to an increased exposure to UV radiation and dry environments. The associated pathology culminates in visual impairment and, in some rare cases, blindness. However, there remains a lot of uncertainty concerning the pathogenesis of this fibrovascular lesion. As the composition of the tear film provides a reflection into the pathological changes at the ocular surface, tear analysis represents an ideal approach to gain insight in the progression of disease following pterygiectomy. This study enrolled 19 patients and age/gender-matched healthy controls. Tear film levels of interleukin- (IL-) 6, IL-8, and vascular endothelial growth factor (VEGF) were investigated over time, and preoperative concentrations were linked to corneal neovascularization and pterygium size. Diminished tear film levels were found in unilateral patients who show no clinical signs of pterygium recurrence over a period of one year. Hence, our results highlight the potential of using the course of IL-6, IL-8, and VEGF levels in tears as biomarkers for recovery. In addition, when focusing on the affected eyes (i.e., primary and recurrent pterygium), we detected fold changes in preoperative cytokine concentrations to correspond with disease severity. As our proposed biomarkers did not reveal a linear relationship with corneal neovascularization nor the invasive behaviour of pterygium, no exact role in the pterygium pathology could be established. Hence, our data point to these factors being contributors rather than decisive players in the pathological processes.

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Significance of Fuchs Flecks in Patients With Pterygium/Pinguecula

Cited by 18 publications

References 13 publications

Association between ultraviolet radiation exposure dose and cataract in Han people living in China and Taiwan: A cross-sectional study

Association between ultraviolet radiation exposure dose and cataract in Han people living in China and Taiwan: A cross-sectional study

The Role of Limbal Epithelial Stem Cells in Regulating Corneal (Lymph)angiogenic Privilege and the Micromilieu of the Limbal Niche following UV Exposure

Pterygium Pathology: A Prospective Case-Control Study on Tear Film Cytokine Levels

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