Ahmet Ozmen | PubMed Health

PubMed2003

Tear function and ocular surface changes in keratoconus.

PURPOSE: To describe the ocular surface disorder in patients with keratoconus. DESIGN: A prospective, case-controlled study. PARTICIPANTS: Seventy-five eyes of 38 patients with keratoconus seen at Uludag University School of Medicine, Department of Ophthalmology, from March 2000 through April 2001, and 80 eyes of 40 normal control subjects were studied. INTERVENTION: The subjects underwent routine ophthalmic examinations, corneal sensitivity measurements, Schirmer test, tear film breakup time (BUT), fluorescein and rose bengal staining of the ocular surface, and conjunctival impression cytology. MAIN OUTCOME MEASURES: Patients and control subjects were compared for corneal sensitivity, tear function, ocular surface staining parameters, goblet cell density, and squamous metaplasia grade. The relation of these parameters to the severity of keratoconus progression was also investigated. RESULTS: The mean corneal sensitivity was significantly lower in keratoconus patients compared with control subjects (P < 0.001). The BUT values were also significantly lower in the keratoconus group. Patients with keratoconus had significantly higher fluorescein and rose bengal staining scores (P < 0.001). Corneal sensitivity and tear function changes seemed to get worse with advanced stages of keratoconus. Impression cytology showed goblet cell loss and conjunctival squamous metaplasia, both of which again related to the extent of progression of keratoconus. CONCLUSIONS: The ocular surface disease in keratoconus is characterized by disorder of tear quality, squamous metaplasia, and goblet cell loss, all of which seem to relate to the extent of keratoconus progression.

Adolescent↗

PubMed2002

Changes in tear function and the ocular surface after topical olopatadine treatment for allergic conjunctivitis: an open-label study.

BACKGROUND: Olopatadine hydrochloride 0.1% eye drops represent a new class of anti-allergic agent with combined antihistaminic and mast cell-stabilizing properties. OBJECTIVE: The purpose of this study was to describe alterations in tear function and the ocular surface in patients with allergic conjunctivitis and to analyze the effect of topical olopatadine treatment on corneal sensitivity, tear function, and impression cytology variables. METHODS: This was a single-center, 3-visit, prospective, open-label study conducted in patients with allergic conjunctivitis. Patients received 1 drop of topical olopatadine hydrochloride 0.1% BID for 3 weeks. At each visit, patients and healthy control subjects underwent routine ophthalmic examinations and measurements of corneal sensitivity and tear function (Schirmer test of tear quantity, tear film break-up time [BUT], fluorescein staining of the cornea). All control subjects and a subgroup of patients also underwent conjunctival impression cytology for assessment of squamous metaplasia and goblet cell density. The outcomes of interest were changes in corneal sensitivity, tear function, and impression cytology variables after 3 weeks of treatment with olopatadine eye drops, both in patients with allergic conjunctivitis and between patients and controls. RESULTS: At enrollment, the study included 46 eyes of 23 patients (9 men, 14 women; age range, 20-42 years) with allergic conjunctivitis; results were calculated based on the 21 patients who completed the study. The control group consisted of 70 eyes of 35 healthy subjects (13 men, 22 women; age range, 22-39 years). Before treatment, 64.3% of the eyes of patients with allergic conjunctivitis had a fluorescein staining score of >1 point, whereas after treatment, 14.3% had a score of >1 point (P < 0.001). Patients' mean (+/- SD) corneal sensitivity improved to 55.0 +/- 2.5 mm from the pretreatment value of 42.5 +/- 2.5 mm (P < 0.001). Mean BUT values before and after treatment were 8.1 +/- 3.5 and 14.0 +/- 7.0 seconds, respectively (P < 0.001). Before treatment, patients' mean squamous metaplasia grade was 2.5 +/- 0.5; at the end of treatment, it had decreased to 1.0 +/- 0.5 (P < 0.001). The mean pretreatment goblet cell density of 545 +/- 85 cells/mm2 improved to 1,090 +/- 100 cells/mm2 after treatment (P < 0.001). CONCLUSION: In the patient population studied, the disorder of tear function, squamous metaplasia, and loss of ocular surface goblet cells associated with allergic conjunctivitis improved with topical olopatadine treatment.

Adult↗