Reduced Dermal and Orbicularis Thickness From Topical Prostaglandins
Ophthalmic Plastic and Reconstructive Surgery
Published online July 31, 2015
Goh et al. set out to investigate the effect of prostaglandin analogue eyedrops on the periobital soft tissue. Using high-resolution ultrasonography, they found that the eyes of patients using these drops have reduced thicknesses of dermis, orbicularis oculi muscle, and skin to arcus marginalis distance compared with fellow eyes.
For this cross-sectional study, the researchers evaluated 20 patients who had been treated unilaterally with a prostaglandin for 12 or more continuous months (mean duration, 5.4 ± 3.9 years). The untreated eye served as a control. Imaging was performed bilaterally on upper and lower eyelids; the center of the ultrasound probe was held vertically in the midpupillary line, evenly spaced between the superior and the inferior orbital rims.
Of the 20 patients, only 3 (15%) did not show any statistically significant decrease in any outcome measure in the upper and lower eyelids in eyes being treated with prostaglandin drops. Univariate analysis did not uncover any further association with other variables, notably type of prostaglandin drop, number of glaucoma medications, and previous glaucoma or cataract surgery.
The authors suggested that the changes in thickness are possibly related to the depletion of periorbital adipose volume and collagen, and additional study is needed.
Psoriasis and Uveitis
Published online July 29, 2015
What is the relationship between psoriatic disease (including psoriasis and psoriatic arthritis) and uveitis? Egeberg et al. evaluated this question and found a bidirectional relationship between these inflammatory disease entities.
For this nationwide cohort study, the researchers included more than 5 million Danish residents aged 18 years or older. (Those who had a history of psoriasis or uveitis before the study began were excluded.) Outcome measures included a diagnosis of uveitis, mild psoriasis, severe psoriasis, and psoriatic arthritis.
During the 15 years of follow-up, 74,129 people were identified as having psoriasis, and 13,114 were diagnosed with uveitis. Further analysis showed that patients with psoriasis and psoriatic arthritis had an increased risk for uveitis—and that patients with uveitis were at increased risk of developing psoriatic disease.
Although other studies have examined the association between psoriasis and uveitis, this is the first to examine the bidirectional relationship between the two. These findings suggest a shared pathogenic pathway between the disease entities. Further, they argue for greater awareness among clinicians, the researchers said, with an increased focus on eye symptoms in patients with psoriasis, and a similar attentiveness to skin and joint symptoms in patients with uveitis. They cautioned, however, that as the Danish population is predominantly white, these results may not be generalizable to other countries and patients of other ethnicities.
Oxygen Therapy Reduces Corneal Edema After Cataract Surgery
Journal of Cataract and Refractive Surgery
Published online July 29, 2015
In a study in Iran, Sharifipour et al. compared the effects of conventional medical therapy and 2 types of oxygen therapy on corneal edema after cataract surgery. They found that transcorneal oxygen delivery yielded the best clinical outcomes.
For this randomized controlled trial, the researchers evaluated 45 patients who had undergone cataract surgery and had severe corneal edema on the first postoperative day. The patients were evenly divided into 3 groups. Group 1 (control) received conventional treatment, with topical sodium chloride, timolol, and betamethasone. Group 2 received conventional treatment plus systemic normobaric 100% oxygen delivered through a face mask; group 3 received conventional therapy plus transcorneal 100% oxygen via an eye shield. Outcomes included central corneal thickness (CCT) and endothelial cell count (ECC).
At day 14, CCT was significantly lower in group 3 than in groups 1 and 2. At the 3- and 12-month marks, patients in group 3 also had less endothelial cell loss and higher ECC than did those in the control group. Patients in group 3 also experienced better clinical outcomes; in contrast, 1 patient in each of the other groups developed pseudophakic bullous keratopathy. The researchers hypothesized that transcorneal oxygen may salvage some borderline endothelial cells before permanent loss occurs.
Roundup of Other Journals is written by Jean Shaw and edited by Deepak P. Edward, MD.
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