Cornea - ARVO

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ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - CorneaCommercial Relationships: Brien C. David, Bausch + Lomb (E);Denise Callahan, Bausch and Lomb, Inc. (E); Julie Bair, Bausch &Lomb, Inc. (E); Susan E. Norton, Bausch and Lomb, Inc. (E)Program Number: 523 Poster Board Number: B0160Presentation Time: 10:30 AM - 12:15 PMEfficacy Of Contact Lens Solutions Against Achromobacterxylosoxidans Biofilms Using Confocal MicroscopyDavid J. McCanna, Jaclyn M. Chang, Lakshman N. Subbaraman,Lyndon W. Jones. Centre for Contact Lens Research, School ofOptometry and Vision Science, Waterloo, ON, Canada.Purpose: Biofilms of Achromobacter xylosoxidans (Ax) can developin contact lens cases. These microorganisms can attach to the contactlens and cause microbial keratitis. This study evaluated theantimicrobial efficacy of contact lens solutions against Ax biofilmsby measuring the damage to cell membranes of Ax using confocalmicroscopy.Methods: Ax biofilms were formed by incubating the bacteriaovernight on glass coverslips. The biofilms were then exposed tocontact lens solutions for four hours. Commercial contact lenssolutions evaluated contained the antimicrobials polyhexamethylenebiguanide (PHMB), polyquaternium-1 (PQ1) and alexidine (ALX),and PQ1 and Aldox (AD). After exposure, the bacteria were stainedwith SYTO 9 and propidium iodide (PI). Using a confocalmicroscope with a 488nm laser and the appropriate emission filtersthe number of cells with damaged cell membranes was determined.In addition to evaluating contact lens solutions, four concentrations ofbenzalkonium chloride (BAK) 0.05%, 0.01%, 0.005% and 0.001% inphosphate buffer saline were also evaluated to demonstrate doserelated effects at exposure times as short as 5 minutes.Results: The contact lens solution that caused the greatest damage tothe Ax cell membranes was the formulation based on PQ1-ALX. Theother formulations tested based on PHMB and PQ1 with AD causedsome of the bacteria to lose membrane integrity but did not cause asmuch damage to the bacteria cell membranes (p < 0.05) as the PQ-ALX formulation. Dose effects of the preservative BAK could beseen at 5 minutes of exposure time. BAK at 0.005% and 0.01%caused an increase in the number of cells that were permeable to PIcompared to the phosphate buffered control (48% and 62%respectively, p < 0.05). All of the Ax bacteria were permeable to PIafter exposure to 0.05% BAK.Conclusions: One of the five lens care systems tested caused asubstantial number of Ax bacteria to lose membrane integrity. Also,this method was able to detect the effect different concentrations ofBAK have on the membrane integrity of the Ax biofilm bacteria.Understanding the ability of antimicrobials to damage bacteria cellmembranes could help in the development of lens care solutions thatcan reduce and/or eliminate Ax biofilms from lens cases.Commercial Relationships: David J. McCanna, None; Jaclyn M.Chang, None; Lakshman N. Subbaraman, None; Lyndon W.Jones, Alcon (F), Alcon (R), Allergan (F), Abbott Medical Optics(R), Bausch & Lomb (R), Ciba Vision (F), Ciba Vision (R),CooperVision (F), Johnson & Johnson (F), Johnson & Johnson (R)Body mass index, peripheral corneal thickness and anteriorchamber depth in young European adults - A pilot studySven Jonuscheit 1, 2 , Michael J. Doughty 1 , Raul Martin 3 , Ana del RioSan Cristóbal 3 , Lisa J. Mackintosh 1 , David MacTaggart 1 , MichaelHiscock 1 . 1 Vision Sciences, Dept. of Life Sciences, GlasgowCaledonian University, Glasgow, United Kingdom; 2 DiabetesResearch Group, Institute for Applied Health Research, GlasgowCaledonian University, Glasgow, United Kingdom; 3 OptometryResearch Group, Instituto Universitario de Oftalmobiología Aplicada(IOBA), Universidad de Valladolid, Valladolid, Spain.Purpose: To assess the relationship of body mass index (BMI) andthe corneal thickness profile in normal white European individuals.Methods: For this pilot study, 63 eyes of 63 healthy subjects wereassessed. Following completion of an ocular and general healthquestionnaire body height and weight were measured and the BMIcalculated. Ocular assessments included habitual visual acuity, slitlampbiomicroscopy, and optical coherence tomography. Non-contactspecular microscopy was performed to rule out cornealendotheliopathy. Scheimpflug photography (Pentacam) was used toassess central, mid-peripheral and peripheral corneal thickness aswell as anterior chamber depth (ACD) at eleven locations nominally1 mm apart along the horizontal meridian. Two consecutiveScheimpflug scans were performed and the mean value used foranalyses. Descriptive statistics were generated. The associationbetween BMI, corneal thickness and ACD at central as well as offcenterlocations was assessed using univariate regression analyses.The coefficient of correlation (r) was calculated.Results: The mean [SD] age was 27 [7] years. Mean body height andbody weight were 1.69 [0.08] meters and 64.6 [11.4] kilogramsrespectively, the mean BMI was 22.7 [3.1]. Mean central cornealthickness was 558 [33] micrometers (µm). Corneal thicknessincreased progressively and asymmetrically from the corneal centerto the periphery with a significantly greater thickness at all nasallocations as compared to the respective temporal sites (P0.05).Conclusions: For this cohort of young, healthy white Europeanadults with normal-weight average BMI, peripheral corneal thicknesswas inversely related to BMI. The findings suggest the possibility ofa different corneal thickness profile in individuals with aboveaverageBMI. Further studies on the relationship between BMI,obesity and corneal parameters are indicated.Commercial Relationships: Sven Jonuscheit, Santander UK plc(F); Michael J. Doughty, None; Raul Martin, None; Ana del RioSan Cristóbal, None; Lisa J. Mackintosh, Santander UK plc (F);David MacTaggart, Santander UK PLC (F); Michael Hiscock,NoneSupport: Santander UK plc Grant127 Corneal Epithelium and Imaging ISunday, May 05, 2013 10:30 AM-12:15 PMExhibit Hall Poster SessionProgram #/Board # Range: 524-567/B0161-B0204Organizing Section: CorneaProgram Number: 524 Poster Board Number: B0161Presentation Time: 10:30 AM - 12:15 PMProgram Number: 525 Poster Board Number: B0162Presentation Time: 10:30 AM - 12:15 PMObjective Estimation for Uncertainty of Restoring CornealTopography SurfaceAnatoly Fabrikant. R&D, Abbott Medical Optics, Fremont, CA.Purpose: Corneal topography (CT) field can be restored frommeasurements data by decomposing available data into Zernikepolynomials and mapping the CT field in the desired area. Theaccuracy of such restoration depends on the measurement noise and©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the ARVO Office at arvo@arvo.org.
ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - Corneanumber of available data. Here we present an algorithm for CT dataassimilation, which yields both CT map and an objective estimationof the restoration accuracy.Methods: The Kalman-Bucy technique is used to combine measuredCT heights with a priori mean and covariance of Zernike coefficients,estimated for the general population (CT data for 308 virgin eyes).This algorithm yields a statistically optimal estimate of Zernikecoefficients for the measured field and also their covariance matrix,which provides a measure of the measurement uncertainty. Theefficiency of the proposed method is demonstrated using archivedcorneal topography data from previous clinical studies.Results: For any CT measurement the proposed technique yields anestimate of Zernike amplitudes and their covariance matrix, whichresult in a reconstructed map of CT heights with no gaps within thearea (Fig.1A). The covariance matrix gives the uncertainty (std) ofCT height restoration (Fig.1B). The uncertainty is higher at the areaedges, because the restoration is based mainly on the data frominternal area. Restored field in the measurement gaps has the highestuncertainty, close to the a priori variance of the general population.Conclusions: The proposed algorithm assimilates measurement datatogether with a priori information, derived from statistics of generalpopulation, which protects the results from measurement outliers. Itrestores the CT field in the entire area and provides an objectiveestimate of measurement uncertainty, based on the measurementnoise level and the number of available data. The uncertainty mapdisplays the areas where the map is less reliable and to what extent.diabetes or history of previous refractive surgery. A control group ofhealthy patients were also included. All patients were screened forperipherial neuropathy using the MNSI questionnaire and classifieddepending on the score obtained as without, mild-moderate or severeperipherial neuropathy. Confocal microscopy was performed toobtain corneal analysis from endothelium to epithelium and fourcorneal subepithelial nerve plexus parameters were evaluated:Number of fibers, tortuosity of fibers, number of beading andbranching grade. Statistical analysis was made using Pearson and t-Student tests, a p ≤ 0.05 was considered statistically significant.Results: We included 14 patients in each group. In the study groupthe mean value of HbA1C was 9.5%. In the study group, 28.5% ofthe patients were classified as without peripheral neuropathy, 28.5%as mild-moderate peripheral neuropathy and 42.8% as severeperipheral neuropathy. The number of fibers, beadings and thebranching grade was decreased in diabetic patients compared with thecontrol group (p = 0.004, p ≤ 0.001 and p = 0.028 respectively). Thegrade of tortuosity was higher in patients with diabetes comparedwith healthy subjects with a p ≤ 0.001. There was a tendency ofprogression of corneal neuropathy with higher levels of HbA1C.Conclusions: The assessment of the corneal nerve plexus is a usefultool in the global study of the diabetic patient by establishing theabsence or presence of early neuropathic damage, even beforeclinical manifestations appear.Commercial Relationships: Juan Antonio De la Campa, None;Oscar Baca, None; Alejandro Babayan, None; Regina Velasco,None; Cristina Pacheco-Del-Valle, NoneA B Fig. 1. A - CT height measured with Atlas topographer andrestored within 6mm diameter circle. B - Estimated uncertainty ofmeasured and restored CT height (Hyperopia Sph=2.25D,Cyl=0.25D)Commercial Relationships: Anatoly Fabrikant, Abbott MedicalOptics (E)Program Number: 526 Poster Board Number: B0163Presentation Time: 10:30 AM - 12:15 PMCorneal nerve plexus condition in type 2 Diabetes Mellituspatients assessed by Confocal MicroscopyJuan Antonio De la Campa, Oscar Baca, Alejandro Babayan, ReginaVelasco, Cristina Pacheco-Del-Valle. Cornea and RefractiveSurgery, Fundacion Hospital Nuestra Señora de la Luz, Mexico,Mexico.Purpose: To correlate the metabolic status of patients with type 2Diabetes Mellitus and its relationship with corneal nerve plexusalterations assessed by Confocal Microscopy along with clinicalquestionnaires to detect peripherial diabetic neuropathy.Methods: Patients with type 2 Diabetes Mellitus within the first yearof diagnosis were included. All patients were asked for glycosylatedhemoglobin (HbA1C). Inclusion criteria included values ofglycosylated hemoglobin ≥7%. We excluded patients with diagnosisof central or peripheral neuropathy, ocular disease not related toProgram Number: 527 Poster Board Number: B0164Presentation Time: 10:30 AM - 12:15 PMNon-invasive objective metrics of Bulbar Hyperemia for ClinicalTrials EndpointsNeha Gadaria-Rathod, Kyu-In Lee, Benyamin Y. Ebrahim, Penny A.Asbell. Ophthalmology, Mount Sinai School of Med, New York, NY.Purpose: Bulbar hyperemia is a prominent feature of ocular irritationassociated with dry eye disease (DED), infection and allergy. Theaims of this study were to evaluate a modified topographer(OCULUS Keratograph 5M) as a non-invasive objective metric forevaluation of DED and ocular surface inflammation, and to evaluateits precision in grading bulbar redness and its correlation withclinician and subject grading.Methods: An IRB approved prospective study of patients presentingwith either normal eyes or external ocular disease was conducted. 39eyes of 20 patients were evaluated for bulbar redness independentlyby 2 ophthalmologists (CLS1 and CLS2), by patients’ selfassessment(SS) and by the keratograph using the R-scan software.Standardized CCLRU grading scales were used to score the bulbarredness on a scale of 0-4. To establish precision of the keratograph, 2pictures (KR1 and KR2) of the same eye were taken by the sameclinician, 2 minutes apart. The repeatability of measurements wasthen analyzed using ANOVA and the repeatability index ‘r’.Bivariate correlation analysis was done to get the Spearman’scorrelation coefficient.Results: The keratograph grading showed high repeatability; r=0.90,p
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