Cornea - ARVO

ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - Corneadetermine storage capability, one duplicate was stained immediatelyand the other after 30 days. To demonstrate the feasibility of the useof the SOP for a multicenter clinical trial, clinicians from out-of-statewere trained to collect IC samples which were shipped to New Yorkfor processing and analysis by a masked independent observer. ICand HLA-DR quantification were incorporated into a maskedrandomized clinical trial of DE.Results: The validity/viability of the SOPs was established: 1)sufficient numbers of cells can be collected via IC (average: 6,677 ±6,302 cells/filter (normal: 8,511 ± 7,743, n = 114, range: 1,389 −101,031; DED: 5,414 ± 5,128, n = 252, range: 1,032 − 58,892). 2)relative biomarker expression quantified in samples isprecise/repeatable (mean difference: −0.12%, p = 0.23; 95% limits ofagreement for splits: −0.82%, +0.58%); 3) personnel at distant sitescan be taught to collect, store and ship samples; 4) samples can bestored until processing can be performed without affecting results[mean difference for HLA-DR%: 0.31% (ie, Day 30 values were onaverage higher by 0.31%; p = 0.11); 95% limits of agreement were(−0.91%, +1.53%)]; 5) a large number of masked samples can bereliably tracked.Conclusions: We demonstrated the repeatability and effects ofstorage, ability to train/gather samples from distant sites and thefeasibility of use in a randomized clinical trial. HLA-DR expressionas determined from IC samples can serve as a minimally invasiveobjective metric of inflammation for efficacy and mechanism ofaction in randomized clinical trials of ocular surface disease.Commercial Relationships: Penny A. Asbell, RPS (F); Seth P.Epstein, Rapid Pathogen Screening, Inc (F); Neha Gadaria-Rathod,None; Yi Wei, None; Maureen G. Maguire, InspirePharmaceuticals (F), Amakem (F), IDx LLC (F), Merck (C)Support: Supported in part by the National Eye Institute (R34-EY017626-01) as well as by The Martin and Toni SosnoffFoundation, New York, New York.Program Number: 5438 Poster Board Number: A0137Presentation Time: 8:30 AM - 10:15 AMCytokine tear film expression in patients with primary andrecurrent pterygiumVictor M. Bautista, Nayeli Rangel-Acosta, Nadia Luz López-Espinosa, Angel Nava-Castañeda. Microbiology and OcularProteomics, Inst de Ophthal Conde de Valenciana, Mexico, Mexico.Purpose: Pterygium is an overgrowth of fibrovascular tissue, oftenwith a wing-like appearance, from the conjuctiva over the cornea.Although the pathogenesis of pterygium is not clearly understood,certain findings concerning common features in pterygium andneoplasia have been proposed, raising the possibility that a pterygiumis a neoplastic-like growth disorder. There is much debate surroundthe pathogenesis of pterygium and a number of theories have beenput forward including genetic instability, cellular proliferation,inflammatory influence, degeneration of connective tissue,angiogenesis, aberrant apoptosis or wound healing process and stemcell dysfunction. Treatment of pterygia entails its surgical excision,however in some cases they aggressively recur. The aim of this studywas to analyze the cytokine tear film expression in patients withprimary and recurrent pterygium.Methods: Tear samples from patient diagnosed with primary andrecurrent pterygium, and tears from patients without pterygiumdiagnostics were taken as a control were analyzed. Cytokine proteinarrays were performed to know relative units of 36 cytokines, withthe Profiler Array Membrane (R&D Systems, Minneapolis, USA)according to the manufacturer instructions. Densitometric analysis ofthe dot blot was performed with Diversity and GeneTools. Weconsidered cytokines with differential expression more or less thantwo times.Results: When we analyzed cytokine tear film expression amongprimary pterygium patients and controls, we found that GROa,Sicam-1, IL-8, IL-16, I-TAC, MCP-1 and MIP-1b wereoverexpressed; meanwhile IP-10, MIF and Serpin E1 weredownregulated. Cytokine tear film expression comparison amongcurrent pterigion patients and controls showed that C5/C5a, IL-16,IL-17, IL-32a and IP-10 were overexpressed; none cytokine showeddownregulation. Finally, cytokine tear film expression comparisonamong recurrent and primary pterygium exhibited a greatoverexpression of IP-10 and MIF, and MCP-1 was downregulated.Conclusions: Cytokine tear film expression in primary pterygiumsuggests an inflammatory response mediated by chemokines. Inrecurrent pterygium tear film, results showed an overexpression ofinflammatory cytokines. Comparison among primary and recurrentpterygium exhibited a MIF and IP-10 overexpression, suggesting achronic inflammatory process.Commercial Relationships: Victor M. Bautista, None; NayeliRangel-Acosta, None; Nadia Luz López-Espinosa, None; AngelNava-Castañeda, NoneProgram Number: 5439 Poster Board Number: A0138Presentation Time: 8:30 AM - 10:15 AMEffectiveness and safety of intralesional injection of 0.01 mgMitomycin C one month prior to bare sclera excision forpterygium treatmentBrian Tieu, Manuj Kapur. UTMB, Galveston, TX.Purpose: Mitomycin C (MMC) is an anti-metabolite withradiomimetic properties that is used as an adjuvant in pterygiumexcisions to reduce recurrence; however, it can cause many sideeffects particularly at high doses. Previous studies have shown thatinjection of 0.15 to 0.2 mg/mL MMC one month prior to bare scleraexcision results in low recurrence rates, but may result in somecomplications. The purpose of this study was to determine if thelowest effective concentration of 0.1 mg/ml MMC injectedintralesionally can maintain low recurrence rates and be potentiallysafer.Methods: A retrospective case review was performed of patientswho underwent bare sclera pterygium excision one month afterintralesional injection of 0.01 mg MMC. The cases were evaluatedfor complications including dellen, persistent corneal epithelial orconjunctival defect, intraocular pressure spikes, scleral thinning, andrecurrence of disease, which was defined as re-growth offibrovascular tissue greater than 1 mm past the limbus. Surgicalspecimens also were reviewed for significant changes.Results: Eleven patients underwent this procedure and were followedpost-operatively for at least 6 months. No recurrences have beennoted nor major complications. Histopathological analysis of theexcised tissue showed less vascularization.Conclusions: Intralesional injection of a lower dose of MMC onemonth prior to bare sclera excision may be as or more effective thanhigher doses, but possibly safer overall with exposure to less of theanti-metabolite.Commercial Relationships: Brian Tieu, None; Manuj Kapur,NoneProgram Number: 5440 Poster Board Number: A0139Presentation Time: 8:30 AM - 10:15 AMExtended Soft Bandage Contact Lenses Therapy for OcularGraft-Versus-Host DiseaseYichen Sun 1, 4 , Yoshihiro Inamoto 3 , Joseph P. Sheehan 1 , Peng Li 2 ,Ruikang K. Wang 1, 2 , Stephanie Lee 3 , Tueng T. Shen 1, 2 .1 Ophthalmology, University of Washington, Seattle, WA;©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.