Correlation of age with central corneal thickness and corneal endthelial cell density in Pakistani population

Objective: Correlation of age with central corneal thickness [CCT] and corneal endothelial cell density [ECD] in Pakistani population

Study Design: Descriptive cross sectional study

Place and Duration of Study: Armed Forces Institute of Ophthalmology Rawalpindi from Apr 2016 to Oct 2016

Material and Methods: CCT and ECD was measured in 330 eyes of 165 patients, aged between 21-70 years of age. Patients were further divided into five age groups. Three readings were taken for each eye, and mean of three readings was used for the analysis. Pearson correlation was calculated between CCT, ECD and age

Results: A total of 330 eyes of 165 patients were studied. Out of study population, 81 [49.09 percent] were males and 84 [50.90 percent] were females. Mean ECD [cell/mm2] was 3063.85 +/- 234.65 cells/mm2 and 256.42 +/- 475.06 cells/mm2 in patients aged 21-30 years, and 61-70 years respectively. Mean CCT [micrometer] was 544 +/- 18 micrometer and 528 +/-21 micrometer in patients aged 21-30 years, and 61-70 years respectively. A statistically significant inverse correlation was observed between age and corneal ECD [r=?0.718, p<0.01] and age and CCT [r=?0.230, p<0.01]

Conclusion: Both CCT and corneal ECD decrease significantly with age in Pakistani population, with statistically more decrease in ECD with age, than CCT

Comparison of corneal endothelial cell density in patients of pseudoexfoliation syndrome with normal population

Objective: To compare the corneal endothelial cell density in patients of Pseudoexfoliation syndrome [PXS] with normal healthy controls. Study Design: Cross sectional comparative. Place and Duration of Study: This study was carried out at Armed Forces Institute of Ophthalmology, Rawalpindi from Mar 2016 to Jan 2017

Patients and Methods: Patients of PXS and healthy subjects of both genders between ages of 40 and 50 years, with best corrected visual acuity of 6/6 on snellen visual acuity chart were included in the study. All the participants including controls and PXS patients were subjected to ophthalmic clinical examination including corrected distance visual acuity, slit lamp examination by the single trainee researcher to exclude bias. Participants in both groups were evaluated for corneal endothelial cell density [ECD] by using non-contact, TOPCON SP 3000P Specular microscope. Sampling bias was eliminated by analyzing 100 cells in the center of each specular microscope photograph and mean of three readings was analyzed

Results: Both the groups were similar with respect to gender and age. In our study sample there were 29 [58%] males in PXS group and 24 [48%] males in control group with no statistical significant [p-value > 0.05] difference between gender distributions of both groups. The mean age of the PXS group was 46.34 +/- 2.932 years, and in control group was 45.54 +/- 2.887 years [p-value >0.05]. The mean value of ECD was found to be 2021.548 +/- 528.142 cells/mm2 in PXS patients and the mean value of ECD in healthy subjects was noted to be 2772.692 +/- 383.395 cells/mm2, showing significantly lower ECD in PXS cases. Similarly, significantly higher number of cases 22 [44%] had CED <2000 in PXS as compared to normal healthy subjects

Conclusion: Corneal endothelial cell density decreases in patients of pseudoexfoliation syndrome and this must be considered while planning any intraocular surgery including cataract extraction

Comparison of plasma homocysteine [HCY] levels in normal population and patients of pseudoexfoliation syndrome

Objective: To compare mean plasma homocysteine [HCY] levels [measured in umol/L] of normal population with patients having pseudoexfoliation syndrome [PXS]. Study Design: Cross sectional comparative study. Place and Duration of Study: This study was carried out at Armed Forces Institute of Ophthalmology, Rawalpindi, from May 2016 to Apr 2017

Patients and Methods: In this study 60 patients of PXS and 60 healthy subjects of both genders between ages of 40 and 50 years, with best corrected visual acuity of 6/6 on snellen visual acuity chart were included. All the participants were subjected to ophthalmic clinical examination including corrected distance visual acuity and slit lamp examination. Participants in both groups were evaluated for plasma homocysteine levels, by collection into a heparinized tube and later transferred in ice blocks. The samples were centrifuged at 4000 rpm for 5 minutes and stored at -20°C until the biochemical assay. HCY levels were determined by high performance liquid chromatography [HPLC]

Results: Total 120 participants of both groups were similar with respect to gender and age [p-value>0.05]. There were 36 [60%] males and 24 [40%] females in PXS group and in control group there were 29 [48.3%] males and 31 [51.7%] females. The mean age of PXS group was 44.68 +/- 3.234 years and for healthy control group it was 45.0 +/- 3.13 years. The comparison of homocysteine level between healthy controls and PXS patients showed a highly significant [p-value<0.01] difference between both groups. The mean homocysteine level was [32.14 +/- 14.33] in PXS group as compared to healthy controls [14.41 +/- 4.51]. The comparison of proportions of homocysteinemia showed that the rate of homocysteinemia was significantly [p-value<0.05] greater among patients of PXS. There were 24 [40%] participants in healthy control group who had homocysteinemia in comparison with 58 [96.67%] patients who had homocysteinemia among PXS group

Conclusion: Plasma HCY levels were raised in patients of pseudoexfoliation syndrome as compared to normal population, hence these patients may be considered for further systemic investigations by a medical specialist

Correlation of anterior chamber depth with peripapillary nerve fiber layer thickness

Objective: To determine correlation of anterior chamber depth with peripapillary nerve fiber layer thickness. Study Design: Descriptive cross sectional study. Place and Duration of study: Armed Forces Institute of Ophthalmology Rawalpindi, from Apr 2016 to Oct 2016

Patients and Methods: Anterior chamber depth and peripapillary nerve fiber layer thickness was measured in 200 eyes of 110 patients, between 10-40 years of age. Anterior chamber depth was measured in mm, by taking average of 3 readings, measured by optical biometry [IOL Master, Carl Zeiss Meditec, Dublin whereas average peripapillary retinal nerve fibre layer pRNFL thickness was obtained by taking average of 12 segments RNFL thickness measurement, calculated by Spectral domain optical coherence tomography [SD OCT] [3D OCT-1000 Markll, Topcon Co, Tokyo, Japan] after dilating pupils with one drop of 1% Tropicamide, instilled three times, 10 minutes apart. Three readings were taken for each eye. The mean of the three readings was used for the analysis. Pearson correlation [+1/-1] was calculated between anterior chamber depth, peripapillary nerve fiber layer thickness and age

Results: Two hundred eyes of 110 patients were included in the study. Both eyes were considered in 90% of the patient, however only Right eye was considered in 6.3% of the patients while left eye in 3.7% of the patients. Mean age of the patients was 26.58 +/- 8.88 years. Mean visual acuity of patients measured by log MAR was 0.52 +/- 0.12. Mean Anterior chamber depth [ACD] of patients was 3.41 +/- 0.35 while mean RNFL appeared to be 103.26 +/- 8.89 um

Conclusion: It was concluded that anterior chamber depth was neither related significantly with peripapillary nerve fiber layer nor with age