Binocular vision parameters and visual performance in bilateral keratoconus corrected with spectacles versus rigid gas-permeable contact lenses / Parámetros de visión binocular y rendimiento visual en queratocono bilateral corregido con gafas versus lentes de contacto rígidos permeables al gas

Purpose: To analyze binocular vision of individuals aged 18 to 35 years diagnosed with keratoconus, utilizing spectacles and rigid gas-permeable (RGP) contact lenses. Research was led by the Universidad Autónoma de Aguascalientes, México and Fundación Universitaria del Área Andina Pereira, Colombia. Methods: A single center, prospective non-randomized, comparative, interventional, open-label study, in which the differences in binocular vision performance with both spectacles and RGP contact lenses was carried out from December 2018 to December 2019. Sampling was performed according to consecutive cases with keratoconus that met the inclusion criteria until the proposed sample size was reached. Results: Rigid gas-permeable (RGP) contact lenses notably enhanced distance and near visual acuity in keratoconus patients compared to spectacles. Visual alignment analysis shows exophoria at both distances and is slightly higher with RGP contact lenses. The difference was statistically significant (p<0.05), with 82.5 % presenting compensated phoria with spectacles and pnly 42.50% with RGP contact lenses. Stereoscopic vision improved while wearing RGP contact lenses (42.59 %), although accommodation and accommodative flexibility remained within normal ranges. Conclusions: Patients with keratoconus fitted with RGP contact lenses have improved binocular vision skills such as visual acuity, stereopsis, and accommodative flexibility. However, even when the vergence and motor system is decompensated with respect to normal ranges, the range between break and recovery points for both fusional reserves and the near point of convergence (NPC) improves with the use of RGP contact lenses, giving indications of an adaptive condition of the motor system from the medium to the long term.(AU)

Binocular vision parameters and visual performance in bilateral keratoconus corrected with spectacles versus rigid gas-permeable contact lenses.

PURPOSE: To analyze binocular vision of individuals aged 18 to 35 years diagnosed with keratoconus, utilizing spectacles and rigid gas-permeable (RGP) contact lenses. Research was led by the Universidad Autónoma de Aguascalientes, México and Fundación Universitaria del Área Andina Pereira, Colombia. METHODS: A single center, prospective non-randomized, comparative, interventional, open-label study, in which the differences in binocular vision performance with both spectacles and RGP contact lenses was carried out from December 2018 to December 2019. Sampling was performed according to consecutive cases with keratoconus that met the inclusion criteria until the proposed sample size was reached. RESULTS: Rigid gas-permeable (RGP) contact lenses notably enhanced distance and near visual acuity in keratoconus patients compared to spectacles. Visual alignment analysis shows exophoria at both distances and is slightly higher with RGP contact lenses. The difference was statistically significant (p<0.05), with 82.5 % presenting compensated phoria with spectacles and pnly 42.50% with RGP contact lenses. Stereoscopic vision improved while wearing RGP contact lenses (42.59 %), although accommodation and accommodative flexibility remained within normal ranges. CONCLUSIONS: Patients with keratoconus fitted with RGP contact lenses have improved binocular vision skills such as visual acuity, stereopsis, and accommodative flexibility. However, even when the vergence and motor system is decompensated with respect to normal ranges, the range between break and recovery points for both fusional reserves and the near point of convergence (NPC) improves with the use of RGP contact lenses, giving indications of an adaptive condition of the motor system from the medium to the long term.

Effectiveness of Polyclonal Antibody Immunoconjugate Treatment with Propamidine Isethionate for Amoebic Keratitis in Golden Hamsters.

Acanthamoeba griffini is known to cause amoebic keratitis (AK); its main causes are inadequate hygiene when contact lenses are handled and/or its prolonged use at night, as well as the use of contact lenses during underwater activities. The most used treatment for AK is the combination of propamidine isethionate combined with polyhexamethylene biguanide, which disrupts the cytoplasmic membrane, and damages cellular components and respiratory enzymes. We proposed an immunoconjugate treatment obtained from Acanthamoeba immunized rabbit serum combined with propamidine isethionate; the corneas of hamsters inoculated with A. griffini (MYP2004) were treated with the combined, at 1, 2, and 3 weeks. Propamidine isethionate is frequently used for AK treatment, in vivo study we are found IL-1ß and IL-10 expression and caspase 3 activity is significantly increased with respect to the group that was inoculated with the amoeba without receiving any treatment, suggesting that it may be an effect of the toxicity of this drug on the corneal tissue. Application of the immunoconjugate showed enhanced amoebicidal and anti-inflammatory activities, with comparison to propamidine isethionate only. The aim of this study is to evaluate the effect of the immunoconjugate of propamidine isethionate and polyclonal antibodies as a treatment of AK in golden hamsters (Mesocricetus auratus).

Osteocalcin serum concentrations and markers of energetic metabolism in pediatric patients. Systematic review and metanalysis.

Background: Osteocalcin plays a role in glucose metabolism in mice, but its relevance in human energetic metabolism is controversial. Its relationship with markers of energetic metabolism in the pediatric population has not been systematically addressed in infants and adolescents. Objective: This study aims to assess the mean differences between tOC, ucOC, and cOC among healthy children and children with type 1 or type 2 diabetes (T1D or T2D) and the correlation of these bone molecules with metabolic markers. Methods: A systematic review and metanalysis were performed following PRISMA criteria to identify relevant observational studies published in English and Spanish using PubMed, Scopus, EBSCO, and Web of Science databases. The risk of bias was assessed using New Castle-Ottawa scale. Effect size measures comprised standardized mean difference (SMD) and Pearson correlations. Heterogeneity and meta-regressions were performed. Results: The 20 studies included were of high quality and comprised 3,000 pediatric patients who underwent tOC, cOC, or ucOC measurements. Among healthy subjects, there was a positive correlation of ucOC with WC and weight, a positive correlation of tOC with FPG, HDL-c, WC, height, and weight, and a negative correlation between tOC and HbA1c. Among diabetic subjects, a negative correlation of ucOC with HbA1c and glycemia in both T1D and T2D was found and a negative correlation between tOC and HbA1c in T1D but not in T2D. The ucOC concentrations were lower in T2D, T1D, and patients with abnormal glucose status than among controls. The serum concentrations of tOC concentrations were lower among T1D than in controls. The patient's age, altitude, and HbA1c influenced the levels of serum tOC. Conclusion: Osteocalcin is involved in energy metabolism in pediatric subjects because it is consistently related to metabolic and anthropometric parameters. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42019138283.

Refractive status of patients attending eye clinics of the Public Health System from Aguascalientes, Mexico

Purpose: This paper aims to evaluate the prevalence of REs in a clinic from Aguascalientes, Mexico by analysing clinical records from the local public health system. Refractive errors (REs) are quite common globally, but no data have been published regarding their frequency in clinics from Mexico. A priori, the frequency of ametropias should be high as admixture ancestry from this region is mainly European and Amerindian, the regions with high prevalence worldwide.MethodsThis cross-sectional study was conducted on 2195 subjects from records of public optometry services during the year 2018. Information obtained included age, gender, sphere, cylinder and axis. The prevalence of myopia, hyperopia and astigmatism was determined by gender and age groups in paediatric and adult patients. Chi-square testing was applied to determine significant differences in prevalence across age groups and gender. A p-value <0.05 was considered significant.ResultsIn subjects under 18 years of age, the prevalence of emmetropia, astigmatism, myopia and hyperopia was 20.1%, 51.1%, 7.0% and 11.8%, respectively. In adults, emmetropia was present at a frequency of 20.1%, while 57.1% presented astigmatism, 12.4% hyperopia and 8.6% presented myopia. A significant association was observed between the presence of REs and age and gender.ConclusionsIn this first report of prevalence of REs from western Mexico, astigmatism was the most prevalent RE in children, adolescents and adults while the least common was myopia. Important differences were found in prevalence in comparison to national and international reports. (AU)

Refractive status of patients attending eye clinics of the Public Health System from Aguascalientes, Mexico.

PURPOSE: This paper aims to evaluate the prevalence of REs in a clinic from Aguascalientes, Mexico by analysing clinical records from the local public health system. Refractive errors (REs) are quite common globally, but no data have been published regarding their frequency in clinics from Mexico. A priori, the frequency of ametropias should be high as admixture ancestry from this region is mainly European and Amerindian, the regions with high prevalence worldwide. METHODS: This cross-sectional study was conducted on 2195 subjects from records of public optometry services during the year 2018. Information obtained included age, gender, sphere, cylinder and axis. The prevalence of myopia, hyperopia and astigmatism was determined by gender and age groups in paediatric and adult patients. Chi-square testing was applied to determine significant differences in prevalence across age groups and gender. A p-value <0.05 was considered significant. RESULTS: In subjects under 18 years of age, the prevalence of emmetropia, astigmatism, myopia and hyperopia was 20.1%, 51.1%, 7.0% and 11.8%, respectively. In adults, emmetropia was present at a frequency of 20.1%, while 57.1% presented astigmatism, 12.4% hyperopia and 8.6% presented myopia. A significant association was observed between the presence of REs and age and gender. CONCLUSIONS: In this first report of prevalence of REs from western Mexico, astigmatism was the most prevalent RE in children, adolescents and adults while the least common was myopia. Important differences were found in prevalence in comparison to national and international reports.

Case report: multiple and atypical amoebic cerebral abscesses resistant to treatment.

BACKGROUND: The parasite Entamoeba histolytica is the causal agent of amoebiasis, a worldwide emerging disease. Amebic brain abscess is a form of invasive amebiasis that is both rare and frequently lethal. This condition always begins with the infection of the colon by E. histolytica trophozoites, which subsequently travel through the bloodstream to extraintestinal tissues. CASE PRESENTATION: We report a case of a 71-year-old female who reported an altered state of consciousness, disorientation, sleepiness and memory loss. She had no history of hepatic or intestinal amoebiasis. A preliminary diagnosis of colloidal vesicular phase neurocysticercosis was made based on nuclear magnetic resonance imaging (NMRI). A postsurgery immunofluorescence study was positive for the 140 kDa fibronectin receptor of E. histolytica, although a serum analysis by ELISA was negative for IgG antibodies against this parasite. A specific E. histolytica 128 bp rRNA gene was identified by PCR in biopsy tissue. The final diagnosis was cerebral amoebiasis. The patient underwent neurosurgery to eliminate amoebic abscesses and was then given a regimen of metronidazole, ceftriaxone and dexamethasone for 4 weeks after the neurosurgery. However, a rapid decline in her condition led to death. CONCLUSIONS: The present case of an individual with a rare form of cerebral amoebiasis highlights the importance of performing immunofluorescence, NMRI and PCR if a patient has brain abscess and a poorly defined diagnosis. Moreover, the administration of corticosteroids to such patients can often lead to a rapid decline in their condition.

Extended low oxygen transmissibility contact lens use induces alterations in the concentration of proinflammatory cytokines, enzymes and electrolytes in tear fluid.

Prolonged and continuous use of contact lenses for as long as 3 or 4 weeks is common in Mexico due to the low socioeconomic status, poor patient education and self-neglect. Furthermore, wearing contact lenses with low oxygen permeability is common due to their low cost. Thus, patients seek ophthalmologic evaluation due to signs and symptoms of overuse such as red eye, discomfort and tearing. In the present study, the effect of wearing soft contact lenses with a low oxygen permeability on the tear fluid composition after 1 day, 1 week and 1 month without removing them was examined. In this prospective clinical trial, several tear fluid biomarkers were measured in 84 non-adapted contact lens wearers (NACLWs), including the pH, electrolytes, osmolarity, pro-inflammatory molecules [interleukin (IL)-8, IL-1ß and interferon (IFN)-γ], total protein (TP) levels and enzymes [aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and alkaline phosphatase (AP)]. The results indicated that the tear pH was significantly decreased after 1 day and 1 week; however, after 1 month of use, the tear pH level returned to the baseline. Tear electrolyte analysis demonstrated a significant decrease in Na+ at 1 day, 1 week and 1 month and Cl- levels at 1 week and 1 month, and a significant increase in Ca2+ at 1 week and 1 month, K+ at 1 day, 1 week and 1 month, IL-8 at 1 week and 1 month, IL-1ß only at 1 week and IFN-γ at 1 week and 1 month. Furthermore, the study observed an elevation of TP, AST, LDH and AP levels, however, there were no significant changes in ALT. In conclusion, the current study revealed that continuous wearing of soft contact lenses with low oxygen permeability increase tear fluid proinflammatory cytokine levels and enzymes reflecting tissue damage.

Doxazosin and Carvedilol Treatment Improves Hepatic Regeneration in a Hamster Model of Cirrhosis.

Regulation of the mechanisms of fibrosis is an important goal in the treatment of liver cirrhosis. One mechanism is the participation of hepatic stellate cells in fibrogenesis when activated by catecholamines. Consequently, α/ß adrenoblockers are proposed as an alternative treatment for chronic liver lesions such as fibrosis and/or cirrhosis and for possible liver regeneration. We herein analyzed the effect of doxazosin and carvedilol treatments during the regeneration of tissue in a hamster model of liver cirrhosis. Tissue samples were examined by H&E and PAS to evaluate tissue damage and with Sirius red to assess collagen fiber content. ALT, AST, albumin, and total proteins were examined by spectrophotometry. Determination of the levels of α-SMA and TGF-ß in hepatic tissue was examined by Western blot and of the expression of TIMP-2, MMP-13, α-FP, HGF, CK-7, and c-Myc was examined by qPCR. Treatment with doxazosin or carvedilol prompted histological recovery and reduced collagen fibers in the livers of cirrhotic hamsters. The expression of TIMP-2 decreased and that of MMP-13 increases in animals treated with adrenoblockers with respect to the group with cirrhosis. Additionally, the concentration of α-SMA and TGF-ß declined with both drugs with respect to placebo p<0.05. On the other hand, each drug treatment led to a distinct scenario for cell proliferation markers. Whereas doxazosin produced no irregularities in α-FP, Ki-67, and c-Myc expression, carvedilol induced an increment in the expression of these markers with respect to the intact. Hence, doxazosin and carvedilol are potential treatments for the regression of hepatic cirrhosis in hamsters in relation to the decrease of collagen in the hepatic parenchyma. However, at regeneration level we observed that doxazosin caused slight morphological changes in hepatocytes, such as its balonization without affecting the hepatic function, and on the other hand, carvedilol elicited a slight irregular expression of cell proliferation markers.

Unfolded protein response activation in cataracts.

PURPOSE: To analyze the expression of 78 kDa glucose-regulated protein (GRP78) and activating transcription factor 6 (ATF6), 2 factors in the unfolded protein response (UPR), in age-related and diabetes-associated cataract. SETTING: Universidad Autónoma de Aguascalientes, Aguascalientes, México. DESIGN: Experimental study. METHODS: The qualitative and quantitative expression of GRP78 and ATF6 were measured in surgical samples from 11 senile cataracts, 9 diabetic-associated cataracts, and 3 normal lenses. Both proteins were detected by immunofluorescence and immunogold-conjugated antibodies. Quantitative morphometry was used to analyze the differences in GRP78 and ATF6 between samples. The Mann-Whitney test was used for statistical analysis. RESULTS: Scanning electron microscopy showed the characteristic organization of fibers in normal lenses with regular alignment and interdigitation between them. On the other hand, lenses from eyes with senile or diabetic cataract showed the same pattern of misalignment and disorganization of the fibers. Both proteins were detected through immunofluorescence in senile and diabetic cataracts, but not in normal lenses. Immunogold-conjugated antibodies and transmission electron microscopy showed that GRP78 and ATF6 grains were 30% higher and 35% higher, respectively, in diabetic cataracts than in senile cataracts (P<.05). CONCLUSIONS: These data show for the first time in humans that GRP78 and ATF6 are present in lens fibers of senile cataracts and diabetic cataracts, establishing that the UPR may be important in the process of cataractogenesis. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Over-expression of human cystatin C in pterygium versus healthy conjunctiva.

BACKGROUND: A prospective, non-randomised, transversal and comparative study, carried out in INOVA Vision Institute and Autonomous University of Aguascalientes. Pterygium is an important illness that affects 22% people from tropic and equatorial zones. Is an inflammatory process caused by UV rays, and it has a behavior similar to a neoplasm. For this study was taken into consideration 191 samples from the INOVA Vision Institute, Aguascalientes, Mexico. Include 73 pterygia samples, which were obtained during resection under sterile conditions. 44 normal conjunctiva samples were obtained from the same patients when harvesting the conjunctival autograft, or from other patients undergoing extracapsular cataract extraction from the superior bulbar region. Tears from patients with pterygium (n = 50) and normal volunteers (n = 24) were obtained using a calibrated glass micro capillary tube. The surgical conjunctiva and pterygia samples were subjected to reverse-transcription polymerase chain reaction (RT-PCR), western blot, and immunohistochemistry. Tears were analyzed by enzyme-linked immunosorbent assays. METHODS: This was a prospective, non-randomised study involving 191 biological samples taken from patients with pterygium and normal volunteers, whom were operated under local anaesthesia by either complete resection of the lesion with primary closure, or resection with conjunctival autograft. Tissue samples were fixed in 10% formaldehyde. Sections were routinely stained with hematoxylin and eosin. HCC expression was evaluated by reverse-transcription polymerase chain reaction (RT-PCR), immunohistochemistry, and by western blotting. All tears samples were analyzed by enzyme-linked immunosorbent assays (ELISA). RESULTS: Expression levels and distribution patterns of HCC in normal conjunctiva and pterygium. Higher levels of HCC mRNAs and proteins were detected in pterygium compared with a normal conjunctiva. Immunohistochemistry revealed that HCC was localized in the apical cells of the epithelium in the normal conjunctiva. In contrast, HCC was detected in all extension of epithelial tissue, from apical to basal cells in pterygia. The concentration of HCC protein in tears was higher in patients with pterygium versus controls. CONCLUSION: HCC may play an important role in protecting normal conjunctiva, and regulating inflammatory conditions of the anterior ocular surface.