Evaluation of recovery time of tear film function and ocular surface after discontinuing oral isotretinoin treatment for acne vulgaris : Correlation between oral isotretinoin and tear film function.

PURPOSE: This study aimed to evaluate the recovery time of tear film function and ocular surface after discontinuing systemic isotretinoin treatment. METHODS: This was a prospective, cross-sectional study. 34 eyes of 17 patients treated with low- dose oral isotretinoin (< 0.5 mg/kg/day) were enrolled. The modified OSDI score, tear break-up time, Schirmer test, and corneal staining were performed in all patients at baseline, during the course of treatment and after withdrawing treatment every two weeks until the result returned to baseline. RESULTS: Tear breakup time appeared to be the most sensitive and changed significantly at 2 weeks after starting treatment (p < 0.001) and returned to baseline at 4 weeks after withdrawal from treatment (p < 0.001). The Schirmer test results significantly decreased at 6 weeks and returned to baseline at 4 weeks after withdrawal from treatment (p < 0.001). OSDI scores were significantly changed at 6 weeks after treatment (81.8%) and returned to baseline at 2 weeks (54.5%) after withdrawal from treatment. No significant change was found in the MGD. Corneal staining was significantly positive 90.9% 6 weeks after starting treatment and returned to baseline 6 weeks after withdrawal from treatment (p < 0.001). CONCLUSION: Dry eye disease can return to baseline levels after treatment withdrawal. At least 6 weeks later, they could wear contact lenses again, and it was useful to prepare all patients requiring further ocular surgery.

Assessment of different wetting time and paper strip size of Schirmer test in dry eye patients.

OBJECTIVE: To evaluate the correlation between different wetting time and paper strip size of Schirmer test with anesthesia in dry eye patient. Finally the authors determined the agreement on using the ocular surface disease index (OSDI), index for evaluate the severity of the dry eye patient, compare to the standard Schirmer test with anesthesia. MATERIAL AND METHOD: A prospective study was performed in 140 eyes of 70 subjects. All subjects had symptoms of dry eye syndrome which was confirmed by Schirmer test with anesthesia before inclusion. The correlation between Schirmer test with anesthesia at 1, 2, 3 and 4 minutes and standard 5-minute test of both 3 mm and 5 mm width of paper strip was evaluated using intraclass correlation coefficient (ICC). The correlation between clinical questions and Schirmer test was documented in Kappa value. RESULTS: The ICCs were higher than 0.8 after 2 minutes in both 3-mm and 5-mm width of paper strip. Furthermore, it indicated that cut-off value for diagnosis of severe dry eye was 2.5 mm for 5-mm width of paper strip and 4.25 mm for 3-mm width of paper strip at 2-minute measurement. The association between data from the OSDI and objective data from Schirmer test were analyzed by Kappa statistic and showed poor agreement beyond chance (p = 0.591). CONCLUSION: Our results suggested that shorter wetting time of 2-minute Schirmer test with anesthesia could be used instead of the standard 5-minute test. The authors found that the 3-mm width of paper strip could be used instead of the standard 5-mm width of paper strip as well.

Corneal endothelial cell density and morphology in Phramongkutklao Hospital.

OBJECTIVE: To describe the corneal endothelial density and morphology in patients of Phramongkutklao Hospital and the relationship between endothelial cell parameters and other factors. METHODS: Four hundred and four eyes of 202 volunteers were included. Noncontact specular microscopy was performed after taking a history and testing the visual acuity, intraocular pressure measurement, Schirmer's test and routine eye examination by slit lamp microscope. The studied parameters included mean endothelial cell density (MCD), coefficient of variation (CV), and percentage of hexagonality. RESULTS: The mean age of volunteers was 45.73 years; the range being 20 to 80 years old. Their MCD (SD), mean percentage of CV (SD) and mean (SD) percentage of hexagonality were 2623.49(325) cell/mm(2), 39.43(8.23)% and 51.50(10.99)%, respectively. Statistically, MCD decreased significantly with age (p < 0.01). There was a significant difference in the percentage of CV between genders. There was no statistical significance between parameters and other factors. CONCLUSION: The normative data of the corneal endothelium of Thai eyes indicated that, statistically, MCD decreased significantly with age. Previous studies have reported no difference in MCD, percentage of CV, and percentage of hexagonality between gender. Nevertheless, significantly different percentages of CV between genders were presented in this study.

The correlations between Central Corneal Thickness and age, gender, intraocular pressure and refractive error of aged 12-60 years old in rural Thai community.

OBJECTIVES: To study the normal Central Corneal Thickness (CCT) and investigate the correlation between CCT and age, gender intraocular pressure and refractive error MATERIAL AND METHOD: Population of age 12-60 years old were interviewed with standard questionnaire. Refractive error was measured and graded according to spherical equivalent power. Then intraocular pressure and central cornea thickness were measured by applanation tonometer and ultrasonic pachymeter, respectively. The data were analyzed using T-test, correlation and multivariate linear regression to identify mean CCT and correlation between age, gender, intraocular pressure, and refractive error. RESULTS: A total of 467 participants were enrolled into the study. One hundred and eighty-six (39.8%) were males and 281 (60.2%) were females. The average CCT was 535.2 +/- 29.9 microm. The mean CCT of right and left eyes were 535.3 +/- 30.4 microm, and 535.1 +/- 29.5 microm, respectively. The multivariate linear regression indicated that increasing in age would decrease the CCT 0.28 microm and an increasing of intraocular pressure would increase the CCT 1.4 microm statistically significance. CONCLUSION: The CCT was independently related to the refractive error and gender Greater CCT was associated with higher intraocular pressure. Conversely, thinner cornea was correlated with older age group.