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Background Vernal keratoconjunctivitis (VKC) is an allergic conjunctival inflammation with severe ocular complications if left untreated. The current management regimen is plagued with adverse effects, long-term problems, and clinical relapses. Tacrolimus offers an alternative treatment option, and long-term studies are needed to determine its efficacy. Methods A two-year follow-up based study was conducted on moderate to severe VKC patients, who were prescribed tacrolimus skin ointment. The 5-5-5 exacerbation scale was used for the monitoring and grading severity of the disease. Analysis of variance (ANOVA) and intergroup comparisons were conducted on exacerbation scale scores among follow-ups. Results A significant reduction was observed in the total score of severity from baseline (203.17±102.05) to three months' follow-up (69.94±70.54), and it kept reducing for 18 months post therapy. Similar results with statistically significant reduction were observed for all grades of the scale. The relapse rate was 5.71% within a month after therapy cessation, and none of the other patients showed relapse afterward. No significant ocular and systemic complications were observed during the study. Conclusion Tacrolimus is effective in the long-term management of VKC without the complications of conventional steroid-based therapy.
RESUMO
Background Peripheral neuropathy is a controversial but serious complication of beta-thalassemia (ß-Th). Although few studies have reported no relationship between neuropathy and thalassemia, many have linked it with increasing age, iron overload, and iron chelator toxicity. This study aims to investigate the presence of neuropathy in ß-Th using corneal nerve fibers. Methodology A cross-sectional study was conducted using corneal confocal microscopy on individuals with intermediate and major ß-Th who were compared to healthy individuals. The main outcome variables were corneal main nerve and branch nerve densities which were calculated using Image J software. The comparison between groups was done using the independent-samples F-test and Bonferroni post-hoc analysis. Results There was reduced corneal main nerve and branch nerve density in ß-Th intermediate and major patients compared to the control group, and the results were statistically significant (p-value <0.05). However, a significant correlation was not observed between serum ferritin levels and corneal nerve parameters. Conclusions The reduction in corneal nerve parameters in ß-Th patients compared to healthy controls can be an indication of peripheral neuropathy in ß-Th. Further work is needed to confirm these findings.
RESUMO
PURPOSE: A novel application of pulsed electronic speckle pattern interferometry (PulseESPI) techniques in important corneal elasticity measurements is presented in this pilot study. For laser-ablative procedures like laser-assisted in situ keratomileusis, it has been found that elastic properties of the cornea have a role in the outcome of corneal refractive surgery, while for optimal ablative laser power calculations this measurement method may possibly be helpful. It may also help in earlier diagnosis of degenerative corneal disorders such as keratoconus. METHODS: The approach of this study is to observe dynamic behavior of cornea against stresses as mapped with PulseESPI. For this purpose, strain was induced to the cornea using a fine rod with a mechanical vibrator. RESULTS: It was found that cornea has a response pattern to the dynamic stressing. Its surface exhibits a resonance frequency which can be measured with PulseESPI. This information of resonance frequency can be characteristic to the cornea. CONCLUSIONS: PulseESPI may help in important corneal elasticity measurements used for complication-free optimized ophthalmic surgery. It seems to be a promising method to conduct stress-related investigations on biological samples. To our knowledge, this is the first time that PulseESPI has been used for such ophthalmic measurements.