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To evaluate the incidence of transient dry eye associated with LASIK for myopia and the efficacy of topical cyclosporine A administration. Group A was formed from 145 (82 female, 63 male) eyes that developed clinically significant dry eye within 1 month post-LASIK and were subjected to cyclosporine A treatment. A \"non-symptomatic for dry eye\" and age- and gender-matched group (group B) was formed from the same pool of patients to serve as control. Schirmer's, tear film break-up time (TBUT) and Ocular Surface Disease Index (OSDI) questionnaire were evaluated. Central corneal epithelial thickness (CET) and topographic epithelial thickness variability (TVT) were evaluated as quantitative dry eye objective markers. Subjective patient survey was also assessed. Mean age was 39.7±6.2 years for the female and 47.67±9.5 years for the male patients, in group A. Schirmer's test mean preoperative value was 8.4±3.1 mm; and 4.5±3.6 mm at 1 month post-LASIK. Statistically significant decrease from 1 month post-LASIK baseline was found at 12 months (8.2±2.1 mm; =0.02). Mean preoperative TBUT value was 7.5±2.5 seconds, 6.5±3.1 seconds at 1 month postoperatively, and 7.6±2.0 seconds at 12 months postoperatively, statistically significant to baseline ( =0.04). Preoperatively, CET was 52.37±3.40 µm and TTV was 1.24±0.57 µm, 59.87±3.89 µm, and 2.74±0.57 µm at 1 month post-LASIK respectively and at 12 months, 55.42±2.75 µm and 1.39±0.96 µm. The differences in CET between 12 months post-LASIK vs baseline were statistically significant ( =0.007). The mean preoperative OSDI scores were 11.47±9.97 for group A and 11.79±10.31 for group B ( =0.782), which changed to 23.03±10.17 and 15.13±9.49 at 12 months postoperatively ( <0.05), respectively. Following commencement of cyclosporine A treatment in group A, statistically significant improvement was noted, greater than the one in group B, in all metrics at the 12-month examination in comparison to the 1-month baseline. Topical cyclosporine A treatment is an effective alternative in the management of LASIK for myopia-related transient dry eye. Optical coherence tomography epithelial mapping may provide an objective benchmark in diagnosing and monitoring this significant disorder and its correlation with visual symptoms.

To investigate epithelial thickness-distribution characteristics in a large group of keratoconic patients and their correlation to normal eyes employing anterior-segment optical coherence tomography (AS-OCT). The study group (n=160 eyes) consisted of clinically diagnosed keratoconus eyes; the control group (n=160) consisted of nonkeratoconic eyes. Three separate, three-dimensional epithelial thickness maps were obtained employing AS-OCT, enabling investigation of the pupil center, average, mid-peripheral, superior, inferior, maximum, minimum, and topographic epithelial thickness variability. Intraindividual repeatability of measurements was assessed. We introduced correlation of the epithelial data via newly defined indices. The epithelial thickness indices were then correlated with two Scheimpflug imaging-derived AS-irregularity indices: the index of height decentration, and the index of surface variance highly sensitive to early and advancing keratoconus diagnosis as validation. Intraindividual repeatability of epithelial thickness measurement in the keratoconic group was on average 1.67 μm. For the control group, repeatability was on average 1.13 μm. In the keratoconic group, pupil-center epithelial thickness was 51.75±7.02 μm, while maximum and minimum epithelial thickness were 63.54±8.85 μm and 40.73±8.51 μm. In the control group, epithelial thickness at the center was 52.54±3.23 μm, with maximum 55.33±3.27 μm and minimum 48.50±3.98 μm epithelial thickness. Topographic variability was 6.07±3.55 μm in the keratoconic group, while for the control group it was 1.59±0.79 μm. In keratoconus, topographic epithelial thickness change from normal, correlated tightly with the topometric asymmetry indices of IHD and ISV derived from Scheimpflug imaging. Simple, OCT-derived epithelial mapping, appears to have critical potential in early and advancing keratoconus diagnosis, confirmed with its correlation with established Scheimpflug-derived asymmetry topometric indices.

BackgroundSpectral-domain optical coherence tomography (OCT) has been used to measure corneal epithelium thickness in dry eye disease, allowing assessment of ocular-surface damage in different disease severity.AimThis study aimed to determine the characteristics of corneal epithelial thickness with spectral-domain OCT in patients with dry eye and correlate epithelial thickness with the clinical severity.SettingThe study was conducted at outpatient clinic in the Department of Ophthalmology, Chulabhorn hospital, Bangkok, Thailand.MethodsIt was a cross-sectional study and 92 dry eye patients were included. All participants were assessed using the Dry Eye Questionnaire-5 (DEQ-5), tear film breakup time and fluorescein staining. Corneal epithelial thickness was measured with spectral-domain OCT. The mean and variance of epithelial thickness were calculated. Correlations of corneal epithelial thickness with other clinical parameters were calculated.ResultsThere were no statistical differences in corneal epithelium thickness between the non-severe and severe dry eye groups. The peripheral corneal epithelial thickness variance was significantly higher in the severe dry eye. There was a significant correlation between peripheral epithelial thickness variance and the clinical parameters.ConclusionPeripheral corneal epithelial thickness variance was higher in the severe dry eye, suggesting that the peripheral ocular surface is more damaged. This also correlated with the symptoms and signs of dry eye, which can be used to assess the disease severity.ContributionThis study provided the correlation of corneal epithelial thickness measurement with spectral-domain OCT on the diagnosis of dry eye severities.

This study investigated one-year outcomes of treatment with one session of intravitreal recombinant tissue plasminogen activator, ranibizumab, and gas injections for submacular hemorrhage secondary to polypoidal choroidal vasculopathy (PCV). An extended study of a previous prospective trial of this treatment modality in PCV patients was conducted in 64 patients (64 eyes). Early Treatment Diabetic Retinopathy Study (ETDRS) score, central retinal thickness (CRT), and central pigment epithelial detachment thickness (CPEDT) before and 1, 3, and 12 months after treatment were analyzed. Mean ETDRS score increased from 58 at baseline to 64 letters (p = 0.0122), CRT decreased from 543 to 192 μm (p < 0.0001), and CPEDT decreased from 161 to 103 μm (p = 0.0668) at 3 months and were maintained until 12 months. Complications requiring reoperation occurred within one month in four eyes. Recurrence was observed in 46 eyes (72%), and 1.6 ± 1.5 (0–7) intravitreal aflibercept injections were given pro re nata. Univariate and multivariate analyses identified CPEDT as the pre- and post-treatment factor affecting 12-month ETDRS score (p < 0.0001). Improved visual acuity stabilized 3 months after treatment. Although 72% of patients experienced recurrence, an average of 1.6 aflibercept injections/patient maintained visual acuity up to 12 months. CPEDT was the most important factor associated with visual outcome.

Purpose: To study the compensatory comeal epithelial changes after femtolaser-assisted intracorneal ring segment (ICRS) implantation in early and moderate cases of keratoconus (KC) using anterior segment optical coherence tomography (AS-OCT). Patients and Methods: A prospective observational non-randomized study of 40 eyes with mild to moderate KC received femtolaser-assisted ICRS implantation. Ferrara ICRS with different arc lengths and thicknesses were used according to the patients' tomographic pattern. Patients had a clear central cornea, keratometry reading < 60 diopters, and corneal thickness > 400 microns. ASOCT was performed preoperatively and at 1, 3, and 6 months after surgery. Corneal epithelial thickness (CET) was measured over 17 points (2 mm central and 16 points on 2-5 mm and 5-7 mm annular zones) over the pupil center. All data were collected and analyzed. Results: Comparing the preoperative and postoperative data, there was a statistically significant increase in the CET postoperatively throughout the 6-month follow-up period in all zones (p<0.001). The epithelial thickness (ET) was noticed shortly around and central to the ring ridges by the first month (5-7 mm zone). By the third month, the flattened central cornea (2 mm zone) and the 2-5 mm zone showed a significant increase in ET up to the 6th month. Conclusion: ICRS implantation in KC results in a thicker and more regular epithelium in the central corneal zone as a secondary response to the corneal stromal changes induced by the implants. Keywords: keratoconus, Ferrara rings, epithelial thickness, AS-OCT

Ting Shao,1– 3 Hua Li,1– 3 Yusu Peng,1– 3 Jiafan Zhang,1– 3 Huifeng Wang,1– 3 Keli Long1– 3 1Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, Shandong, People’s Republic of China; 2State Key Laboratory Cultivation Base, Shandong Key Laboratory of Eye Diseases, Qingdao, Shandong, People’s Republic of China; 3School of Ophthalmology, Shandong First Medical University, Qingdao, Shandong, People’s Republic of ChinaCorrespondence: Keli Long, Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, No. 5. Yanerdao Road, Shi-Nan District, Qingdao, Shandong, 266000, People’s Republic of China, Email longkeli2002@aliyun.comPurpose: To compare the changes in corneal biomechanics and epithelial thickness after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) in high myopia over − 8.00D patients with and without myopia regression.Methods: This retrospective case-control study included thirty-nine patients. Based on refractive status at one year after surgery, patients with a myopic shift ≥ 1.00 D were classified as the myopic regression group (R group, 33 eyes), while the remaining patients were classified as the normal group (N group, 42 eyes). Preoperative and postoperative visual outcomes, refraction, topography, corneal epithelial thickness, and corneal biomechanics were compared.Results: Ambrosio relational thickness to the horizontal profile (ARTh) at 3, 6, and 12 months postoperatively was significantly smaller in the R than in the N group, with mean differences of − 9.75 (95% confidence interval (CI): − 18.44 to − 1.04), p= 0.029; − 12.23 (95% CI: − 20.02 to − 4.42), p= 0.003; and − 9.47 (95% CI: − 16.86 to − 2.08), p= 0.013, respectively. Meanwhile, the stiffness parameter A1 (SP-A1) at 6 and 12 months after surgery was smaller in the R than in the N group, with mean differences of − 6.62 (95% CI: − 12.85 to − 0.37), p= 0.038 and − 7.26 (95% CI: − 13.79 to − 0.71), p= 0.030, respectively. The postoperative changes in SP-A1 at 6 and 12 months were significantly larger in the R group than in the N group (6.47, 95% CI: 1.04 to 11.91, p= 0.020; and 5.96, 95% CI: 0.37 to 11.52, p= 0.037, respectively). In addition, corneal epithelial thickness (CET) in different zones showed a significant negative correlation with refractive error at 12 months after surgery, with correlation coefficients ranging from − 0.55 to − 0.32 (all p< 0.05, with the central zone showing p< 0.001).Conclusion: Ultra-high myopic patients with post-FS-LASIK regression have poorer corneal biomechanics and greater central epithelial thickening, highlighting these factors as key susceptibility features for refractive instability. Early assessment of these parameters may help identify at-risk patients and guide personalized management to improve long-term outcomes.Keywords: myopic regression, FS-LASIK, biomechanics, epithelial thickness, ultra-high myopia

To accurately measure the vaginal mucosa thickness across different age groups using histopathologic techniques and investigate the factors that may influence the thickness changes. This study aims to provide clinicians with objective evidence of variations in vaginal mucosal thickness, facilitating personalized medical decisions for patients. A retrospective analysis was conducted on clinical data from 348 patients who underwent local vaginal wall resection at the West China Second University Hospital, Sichuan University, from January 2021 and May 2022. The thickness of vaginal mucosa, epithelium and lamina propria was measured precisely under the microscope. And the 10th, 25th, 50th, 75th, and 90th percentile values of vaginal mucosa thickness across different age groups were counted and charted a dot-line plot. The percentile values for vaginal mucosa thickness exhibited a decreasing trend with increasing age; vaginal mucosa thickness showed significant correlations with times of delivery ( P  = 0.031) and age ( P  < 0.001), both of which were negatively associated. And vaginal mucosa thickness demonstrated no significant correlation with body mass index (BMI) ( P  = 0.325), times of abortions ( P  = 0.511), times of gestation ( P  = 0.101), menstrual cycle ( P  = 0.533), or types of delivery ( P  = 0.056); epithelial thickness showed significant associations with age ( P  < 0.001) and types of delivery ( P  = 0.017), both of which were negative correlations. Moreover, BMI ( P  = 0.429), times of abortions ( P  = 0.764), delivery ( P  = 0.079), gestation ( P  = 0.475), and menstrual cycle ( P  = 0.950) were nonassociated with epithelial thickness; lamina propria thickness displayed a significant correlation only with age ( P  = 0.002), and there were no obvious correlations observed between lamina propria thickness and BMI ( P  = 0.374), times of abortion ( P  = 0.417), delivery ( P  = 0.053), gestation ( P  = 0.101), types of delivery ( P  = 0.132) and menstrual cycle ( P  = 0.495). Moreover, when the age segmentation was thresholded at 35 and 50 years, both epithelial thickness and vaginal mucosa thickness were significantly correlated with age ( P  < 0.05). Lamina propria thickness was associated with age when the age threshold was set at 35 years ( P  = 0.007), whereas it showed no strong link with age when the age threshold was 50 years ( P  = 0.072). This study has innovatively established percentile reference values for vaginal mucosa thickness based on histopathology, furnishing clinicians with objective evidence of variations in vaginal mucosal thickness to facilitate personalized medical decisions for patients. The findings demonstrated a strong link between vaginal mucosa thickness and age, with epithelium likely playing a predominant role, while the association with lamina propria appeared to be less significant. Further research involving a larger sample size is warranted to elucidate the potential relationship with the lamina propria.

The relationship between diabetes mellitus and ocular complications has been extensively studied by many authors. Diabetic keratopathy has already been well characterized and defined as a clinical entity. This review focuses on exploring corneal epithelial changes in diabetic patients, aiming to provide a pragmatic overview of the existing knowledge on this topic. The paper systematically examines alterations in corneal epithelial structure and their impact on diabetic patients. Advanced imaging techniques are also discussed for their role in precise characterization and improved diagnostics. Additionally, the paper explores the mechanisms behind corneal epithelial changes in diabetes, looking at factors such as hyperglycemia, oxidative stress, and Advanced Glycation End-Products. The impact of altered corneal epithelial integrity on barrier function and susceptibility to external issues is considered, addressing potential links to heightened proteolytic enzyme activities and delayed wound healing observed in diabetic individuals. The review also covers the practical implications of corneal epithelial changes, including the association with corneal erosions, persistent epithelial defects, and an increased risk of dry eye syndrome in diabetic patients.

To compare the changes in corneal biomechanics and epithelial thickness after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) in high myopia over -8.00D patients with and without myopia regression. This retrospective case-control study included thirty-nine patients. Based on refractive status at one year after surgery, patients with a myopic shift ≥1.00 D were classified as the myopic regression group (R group, 33 eyes), while the remaining patients were classified as the normal group (N group, 42 eyes). Preoperative and postoperative visual outcomes, refraction, topography, corneal epithelial thickness, and corneal biomechanics were compared. Ambrosio relational thickness to the horizontal profile (ARTh) at 3, 6, and 12 months postoperatively was significantly smaller in the R than in the N group, with mean differences of -9.75 (95% confidence interval (CI): -18.44 to -1.04), p= 0.029; -12.23 (95% CI: -20.02 to -4.42), p= 0.003; and -9.47 (95% CI: -16.86 to -2.08), p= 0.013, respectively. Meanwhile, the stiffness parameter A1 (SP-A1) at 6 and 12 months after surgery was smaller in the R than in the N group, with mean differences of -6.62 (95% CI: -12.85 to -0.37), p= 0.038 and -7.26 (95% CI: -13.79 to -0.71), p= 0.030, respectively. The postoperative changes in SP-A1 at 6 and 12 months were significantly larger in the R group than in the N group (6.47, 95% CI: 1.04 to 11.91, p= 0.020; and 5.96, 95% CI: 0.37 to 11.52, p= 0.037, respectively). In addition, corneal epithelial thickness (CET) in different zones showed a significant negative correlation with refractive error at 12 months after surgery, with correlation coefficients ranging from -0.55 to -0.32 (all p< 0.05, with the central zone showing p< 0.001). Ultra-high myopic patients with post-FS-LASIK regression have poorer corneal biomechanics and greater central epithelial thickening, highlighting these factors as key susceptibility features for refractive instability. Early assessment of these parameters may help identify at-risk patients and guide personalized management to improve long-term outcomes.

Objective: Burns has become a global health problem because it causes about 180.000 deaths worldwide every year. In developing countries, silver sulfadiazine cream is usually used as drug management for second-degree burns, but it is expensive, so several herbal treatments have developed recently. The seed of edamame has genistein compounds that can increase collagen synthesis. The antioxidant component also enhances the burn wound healing process. The study aims to prove the effectiveness of ethanolic extract of edamame’s seed in the second-degree burn wound healing process.Methods: Burn wound was made by applying hot aluminum (70 °C) coin on the skin rat. The negative control group (C-) was given Na-CMC 0.5%, the positive control group (C+) was given cream silver sulfadiazine, the treatment groups T1, T2, T3, and T4 were given an ethanolic extract of edamame with the concentration of 20%, 40%, 60%, and 80% for 15 days. Hydroxyproline levels were evaluated by hydroxyproline biochemistry assay, the epithelial thickness was observed on histopathological preparations with HE staining.Results: The results showed that the hydroxyproline levels on the 16th were modulated, while epithelial thickness was higher in the treatment group than in the control group (P<0.05).Conclusions: We conclude that the certain concentration of ethanolic extract of edamame (Glycine max L. Merril) was effectively enhanced the second-degree burn wound healing by modulating hydroxyproline levels and increasing epithelial thickness.