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Bruna Duarte, Ana Claudia Viana Wanzeler, Daniel Borges, Alex Treiger Grupenmacher, Monica Alves; Impact of pterygium in the ocular surface parameters and tear cytokine profile. Invest. Ophthalmol. Vis. Sci. 2018;59(9):130. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Pterygium is a fibrovascular condition of the ocular surface that can cause a broad range of irritative and visual symptoms. Controversy exists regarding the pterygium mechanisms, management, surgical techniques, adjuvant approaches and its impact on the quality of life of patients. We performed a comprehensive evaluation and quantification of the ocular surface parameters, related symptoms and tear film cytokine profile prior to surgical treatment.
We evaluated (1) ocular surface parameters, such as corneal fluorescein staining (CFS), conjunctival hyperemia (CH), non-invasive tear break-up time (NITBUT), meiboscore and keratometric index; (2) related symptoms (irritation, hyperemia, tearing, blurred vision and aesthetics); and (3) cytokine (IL-6, IL-4, IL-10, TNF-α and IFN-γ) levels in tear samples prior to surgery.
A total of 47 patients, aged 52.79 ± 11.46 SD (26-75) years old, were included. Pterygia classification regarding tissue progression from limbus to the visual axis was: 2.12% as grade 1, 57.40% grade 2, 36.20% grade 3, and 4.25% grade 4 (tissue over visual axis). In addition, 17.02% 8/47 had atrophic and 82.97% 39/47 had fleshy/active clinical apperance. Corneal astigmatism induction was 2.50 ± 2.39 (min-0.07-10.80 D). We also noted an important impact of pterygium on the ocular surface parameters: hyperemia 2.21 ± 0.57 SD, meniscos 0.37 ± 0.14 SD, TBUT 10.01 ± 5.12 SD, meiboscore 1.14 ± 0.75 SD (upper) and 1.59 ± 0.82 SD (lower). We found that 88.09% of the meiboscore results ranged from 1-3, among which there was an interesting and high correlation between meibomian gland loss and the topography of the pterygium in 50.97% of our cases. Indeed, tear cytokine levels were higher in pterygium patients compared to controls with a slight difference among the classification subgroups. Patients highly complained about irritative symptoms and ocular surface impairment.
The present study shows that pterygium impacts on the quality of life, ocular surface structure, specially inducing meibomian gland loss, and tear profile of patients. However, there is still lack of understanding on pterygium mechanisms, justifying the need of further research on this area.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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