Maküler Kornea Distrofisinde Korneanın Biyomekanik Özellikleri

Year 2021, , 287 - 291, 31.08.2021

Selma Uzman , Gülizar Demirok Zuleyha Yalnız-akkaya , Umit Eksioglu , Evin Şingar , Mehmet Yakın , Firdevs Ornek , Ayşe Burcu

https://doi.org/10.20492/aeahtd.910968

Abstract

Amaç: Maküler kornea distrofisinin (MKD) korneanın biyomekanik özellikleri üzerindeki etkisinin değerlendirilmesi ve sağlıklı bireyler ile karşılaştırılması amaçlandı.
Gereç ve Yöntem: Klinik olarak MKD tanısı konulmuş 45 hastanın 45 gözü (MKD grubu) ve 61 sağlıklı bireyin 61 gözü (kontrol grubu) çalışma kapsamına alındı. Tam oftalmolojik muayene sonrasında oküler cevap analizörü (ORA) ile, kornea histerezisi (KH), kornea direnç faktörü (KRF), Goldmann ile uyumlu göz içi basıncı (GİBg) ve kornea düzeltmeli GİB (GİBcc) değerleri ve Pentacam veya ultrason pakimetrisi ile merkezi kornea kalınlığı (MKK) ölçüldü ve kaydedildi.
Bulgular: İki grup, ortalama yaş (37,49 ± 10,05 ve 36,70 ± 10,72 yıl, p=0,703) ve cinsiyet dağılımı açısından (p=0,976) benzerdi. Maküler kornea distrofisi grubu ve kontrol grubunda ortalama KH [9,52 ± 1,37 ve 10,99 ± 1,16 mmHg (p <0.001)]; ortalama KRF [8,92 ± 1,48 ve 10,70 ± 1,30 mmHg (p <0,001)]; ortalama MKK [395,71 ± 41,62ve 531,39 ± 28,69 µm (p <0,001)]; ortalama GİBg [12,14 ± 2,49 ve 14,75 ± 2,66 mmHg (p< 0,001)]; ve ortalama GİBcc [13,78 ± 2,65 ve 14,75 ± 2,56 mmHg (p = 0,021)] açısından anlamlı fark tespit edildi. Ancak MKK’nin etkisi istatiksel olarak kontrol altına alındığında, KH, KRF, GİBg ve GİBcc her iki grupta da benzer olarak bulundu.
Sonuç: Maküler kornea distrofisinde ortalama CH, CRF, IOPcc ve IOPg sağlıklı kontrollere göre daha düşüktür. Ancak maküler kornea distrofisinde görülen korneanın kollajen tabakaları ve hücre dışı matriksindeki histopatolojik değişiklikler korneanın biyomekanik özelliklerinde ORA ile tespit edilebilen değişikliğe neden olmamaktadır.

Keywords

Oküler cevap analizörü, kornea histerezisi, kornea direnç faktörü, maküler kornea distrofisi, merkezi kornea kalınlığı

Supporting Institution

yok

References

• 1. Javadi MA, Rafee’i AB, Kamalian N, et al. Concomitant keratoconus and macular corneal dystrophy. Cornea 2004;23:508-512.
• 2. Kocluk Y, Yalniz-Akkaya Z, Burcu A, et al. Corneal topography analysis of stromal corneal dystrophies. Pak J Med Sci 2015;31:116-120.
• 3. Lang GK, Naumann GO. The frequency of corneal dystrophies requiring keratoplasty in Europe and the U.S.A. Cornea 1987;6:209-211.
• 4. Alzuhairy S, Alkatan HM, Al-Rajhi AA. Prevalence and histopathological characteristics of corneal stromal dystrophies in Saudi Arabia. Middle East Afr J Ophthalmol 2015;22:179-185.
• 5. Pandrowala H, Bansal A, Vemuganti GK, et al. Frequency, distribution, and outcome of keratoplasty for corneal dystrophies at a tertiary eye care center in South India. Cornea 2004;23:541-6.
• 6. Garcia-Porta N, Fernandes P, Queiros A, et al. Corneal biomechanical properties in different ocular conditions and new measurement techniques. ISRN Ophthalmol 2014;4:724546.
• 7. Gkika M, Labiris G, Giarmoukakis A, et al. Evaluation of corneal hysteresis and corneal resistance factor after corneal cross-linking for keratoconus. Graefes Arch Clin Exp Ophthalmol 2012;250:565-573.
• 8. del Buey MA, Cristóbal JA, Ascaso FJ, et al. Biomechanical properties of the cornea in Fuchs’ corneal dystrophy. Invest Ophthalmol Vis Sci 2009;50:3199-3202.
• 9. Clemmensen K, Hjortdal J. Intraocular pressure and corneal biomechanics in Fuchs’ endothelial dystrophy and after posterior lamellar keratoplasty. Acta Ophthalmologica 2014;4:350-354.
• 10. Ortiz D, Piñero D, Shabayek MH, et al. Corneal biomechanical properties in normal, post-laser in situ keratomileusis, and keratoconic eyes. J Cataract Refract Surg 2007;33:1371-1375.
• 11. Weiss JS, Moller HU, Aldave AJ, et al. IC3D classification of corneal dystrophies-edition 2. Cornea 2015;34:117-159.
• 12. Moshirfar M, Edmonds JN, Behunin NL, et al. Corneal biomechanics in iatrogenic ectasia and keratoconus: A review of the literature. Oman J Ophthalmol 2013;6:12-17.
• 13. Del Monte DW, Kim T. Anatomy and physiology of the cornea. J Cataract Refract Surg 2011;37:588-598.
• 14. Ihanamaki T, Pelliniemi LJ, Vuorio E. Collagens and collagen-related matrix components in the human and mouse eye. Prog Retin Eye Res 2004;23:403-434.
• 15. Murab S, Chameettachal S, Ghosh S. Establishment of an in vitro monolayer model of macular corneal dystrophy. Lab Invest 2016;96:1311-1326.
• 16. Akhtar S, Alkatan HM, Kirat O, et al. Collagen fibrils and proteoglycans of macular dystrophy cornea: ultrastructure and 3D transmission electron tomography. Microsc Microanal 2015;21:666-679.
• 17. Meek KM, Quantock AJ, Elliott GF, et al. Macular corneal dystrophy: the macromolecular structure of the stroma observed using electron microscopy and synchrotron X-ray diffraction. Exp Eye Res 1989;49:941-958.
• 18. Quantock AJ, Meek KM, Thonar EJ, et al. Synchrotron X-ray diffraction in atypical macular dystrophy. Eye (Lond) 1993;7:779-784.
• 19. Birk DE, Fitch JM, Babiarz JP, et al. Collagen fibrillogenesis in vitro: interaction of types I and V collagen regulates fibril diameter. J Cell Sci 1990;95:649-657.
• 20. Shah S, Laiquzzaman M, Bhojwani R, et al. Assessment of the biomechanical properties of the cornea with the ocular response analyzer in normal and keratoconic eyes. Invest Ophthalmol Vis Sci 2007;48:3026-3031.
• 21. Kara N, Altinkaynak H, Baz O, et al. Biomechanical evaluation of cornea in topographically normal relatives of patients with keratoconus. Cornea 2013;32:262-266.
• 22. Meek KM, Tuft SJ, Huang Y, et al. Changes in collagen orientation and distribution in keratoconus corneas. Invest Ophthalmol Vis Sci 2005;46:1948-1956.
• 23. Wollensak G, Spoerl E, Seiler T. Stress-strain measurements of human and porcine corneas after riboflavinultraviolet-A-induced cross-linking. J Cataract and Refract Surg 2003;29:1780-1785.
• 24. Poli M, Cornut PL, Balmitgere T, et al. Prospective study of corneal collagen cross-linking efficacy and tolerance in the treatment of keratoconus and Corneal ectasia: 3-year results. Cornea 2013;5:583-590.
• 25. Kamiya K, Shimizu K, Ohmoto F. The changes in corneal biomechanical parameters after phototherapeutic keratectomy in eyes with granular corneal dystrophy. Eye (Lond) 2009;23:1790-1795.
• 26. Medeiros FA, Weinreb RN. Evaluation of the influence of corneal biomechanical properties on intraocular pressure measurements using the ocular response analyzer. J Glaucoma 2006;15:364-370.
• 27. Touboul D, Roberts C, Kérautret J, et al. Correlations between corneal hysteresis, intraocular pressure, and corneal central pachymetry. J Cataract Refract Surg 2008;34:616-622.28.
• 28. Franco S and Lira M. Biomechanical properties of the cornea measured by the Ocular Response Analyzer and their association with intraocular pressure and the central corneal curvature. Clin Expt Optom 2009;92:469-475.