Allergic Conjunctivitis in Patients with Respiratory Allergic Symptoms; a Retrospective Study in Greece

Here, we report on the prevalence of allergic conjunctivitis and positive skin prick test (SPT) results in relation to respiratory allergic conditions among patients with symptoms of allergies at a respiratory outpatient clinic. A questionnaire survey of symptoms (i.e., asthma-like, rhinitis, and conjunctivitis symptoms) involving 1522 patients was carried out. The responses of 1242 patients indicated that they had allergic conjunctivitis, asthma, rhinitis, or a combination of these conditions, and 869 of these patients underwent SPTs that assessed responses to 40 allergens. Allergic conjunctivitis was found to be very common (40%, 497 out of 1242 patients) among those with symptoms of allergies. Conjunctivitis was slightly more common among women, while rhinitis was more common among men. Patients with both conjunctivitis and rhinitis were more likely to undergo SPTs, and they had a higher rate of positive SPTs. The coexistence of two or more comorbidities increased the risk of having an immunoglobulin E (IgE)-mediated allergy (based on the SPT results) compared to having each of the conditions alone. In conclusion, allergic conjunctivitis can occur either alone or with asthma and/or rhinitis. It is not always accompanied by rhinitis, but the coexistence of these conditions was the strongest indicator of IgE-mediated allergies

Experimental treatment of corneal burns by alkaline substances using stem cells

The cornea of the eye is the most refractive segment of the ocular diopters. The integrity and transparency is necessary both for the quality of vision and for the proper functioning of the eye. A prerequisite for the proper function is to prevent neovascularization and haze. However, in adverse conditions such as chemical burns. They have published studies concerning the treatment affecting neovascularization, opacification caused by alkali burns Moreover, they have published and new drugs and compounds that have anti-angiogenic properties. Moreover, they have reported in the literature and recent promising new therapy with Mesenchymal stem cells(MSCs) . Antiinflammatory and antioangiogenetic action of mesenchymal cells is achieved largely by paracrine mobilize certain substances (IL-10, TGF-b1, IL-6, and TSP-1).This study evaluated the efficacy of MSCs to improve the effects of alkali burn of cornea. It was created corneal alkali burns in 30 rabbit eyes. The team with the MSCs (n = 15) was treated with intrastromal injection, subconjunctival injection of phosphate buffered saline (PBS) containing 2x106 MSCs as well as topical application. The control group (n = 15), was treated with PBS on the same modes of application. They have been instilled local eye drops (10% ascorbate, citrate 10%, tobramycin, dexamethasone, cyclogyl) for two weeks. The rabbits were examined under slit lamp, and assessed for neovascularization, opacity and epithelial defects of the cornea. Moreover, the tear secretion was assessed by tear test Schirmet test 1, and measurements were made for IOP (Intraocular pressure), hyperemia, toxic reaction. Furthermore, the concentration of SGPT (Serum Glutamic Pyruvic Transaminase) and VEGF (Vascular Endothelial Growth Factor) were measured and CCT (Corneal Touch Threshold). Also, an analysis of histological samples and immunohistochemistry were performed for the indicators: a-SMA, Ki-67 and FVIII factor.The eyes of the group with MSCs showed greater recovery. The mean area of neovascularization was significantly lower in MSCs (p <0,05). A significant difference in the degree of corneal opacity, re-epithelialization, and the IOP 21 and 28 posttraumatic days were also observed (p <0.05). Histological shown that MSCs resulted in near normal architecture of the eye tissue. After injection of MSCs, SGPT levels and VEGF corneal decreased significantly. Immunohistochemistry revealed a reduction of a-SMA in the group of MSCs, with highest activity in mitotic-regenerating, by the presence of Ki67. The lower values, in comparison to control group, of hyperemia, toxic reaction and SGPT in corneas accepted MSCs treatment, although without statistically significant differences, they are an indication that these new studied parameters can used as indexes of the presence and action of MSCs. It is worthy to note that the lower hyperemia at corneas, after MSCs treatment, it is approved by the presence of less blood vessels observed by electron microscopy (Coagulation factor-FVIII)Our study shows that such an approach improves the clinical results and leads to a better prognosis.Ο κερατοειδής χιτώνας του οφθαλμού είναι το διαθλαστικότερο τμήμα του οφθαλμικού διόπτρου. Η ακεραιότητα και η διαφάνεια του είναι αναγκαία τόσο για την ποιότητα όρασης όσο και για τη σωστή λειτουργία του οφθαλμού. Απαραίτητη προϋπόθεση για την σωστή λειτουργία του, είναι η αποφυγή νεοαγγείωσης και θόλωσης. Όμως, σε ανεπιθύμητες καταστάσεις όπως σε χημικά εγκαύματα είναι πιθανό να δημιουργηθούν νέα αγγεία. Έχουν δημοσιοποιηθεί μελέτες που αφορούν στην εφαρμογή θεραπευτικών παραγόντων που επιδρούν στη νεοαγγείωση, στη θόλωση που προκαλούνται από εγκαύματα του κερατοειδή Επιπλέον, υπάρχουν και άλλες φαρμακευτικές ουσίες και χημικές ενώσεις που έχουν αντί-αγγειογενετικές ιδιότητες. Εκτός τούτων, εμφανίζεται στη βιβλιογραφία και η υποσχόμενη νέα θεραπεία με μεταμόσχευση μεσεγχυματικών βλαστικών κυττάρων(MSCs). Αυτά έχουν την ικανότητα αναπαράγωγής και διαφοροποίησης προς πολλές κυτταρικές σειρές. Η αντιφλεγμονώδης και η αντιοαγγειογενετική δράση των μεσεγχυματικών κυττάρων επιτυγχάνεται σε μεγάλο βαθμό με την παρακρινή δράση τους (IL-10, TGF-β1 ,IL-6 και TSP-1). Στην παρούσα μελέτη αξιολογήθηκε η αποτελεσματικότητα της εφαρμογής των MSCsγια τη βελτίωση των συνεπειών μετά από αλκαλικό εγκαύμα του κερατοειδή. Δημιουργήθηκαν αλκαλικά εγκαύματα κερατοειδή σε 30 οφθαλμούς κονίκλων. Η ομάδα των MSCs (n = 15) υποβλήθηκε σε αγωγή με ενδοστρωματική έγχυση και ένεση υπό τον επιπεφυκότα αλατούχου φωσφορικού ρυθμιστικού διαλύματος (PBS) που περιέχει 2Χ106 MSCs, καθώς επίσης και με τοπική εφαρμογή. Η ομάδα ελέγχου (n = 15), υποβλήθηκε σε αγωγή με PBS με τους ίδιους τρόπους εφαρμογής. Ενσταλλάχθηκαν τοπικά (ασκορβικό 10%, κιτρικό 10%, τομπραμυκίνη, δεξαμεθαζόνη, cyclogyl) για 2 εβδομάδες. Οι κόνικλοι υποβλήθηκαν σε εξέταση με σχισμοειδή λυχνία, και αξιολογήθηκαν ως προς την νεοαγγείωση, τη θόλωση και τα επιθηλιακά ελλείμματα του κερατοειδή. Επιπλέον, αξιολογήθηκε η παραγωγή δακρύων με τη δοκιμασία του Schirmer test1, η Ε.Ο.Π., η υπεραιμία, η αντίδραση του προσθίου θαλάμου και η αισθητικότητα, καθώς επίσης προσδιορίστηκε η συγκέντρωση του SGPT (Serum Glutamic Pyruvic Transaminase)και του VEGF (Vascular Endothelial Growth Factor). Επίσης, πραγματοποιήθηκε ανάλυση των ιστολογικών δειγμάτων καθώς και ανοσοιστοχημεία στους δείκτες: a-SMA,Ki-67και FVIII παράγοντα πήξης.Οι οφθαλμοί της ομάδας με MSCs παρουσίασαν καλύτερη ανάκαμψη. Η μέση περιοχή νεοαγγείωσης ήταν σημαντικά μικρότερη στην ομάδα MSCs (p <0,05).Επιπλέον, υπήρξαν ευνοϊκά αποτελέσματα στο βαθμό της κερατοειδικής θόλωσης και επαναεπιθηλιοποίησης, καθώς και στην ΕΟΠ κατά την 21 και 28 μετατραυματική ημέρα (p<0,05). Οι ιστολογικές εξετάσεις έδειξαν ότι οι κερατοειδείς που δέχθηκαν εφαρμογή MSCs απέκτησαν σχεδόν κανονική αρχιτεκτονική των ιστών τους. Μετά την έγχυση των MSCs, τα επίπεδα του SGPT και του VEGF στον κερατοειδή μειώθηκαν σημαντικά. Η ανοσοϊστοχημεία έδειξε μείωση της α-SMA, στην ομάδα των MSCs, με υψηλότερη όμως δραστικότητα στη μιτωτική-αναγέννητική δραστηριότητα, από την παρουσία του Κί-67. Αξίζει να σημειωθεί ότι η μικρότερη υπεραιμία σε κερατοειδείς μετά από εφαρμογή MSCs επιβεβαιώθηκε και από την παρουσία λιγότερων αιμοφόρων αγγείων στο ηλεκτρονικό μικροσκόπιο.Η μελέτη δείχνει ότι μια τέτοια προσέγγιση βελτιώνει σημαντικά τα αποτελέσματα και οδηγεί σε καλύτερη πρόγνωση

Design and Validation of a Novel Smartphone-Based Visual Acuity Test: The K-VA Test

Abstract Introduction Visual acuity (VA) testing is a critical screening examination for the assessment of visual function. This study describes the development and validation of a smartphone-based VA test: the K-VA test. Methods A total of 171 patients with various ocular diseases were examined in our outpatient unit at Aristotle University of Thessaloniki, School of Medicine in Greece. Participants underwent VA examination using the standard Early Treatment Diabetic Retinopathy Study (ETDRS) charts and the K-VA smartphone-based test. The K-VA test was performed by participants themselves. The Bland–Altman method was employed to assess the agreement between the ETDRS charts and the new test for the examination of VA at 1 m and 40 cm. Test–retest reliability was also calculated. A questionnaire regarding the participants’ feedback on the K-VA test was completed. Results No significant bias was observed between the gold standard ETDRS charts and the K-VA test measurements. The mean difference (95% limits of agreement, LoA) between the K-VA test at 1 m and the ETDRS chart at 4 m was −0.006 (95% LoA −0.129 to 0.117) logarithm of the minimal angle of resolution (logMAR). The agreement of the K-VA test at 40 cm with the near ETDRS chart was also high with a mean difference of −0.007 (95% LoA −0.105 to 0.090) logMAR. Test–retest reliability was found to be high with a mean difference of 0.003 (95% LoA −0.045 to 0.033) logMAR and 0.005 (95% LoA −0.065 to 0.076) logMAR for the K-VA test at 1 m and 40 cm, respectively. A total of 97 participants answered the questionnaire and 71 (73.2%) stated that the test was easy to very easy to use for self-performance. Conclusions The study demonstrated that the K-VA application performed well compared with the ETDRS charts and provides reliable and repeatable measurements of VA across a wide range of VA

Daily Functionality of People with Low Vision: The Impact of Visual Acuity, Depression, and Life Orientation—A Cross-Sectional Study

Background. Low vision (LV) has a significant negative impact on the activities of daily life as well as on the psychological health of patients. Objectives. The objective of this study is to investigate psychological, clinical, and demographic factors that may impact the daily functionality of patients with LV. Methods. A convenience sample of 53 patients, meeting the WHO criteria for LV, was recruited. Questionnaires on daily functionality, depression, and life orientation (in terms of optimism/pessimism) were administered along with a semistructured personal interview. Key Findings. The main results revealed a significant negative correlation between daily functionality and depression (r=−0.423, p<0.001). Conversely, there is a positive correlation between daily functionality and visual acuity (r=0.415, p<0.001), while years since diagnosis were negatively correlated with depression (r=−0.345, p<0.001). Depression seems to be a moderate predictor of a person’s daily functionality (β=−0.389, p<0.002), followed by visual acuity (β=−0.344, p=0.006), explaining the 31.1% of the total variance. Conclusions. The study supports a correlation between daily functionality and both depression and visual acuity. Optimism as a personality characteristic did not factor into the prediction model for daily functionality, but it showed a strong correlation with lower levels of depressive symptoms. This highlights the potential for developing coping strategies for chronic disease management. Recommendations. The study could serve as a useful guide and may urge clinicians to pay attention to the psychological evaluation of these patients, supporting their unique emotional needs. Mental health professionals can use patients’ positive resources to provide appropriate counseling and embrace the coping skills that encourage their engagement in activities of daily life

A Novel Smartphone-Based Color Test for Detection of Color Vision Defects in Age Related Macular Degeneration

Purpose. To evaluate the efficacy of the smartphone-based K-color test to detect color defects in patients with Age-related Macular Degeneration (AMD). Methods. 88 patients (n = 135 eyes) with AMD and 28 controls (n = 53 eyes) underwent color testing with the Hardy–Rand–Rittler (H-R-R), the K-color test, and the Ishihara test. The K-color test presents randomized colored shapes in decreasing steps of intensity, providing also a record system for result tele-transmission. Sensitivity, specificity, and reliability were examined to investigate the validity of the novel test. 26 participants with AMD also completed a questionnaire regarding the feasibility of the test. Results. Linear mixed-effects models indicated a significant difference ( p &lt; 0.001 ) between AMD and normal eyes. The areas under the curve (AUC) were estimated to be 0.897 [95% CI: 0.841–0.952], 0.943 [95% CI: 0.901–0.984], and 0.931 [95% CI: 0.886–0.977] for the red, green, and blue color, respectively. Based on the H-R-R, the sensitivity of the test was 0.79, 0.90, and 0.95 for the red, green, and blue colors, respectively, and specificity was 0.88 for all colors. The new test recognized more abnormal cases than the Ishihara (sensitivity of 0.98 and 1.0 and specificity of 0.48 and 0.38 for red and green colors, respectively). Test-retest reliability was found to be high for the red [ICC = 0.996 (0.990–0.999)], green [ICC = 0.974 (0.929–0.990)], and blue [ICC = 0.992 (0.981–0.997)] colors. The majority of the asked participants stated that they could easily perform the test. Conclusion. The K-color test was found to be sensitive and specific in detecting color defects in AMD patients. The K-color test may serve as a useful tool both for patients and their physicians.</jats:p

A Novel Smartphone-Based Color Test for Detection of Color Vision Defects in Age Related Macular Degeneration

Purpose. To evaluate the efficacy of the smartphone-based K-color test to detect color defects in patients with Age-related Macular Degeneration (AMD). Methods. 88 patients (n = 135 eyes) with AMD and 28 controls (n = 53 eyes) underwent color testing with the Hardy–Rand–Rittler (H-R-R), the K-color test, and the Ishihara test. The K-color test presents randomized colored shapes in decreasing steps of intensity, providing also a record system for result tele-transmission. Sensitivity, specificity, and reliability were examined to investigate the validity of the novel test. 26 participants with AMD also completed a questionnaire regarding the feasibility of the test. Results. Linear mixed-effects models indicated a significant difference (p<0.001) between AMD and normal eyes. The areas under the curve (AUC) were estimated to be 0.897 [95% CI: 0.841–0.952], 0.943 [95% CI: 0.901–0.984], and 0.931 [95% CI: 0.886–0.977] for the red, green, and blue color, respectively. Based on the H-R-R, the sensitivity of the test was 0.79, 0.90, and 0.95 for the red, green, and blue colors, respectively, and specificity was 0.88 for all colors. The new test recognized more abnormal cases than the Ishihara (sensitivity of 0.98 and 1.0 and specificity of 0.48 and 0.38 for red and green colors, respectively). Test-retest reliability was found to be high for the red [ICC = 0.996 (0.990–0.999)], green [ICC = 0.974 (0.929–0.990)], and blue [ICC = 0.992 (0.981–0.997)] colors. The majority of the asked participants stated that they could easily perform the test. Conclusion. The K-color test was found to be sensitive and specific in detecting color defects in AMD patients. The K-color test may serve as a useful tool both for patients and their physicians

Evaluation of contrast sensitivity in visually impaired individuals using K-CS test. A novel smartphone-based contrast sensitivity test-Design and validation.

BackgroundTo describe the development and investigate the accuracy of a novel smartphone-based Contrast Sensitivity (CS) application, the K-CS test.MethodsA total of 67 visually impaired and 50 normal participants were examined monocularly using the novel digital K-CS test and the Pelli-Robson (PR) chart. The K-CS test examines letter contrast sensitivity in logarithmic units, using eight levels of contrast from logCS = ~0,1 to logCS = ~2,1 at two spatial frequencies of 1.5 and 3 cycles per degree (cpd). The K-CS test was compared to the gold standard, PR test and intra-session test repeatability was also examined.ResultsThe K-CS test in normally sighted was found to agree well with the PR, providing comparable mean scores in logCS (±SD) (K-CS = 1.908 ± 0.06 versus PR = 1.93 ± 0.05) at 1.5 cpd and mean (± SD) logCS at 3 cpd (K-CS = 1.83 ± 0.13 versus PR = 1.86 ± 0.07). The mean best corrected visual acuity of visually impaired participants was 0.67 LogMAR (SD = 0.21) and the K-CS was also found to agree well with the Pelli-Robson in this group, with an equivalent mean (±SD) logCS at 1.5 cpd: (K-CS = 1.19 ± 0.27, PR = 1.15 ± 0.31), 3 cpd: K-CS = 1.01 ± 0.33, PR = 0.94 ± 0.34. Regarding the intra-session test repeatability, both the K-CS test and the PR test showed good repeatability in terms of the 95% limits of agreement (LoA): K-CS = ±0.112 at 1.5 cpd and ±0.133 at 3 cpd, PR = ±0.143 at 1.5 cpd and ±0.183 in 3 cpd in visually impaired individuals.ConclusionThe K-CS test provides a quick assessment of the CS both in normally sighted and visually impaired individuals. The K-CS could serve as an alternative tool to assess contrast sensitivity function using a smartphone and provides results that agree well with the commonly used PR test