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Corneal Epithelium Remodelling After Eye Rubbing Discontinuation in Pediatric Allergic Patients

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Summary:Introduction: Our purpose was to evaluate the effect of eye rubbing discontinuation on the epithelial thickness profile by spectral-domain AS-OCT (anterior segment optical coherence tomography) in allergic children with no tomographic sign of corneal ectasia.   Methods: Right-handed boys (average age 11.2 years, 8-12 years) with history of eye rubbing and relatively normal Pentacam (Oculus; Wetzlar, Germany) exams were recruited for the study. Patients were evaluated using AS-OCT (Zeiss Cirrus 5000 HD-OCT, Carl Zeiss Meditec, Dublin, CA, USA) at the baseline and after 8 weeks of treatment. Treatment included education to avoid eye rubbing and preservative free 0.25 mg/mL topical ketotifen. Epithelial thickness (ET) and full corneal thickness (CT) parameters were compared with paired non-parametric Wilcoxon (signed-ranked) test.  A p-value lower than 0.05 was considered for statistical significance.   Results: Twenty-five boys completed the protocol. No eyes had tomographic criteria for keratoconus (Belin-Ambrosio Deviation Value < 1.22). Minimum epithelial location moved from the inferotemporal to superotemporal octant after treatment. The differences between minimum and maximum epithelial thickness (-2.8 µm vs -5.2 µm; p<0.01) and between nasal and temporal octants (N-T) (3.1 µm vs 1.4 µm; p<0.01) were higher at the baseline. The difference between inferior and superior (I-S) octants (1.1 µm vs 2.7 µm; p<0.01) was lower at the baseline.    Conclusion: AS-OCT analyses reveal epithelial remodeling after allergy treatment and eye rubbing discontinuation, with marked inferotemporal thickening. The importance of educating against eye rubbing and treating allergy should consider its importance on corneal epithelial remodeling. Further studies should include patients with corneal ectatic conditions and to explore other clinical measurements such as biomechanical assessment. 
Main Authors:Loureiro, Tomás
Other Authors:Rodrigues-Barros, Sandra; Carreira, Ana Rita; Moraes, Filipe; Carreira, Pedro; Vide Escada, Ana; Campos, Paul; Machado, Inês; Campos, Nuno; Ambrósio Jr, Renato
Subject:Artigos Originais
Year:2021
Country:Portugal
Document type:article
Access type:open access
Associated institution:Sociedade Portuguesa de Oftalmologia
Language:English
Origin:Revista Sociedade Portuguesa de Oftalmologia
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author Loureiro, Tomás
author2 Rodrigues-Barros, Sandra
Carreira, Ana Rita
Moraes, Filipe
Carreira, Pedro
Vide Escada, Ana
Campos, Paul
Machado, Inês
Campos, Nuno
Ambrósio Jr, Renato
author2_role author
author
author
author
author
author
author
author
author
author_facet Loureiro, Tomás
Rodrigues-Barros, Sandra
Carreira, Ana Rita
Moraes, Filipe
Carreira, Pedro
Vide Escada, Ana
Campos, Paul
Machado, Inês
Campos, Nuno
Ambrósio Jr, Renato
author_role author
country_str PT
creators_json_txt [{\"Person.name\":\"Loureiro, Tomás\"},{\"Person.name\":\"Rodrigues-Barros, Sandra\"},{\"Person.name\":\"Carreira, Ana Rita\"},{\"Person.name\":\"Moraes, Filipe\"},{\"Person.name\":\"Carreira, Pedro\"},{\"Person.name\":\"Vide Escada, Ana\"},{\"Person.name\":\"Campos, Paul\"},{\"Person.name\":\"Machado, Inês\"},{\"Person.name\":\"Campos, Nuno\"},{\"Person.name\":\"Ambrósio Jr, Renato\"}]
datacite.creators.creator.creatorName.fl_str_mv Loureiro, Tomás
Rodrigues-Barros, Sandra
Carreira, Ana Rita
Moraes, Filipe
Carreira, Pedro
Vide Escada, Ana
Campos, Paul
Machado, Inês
Campos, Nuno
Ambrósio Jr, Renato
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Artigos Originais
datacite.titles.title.fl_str_mv Corneal Epithelium Remodelling After Eye Rubbing Discontinuation in Pediatric Allergic Patients
Alterações Epiteliais da Córnea Após Descontinuação de Coçar os Olhos em Crianças Atópicas
dc.creator.none.fl_str_mv Loureiro, Tomás
Rodrigues-Barros, Sandra
Carreira, Ana Rita
Moraes, Filipe
Carreira, Pedro
Vide Escada, Ana
Campos, Paul
Machado, Inês
Campos, Nuno
Ambrósio Jr, Renato
dc.description.none.fl_str_mv Introdução: O nosso objetivo foi fazer a avaliação do efeito de parar de coçar os olhos no perfil epitelial da córnea através de análise com tomografia de coerância ótica do segmento anterior (AS-OCT) em crianças atópicas sem sinais tomográficos de ectasia.    Métodos: Rapazes dextros (idade média 11,2 anos) com hábito de coçar os olhos e tomografia de córnea (Pentacam, Oculus; Wetzlar, Germanh) sem alterações foram incluídos. Foi realizado AS-OCT (Zeiss Cirrus 5000 HD-OCT, Carl Zeiss Meditec, Dublin, CA, USA) na baseline e após 8 semanas de tratamento com cetotifeno tópico sem conservantes (0,25 mg/mL). A espessura epitelial e a espessura total da córnea foram comparadas através de testes não paramétricos emparelhados de Wilcoxon. Um p-value inferior a 0,05 foi considerado estatisticamente significativo.    Resultados: Vinte e cinco rapazes completaram o estudo. Nenhum olho apresentou critérios tomográficos de ectasia (Belin-Ambrosio Deviation Value < 1,22). A espessura epitelial mínima deslocou-se  da região inferotemporal para a região inferotemporal após o tratamento. As diferenças entre a espessura epitelial minima e máxima (-2,8 µm vs -5,2 µm; p<0,01) e entre as regiões nasal e temporal (N-T) (3,1 µm vs 1.4 µm; p<0,01) foram superiores na baseline. A diferença entre as regiões inferior e superior (I-S) (1,1 µm vs 2,7 µm; p<0,01) foi inferior na baseline.    Conclusão: A análise do epitélio da córnea atráves de OCT do segmento anterior revelou um espessamento inferotemporal após tratamento antialérgico e consequente descontinuação do ato de coçar os olhos.  Estes resultados parecem ilustrar o dano deste ato repetido sobre a córnea e salientam a importância de educação da população acerca dos riscos associados ao mesmo.
dc.identifier.none.fl_str_mv https://doi.org/10.48560/rspo.25443
dc.language.none.fl_str_mv eng
dc.publisher.none.fl_str_mv Ajnet
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.subject.none.fl_str_mv Artigos Originais
dc.title.fl_str_mv Corneal Epithelium Remodelling After Eye Rubbing Discontinuation in Pediatric Allergic Patients
Alterações Epiteliais da Córnea Após Descontinuação de Coçar os Olhos em Crianças Atópicas
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description Introduction: Our purpose was to evaluate the effect of eye rubbing discontinuation on the epithelial thickness profile by spectral-domain AS-OCT (anterior segment optical coherence tomography) in allergic children with no tomographic sign of corneal ectasia.   Methods: Right-handed boys (average age 11.2 years, 8-12 years) with history of eye rubbing and relatively normal Pentacam (Oculus; Wetzlar, Germany) exams were recruited for the study. Patients were evaluated using AS-OCT (Zeiss Cirrus 5000 HD-OCT, Carl Zeiss Meditec, Dublin, CA, USA) at the baseline and after 8 weeks of treatment. Treatment included education to avoid eye rubbing and preservative free 0.25 mg/mL topical ketotifen. Epithelial thickness (ET) and full corneal thickness (CT) parameters were compared with paired non-parametric Wilcoxon (signed-ranked) test.  A p-value lower than 0.05 was considered for statistical significance.   Results: Twenty-five boys completed the protocol. No eyes had tomographic criteria for keratoconus (Belin-Ambrosio Deviation Value < 1.22). Minimum epithelial location moved from the inferotemporal to superotemporal octant after treatment. The differences between minimum and maximum epithelial thickness (-2.8 µm vs -5.2 µm; p<0.01) and between nasal and temporal octants (N-T) (3.1 µm vs 1.4 µm; p<0.01) were higher at the baseline. The difference between inferior and superior (I-S) octants (1.1 µm vs 2.7 µm; p<0.01) was lower at the baseline.    Conclusion: AS-OCT analyses reveal epithelial remodeling after allergy treatment and eye rubbing discontinuation, with marked inferotemporal thickening. The importance of educating against eye rubbing and treating allergy should consider its importance on corneal epithelial remodeling. Further studies should include patients with corneal ectatic conditions and to explore other clinical measurements such as biomechanical assessment. 
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person_str_mv Loureiro, Tomás
Rodrigues-Barros, Sandra
Carreira, Ana Rita
Moraes, Filipe
Carreira, Pedro
Vide Escada, Ana
Campos, Paul
Machado, Inês
Campos, Nuno
Ambrósio Jr, Renato
publishDate 2021
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spelling AjnetenIntroduction: Our purpose was to evaluate the effect of eye rubbing discontinuation on the epithelial thickness profile by spectral-domain AS-OCT (anterior segment optical coherence tomography) in allergic children with no tomographic sign of corneal ectasia.   Methods: Right-handed boys (average age 11.2 years, 8-12 years) with history of eye rubbing and relatively normal Pentacam (Oculus; Wetzlar, Germany) exams were recruited for the study. Patients were evaluated using AS-OCT (Zeiss Cirrus 5000 HD-OCT, Carl Zeiss Meditec, Dublin, CA, USA) at the baseline and after 8 weeks of treatment. Treatment included education to avoid eye rubbing and preservative free 0.25 mg/mL topical ketotifen. Epithelial thickness (ET) and full corneal thickness (CT) parameters were compared with paired non-parametric Wilcoxon (signed-ranked) test.  A p-value lower than 0.05 was considered for statistical significance.   Results: Twenty-five boys completed the protocol. No eyes had tomographic criteria for keratoconus (Belin-Ambrosio Deviation Value < 1.22). Minimum epithelial location moved from the inferotemporal to superotemporal octant after treatment. The differences between minimum and maximum epithelial thickness (-2.8 µm vs -5.2 µm; p<0.01) and between nasal and temporal octants (N-T) (3.1 µm vs 1.4 µm; p<0.01) were higher at the baseline. The difference between inferior and superior (I-S) octants (1.1 µm vs 2.7 µm; p<0.01) was lower at the baseline.    Conclusion: AS-OCT analyses reveal epithelial remodeling after allergy treatment and eye rubbing discontinuation, with marked inferotemporal thickening. The importance of educating against eye rubbing and treating allergy should consider its importance on corneal epithelial remodeling. Further studies should include patients with corneal ectatic conditions and to explore other clinical measurements such as biomechanical assessment. ptIntrodução: O nosso objetivo foi fazer a avaliação do efeito de parar de coçar os olhos no perfil epitelial da córnea através de análise com tomografia de coerância ótica do segmento anterior (AS-OCT) em crianças atópicas sem sinais tomográficos de ectasia.    Métodos: Rapazes dextros (idade média 11,2 anos) com hábito de coçar os olhos e tomografia de córnea (Pentacam, Oculus; Wetzlar, Germanh) sem alterações foram incluídos. Foi realizado AS-OCT (Zeiss Cirrus 5000 HD-OCT, Carl Zeiss Meditec, Dublin, CA, USA) na baseline e após 8 semanas de tratamento com cetotifeno tópico sem conservantes (0,25 mg/mL). A espessura epitelial e a espessura total da córnea foram comparadas através de testes não paramétricos emparelhados de Wilcoxon. Um p-value inferior a 0,05 foi considerado estatisticamente significativo.    Resultados: Vinte e cinco rapazes completaram o estudo. Nenhum olho apresentou critérios tomográficos de ectasia (Belin-Ambrosio Deviation Value < 1,22). A espessura epitelial mínima deslocou-se  da região inferotemporal para a região inferotemporal após o tratamento. As diferenças entre a espessura epitelial minima e máxima (-2,8 µm vs -5,2 µm; p<0,01) e entre as regiões nasal e temporal (N-T) (3,1 µm vs 1.4 µm; p<0,01) foram superiores na baseline. A diferença entre as regiões inferior e superior (I-S) (1,1 µm vs 2,7 µm; p<0,01) foi inferior na baseline.    Conclusão: A análise do epitélio da córnea atráves de OCT do segmento anterior revelou um espessamento inferotemporal após tratamento antialérgico e consequente descontinuação do ato de coçar os olhos.  Estes resultados parecem ilustrar o dano deste ato repetido sobre a córnea e salientam a importância de educação da população acerca dos riscos associados ao mesmo.engenCorneal Epithelium Remodelling After Eye Rubbing Discontinuation in Pediatric Allergic PatientsptAlterações Epiteliais da Córnea Após Descontinuação de Coçar os Olhos em Crianças AtópicasTranslatedTitleLoureiro, TomásLoureiroTomásHospital Garcia de Orta, Almada, PortugalRodrigues-Barros, SandraRodrigues-BarrosSandraHospital Garcia de Orta, Almada, Portugal; Hospital CUF Cascais, Lisboa, Portugal; Clínica CUF Almada, Almada, PortugalCarreira, Ana RitaCarreiraAna RitaHospital Garcia de Orta, Almada, PortugalMoraes, FilipeMoraesFilipeHospital Garcia de Orta, Almada, PortugalCarreira, PedroCarreiraPedroHospital Garcia de Orta, Almada, PortugalVide Escada, AnaVide EscadaAnaHospital Garcia de Orta, Almada, Portugal; Clínica CUF Almada, Almada, Portugal; Hospital da Luz Lisboa, Lisboa, PortugalCampos, PaulCamposPaulHospital Garcia de Orta, Almada, Portugal; Hospital da Luz Lisboa, Lisboa, PortugalMachado, InêsMachadoInêsHospital Garcia de Orta, Almada, Portugal; Clínica CUF Almada, Almada, Portugal; Hospital CUF TEJO, Lisboa, PortugalCampos, NunoCamposNunoClínica CUF Almada, Almada, Portugal; Hospital CUF TEJO, Lisboa, PortugalAmbrósio Jr, RenatoAmbrósio JrRenatoFederal University of the State of Rio de Janeiro, Rio de Janeiro, BrazilEISSN3051-6579IsPartOf2021-12-31DOIhttps://doi.org/10.48560/rspo.25443http://purl.org/coar/access_right/c_abf2open accessArtigos Originaishttp://purl.org/coar/resource_type/c_6501journal articlehttps://creativecommons.org/licenses/by-nc/4.02021-12-31fulltextapplication/pdfRevista Sociedade Portuguesa de Oftalmologia454210217
spellingShingle Corneal Epithelium Remodelling After Eye Rubbing Discontinuation in Pediatric Allergic Patients
Loureiro, Tomás
Artigos Originais
status SINGLETON
subject.fl_str_mv Artigos Originais
title Corneal Epithelium Remodelling After Eye Rubbing Discontinuation in Pediatric Allergic Patients
title_full Corneal Epithelium Remodelling After Eye Rubbing Discontinuation in Pediatric Allergic Patients
title_fullStr Corneal Epithelium Remodelling After Eye Rubbing Discontinuation in Pediatric Allergic Patients
title_full_unstemmed Corneal Epithelium Remodelling After Eye Rubbing Discontinuation in Pediatric Allergic Patients
title_short Corneal Epithelium Remodelling After Eye Rubbing Discontinuation in Pediatric Allergic Patients
title_sort Corneal Epithelium Remodelling After Eye Rubbing Discontinuation in Pediatric Allergic Patients
topic Artigos Originais
topic_facet Artigos Originais
url https://doi.org/10.48560/rspo.25443
visible 1