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Corneal Diseases: Clinical Diagnosis and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (25 December 2024) | Viewed by 3923

Special Issue Editors


E-Mail Website
Guest Editor
Clinical Department of Ophthalmology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
Interests: ophthalmology

E-Mail Website
Guest Editor
Department of Ophthalmology, Medical University of Silesia in Katowice, Katowice, Poland
Interests: cornea;aniridic keratopathy; surgical cornea

Special Issue Information

Dear Colleagues,

Due to their optical function, corneal diseases are a major challenge. Efficient diagnosis and combined therapy methods can effectively save vision or improve its quality. The main goal of this Special Issue is to indicate the connections between modern diagnostic methods and the optimization of the therapeutic process. Combining advances in imaging and molecular techniques can support diagnoses and indicate the appropriate therapeutic path.

Currently, OCT technology comprises a wide range of diagnostic applications supported by confocal microscopy and cytodiagnostics. In turn, numerical methods can segregate such data and obtain more precise information and locate it in a specific tissue area. Rare diseases, where quick diagnoses are crucial, are a challenge, as are diseases with rapid progression.

Let us prove that imaging techniques and diagnostics based on the latest achievements in this field and molecular techniques are the future of ophthalmology.

Dr. Dariusz Dobrowolski
Dr. Bogumil Wowra
Guest Editors

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Keywords

  • corneal pathology
  • molecular diagnostics
  • OCT
  • IVCM
  • cytology
  • cytokines
  • rare diseases
  • surgical treatment
  • treatment potency assessment

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Published Papers (4 papers)

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Research

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12 pages, 1768 KiB  
Article
The Impact of the Position of the Upper Eyelid on the Profile of Epithelial Thickness and the Topography of the Cornea
by Kroczek Marta, Kudelska Dagmara, Młyniuk Patryk and Kałużny Bartłomiej
J. Clin. Med. 2025, 14(4), 1327; https://doi.org/10.3390/jcm14041327 - 17 Feb 2025
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Abstract
Aim: To evaluate the impact of the position of the upper eyelid on the corneal epithelial thickness, anterior elevation map, and corneal aberrations in patients with unimpaired function of the eyelids. Methods: Sixty-one right eyes were included in this prospective, non-randomized study. [...] Read more.
Aim: To evaluate the impact of the position of the upper eyelid on the corneal epithelial thickness, anterior elevation map, and corneal aberrations in patients with unimpaired function of the eyelids. Methods: Sixty-one right eyes were included in this prospective, non-randomized study. The low-positioned eyelid group (LP group) consisted of 30 patients with a mean upper eyelid margin position at 3.45 ± 0.45 mm above the corneal apex at primary gaze. The high-positioned eyelid group (HP group) comprised 31 eyes for which the respective value was 4.56 ± 0.36 mm. The anterior elevation map, corneal aberrations, and epithelial thickness profile were obtained with eyes wide open, using a MS-39 corneal tomograph (CSO, Florence, Italy). The analysis was also performed at measurement points 0.3 mm above and 0.3 mm below the eyelid margin. Results: Significantly thinner epitheliums at 4.5 mm above the center of the cornea on the vertical meridian in the LP group were observed (p < 0.05). Higher anterior elevations and thicker epitheliums of the cornea were observed at the measurement location of 0.3 mm above the upper eyelid’s margin in the HP group (p < 0.05). A negative correlation between the height of the upper eyelid and spherical aberration was noted. Conclusions: The findings provide evidence that the positioning of the upper eyelid in individuals with normal eyelid function influences the epithelial thickness map, the anterior elevation map, and corneal spherical aberrations. Full article
(This article belongs to the Special Issue Corneal Diseases: Clinical Diagnosis and Management)
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11 pages, 1542 KiB  
Article
Corneal Epithelial Thickness Maps in Eyes with Mild and Moderate Keratoconus
by Patryk Mlyniuk, Magdalena Kaszuba-Modrzejewska, Jagoda Rzeszewska-Zamiara, Ilona Piotrowiak-Slupska and Bartlomiej J. Kaluzny
J. Clin. Med. 2025, 14(4), 1256; https://doi.org/10.3390/jcm14041256 - 14 Feb 2025
Viewed by 675
Abstract
Background/Objectives: The evaluation of the differences in corneal epithelial thickness profiles in healthy eyes and eyes with mild and moderate stages of keratoconus, using optical coherence tomography (OCT). Methods: Fifty-two healthy eyes (group 0), forty-one eyes with mild keratoconus (group I), and thirty [...] Read more.
Background/Objectives: The evaluation of the differences in corneal epithelial thickness profiles in healthy eyes and eyes with mild and moderate stages of keratoconus, using optical coherence tomography (OCT). Methods: Fifty-two healthy eyes (group 0), forty-one eyes with mild keratoconus (group I), and thirty eyes with moderate keratoconus (group II) were included in this study. Only one of the patient’s eyes was enrolled, and they were divided into groups using the Amsler–Krumeich (A–K) classification—stage I and II. All patients underwent a visual acuity assessment, slit-lamp examination, corneal tomography, and automatic mapping of corneal thickness and epithelial thickness on a diameter of 9 mm. Corneal tomography with a Placido/Scheimpflug instrument (Sirius, CSO, Florence, Italy) and OCT with a corneal adaptor module (Avanti RTVue XR, Optovue, Lombard, IL, USA) were used. Results: Minimum corneal epithelium thickness was 49.5, 43, and 40 µm in groups 0, I, and II, respectively (Kruskal–Wallis test, p < 0.001). A moderate correlation was found between minimum epithelial thickness and the apex curvature (Pearsons’s coefficient r = −0.62, p < 0.001) and posterior radius of central corneal curvature (Pearsons’s coefficient r = 0.62, p < 0.001). The difference between minimum and maximum epithelial thickness showed a high correlation (r = −0.770, p < 0.001). In groups I and II, on corneal epithelial thickness maps the thinnest sector, located inferiorly and temporally to the center, was surrounded by sectors with increased thickness. Conclusions: At the apex of the cone, the corneal epithelium becomes thinner, and a thicker ring forms around the cone. Although there is a moderate-to-strong correlation to parameters linked with the severity of keratoconus, and minimum epithelial thickness as well as the minimum–maximum difference, it is not possible to establish cut-off values for stages I and II in the Amsler–Krumeich (A–K) classification. Full article
(This article belongs to the Special Issue Corneal Diseases: Clinical Diagnosis and Management)
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Review

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18 pages, 885 KiB  
Review
A Review of Keratoconus Cross-Linking Treatment Methods
by Natalie Papachristoforou, Anthony Ueno, Kamila Ledwos, Jerzy Bartuś, Anna Nowińska and Izabella Karska-Basta
J. Clin. Med. 2025, 14(5), 1702; https://doi.org/10.3390/jcm14051702 - 3 Mar 2025
Viewed by 1145
Abstract
Corneal collagen cross-linking (CXL) is a therapeutic intervention that utilizes riboflavin photochemical activation with ultraviolet-A (UV-A) light to induce covalent cross-links within the stromal corneal fibers, effectively increasing corneal biomechanical stability and halting the progressive ectasia. The method was introduced in the late [...] Read more.
Corneal collagen cross-linking (CXL) is a therapeutic intervention that utilizes riboflavin photochemical activation with ultraviolet-A (UV-A) light to induce covalent cross-links within the stromal corneal fibers, effectively increasing corneal biomechanical stability and halting the progressive ectasia. The method was introduced in the late 1990s in Germany at the University of Dresden. The cross-linking method using the Avedro system (Waltham, MA, USA) was approved by the US Food and Drug Administration (FDA) on 18 April 2016, based on three prospective, multicenter, randomized clinical trials for keratoconus and other corneal ectasias. Recent innovations in CXL include a range of new treatment protocols and methods, which have been introduced to further enhance the clinical effectiveness, efficiency, and safety of CXL. These modifications encompass approaches like transepithelial or epithelium-on CXL (TE-CXL or epi-on CXL), accelerated CXL (ACXL), pulsed CXL (PL-CXL), transepithelial iontophoresis-assisted crosslinking (I-CXL), diluted alcohol and iontophoresis-assisted corneal cross-linking (DAI-CXL), slit-lamp CXL, and CXL plus (combined) methods. This review synthesizes findings on currently used modifications of the cross-linking method, the effectiveness, and directions of development of this currently dominant surgical method of treating corneal ectasia. This review concentrates on the long-term follow-up data, based on publications ranging from 1998 up to 2023. Full article
(This article belongs to the Special Issue Corneal Diseases: Clinical Diagnosis and Management)
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Other

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8 pages, 2857 KiB  
Case Report
Diagnostic Challenges of Axenfeld-Rieger Syndrome and a Novel FOXC1 Gene Mutation in a Polish Family
by Bogumił Wowra, Marzena Wysocka-Kosmulska, Karolina Stanienda-Sokół, Olga Łach-Wojnarowicz, Dariusz Dobrowolski and Edward Wylęgała
J. Clin. Med. 2024, 13(19), 5761; https://doi.org/10.3390/jcm13195761 - 27 Sep 2024
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Abstract
(1) Axenfeld-Rieger syndrome (ARS) is a rare autosomal dominant disorder, the symptoms of which include both ocular and systemic abnormalities. In the studied subjects, the cornea was significantly opacified with peripheral scarring neovascularization, which is not specific to this syndrome. A suspicion of [...] Read more.
(1) Axenfeld-Rieger syndrome (ARS) is a rare autosomal dominant disorder, the symptoms of which include both ocular and systemic abnormalities. In the studied subjects, the cornea was significantly opacified with peripheral scarring neovascularization, which is not specific to this syndrome. A suspicion of incorrect diagnosis was raised despite an initial diagnosis of a bilateral Chandler syndrome. (2) In order to provide the proper diagnosis, a DNA sequencing genetic test was conducted with three sisters carrying the presence of a genome imbalance in the FOXC1 gene. The aim of this study is to report a case of a Polish family with a novel gene mutation and its relation with ARS. (3) Our findings implicate the novel deletion of the FOXC1 gene in the pathogenesis of ARS in the affected family. The phenotypic variability observed, including differences in corneal and systemic anomalies, underscores the importance of genetic testing and suggests the influence of non-genetic factors on ARS manifestation. Full article
(This article belongs to the Special Issue Corneal Diseases: Clinical Diagnosis and Management)
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