Avaliação da superfície ocular e filme lacrimal em portadores de ceratocone e em portadores com doença do olho seco
Data
2023-01-16
Autores
Carrasqueira, Augusto 
Santos, Luzia Alves dos
Orientadores
Hazarbassanov, Rossen Mihaylov
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: O objetivo deste estudo foi determinar a associação entre a doença do olho seco evaporativo (DOS-E) e os pacientes com ceratocone (CC) usando exames automatizados não invasivos.
Metodologia: Um estudo observacional transversal de sessão única. O estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Federal de São Paulo - UNIFESP/EPM e foi conduzido de acordo com os códigos de ética da declaração de Helsinki após consentimento informado dos participantes. O protocolo de cinquenta e seis olhos de 28 pacientes com CC e 48 olhos de 24 pacientes DOS-E foram analisados. Todos os participantes foram requisitados a preencher dois questionários: Ocular Surface Disease Index (OSDI) e questionário de olho seco (DEQ-5). Os participantes também foram submetidos aos exames de tempo de ruptura não invasivo (NIBUT), interferometria para avaliar a espessura da camada lipídica (LLT), altura do menisco lacrimal (TMH), meibografia infravermelha para a medição da perda da glândula meibomiana (MGL) e análise de piscar.
Resultados: Foram encontradas diferenças significativas entre os grupos para idade, ceratometria média, paquimetria corneana, N-BUT e vermelhidão do bulbo ocular. Não houve diferenças nos valores médios de sexo, atopia, questionários, altura do menisco lacrimal, interferometria do filme lacrimal ou meibografia na pálpebra superior e inferior entre os grupos.
Conclusão: Neste estudo, o ceratocone está relacionado tanto ao afinamento da camada lipídica do filme lacrimal, quanto à redução dos valores de N-BUT. Essa relação pode ser pertinente a outras anormalidades epiteliais, dada a proteção reduzida do filme lacrimal, que podem causar a degradação do colágeno estromal e o enfraquecimento da córnea através da liberação de enzimas proteolíticas. Um novo estudo poderia ser realizado com um maior número de pacientes e faixa etária ampliada. A comparação de valores entre jovens e pessoas acima de 50 anos, do sexo feminino, pode esclarecer a existência de uma correlação entre a qualidade do filme ocular e mudanças hormonais decorrentes do climatério.
Objective: The purpose of this study was to determine the association between evaporative dry eye disease (E-DOS) and patients with keratoconus (CC) using non-invasive automated tests. Methodology: A single-session cross-sectional observational study. The study was approved by the Research Ethics Committee of the Federal University of São Paulo - UNIFESP/EPM and was conducted in accordance with the codes of ethics of the Declaration of Helsinki after informed consent from the participants. The protocol of fifty-six eyes from 28 patients with CC and 48 eyes from 24 patients DOS-E were analyzed. All participants were required to complete two questionnaires: Ocular Surface Disease Index (OSDI) and dry eye questionnaire (DEQ-5). Participants also underwent non-invasive break-up time (NIBUT) scans, interferometry to assess lipid layer thickness (LLT), tear meniscus height (TMH), infrared meibography to measure meibomian gland loss (MGL) and blink analysis. Results: Significant differences were found between groups for age, mean keratometry, corneal pachymetry, N-BUT and eyeball redness. There were no differences in mean values for gender, atopy, questionnaires, tear meniscus height, tear film interferometry, or upper and lower eyelid meibography between groups. Conclusion: In this study, keratoconus is related to both the thinning of the lipid layer of the tear film and the reduction of N-BUT values. This relationship may be pertinent to other epithelial abnormalities, given the reduced protection of the tear film, which can cause degradation of stromal collagen and weakening of the cornea through the release of proteolytic enzymes. A new study could be carried out with a larger number of patients and a broader age range. The comparison of values between young people and people over 50 years of age, female, can clarify the existence of a correlation between the quality of the ocular film and hormonal changes resulting from the climacteric.
Objective: The purpose of this study was to determine the association between evaporative dry eye disease (E-DOS) and patients with keratoconus (CC) using non-invasive automated tests. Methodology: A single-session cross-sectional observational study. The study was approved by the Research Ethics Committee of the Federal University of São Paulo - UNIFESP/EPM and was conducted in accordance with the codes of ethics of the Declaration of Helsinki after informed consent from the participants. The protocol of fifty-six eyes from 28 patients with CC and 48 eyes from 24 patients DOS-E were analyzed. All participants were required to complete two questionnaires: Ocular Surface Disease Index (OSDI) and dry eye questionnaire (DEQ-5). Participants also underwent non-invasive break-up time (NIBUT) scans, interferometry to assess lipid layer thickness (LLT), tear meniscus height (TMH), infrared meibography to measure meibomian gland loss (MGL) and blink analysis. Results: Significant differences were found between groups for age, mean keratometry, corneal pachymetry, N-BUT and eyeball redness. There were no differences in mean values for gender, atopy, questionnaires, tear meniscus height, tear film interferometry, or upper and lower eyelid meibography between groups. Conclusion: In this study, keratoconus is related to both the thinning of the lipid layer of the tear film and the reduction of N-BUT values. This relationship may be pertinent to other epithelial abnormalities, given the reduced protection of the tear film, which can cause degradation of stromal collagen and weakening of the cornea through the release of proteolytic enzymes. A new study could be carried out with a larger number of patients and a broader age range. The comparison of values between young people and people over 50 years of age, female, can clarify the existence of a correlation between the quality of the ocular film and hormonal changes resulting from the climacteric.