Sayena Jabbehdari1, Taylor W Starnes1, Khaliq H Kurji2, Medi Eslani3, Maria S Cortina1, Edward J Holland2, Ali R Djalilian4. 1. Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA. 2. Cincinnati Eye Institute, University of Cincinnati, Department of Ophthalmology, Cincinnati, OH, USA. 3. Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA; Cincinnati Eye Institute, University of Cincinnati, Department of Ophthalmology, Cincinnati, OH, USA. 4. Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA. Electronic address: https://mg.mail.yahoo.com/neo/b/compose?to=adjalili@uic.edu.
Abstract
AIM & OBJECTIVE: Severe ocular surface disease, including limbal stem cell deficiency (LSCD) can occur as a consequence of severe atopic keratoconjunctivitis (AKC) that has been inadequately treated. Our goal was to describe the management and outcomes of severe ocular surface disease in AKC patients. METHODS: We performed a retrospective analysis of a case series of 13 eyes of 8 patients with advanced ocular surface disease associated with severe AKC. The clinical presentation, medical and surgical management, and visual and anatomic outcomes were analyzed. RESULTS: Five eyes were treated with medical interventions alone, which included topical or systemic immunomodulatory therapy (IMT) for all eyes. These eyes had a decline in mean visual acuity from LogMAR 0.96 to 2.04 between the initial and final visits related to recurrent epithelial defects or corneal ulceration. Eight eyes were treated with surgical approaches in addition to medical treatment. Initial surgical treatments included limbal stem cell transplantation (n = 5), Boston keratoprosthesis (n = 2), and superficial keratectomy (n = 1). Both eyes that underwent primary keratoprosthesis had severe post-operative complications and became no light perception. In the remainder of the surgically treated eyes, there was an improvement visual acuity from LogMAR 1.43 to 0.6 between the pre-operative and final post-operative visit. CONCLUSION: Visual rehabilitation in eyes severe ocular surface disease due to prolonged AKC is challenging. While some patients did experience improved vision, most eyes did not improve or experienced severe complications with vision loss. Early intervention with immunomodulatory therapy may prevent progression of the disease to advanced stages.
AIM & OBJECTIVE: Severe ocular surface disease, including limbal stem cell deficiency (LSCD) can occur as a consequence of severe atopic keratoconjunctivitis (AKC) that has been inadequately treated. Our goal was to describe the management and outcomes of severe ocular surface disease in AKC patients. METHODS: We performed a retrospective analysis of a case series of 13 eyes of 8 patients with advanced ocular surface disease associated with severe AKC. The clinical presentation, medical and surgical management, and visual and anatomic outcomes were analyzed. RESULTS: Five eyes were treated with medical interventions alone, which included topical or systemic immunomodulatory therapy (IMT) for all eyes. These eyes had a decline in mean visual acuity from LogMAR 0.96 to 2.04 between the initial and final visits related to recurrent epithelial defects or corneal ulceration. Eight eyes were treated with surgical approaches in addition to medical treatment. Initial surgical treatments included limbal stem cell transplantation (n = 5), Boston keratoprosthesis (n = 2), and superficial keratectomy (n = 1). Both eyes that underwent primary keratoprosthesis had severe post-operative complications and became no light perception. In the remainder of the surgically treated eyes, there was an improvement visual acuity from LogMAR 1.43 to 0.6 between the pre-operative and final post-operative visit. CONCLUSION: Visual rehabilitation in eyes severe ocular surface disease due to prolonged AKC is challenging. While some patients did experience improved vision, most eyes did not improve or experienced severe complications with vision loss. Early intervention with immunomodulatory therapy may prevent progression of the disease to advanced stages.
Authors: Sina Sharifi; Hannah Sharifi; Ali Akbari; Fengyang Lei; Claes H Dohlman; Miguel Gonzalez-Andrades; Curtis Guild; Eleftherios I Paschalis; James Chodosh Journal: Acta Biomater Date: 2021-10-28 Impact factor: 8.947
Authors: Sina Sharifi; Hannah Sharifi; Curtis Guild; Mohammad Mirazul Islam; Khoa D Tran; Corrina Patzer; Claes H Dohlman; Eleftherios I Paschalis; Miguel Gonzalez-Andrades; James Chodosh Journal: Ocul Surf Date: 2021-03-03 Impact factor: 5.033
Authors: Abdelrahman M Elhusseiny; Mohammad Soleimani; Taher K Eleiwa; Reem H ElSheikh; Charles R Frank; Morteza Naderan; Ghasem Yazdanpanah; Mark I Rosenblatt; Ali R Djalilian Journal: Stem Cells Transl Med Date: 2022-03-31 Impact factor: 6.940
Authors: Sohil Amin; Elmira Jalilian; Eitan Katz; Charlie Frank; Ghasem Yazdanpanah; Victor H Guaiquil; Mark I Rosenblatt; Ali R Djalilian Journal: Vision (Basel) Date: 2021-09-22