Eyeworld

Cornea Society News – published quarterly by the Cornea Society 3 Differentiating between early keratoconus, ametropic eyes the "Corneal Tissue Engineering, Physiolo- gy, and Wound Healing" session. One of the options Dr. Kinoshita has begun to explore is injecting cultivated corneal endothelial cells (CECs) from a donor cornea for advanced-stage diseases such as Fuchs' endothelial corneal dystrophy or pseudophakic bullous keratopathy. In addition to being less invasive than an endothelial keratoplasty, this technique helps conserve precious donor tissue—1 donor cornea can provide enough cells to treat more than 200 patients. For early phase endothelial disease, Dr. Kinoshita has been developing a method of using ROCK inhibitor eye drops to stimu- late recovery of a patient's endothelial function. ROCK inhibitors promote cell adhesion and proliferation and inhibit apoptosis, making them excellent candi- dates for this procedure. Using CECs and eye drop therapy allows physicians to treat disease at an earlier stage and offer a less invasive alternative to a corneal transplant. CN Editors' note: Dr. Holland has financial interests with Alcon, Bausch + Lomb, Kala Pharmaceuticals, Mati Therapeutics, Rapid Pathogen Screening, Senju Pharma- ceuticals, TearLab, and TearScience. Dr. Kinoshita has financial interests with Abbott Medical Optics, Hoya, JCR Pharmaceutical Co., Otsuka Pharmaceutical Group, Pfizer, Santen, and Senju Pharmaceuticals. Dr. Price has financial interests with Bausch + Lomb. Drs. Cohen and Rapuano have no related financial interests. continued from page 1 H igh ametropic eyes had lower asymmetric values than those with very early keratoconus, according to recent research. The study aimed to discriminate between eyes with high myopia and astigmatism from those with forme fruste keratoconus (FFKC) and kerato- conus (KC) using the intereye asym- metry of several parameters obtained from Scheimpflug imaging. The study, presented by Maria A. Henriquez, MD, Lima, Peru, aimed to address the problems of very early KC and normal eyes showing similar pa- rameters, as well as high ametropic eyes showing similar parameters to very early KC. "It is easy to discriminate between normal and keratoconus eyes but it is hard to discriminate between very early keratoconus and ametropia eyes," Dr. Henriquez said. The results of the prospective com- parative study comparing groups of 294 bilateral keratoconus patients, 50 with high myopia or astigmatism, 30 with FFKC, and a 341 ammetropia patient control group was presented during a symposium at the 2015 ASCRS•ASOA Symposium & Congress of highlights from World Cornea Congress VII. The asymmetry was determined by subtracting the right eye value from the left eye value for each variable—includ- ing keratometry, astigmatism, and asphe- ricity—and by considering the absolute value of the result. In addition to the finding that high ametropic eyes showed lower asymmetric values than very early ker- atoconus, the study also found that the asymmetry of the eyes was effective in discriminating between very early keratoconus and high ametropic eyes. The best parameter of asymmetry included elevation front and back, Belin-Ambrosio D, and astigmatism. A separate presentation detailed the clinical presentation, characteristics, treatment, recurrences, complications, and final outcomes in children with her- pes simplex virus infections. The 10-year observational, retrospective clinical study concluded that herpetic eye disease in children often is diagnosed late or misdi- agnosed. High rates of epithelial dendrit- ic and interstitial keratitis were found, as well as an increased risk of recurrence and vision loss due to corneal complica- tions or amblyopia. Specifically, the 109-patient study identified a median 30-day delay from the onset of symptoms to presentation. Red eye in patients was the most com- mon (47.5%) reason for consultation, and the median best corrected visual acuity at presentation was a median of 20/80. In the study, 38.8% of patients had a previous HSV diagnosis and 15.5% were misdiagnosed. The study also found a rate of recurrence of 9.4 per 1,000 person years. "The only significant risk factor for the recurrence of the disease was the presence of epithelial dendritic keratitis," Juan C. Serna-Ojeda, MD, Mexico City, said about one of the major causes of infectious corneal blindness. Additionally, the study found that the results of penetrating keratoplasty were good when not compromised by amblyopia. A final finding was to urge prophy- lactic treatment with acyclovir on a long- term basis. The treatment had an adverse effect in only 4.8% of the children. Other data presented included preliminary results of recombinant human nerve growth factor (rhNGF) eye drops used for treating neurotrophic keratitis (NK). No pharmacologic therapy is available for NK, but previous research suggested that murine NGF eye drops could be a safe and effective treatment. The phase 1/2 multicenter, random- ized, double-masked, vehicle-controlled parallel group study has examined the safety and efficacy of 2 doses of recom- binant human nerve growth factor eye drops compared to a vehicle in patients with stage 2 and 3 NK. "The masked phase 1 results of the REPARO study suggest that rhNGF eye drops are safe and well tolerated, with no significant systemic or ophthalmic complications observed," said Flavio Mantelli, MD, PhD, Miami. Enrollment in phase 2 of the study was completed in March and follow up is ongoing. CN Editors' note: Drs. Henriquez and Serna- Ojeda had no related financial interests. Dr. Mantelli has financial interests with Dompe US.

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