Department of Ophthalmology, Yozgat City Hospital, Yozgat, Turkey.
Department of Ophthalmology, Yildirim Beyazit University Faculty of Medicine, Ankara, Turkey.
Ocul Immunol Inflamm. 2024 Dec;32(10):2428-2435. doi: 10.1080/09273948.2024.2397448. Epub 2024 Sep 6.
This study aimed to evaluate the tomographic, biomechanical, and confocal microscopic (IVCM) effects of chronic gout disease on human cornea.
This prospective study included 60 eyes of 30 participants with chronic gout disease and 60 eyes of 30 healthy controls. Corneal thickness, keratometry (K) readings, and corneal aberrations were measured with Sirius 3 D corneal tomography system (Sirius, CSO, Italy). Corneal biomechanical properties (corneal hysteresis [CH], corneal resistance factor [CRF], and intraocular pressure [IOP] parameters) were assessed with an ocular response analyzer (ORA, Reichert Ophthalmic Instruments). The number and morphology of corneal endothelial cells and the number of basal epithelial cells were evaluated with IVCM (Confoscan 4.0). Tear breakup time (TBUT) was also evaluated.
The mean diagnosis time of the patients with gout was 91.2 ± 69.6 months (12-300 month). Among corneal tomography measurements, K readings were similar between the two groups, while total and higher-order aberrations(coma, trefoil,s pherical, and quadrafoil) were significantly higher in the gout group. In the evaluation of biomechanical measurements, the CH value was significantly lower and the corneal-compensated IOP value was significantly higher in the gout group ( = 0.02, = 0.01, respectively). The two groups did not significantly differ regarding the CRF or Goldmann IOP ( = 0.61, = 0.15, respectively). Among the IVCM parameters, the number of corneal basal epithelial cells and the percentage of corneal endothelial hexagonality were significantly lower in the gout group, but no significant difference was detected in terms of the number of endothelial cells or polymegathism ( = 0.02, < 0.001, = 0.18, = 0.59, respectively). While TBUT was significantly lower in the gout group ( < 0.001).
This study showed that chronic gout disease increases the corneal aberrations and decreases the basal epithelial cell count, hexagonality ratio of endothelial cell and corneal biomechanics.
本研究旨在评估慢性痛风疾病对人眼角膜的断层成像、生物力学和共焦显微镜（IVCM）的影响。
这是一项前瞻性研究，纳入了 30 名慢性痛风患者的 60 只眼和 30 名健康对照者的 60 只眼。使用 Sirius 3D 角膜断层扫描仪（CSO，意大利）测量角膜厚度、角膜曲率（K）读数和角膜像差。使用眼反应分析仪（ORA，Reichert 眼科仪器）评估角膜生物力学特性（角膜滞后[CH]、角膜阻力因子[CRF]和眼压[IOP]参数）。使用共焦显微镜（Confoscan 4.0）评估角膜内皮细胞的数量和形态以及基底上皮细胞的数量。还评估了泪膜破裂时间（TBUT）。
痛风患者的平均诊断时间为 91.2±69.6 个月（12-300 个月）。在角膜断层成像测量中，两组的 K 读数相似，而痛风组的总像差和高阶像差（彗差、三叶草、球差和四叶草）明显更高。在生物力学测量评估中，CH 值明显较低，而角膜补偿 IOP 值明显较高（=0.02，=0.01）。两组在 CRF 或 Goldmann IOP 方面无显著差异（=0.61，=0.15）。在 IVCM 参数中，痛风组角膜基底上皮细胞数量和角膜内皮细胞六边形比例明显较低，但内皮细胞数量或多形性无显著差异（=0.02，<0.001，=0.18，=0.59）。TBUT 明显较低（<0.001）。
本研究表明，慢性痛风病增加了角膜像差，减少了基底上皮细胞计数、内皮细胞的六边形比例和角膜生物力学特性。
