CC BY
0ARTICLE INFO
EURASIAN JOURNAL OF MEDICAL AND NATURAL SCIENCES
Innovative Academy Research Support Center UIF = 8.3 | SJIF = 7.921 www.in-academy.uz
THE ROLE OF CORNEAL ENDOTHELIAL MICROSCOPY IN THE DIAGNOSIS OF THE ANTERIOR UVEITIS OF POSTCOVID PERIOD
Rizaeva Manzurakhon Asrorovna1 Kamilov Khalidbek Mukhamedjanovich2
1Republican Clinical Ophthalmological Hospital, Ziyo Str. 12a,
Almazar district. Tashkent, Uzbekistan 2Department of Ophthalmology, Center for the Development of Professional Qualification of Medical Workers, Parkentskaya Str. 51, Tashkent. 100007, Uzbekistan Correspondence to: Manzura Rizayeva. Republican Clinical Ophthalmological Hospital, Ziyo Str. 12a, Almazar district . Tashkent, Uzbekistan. manzuraxon1984@mail.ru https://doi.org/10.5281/zenodo.13132054 ABSTRACT
Received: 25th July 2024 Accepted: 29th July 2024 Online: 30th July 2024 KEYWORDS
Cornea, corneal
endothelial microscopy, antherior uveitis, post covid.
Endothelial microscopy plays an important role in measuring the density of corneal endothelial cells for clinical diagnosis, clinical studies with pathology antherior segment postcovid period.
The purpose of the study: a comparative analysis of the structure of the cornea in anterior uveitis of postcovid period.
Material and methods of research. We observed 11 people (22 eyes), who were divided into 2 groups. The first group consisted of 6 patients (12 eyes) with anterior uveitis of postcovid period. The second control group consisted of 5 (10 eyes) practically healthy people without any ophthalmopathology. In addition to the standard ophthalmological examination, all patients underwent endothelial microscopy of the cornea results. Therefore, we used endothelial microscopy examination for qualitative and quantitative determination of changes in the structure of the cornea in the early stages of anterior uveitis of postcovid period.The results of the study using endothelial microscopy differed in clinical diversity. The most pronounced changes were observed in the area of the cornea involved in the ectatic process.
Conclusions. In the early stages of anterior uveitis of postcovid period, as a result of degenerative changes, a decrease in the number of endothelial cells by 26.3%, a decrease in the average density of endothelial cells by 58.5% was revealed.
INTRODUCTION
Endothelial microscopy plays an important role in measuring corneal endothelial cell density for clinical diagnosis, clinical research, and in assessing the endothelium before and after cornel surgery [1]. Endothelial microscopy is quantitative and qualitative assessment of the endothelium, the inner layer of corneal cells. Endothelial microscopy indicators help to identify pathology of cornea and plan the correct treatment for this pathology [2,5].
EURASIAN JOURNAL OF MEDICAL AND NATURAL SCIENCES
Innovative Academy Research Support Center UIF = 8.3 | SJIF = 7.921 www.in-academy.uz
Uveitis is a collection of diseases characterized by inflammation within the eye, and its etiology multifactorial, including autoimmune (60.1%), systemic (30-50%), infectious (3050%), and idiopathic (20-40%) causes [3].
Additionally, SARS-CoV-2 can induce retinal lesions or retinal vascular changes. Whether SARS-CoV-2 can cause distinct retinitis, similar to retinitis caused by herpes viruses, remines to be confirmed in larger series studies [4]
THE OBJECTIVE OF THE RESEARCHa comparative analysis of the structure of the cornea in anterior uveitis of postcovid period.
SUBJECTS AND METHODS: We observed 11 people (22 eyes), who were divided into 2 groups. The first group consisted of 6 patients (12 eyes) with anterior uveitis of postcovid period. The second control group consisted of 5 (10 eyes) practically healthy people without any ophthalmopathology. All patients underwent visometry, pneumotonometry, perimetry, biomicroscopy, B-scan, and ophthalmoscopy. The study was carried out using an automated non-contact microscope TOMEY EM 400 (Japan). Advantages of study: non-contact measurement - a few seconds to examine one eye, 190 optical zoom, non-contactpachymetry, measurment of 13 zones of the cornea is aviailable - 1 central, 6 paracentral and 6 peripherial.
RESULTS:Specular microscopy data showed that the CD was 2722.56±255.31 and 2832.78±300/28 in groups 1 and 2, respectively (p<0.03). The CV values were 41.98±6.88 and 41.15±5.67, respectively (p<0.08). The hexagonalitywere 45.55±75 and 48.12±5.87, respectively (p<0,024). Average was 371.60±35.65 and
353.16 ±35.29, respectively (p<0.007). The CCT values were 553.00 ±73.2, and 526.84 ± 33.57, respectively (p< 0.005). Tabl.1
Measure Measure1 Group Measure 2Group
(n=12 eyes) (n=10 eyes)
NUM 207±9,4* 281,4±14,78
CD 2713.56±35.65* 2845,80±299,27
AVG 371.60±34.65* 353,16±35,29
SD 172,8±13,3* 126,7±7,9
CV 42,92±6,79* 40,16±5,79
MAX 1266±77,1* 819,9±48,4
MIN 91,3±6,3 95,5±3,5
6A 38,1±1,9* 49,12±6,87
CCT 553.00±12,82* 526,84±33,57
Endothelial microscopy of patients with anterior uveitis in the post-Covid period allowed us to state a decrease in the number of endothelial and hexagonal cells (polymorphism), an increase in the coefficient of change in cell area (polymegatism) and the average area of corneal cells.
Higher CCT (central corneal thickness) detected in patients with anterior uveitis in the post-Covid period is due to dysfunction of endothelial cells due to impaired immune regulation and pro-inflammatory effect in the post-Covid period.
DISCUSSION
EURASIAN JOURNAL OF MEDICAL AND NATURAL SCIENCES
Innovative Academy Research Support Center UIF = 8.3 | SJIF = 7.921 www.in-academy.uz
This study aimed to compare the effects of COVID-19 on the corneal endothelium with those in normal individuals matched in terms of age and gender using specular microscopy in the early period during recovery from the disease. The corneal specular microscopic examination showed a decrease in the number of endothelial and hexagonal cells (polymorphism) and an increase in the cell area change coefficient (polymegatism) and in the average cell area. In addition, while COVID-19 patients had a lower ECD, it was found that their endothelial parameters remained within the clinically normal range.In the early stages of anterior uveitis of postcovid period, as a result of degenerative changes, a decrease in the number of endothelial cells by 26.3%, a decrease in the average density of endothelial cells by 58.5% was revealed.This allowed us to adjust treatment tactics in accordance with the results of the study and subsequently evaluate the effectiveness of treatment using endothelial microscopy.
ACKNOWLEDGEMENTS. Conflicts of Interest: Rizayeva M.A, None; Kamilov Kh.M. None.
References:
1. Asroui L, Mehanna CJ, Salloum A, Chalhoub RM, Roberts CJ, Awwad ST. Repeatability of zone averages compared to single point measurements of maximal curvature in keratoconus. Am J Ophthalmol. 2021;221(1):226
2. Duncan JK, Belin MW, Borgstrom M. Assessing progression of keratoconus: novel tomographic determinants. Eye Vis (London, England). 2016;3(1):6.
3. Grumet P, Kodjikian L, de Parisot A, Errera MH, Sedira N, Heron E, et al. Contribution of diagnostic tests for the etiological assessment of uveitis, data from ULISSE study (Uveitis: clinical and medicoeconomicevalution of a standardized strategy of the etiological diagnosis). Autoimmun Rev. 2018;17(4);331-43.
4. Zhang Y, Stewart JM. Retinal and choriodal manifestation of COVID-19. CurrOpinOphthalmol. 2021;32(6):536-40.
5. Ophthalmology AA of Corneal endothelial photography. Ophthalmology. 1991;98:1464-1468. doi: 10.1016/S0161-6420(91)32110-9. [PubMed] [CrossRef] [GoogleScholar
