Introduction: Patients suffering from limbal stem cell deficiency have a variety of symptoms ranging from hard-to-heal epithelial defects and recurrent corneal erosions to corneal vascularization and conjunctivalization, reduced visual acuity, photophobia, foreign body sensation, tearing, blepharospasm, and recurrent episodes of pain.
Aim: The aim of the present study is to evaluate subjective symptoms in patients with limbal stem cell deficiency.
Materials and Methods: The study included 64 patients with limbal stem cell deficiency, whose subjective signs of pain, photophobia, redness, tearing were evaluated using a questionnaire. The results were processed with SPSS v. 20 for Windows using variation, comparison and correlation analyses.
Results and Discussion: An important part of the discomfort of patients, regardless of the type of the illness, is the pain that affects their psycho-emotional state. The best pain response was found in eye diseases, wearing contact lenses, dry eye, iatrogenic factors and eye surgery. A significant part of the patients (61%) complained of photophobia in the absence of light or medium illumination. After being treated, the percentage dropped to 15.6%. In our sample, before treatment, 54.7% of the patients complained of moderate to severe redness. After the treatment, this number fell to 9.4%. In 59.4% of the individuals redness was missing or slightly present. Prior to treatment, the most severe redness was found in patients with chemical/thermal burns (44.4%) followed by those with injuries (34.5%). The appearance of secretion did not change significantly, which we think is due to the relocation of the patients from the group of those with a puruloid secretion to the previous group, that with the appearance of clear secretion only.
Conclusion: The assessment of subjective symptomatology and visual function in patients with limbal stem cell deficiency showed that the greatest effect was observed in pain followed by photophobia, which was greatly reduced after treatment with amniotic membrane transplantation and the symptoms were minimized as well
Afsharkhamseh N, Movahedan A, Gidfar S, Huvard M, Wasielewski L, Milani BY, et al. Stability of limbal stem cell deficiency after mechanical and thermal injuries in mice. Exp Eye Res. 2016;145:88–92. doi: 10.1016/j.exer.2015.11.012.
Di Girolamo N, Bobba S, Raviraj V, Delic NC, Slapetova I, Nicovich PR, et al. Tracing the fate of limbal epithelial progenitor cells in the murine cornea. Stem Cells Dayt Ohio. 2015;33(1):157–69.
Ebato B, Friend J, Thoft RA. Comparison of central and peripheral human corneal epithelium in tissue culture. Invest Ophthalmol Vis Sci. 1987;28(9):1450–6.
Lehrer MS, Sun TT, Lavker RM. Strategies of epithelial repair: modulation of stem cell and transit amplifying cell proliferation. J Cell Sci. 1998;111 (Pt 19):2867–75.
Tseng SC, Zhang SH. Limbal epithelium is more resistant to 5-fluorouracil toxicity than corneal epithelium. Cornea. 1995;14 (4): 394–401.
Tseng SC. Regulation and clinical implications of corneal epithelial stem cells. Mol Biol Rep. 1996; 23(1):47–58.
Kurpakus MA1, Maniaci MT, Esco M. Expression of keratins K12, K4 and K14 during development of ocular surface epithelium. Curr Eye Res. 1994;13(11):805-14. doi: 10.3109/02713689409025135.
Davanger M, Evensen A. Role of the pericorneal papillary structure in renewal of corneal epithelium. Nature. 1971;229(5286):560–1.
Goldberg MF, Bron AJ. Limbal palisades of Vogt. Trans Am Ophthalmol Soc. 1982; 80:155-71.
Townsend WM. The limbal palisades of Vogt. Trans Am Ophthalmol Soc. 1991; 89:721–56.
Watt FM, Hogan BL. Out of Eden: stem cells and their niches. Science. 2000;287(5457):1427–30.
Dua HS, Shanmuganathan VA, Powell-Richards AO, Tighe PJ, Joseph A. Limbal epithelial crypts: a novel anatomical structure and a putative limbal stem cell niche. Br J Ophthalmol. 2005;89(5):529–32. doi: 10.1136/bjo.2004.049742.
Shanmuganathan VA, Foster T, Kulkarni BB, Hopkinson A, Gray T, Powe DG, et al. Morphological characteristics of the limbal epithelial crypt. Br J Ophthalmol. 2007;91(4): 514–9. doi: 10.1136/bjo.2006.102640.
Budak MT, Alpdogan OS, Zhou M, Lavker RM, Akinci MA, Wolosin JM. Ocular surface epithelia contain ABCG2-dependent side population cells exhibiting features associated with stem cells. J Cell Sci. 2005;118(Pt 8):1715-24. doi:10.1242/jcs.02279.
de Paiva CS, Chen Z, Corrales RM, Pflugfelder SC, Li DQ. ABCG2 transporter identifies a population of clonogenic human limbal epithelial cells. stem cells. Stem Cells. 2005;23(1):63-73. doi:10.1634/stemcells.2004-0093.
Beebe DC, Masters BR. Cell lineage and the differentiation of corneal epithelial cells. Invest Ophthalmol Vis Sci. 1996;37(9):1815-25.
Chen JJ, Tseng SC. Corneal epithelial wound healing in partial limbal deficiency. Invest Ophthalmol Vis Sci. 1990;31(7):1301–14.
Tseng SC. Concept and application of limbal stem cells. Eye Lond Engl. 1989;3 (Pt 2):141–57.
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