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Background: Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of dryness, grittiness, redness, burning sensation or any discomfort, visual disturbance and tear film instability leading to potential damage to ocular surface. The tear film consists of three layers starting from within outwards mucus, the aqueous layer and the lipid layer. The tear film and ocular surface form a complex and stable system that can lose its equilibrium through numerous disturbing factors. Studies which also involve tests of tear functions including Schirmer’s test, Tear break-up time, Fluorescein staining for determination of dry eye have found generally low prevalence rates.Hence the physiology of tear film and its binding with the eye shows that there is some involvement of serum calcium level with dry eye. The present study encourages us to assess the role of serum calcium level with patients of dry eye. Aims and Objective: To assess the role of calcium with dry eye. Material and Methods: Total 90 subjects (30 cases and 60 controls) who met the selection criteria were included in the study. Serum analysis has been done for calcium level in the body in the patients of dry eye.The study was conducted between August 2014 to November 2016. Results: The lower serum level of calcium was significantly associated with dry eyes in the study. Conclusion: Calcium plays an important role in the causative mechanism of dry eye in the patients of dry eye disease.

Keywords

Calcium, Dry Eye, Serum Level, Tear Film.

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References

McCarty CA, Bansal AK, Livingston PM, Stanislavsky YL, Taylor HR. The epidemiologyof dry eye in Melbourne, Australia. Ophthalmogy. 1998; 105:1114–9. https://doi.org/10.1016/S0161-6420%2898%2996016-X

Moss SE, Klein R, Klein BE. Prevalence of and risk factors for dry eye syndrome. Arch Ophthalmol. 2000; 118:1264–8. https://doi.org/10.1001/archopht.118.9.1264 PMid:10980773

Brewitt H, Sistani F. Dry eye disease: The scale of the problem. Surv Ophthalmol. 2001; 45(Supp 2):S199–202. https:// doi.org/10.1016/S0039-6257%2800%2900202-2

Lapalus P, Fredj-Reygrobellet D, Delayre T. Effect of vitamin B12 on the healing of corneal wounds in the rabbit. Contactologia. 1988; 10:73–5.

Wolff E. Mucocutaneous junction of lid margin and the distribution of the tear fluid. Trans Ophthal Soc. 1946; 66:291– 308.

Plum LA, DeLuca HF. Vitamin D, disease and therapeutic opportunities. Nat Rev Drug Discov. 2010; 9:941–55. https://doi.org/10.1038/nrd3318 PMid:21119732

Adams JS, Hewison M. Extrarenal expression of the 25-hydroxyvitamin D-1-hydroxylase. Arch Biochem Biophys. 2012; 523:95–102. https://doi.org/10.1016/j.abb.2012.02.016 PMid:22446158 PMCid:PMC3361592

Alsalem JA, Patel D, Susarla R, Coca-Prados M, Bland R, Walker EA, et al. Characterization of vitamin D production by human ocular barrier cells. Invest Ophthalmol Vis Sci. 2014; 55:2140–7. https://doi.org/10.1167/iovs.13-13019 PMid:24576880

Lin Y, Ubels JL, Schotanus MP, Yin Z, Pintea V, Hammock BD, et al. Enhancement of vitamin D metabolites in the eye following vitamin D3 supplementation and UV-B irradiation. Curr Eye Res. 2012; 37:871–8. https://doi.org/1 0.3109/02713683.2012.688235 PMid:22632164 PMCid:PMC3572765

Reins RY, McDermott AM. Vitamin D: Implications for ocular disease and therapeutic potential. Exp Eye Res. 2015; 134:101–10. https://doi.org/10.1016/j.exer.2015.02.019 PMid:25724179 PMCid:PMC4426046

Yin Z, Pintea V, Lin Y, Hammock BD, Watsky MA. Vitamin D enhances corneal epithelial barrier function. Invest Ophthalmol Vis Sci. 2011; 52:7359–64. https://doi.org/10.1167/ iovs.11-7605 PMid:21715350 PMCid:PMC3183972

Schaumberg DA, Sullivan DA, Buring JE, Dana MR. Prevalence of dry eye syndrome among US women. Am J Ophthalmol. 2003; 136:318–26. https://doi.org/10.1016/S00029394%2803%2900218-6

Schaumberg DA, Dana R, Buring JE, Sullivan DA. Prevalence of dry eye disease among US men: Estimates from the Physicians’ Health Studies. Arch Ophthalmol. 2009; 127:763–68. https://doi.org/10.1001/archophthalmol.2009.103 PMid:19506195 PMCid:PMC2836718

Yazdani C, McLaughlin T, Smeeding JE, Walt J. Prevalence of treated dry eye disease in a managed care population. Clin Ther. 2001; 23:1672–82. https://doi.org/10.1016/S0149-2918%2801%2980136-3

Schein OD, Hochberg MC, Munoz B, et al. Dry eye and dry mouth in the elderly: A population-based assessment. Arch Intern Med. 1999; 159:1359–63. https://doi.org/10.1001/ archinte.159.12.1359 PMid:10386512

Munoz B, West SK, Rubin GS, et al. Causes of blindness and visual impairment in a population of older Americans: The Salisbury Eye Evaluation Study. Arch Ophthalmol 2000; 118:819–25. https://doi.org/10.1001/archopht.118.6.819 PMid:10865321

Dadaci Z, Borazan M, Kiyici A, OncelAcir N. Plasma vitamin D and serumtotal immunoglobulin E levels in patients with seasonal allergicconjunctivitis. Acta Ophthalmol. 2014; 92:443–6. https://doi.org/10.1111/aos.12398 PMid:24667068

Yildirim P, Garip Y, Karci AA, Guler T. Dry eye in vitamin D deficiency: More than an incidental association. Int J Rheum Dis. 2016; 19:49–54. https://doi.org/10.1111/1756185X.12727 PMid:26269110

Yoon SY, Bae SH, Shin YJ, Park SG, Hwang SH, Hyon JY, et al. Low serum 25-hydroxyvitamin d levels are associated with dry eye syndrome. PLoS One. 2016; 11:e0147847. https://doi.org/10.1371/journal.pone.0147847 PMid:26807908 PMCid:PMC4726745

Suzuki T, Sano Y, Kinoshita S. Effects of 1-alpha,25-dihydroxyvitamin D3 on Langerhans cell migration and corneal neovascularization in mice. Invest Ophthalmol Vis Sci. 2000; 41:154–8. PMid:10634615

Dang ST, Lu XH, Zhou J, Bai L. Effects of 1alpha, 25-dihydroxyvitamin D3 on the acute immune rejection and corneal neovascularization in high-risk penetrating keratoplasty in rats. Di Yi Jun Yi Da Xue Xue Bao. 2004; 24:892–6, 903.

Shetty R, Sethu S, Deshmukh R, Deshpande K, Ghosh A, Agrawal A, Shroff R. Corneal dendritic cell density is associated with subbasal nerve plexus features, ocular surface disease index, and serum vitamin D in evaporative dry eye disease. Biomed Res Int. 2016; 4369750. https://doi.org/10.1155/2016/4369750

Shetty R, Deshpande K, Deshmukh R, Jayadev C, Shroff R. Bowman break and subbasal nerve plexus changes in a patient with dry eye presenting with chronic ocular pain and vitamin D deficiency. Cornea. 2016 May; 35(5):688–91. https://doi.org/10.1097/ICO.0000000000000785 PMid:26890669

A Study of Ocular Fundus Findings in Hypertension during Pregnancy in a Tertiary Care Hospital

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Authors

Chetan Gaikwad ¹, Ajit Khune ², Sanjay Mahadik ³, Dhiraj Balwir ⁴

Affiliations
1 Former PG Resident, Department of Ophthalmology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
2 Associate Professor, Department of Ophthalmology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
3 Senior Resident, Department of Ophthalmology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN
4 Professor and Head, Department of Ophthalmology, Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik – 422003, Maharashtra, IN

Source

MVP Journal of Medical Sciences, Vol 8, No 2 (2021), Pagination: 163-170

Abstract

Introduction: Hypertension is one of the most common medical disorders during pregnancy, affecting 6-8% of all pregnancies. Around 16-25% of 1st pregnancy &12-15% of subsequent pregnancies8 . Ocular fundus changes are found in 40% to 100% of pregnant women with raised blood pressure, whose severity correlates with pre-eclampsia or eclampsia. In hypertensive disorders in pregnancy, ophthalmic manifestations include conjunctival vasculopathy, hypertensive retinopathy, exudative retinal detachment, hypertensive choroidopathy. The retina is involved due to the basic pathology of vasospasm and increased capillary permeability, the consequences of vascular endothelial dysfunction. Rare complications were reversible cortical blindness, and extra-ocular muscle palsy have been documented. Methodology: The present study was conducted in the Outpatient Department (OPD) of Ophthalmology at Dr. Vasantrao Pawar Medical College, Hospital and Research Centre, Nashik , Maharashtra. All the 182 cases included in this study underwent indirect ophthalmoscopy during the study period of 2 years (August 2018 to December 2020). Patients were collected from ANC clinic of department of obstetrics and Gynaecology OPD. Results: Prevalence of abnormal fundus findings was 10.1% in grade I hypertension while it was 100% in cases with grade II and III hypertension. A significant association was observed between severity of hypertension and abnormal fundus findings (p0.05). Conclusion: As these vascular changes in the retina usually correlate with the severity of the systemic hypertension, the eyes can truly be considered a mirror to the otherwise elusive vascular changes occurring elsewhere in the body. It thus stands to reason that observing the retinal changes holds the ability to prognosticate and also determine the severity of the disease. Fundoscopy is an essential investigation that needs to be done in all cases of hypertensive disorders of pregnancy with special emphasis in younger and primigravida women.

Keywords

Conjunctival Vasculopathy, Fundus, Hypertension, Ocular, Pregnancy

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References

Erem C, Hacihasanoglu A, Kocak M, Deger O, Topbas M. Prevalence of prehypertension and hypertension and associated risk factors among Turkish adults: Trabzon Hypertension Study. J. Public Health. 1 Mar 2009; 31(1):47–58. https://doi.org/10.1093/pubmed/fdn078

Ahmed A, Rahman M, Hasan R, Shima SA, Faruquee MH, Islam T, Haque SE. Hypertension and associated risk factors in some selected rural areas of Bangladesh. Int J Res Med Sci. Jul 2014; 2(3):925. https://doi.org/10.5455/23206012.ijrms20140816

Mishra CP, Kumar S. Risk factors of hypertension in a rural area of Varanasi. Indian Journal of Preventive and Social Medicine. Jan 2011; 42(1):101–11.

Abebe SM, Berhane Y, Worku A, Getachew A. Prevalence and associated factors of hypertension: a crossectional community-based study in Northwest Ethiopia. PloS one.24 Apr 2015; 10(4):e0125210. https://doi.org/10.1371/journal.pone.0125210

Mendis S, Armstrong T, Bettcher D, Branca F, Lauer J, Mace C. World Health Organisation; 2010. Global status report on non-communicable diseases 2010. World Health Organization http://www.who. int/nmh/publications/ncd_ report2010/en. 2014.

Tabrizi JS, Sadeghi-Bazargani H, Farahbakhsh M, Nikniaz L, Nikniaz Z. Prevalence and associated factors of prehypertension and hypertension in Iranian population: the Lifestyle Promotion Project (LPP). PloS one. 26 Oct 2016; 11(10):e0165264. https://doi.org/10.1371/journal. pone.0165264

Iqbal AM, Jamal SF. Essential Hypertension. In Stat Pearls [Internet] 1 Dec 2019. Stat Pearls Publishing.

Nelson-Piercy C. Handbook of obstetric medicine. CRC press; 26 Aug 2020. https://doi.org/10.1201/9780429330766

Mackensen F, Paulus WE, Max R, Ness T. Ocular changes during pregnancy. Deutsches Ärzteblatt International. Aug 2014; 111(33–34):567. https://doi.org/10.3238/arztebl.2014.0567

Dieckmann WJ. Toxemias of pregnancy.

Hughes EC. Obstetric-gynecologic terminology.

Philadelphia: FA Davis. 1972; 422:423.

Davey DA, MacGillivray I. The classification and definition of the hypertensive disorders of pregnancy. Am. J.

Obstet. Gynecol. 1 Apr 1988; 158(4):892–8. https://doi.

org/10.1016/0002-9378(88)90090-7

Bakhda RN. Ocular manifestations of Pregnancy induced Hypertension. The Official Scientific Journal of Delhi Ophthalmological Society. 30 Sep 2015; 26(2):88–92.

https://doi.org/10.7869/djo.144

A System of Ophthalmology. Vol. V. Ophthalmic Optics and Refraction. Br J Ophthalmol. 1970; 54(12):827–827. DukeElder S. System of ophthalmology V. Ophthalmic optics & refraction. 1970. https://doi.org/10.1136/bjo.54.12.827

Karki P, Malla P, Das H, Uprety DK. Association between pregnancy-induced hypertensive fundus changes and fetal outcomes. Nepal. J Ophthalmol. 2010; 2(1):26–30. https:// doi.org/10.3126/nepjoph.v2i1.3700

Bharathi RN et al. Fundus changes in pregnancy induced hypertension: a clinical study. JEMDS. 2015; 4(9):1552– 1562. https://doi.org/10.14260/jemds/2015/217

Sharma JC, Choudhary B, Maru L, Mathur P. The retina in hypertensive disorders of pregnancy: a study of the prevalence and association with severity of disease in a tertiary referral centre in India. Int J Reprod Contracept ObstetGynecol 2020; 9:375–82. https://doi.org/10.18203/2320-1770.ijrcog20196051

Varija T, Vanaja D, Sindhura, Raghavenda B. A study of prevalence and association of fundus changes in pregnancy induced hypertension. Int J Reprod Contracept Obstet Gynecol 2016; 5:1375–9. https://doi.org/10.18203/23201770.ijrcog20161289

Reddy SC, Nalliah S, George SRA, Who TS. Fundus changes in pregnancy induced hypertension. Int J Ophthalmol. 18 Dec 2012; 5(6): 694–7.

Shah AP, Lune AA, Magdum RM, Deshpande H, Shah AP, Bhavsar D. Retinal changes in pregnancy-induced hypertension. Med J DY Patil Univ 2015; 8:304–7. https://doi.

org/10.4103/0975-2870.157067

Sudha R, Moizuddin MD, Kavya SSK, Sulaiman A. Study of prevalence of fundus changes in pregnancy induced hypertension in a teaching hospital. Indian J Clin Exp Ophthalmol 2019; 5(2):215–8. https://doi.org/10.18231/j.

ijceo.2019.051

Tadin I, Bojić L, Mimica M, Karelović D, Đogaš Z.

Hypertensive retinopathy and pre-eclampsia. Collegium antropologicum. 23 Jul 2001; 25(1):77–81.

Karki P, Malla KP, Das H, Uprety DK. Association between pregnancy induced hypertensive fundus changes and fetal outcome. Nepal J Ophthalmol. 2010; 2(1):26–30. https:// doi.org/10.3126/nepjoph.v2i1.3700

Kurdoğlu Z, Kurdoğlu M, Ay EG, Yaşar T. Retinal findings in cases of preeclampsia. Perinatal Journal. 2011; 19(2):60– 3. https://doi.org/10.2399/PRN.11.0192003

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