Corneal blindness in Plato’s cave: the acting forces to prevent and revert corneal opacity. Part I: epidemiology and new physiopathological concepts

Barbosa, Amanda Pires; Alves, Monica; Furtado, João Marcello Fortes; Adriano, Leidiane; Nominato, Luis Fernando; Dias, Lara Cristina; Fantucci, Marina Zilio; Murashima, Adriana de Andrade Batista; Rocha, Eduardo Melani

doi:10.5935/0004-2749.20200102

Amanda Pires Barbosa

Research Core in Ocular Physiopathology and Therapeutics and Department of Ophthalmology, Otorhinolaryngology and Head & Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

Monica Alves

Department of Ophthalmology and Otorhinolaryngology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.

http://orcid.org/0000-0001-7940-0194

João Marcello Fortes Furtado

Research Core in Ocular Physiopathology and Therapeutics and Department of Ophthalmology, Otorhinolaryngology and Head & Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

Leidiane Adriano

Research Core in Ocular Physiopathology and Therapeutics and Department of Ophthalmology, Otorhinolaryngology and Head & Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

http://orcid.org/0000-0002-3637-7307

Luis Fernando Nominato

Research Core in Ocular Physiopathology and Therapeutics and Department of Ophthalmology, Otorhinolaryngology and Head & Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

Lara Cristina Dias

Research Core in Ocular Physiopathology and Therapeutics and Department of Ophthalmology, Otorhinolaryngology and Head & Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

Marina Zilio Fantucci

Research Core in Ocular Physiopathology and Therapeutics and Department of Ophthalmology, Otorhinolaryngology and Head & Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

Adriana de Andrade Batista Murashima

Research Core in Ocular Physiopathology and Therapeutics and Department of Ophthalmology, Otorhinolaryngology and Head & Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

Eduardo Melani Rocha Corresponding author: Eduardo Melani Rocha. E-mail: emrocha@fmrp.usp.br

Research Core in Ocular Physiopathology and Therapeutics and Department of Ophthalmology, Otorhinolaryngology and Head & Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

Corresponding author: Eduardo Melani Rocha. E-mail: emrocha@fmrp.usp.br

Disclosure of potential conflicts of interest: None of the authors have any potential conflicts of interest to disclose.

Type of prevention	Description	Effects	Author, year
Individual	Seatbelt use and air bags in automobile transportation	Reducing the severity and the grade of visual loss by ocular trauma in car accidents	Rao SK et al, 2008(49)
	Standard specifications for eye protective devices at work and during sportive activities	Significant reduction in eye injuries, face, and head attachments due to impact or penetration of a paintball	Tseng VL, et al, 2014(50)
	Ocular prophylaxis with 1% silver nitrate, 0.5% erythromycin ointment, or 1% tetracycline hydrochloride to all newborns	Reduction of gonorrheal ophthalmia neonatorum incidence	Paediatr Child Health, 2002(51)
Collective	Legislation for the control of fireworks use	Reduction in the frequency of eye injuries in states in the USA with a “Model Law” banning all fireworks, except those used in public displays	Kuhn F, 2010(52)
	Vitamin A distribution, breastfeeding promotion, food fortification, and counseling regarding dietary changes	Reduction of keratomalacia incidence	Oliva MS et al, 2012(53)
	Ivermectin widespread distribution	Reduction in the incidence of onchocerciasis in endemic areas	Kim YE et al, 2015(54)
	SAFE plan	Reduction in the frequency of trachoma and parallel rates of corneal blindness due to trachoma	Travers A et al, 2013(55)

	Topic	Observation	Authors
1	Avascularity	Active mechanism of corneal vascularity inhibition	Ambati et al, 2006,
1	Avascularity	Active mechanism of corneal vascularity inhibition	Ferrari e t al, 2013⁽⁶⁶66 Bonini S, Rama P, Olzi D, Lambiase A. Neurotrophic keratitis. Eye (Lond). 2003;17(8):989-95.^,⁸²82 Bourne WM. The effect of long-term contact lens wear on the cells of the cornea. CLAO J. 2001;27(4):225-30.⁾
2	Sensitivity	Ion channels with distinct sensorial and repair responses in different corneal layers	Zhang et al, 2007 and Okada et al 2013⁽⁷¹71 Obata H, Tsuru T. Corneal wound healing from the perspective of keratoplasty specimens with special reference to the function of the Bowman layer and Descemet membrane. Cornea. 2007;26(9 Suppl 1):S82-9.^,⁷⁵75 Pan Z, Wang Z, Yang H, Zhang F, Reinach PS. TRPV1 activation is required for hypertonicity-stimulated inflammatory cytokine release in human corneal epithelial cells. Invest Ophthalmol Vis Sci. 2011;52(1):485-93.⁾
3	Structure	A dua membrane protects the deep cornea	Dua et al, 2013⁽⁶¹61 Dua HS, Said DG. Clinical evidence of the pre-Descemets layer (Dua’s layer) in corneal pathology. Eye (Lond). 2016;30(8):1144-5.⁾
4	Inflammation	Interchangeable effect of damage to the inner face of the cornea on the ocular surface	Uchino et al, 2006⁽⁸²82 Bourne WM. The effect of long-term contact lens wear on the cells of the cornea. CLAO J. 2001;27(4):225-30.⁾
5	Epithelial stem cells	Mechanisms of corneal epithelial replacement based on the limbal niche of stem cells	Tseng & Tsubota, 1997, Dua et al, 2005⁽⁵⁹59 Dawson DG, Watsky MA, Geroski DH, Edelhouser HF. Cornea and sclera. In: Tasman W, Jaeger EA, editors. Duane’s ophthalmology. Philadelphia: Lippincott Willians and Wilkins; 2008. p. 75.^,⁸⁷87 Echevarria TJ, Di Girolamo N. Tissue-regenerating, vision-restoring corneal epithelial stem cells. Stem Cell Rev Rep. 2011;7(2):256-68.⁾

	Limitations	Analysis	Authors
1	Limited availability of corneal donation for transplants	Estimated 180,000 keratoplasties/year for an estimated total of 16 million people with corneal blindness	Pascolini & Mariotti 2012, Gian et al., 2016⁽⁹9 Pascolini D, Mariotti SP. Global estimates of visual impairment: 2010. Br J Ophthalmol. 2012;96(5):614-8.^,¹⁰⁰100 Garg P, Krishna PV, Stratis AK, Gopinathan U. The value of corneal transplantation in reducing blindness. Eye (Lond). 2005;19(10):1106-14.⁾
2	Limited survival of corneal transplants compared to the patients’ life expectancies	The corneal transplant survival is around 12 years, and the average life expectancy for patients is longer	Tan et al, 2008, and Kontis et al, 2017⁽¹⁰²102 Coster DJ, Williams KA. The impact of corneal allograft rejection on the long-term outcome of corneal transplantation. Am J Ophthalmol. 2005;140(6):1112-22.^,¹⁰⁵105 Al-Swailem SA. Graft failure: II. Ocular surface complications. Int Ophthalmol. 2008;28(3):175-89.⁾

[1] Corresponding author: Eduardo Melani Rocha. E-mail: emrocha@fmrp.usp.br

Brasil

Brasil

Corneal blindness in Plato’s cave: the acting forces to prevent and revert corneal opacity. Part I: epidemiology and new physiopathological concepts

A cegueira corneal na caverna de Platão: as forças para prevenir e reverter a opacidade da córnea. Parte I: epidemiologia e novos conceitos na fisiopatologia

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