Browsing by Author "Hamrah, Pedram"

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    Contralateral clinically unaffected eyes of patients with unilateral infectious keratitis demonstrate a sympathetic immune response
    (2015) Cruzat Corssen, Andrea; Schrems, Wolfgang A.; Schrems-Hoesl, Laura M.; Cavalcanti, Bernardo M.; Baniasadi, Neda; Witkin, Deborah; Pavan-Langston, Deborah; Dana, Reza; Hamrah, Pedram
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    Corneal epithelial immune dendritic cell alterations in subtypes of dry eye disease : a pilot in vivo confocal microscopic study
    (2015) Kheirkhah, Ahmad; Darabad, Raheleh Rahimi; Cruzat Corssen, Andrea; Reza Hajrasouliha, Amir; Witkin, Deborah; Wong, Nadia; Dana, Reza; Hamrah, Pedram
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    Corneal nerve regeneration is affected by scar location in herpes simplex keratitis: A longitudinal in vivo confocal microscopy study
    (2023) Posarelli, Matteo; Chirapapaisan, Chareenun; Müller, Rodrigo; Abbouda, Alessandro; Pondelis, Nicholas; Cruzat Corssen, Andrea; Cavalcanti, Bernardo M.; Cox, Stephanie M.; Jamali, Arsia; Pavan-Langston, Deborah; Hamrah, Pedram
    Purpose: To assess the effect of corneal scar location on corneal nerve regeneration in patients with herpes simplex virus (HSV) keratitis in their affected and contralateral eyes over a 1-year period by in vivo confocal microscopy (IVCM), and to correlate these findings to corneal sensation measured by Cochet-Bonnet Esthesiometer. Methods: Prospective, longitudinal, case-control study. Bilateral corneal nerve density and corneal sensation were analyzed centrally and peripherally in 24 healthy controls and 23 patients with unilateral HSV-related corneal scars using IVCM. Results: In the central scar (CS) group, total nerve density in the central cornea remained significantly lower compared to controls at follow-up (11.05 ± 1.97mm/mm2, p < 0.001), and no significant nerve regeneration was observed (p = 0.090). At follow-up, total nerve density was not significantly different from controls in the central and peripheral cornea of the peripheral scar (PS) group (all p > 0.05), but significant nerve regeneration was observed in central corneas (16.39 ± 2.39mm/mm2, p = 0.007) compared to baseline. In contralateral eyes, no significant corneal nerve regeneration was observed in central or peripheral corneas of patients with central scars or peripheral scars at 1-year follow-up, compared to baseline (p > 0.05). There was a positive correlation between corneal nerve density and sensation in both central (R = 0.53, p < 0.0001) and peripheral corneas (R = 0.27, p = 0.0004). In the CS group, the corneal sensitivity was <4 cm in 4 (30.8%) and 7 (53.8%) patients in the central and peripheral corneas at baseline, and in 5 (38.5%) and 2 subjects (15.4%) at follow-up, whereas in the PS group only 1 patient (10%) showed a corneal sensation < 4 cm in the central cornea at baseline, and only 1 (10.0%), 3 (30.0%) and 1 (10.0%) patients at follow-up in the central, affected and opposite area of the cornea, respectively. Conclusion: The location of HSV scarring in the cornea affects the level of corneal nerve regeneration. Eyes with central corneal scar have a diminished capacity to regenerate nerves in central cornea, show a more severe reduction in corneal sensation in the central and peripheral corneas that persist at follow-up, and have a reduced capability to restore the corneal sensitivity above the cut-off of 4 cm. Thus, clinicians should be aware that CS patients would benefit from closer monitoring for potential complications associated with neurotrophic keratopathy, as they have a lower likelihood for nerve regeneration.
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    Correlation of corneal immune cell changes with clinical severity in dry eye disease: An in vivo confocal microscopy study
    (2021) Aggarwal, Shruti; Kheirkhah, Ahmad; Cavalcanti, Bernardo M.; Cruzat, Andrea; Jamali, Arsia; Hamrah, Pedram
    Purpose: To evaluate corneal immune dendritiform cell (DC) changes in dry eye disease (DED) using in vivo confocal microscopy (IVCM) and to correlate IVCM parameters with clinical severity.
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    Density and distribution of dendritiform cells in the peripheral cornea of healthy subjects using in vivo confocal microscopy
    (2022) Akhlaq, Anam; Colon, Clara; Cavalcanti, Bernardo M.; Aggarwal, Shruti; Qazi, Yureeda; Cruzat, Andrea; Jersey, Candice; Critser, Douglas B.; Watts, Amy; Beyer, Jill; Sindt, Christine W.; Hamrah, Pedram
    Purpose: To establish in a large healthy cohort, dendritiform cell (DC) density and morphological parameters in the central and peripheral cornea using in vivo confocal microscopy (IVCM).Methods: A prospective, cross-sectional, observational study was conducted in 85 healthy volunteers (n = 85 eyes). IVCM images of corneal center and four peripheral zones were analyzed for DC density and morphology to compare means and assess correlations (p < 0.05 being statistically significant).Results: Central corneas had lower DC density (40.83 +/- 5.14 cells/mm(2); mean +/- SEM) as compared to peripheral corneas (75.42 +/- 2.67 cells/mm(2), p < 0.0001). Inferior and superior zones demonstrated higher DC density (105.01 +/- 7.12 and 90.62 +/- 4.62 cells/mm(2)) compared to the nasal and temporal zones (59.93 +/- 3.42 and 51.77 +/- 2.98 cells/mm(2), p < 0.0001). Similarly, lower DC size, field and number of dendrites were observed in the central as compared to the average peripheral cornea (p < 0.0001), with highest values in the inferior zone (p < 0.001 for all, except p < 0.05 for number of dendrites in superior zone). DC parameters did not correlate with age or gender. Inter-observer reliability was 0.987 for DC density and 0.771-0.922 for morphology.Conclusion: In healthy individuals, the peripheral cornea demonstrates higher DC density and larger morphology compared to the center, with highest values in the inferior zone. We provide the largest normative cohort for sub -stratified DC density and morphology, which can be used in future clinical trials to compare differential changes in diseased states. Furthermore, as DC parameters in the peripheral zones are dissimilar, random sampling of peripheral cornea may be inaccurate.