OBJECTIVE: To evaluate the intraoperative central corneal epithelial thickness (ET) as measured by optical coherence pachymetry (OCP) in myopic eyes undergoing alcohol-assisted photorefractive keratectomy (PRK).
METHODS: A retrospective review of patients who underwent alcohol-assisted PRK was performed. Data were abstracted on age, gender, contact lens (CL) wear, preoperative refractive errors, keratometry, topographic and ultrasonic pachymetry, and intraoperative OCP measurements before and after epithelium removal. The central ET was calculated by subtracting OCP measurement after epithelium removal from the OCP measurement prior to epithelium removal.
RESULTS: The study comprised of 162 consecutive eyes from 81 patients. Mean age was 26.73 ± 6.47 years, 50.6% were males. CL was used in 92 eyes (56.8%). The mean sphere and spherical equivalent were -3.60 ± 1.84 D and -3.26 ± 1.85D, respectively. The mean intraoperative ET was 58.22 ± 17.53 µm (range, 15-121µm). Fifty-five percent of the eyes had an ET measurement above or below the range of 40-60µm. ET was significantly higher in the second operated eye compared to the first operated eye (p = 0.006), and an association was found to CL-wear (p = 0.03). There was no significant difference in thickness between genders (p = 0.62), and no correlation to patient age (p = 0.45, rp = 0.06), refractive errors (p > 0.30,rp=-0.07-0.08), nor keratometry(p > 0.80, rp=-0.01- (-0.02)).
CONCLUSIONS: The intraoperative assessment of ET in alcohol-assisted PRK showed a high variability of the central corneal epithelium, with a significant difference between the first and second operated eyes. This difference may have implications when the epithelium is not included in the surgical planning in surface ablation.

Increased tissue rigidity is able to activate the Hippo signaling pathway, leading to YAP inactivation by phosphorylation and translocation into the cytoplasm. Accumulating evidence suggests that cytoplasmic pYAP serves as a tumor suppressor and could be a prognostic biomarker for several solid cancers. However, the relationship between tissue rigidity and cytoplasmic pYAP expression in the early stage of lung squamous cell carcinoma (SCC) remains elusive; this was determined in this study by using a mouse model. Female BALB/c mice were assigned into two groups (n = 6; the vehicle (VC) and the pre-malignant (PM) group, which received 70% acetone and 0.04 M N-nitroso-tris-chloroethylurea (NTCU) for 15 weeks, respectively. In this study, the formation of hyperplasia and metaplasia lesions was found in the PM group, indicating the pre-malignant stage of lung SCC. The pre-malignant tissue appeared to be more rigid as characterized by significantly higher (p < 0.05) epithelium thickness, proliferative activity, and collagen content than the VC group. The PM group also had a significantly higher (p < 0.05) cytoplasmic pYAP protein expression than the VC group. In conclusion, increased tissue rigidity may contribute to the upregulation of cytoplasmic pYAP expression, which may act as a tumor suppressor in the early stage of lung SCC.

UNASSIGNED: To study the corneal epithelial thickness with 9-mm scans of optical coherence tomography in normal Indians with appropriate representation of all age groups.
UNASSIGNED: This was a cross-sectional observational study. 263 patients were divided into the age groups 5-20 years, 21-35 years, 36-50 years and more than 51 years were recruited for the study. All patients underwent a detailed ophthalmic examination. Patients found to have any ocular surface or intraocular disease condition (except cataract and refractive error), or who had undergone any ophthalmic surgery in the past, or had corneal topography changes suggestive of corneal ectasias (screened in patients with astigmatism more than 3 diopters) or had been continuously using any topical medication in either eye for a period of 3 months or more with the last instillation being within 1 month of inclusion in the study were excluded. All subjects underwent corneal epithelial thickness measurement with anterior segment optical coherence tomography (AS-OCT) on the Avanti OCT (Model RTVueXR1002, Optovue, USA). The corneal epithelial thickness (CET) data from 25 sectors in each eye were analyzed.
UNASSIGNED: 263 right and left eyes of 263 patients were analyzed in the study. Mean CETs in the central 2 mm zone were 54.13 ± 4.51 μm and 54.37 ± 3.75 μm for the right and left eyes, respectively. The superior peripheral sectors and inferior paracentral sectors were the thinnest and the thickest sectors, respectively, in both eyes.
UNASSIGNED: CET parameters for Indian eyes are comparable to those reported from racially distinct and geographically distant study subjects.

OBJECTIVE: It has long been known that the spermatogenic tissue is very sensitive to temperatures higher than its physiologic temperature and causing cessation of activity and resulting in sterility. This study investigated the effect of a standardized 40% ellagic acid extract of pomegranate on the histopathology, diameter, and epithelial thickness of seminiferous tubules in albino rats exposed to heat.
METHODS: Twenty-five male albino Wistar rats were randomized at 7-8 months of age to five treatment groups. Group C was not treated; Group T0 was treated with 0.5% of Na carboxymethyl cellulose (CMC) 2 ml/day and exposed to heat. T1, T2, and T3 were treated with 75, 150, and 300 mg/kg/day of a standardized 40% ellagic acid extract of pomegranate (Punica granatum L.), respectively. The animals were orally administered Na CMC or pomegranate extract and were exposed to sunlight for 15 min at 40°C-42°C for 14 days. The animals were sacrificed on day 15 and the testes were removed for histological evaluation and measurement of seminiferous tubule diameter and epithelium thickness.
RESULTS: The diameter of seminiferous tubules from rats exposed to heat and treated with 300 mg/kg/day pomegranate extract was larger and the epithelia thicker than those in the other groups (p<0.05). The protective effects of the standardized 40% ellagic acid extract may have been mediated by its antioxidant activity.
CONCLUSIONS: Compared with controls, administration of 300 mg/kg/day of a standardized 40% ellagic acid extract of P. granatum L. for 14 days increased seminiferous tubule diameter and epithelium thickness in albino Wistar rats exposed to heat.

The measurement of regional corneal epithelial thickness and characterization of its behavior in response to changes in corneal architecture are increasingly drawing interest in clinical practice. The epithelium has tremendous capacity for remodeling and does so in response to underlying stromal pathology or changes in anterior corneal curvature. Various remodeling patterns have been identified that help distinguish between ectatic and nonectatic corneal conditions. Epithelial mapping has also facilitated more precise, individualized corneal surface disorder treatments. We highlight the different imaging modalities for epithelium measurement, epithelial remodeling patterns in ectatic disorders and after corneal refractive surgery, discuss utility of epithelial measurement in therapeutic refractive surgery planning, and discuss controversies that exist regarding epithelial remodeling, including its mechanisms and its relative importance in surgical planning and screening evaluations.

Vulvo-vaginal atrophy affects the daily lives of most post-menopausal women. We know that ospemifene intake can induce vaginal epithelial improvements within a few weeks; however, direct evidence of the effects of ospemifene on the human vulva and on connective tissue of both the vagina and vulva are lacking.
To evaluate the changes induced by ospemifene on epithelium thickness, glycogen content proliferation index, collagen content, and type I/III collagen ratio in vulvar and vaginal tissue of post-menopausal women.
20 women who attended our gynecologic clinic for planned surgery were recruited for the study. 11 subjects were taking ospemifene at the time of inclusion, and 9 subjects who were not taking ospemifene were selected as control group. Vaginal and vulvar biopsies were taken during surgery. Histological features and glycogen content were evaluated by standard hematoxylin-eosin and periodic acid-Schiff staining, total collagen and collagen type I/III ratio were evaluated by hydroxyproline assay and Sirius red staining, while the expression of Ki67 was evaluated by immunohistochemistry.
We analyzed histological features of the epithelial and stromal layer of the vaginal and vulvar vestibule mucosa.
Vaginal and vulvar biopsies from women taking ospemifene showed an increased epithelium thickness, glycogen content, and proliferation index compared with the control group. Collagen content was also higher in women taking ospemifene, while an increased ratio between type I and III collagen fibers was found only at vaginal level.
Our study shows that the effectiveness of ospemifene on vaginal tissue also extends to the vulvar vestibule.
This study provides direct evidence of the impact of ospemifene on vaginal and vulvar tissue. A specifically designed longitudinal study may further support our findings.
Ospemifene intake is associated with a marked improvement of various morphological and physiological features of both vaginal and vulvar vestibule epithelium, including the collagen content of the tissues. Alvisi S, Baldassarre M, Gava G, et al. Structure of Epithelial and Stromal Compartments of Vulvar and Vaginal Tissue From Women With Vulvo-Vaginal Atrophy Taking Ospemifene. J Sex Med 2018;15:1776-1784.

Our aim was to examine the associations between the cornea morphological parameters, endothelial cell density, and anterior chamber measurements.
This observational study included 50 eyes of 50 healthy volunteers. The thicknesses of corneal epithelium, Bowman\'s layer, stroma, Descemet\'s membrane-endothelium complex, and pre-ocular tear film were measured by means of anterior segment optical coherence tomography. The keratometry (K), corneal volume (CV), corneal optical densitometry (COD), iridocorneal angle (ICA), anterior chamber depth (ACD), and anterior chamber volume (ACV) measurements were taken by the Scheimpflug anterior segment imaging. The corneal endothelial cell density and percentage of hexagonality were measured by specular microscopy.
The COD was only correlated with the thickness of Bowman\'s layer (r = -0.30, p = 0.035). The hexagonal endothelial cell percentage was correlated with the thickness of the pre-ocular tear film (r = -0.50, p < 0.001), ACD (r = 0.40, p = 0.004), and ACV (r = 0.34, p = 0.015). The corneal epithelium thickness was associated with the ACD (r = 0.30, p = 0.034), ACV (r = 0.34, p = 0.018), K-flat (r = -0.35, p = 0.013), and K-steep (r = -0.29, p = 0.038) readings.
The anterior chamber morphological parameters (i.e., ACV, ACD) were significantly positively correlated with the hexagonal endothelial cell percentage and corneal epithelium thickness in healthy adults.

OBJECTIVE: To measure the palpebral conjunctival epithelium thickness in young adults with optical coherence tomography (OCT).
METHODS: A Cirrus HD-OCT 4000 system was used to image the superior palpebral conjunctival with the Anterior Segment 5 Line Raster scanning protocol at the central region in 36 male and 26 female subjects aged between 20 and 30 years of age with normal, healthy eyes. The palpebral conjunctival epithelium thickness was measured according to the difference in brightness on OCT between the epithelium and its underlying substantia propria. The measurements were respectively performed in the same subjects by two operators and the Bland-Altman plot and intraclass correlation coefficient (ICC) were used to measure the agreement between two operators.
RESULTS: No difference in the palpebral conjunctival epithelium thickness was found between the males (34.00±5.78 μm) and females (33.67±4.51 μm) (t=0.2425, p=0.8095). The mean values of the superior palpebral conjunctival epithelium thickness from operator 1 and operator 2 were 33.81±5.04 μm and 34.74±4.28 μm, respectively. The analysis of inter-operator variability demonstrated a good agreement between two operators: ICC=0.944, F=17.787, p<0.001; on the Bland-Altman plot, the 95% limits included 100% of differences between the two operators and the maximal difference is 5 μm.
CONCLUSIONS: The palpebral conjunctival epithelium thickness can be measured using OCT with a good repeatability.