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Questions and Answers
What was the outcome at the end of three months after the use of amniotic membrane graft?
Which of the following is a primary application of human amniotic membrane transplantation?
What does the reference by Malhotra C and Jain AK focus on?
What is indicated by the term 'serial photographs' in the context of amniotic membrane graft study?
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What is a key advantage of using human amniotic membrane in ophthalmology?
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What aspect of amniotic membrane grafts was particularly noted after three months?
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Which of the following best describes the duration for observing the results of the amniotic membrane graft?
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What occurs during the latent phase of corneal wound healing?
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Which factor plays a significant role in the proliferation phase of corneal wound healing?
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What is a key reason for using amniotic membrane in corneal treatments?
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During which phase do cells firmly adhere to the basement membrane?
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What is NOT a component found in amniotic membrane?
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Which condition is NOT typically treated with an amniotic membrane?
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What is a major consequence of severe chronic inflammation in corneal scarring?
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What is the role of antimicrobial proteins like CAP37 during the migration phase?
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Which statement about amniotic membrane is incorrect?
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What primarily happens in the migration phase of corneal healing?
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Study Notes
Corneal Wound Healing Phases
- Healing involves four distinct phases: latent, migration, proliferation, and attachment.
Latent Phase (First 6 hours)
- Reduction of intracellular junctions and hemidesmosomes, promoting the removal of damaged basal cells.
- Infiltration of neutrophils occurs, along with keratinocyte apoptosis.
Migration Phase (6-36 hours post-injury)
- Epithelial cells begin migrating to close the surface gap.
- Cells start adhering to the basement membrane (BM) with primary neutrophil wave at 18 hours and secondary wave at 30 hours.
- Neutrophils contain antimicrobial proteins (AMPs) for protection.
Proliferation Phase (36-48 hours)
- Basal cells from the columnar layer proliferate, differentiating into wing and superficial cells.
Attachment Phase (48 hours)
- Epithelial cells adhere firmly to the BM, increasing intercellular junctions to prevent separation and restore normal functionality.
Importance of Antimicrobial Peptides (AMPs)
- Present throughout the wound healing process including tear film.
- CAP37 protein plays a key role in antimicrobial defense.
Corneal Scarring
- Severe chronic inflammation, marked by lymphocyte and neutrophil infiltration, leads to fibroblast proliferation and disorganized collagen, resulting in scarring.
- Corneal scarring can lead to low visual acuity (VA).
Amniotic Membrane in Corneal Treatment
- Utilized for corneal ulcers, pterygium, and epithelial damage, promotes corneal regeneration without causing neovascularization.
- Composed of thick basement membrane (BM) derived from placenta, rich in collagen and proteins aiding in keratinocyte proliferation.
Growth Factors in Amniotic Membrane
- Contains signaling molecules such as epidermal growth factor (EGF), transforming growth factor beta (TGFβ), fibroblast growth factor (FGF), and platelet-derived growth factor (PDGF) which promote epithelialization.
Benefits of Amniotic Membrane
- Facilitates quicker epithelial healing and reinforces adhesion while preventing apoptosis and reducing pain.
- FDA-approved PROKERA is a cryopreserved amniotic membrane product.
Clinical Applications of Amniotic Membrane
- Used in treating conditions like exposure keratitis, neurotrophic corneal diseases, bullous keratopathy, persistent corneal epithelial defects, recurrent corneal erosion (RCE), Stevens-Johnson Syndrome (SJS), acute corneal burns, and others.
Coverage and Integration
- Amniotic membrane can completely cover the cornea and allows cell migration from the limbus, promoting healing.
- Successful integration noted in procedures such as covering bare sclera post-pterygium excision with excellent cosmetic results observed after three months.
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Description
Explore the four distinct phases of corneal wound healing: latent, migration, proliferation, and attachment. This quiz delves into the intricate processes involved in each phase and highlights the significance of antimicrobial peptides in wound care.
