A pre-test post-test assessment of non-invasive keratograph break up time and corneal epithelial thickness after vaping

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Abstract

Background

The effects of electronic cigarettes on the ocular surface has yet to be shown. The purpose of the study was to assess the impact of e-cigarette use on the anterior corneal surface integrity.

Methods

Forty three males and 21 females with an average of 21years were required to vape 0.05ml of e-liquid of 8mg nicotine concentration. Corneal epithelial thickness (CET) and Non Invasive Keratograph Tear Break up Time (NIKBUT) measurements were obtained prior to and post vaping. The Optovue iVue optical coherence topographer was used to measure central; superior; inferior; nasal and temporal CET and NIKBUT was assessed using the Oculus Keratograph 5M.

Results

There was a mean increase for central corneal epithelial thickness of 0.3448 microns. The superior CET increased by 0.2414 microns. The inferior CET increased by 0.2931microns. The nasal CET increased by 0.2069 microns. The temporal CET increased by 0.2759 microns. The mean change in NIKBUT post-vaping was an increase of 1.40 seconds. All observations occurred at p > 0.05.

Conclusion

The acute effect of e-cigarette use does not impact corneal epithelial thickness and non-invasive keratography tear break up time after 10 puffs mild exposure but more research is needed to assess if this remains the case with more frequent, higher exposure.

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Most cited references 18

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Epithelial thickness in the normal cornea: three-dimensional display with Artemis very high-frequency digital ultrasound.

D Reinstein, Norman Silverman, Marine Gobbe … (2008)

To characterize the in vivo epithelial thickness profile in a population of normal eyes. An epithelial thickness profile was measured by Artemis 1 (ArcScan Inc) very high-frequency (VHF) digital ultrasound scanning across the central 10-mm diameter of the cornea of 110 eyes of 56 patients who presented for refractive surgery assessment. The average, standard deviation, minimum, maximum, and range of epithelial thickness were calculated for each point in the 10x10-mm Cartesian matrix and plotted. Differences between the epithelial thickness at the corneal vertex and peripheral locations at the 3-mm radius were calculated. The location of the thinnest epithelium was found for each eye and averaged. Correlations of corneal vertex epithelial thickness with age, spherical equivalent refraction, and average keratometry were calculated. The mean epithelial thickness at the corneal vertex was 53.4+/-4.6 microm, with no statistically significant difference between right and left eyes, and no significant differences in age, spherical equivalent refraction, or keratometry. The average epithelial thickness map showed that the corneal epithelium was thicker inferiorly than superiorly (5.9 microm at the 3-mm radius, P<.001) and thicker nasally than temporally (1.3 microm at the 3-mm radius, P<.001). The location of the thinnest epithelium was displaced on average 0.33 mm temporally and 0.90 mm superiorly with reference to the corneal vertex. Three-dimensional thickness mapping of the corneal epithelium demonstrated that the epithelial thickness is not evenly distributed across the cornea; the epithelium was significantly thicker inferiorly than superiorly and significantly thicker nasally than temporally with a larger inferosuperior difference than nasotemporal difference.

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Experimental exposure to propylene glycol mist in aviation emergency training: acute ocular and respiratory effects.

G Wieslander (2001)

Propylene glycol (PG) (1-2 propanediol; CAS No 57-55-6) is a low toxicity compound widely used as a food additive, in pharmaceutical preparations, in cosmetics, and in the workplace-for example, water based paints, de-icing fluids, and cooling liquids. Exposure to PG mist may occur from smoke generators in discotheques, theatres, and aviation emergency training. Propylene glycol may cause contact allergy, but there is sparse information on health effects from occupational exposure to PG. Non-asthmatic volunteers (n=27) were exposed in an aircraft simulator to PG mist over 1 minute, during realistic training conditions. Geometric mean concentration of PG was 309 mg/m3 (range 176-851 mg/m3), with the highest concentrations in the afternoon. The medical investigation was performed both before and after the exposure (within 15 minutes). It included an estimate of tear film stability break up time, nasal patency by acoustic rhinometry, dynamic spirometry, and a doctor's administered questionnaire on symptoms. After exposure to PG mist for 1 minute tear film stability decreased, ocular and throat symptoms increased, forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC) was slightly reduced, and self rated severity of dyspnoea was slightly increased. No effect was found for nasal patency, vital capacity (VC), FVC, nasal symptoms, dermal symptoms, smell of solvent, or any systemic symptoms. Those exposed to the higher concentrations in the afternoon had a more pronounced increase of throat symptoms, and a more pronounced decrease of tear film stability. In four subjects who reported development of irritative cough during exposure to PG, FEV1 was decreased by 5%, but FEV1 was unchanged among those who did not develop a cough. Those who developed a cough also had an increased perception of mild dyspnoea. Short exposure to PG mist from artificial smoke generators may cause acute ocular and upper airway irritation in non-asthmatic subjects. A few may also react with cough and slight airway obstruction.

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Electronic Cigarettes and Vaping: A New Challenge in Clinical Medicine and Public Health. A Literature Review

Dominic L. Palazzolo (2013)

Electronic cigarette (e-cigarette) use, or vaping, in the United States and worldwide is increasing. Their use is highly controversial from scientific, political, financial, psychological, and sociological ideologies. Given the controversial nature of e-cigarettes and vaping, how should medical care providers advise their patients? To effectively face this new challenge, health care professionals need to become more familiar with the existing literature concerning e-cigarettes and vaping, especially the scientific literature. Thus, the aim of this article is to present a review of the scientific evidence-based primary literature concerning electronic cigarettes and vaping. A search of the most current literature using the pubmed database dating back to 2008, and using electronic cigarette(s) or e-cigarette(s) as key words, yielded a total of 66 highly relevant articles. These articles primarily deal with (1) consumer-based surveys regarding personal views on vaping, (2) chemical analysis of e-cigarette cartridges, solutions, and mist, (3) nicotine content, delivery, and pharmacokinetics, and (4) clinical and physiological studies investigating the effects of acute vaping. When compared to the effects of smoking, the scant available literature suggests that vaping could be a “harm reduction” alternative to smoking and a possible means for smoking cessation, at least to the same degree as other Food and Drug Administration-approved nicotine replacement therapies. However, it is unclear if vaping e-cigarettes will reduce or increase nicotine addiction. It is obvious that more rigorous investigations of the acute and long-term health effects of vaping are required to establish the safety and efficacy of these devices; especially parallel experiments comparing the cardiopulmonary effects of vaping to smoking. Only then will the medical community be able to adequately meet the new challenge e-cigarettes and vaping present to clinical medicine and public health.

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Author and article information

Journal

Journal ID (nlm-ta): Afr Health Sci

Journal ID (iso-abbrev): Afr Health Sci

Title: African Health Sciences

Publisher: Makerere Medical School (Kampala, Uganda )

ISSN (Print): 1680-6905

ISSN (Electronic): 1729-0503

Publication date (Print): December 2019

Volume: 19

Issue: 4

Pages: 2926-2933

Affiliations

University of KwaZulu-Natal College of Health Sciences Optometry

Author notes

Corresponding author: Alvin Munsamy, University of KwaZulu-Natal College of Health Sciences, Optometry. alvinjmunsamy@ 123456gmail.com , munsamya1@ 123456ukzn.ac.za

Article

Publisher ID: jAFHS.v19.i4.pg2926

DOI: 10.4314/ahs.v19i4.13

PMC ID: 7040307

PubMed ID: 32127867

SO-VID: 752475f8-7282-4331-b27c-92f5134b059c

License:

Licensee African Health Sciences. This is an Open Access article distributed under the terms of the Creative commons Attribution License ( https://creativecommons.org/licenses/BY/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

A pre-test post-test assessment of non-invasive keratograph break up time and corneal epithelial thickness after vaping

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Abstract

Background

Methods

Results

Conclusion

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Metrics and Research Assessment

Most cited references 18

Epithelial thickness in the normal cornea: three-dimensional display with Artemis very high-frequency digital ultrasound.

Experimental exposure to propylene glycol mist in aviation emergency training: acute ocular and respiratory effects.

Electronic Cigarettes and Vaping: A New Challenge in Clinical Medicine and Public Health. A Literature Review

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