Herpes zoster: protecting older patients' vision.
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Acyclovir↗
Biomedical subjects
J H Lass
Publications and source records attributed to J H Lass.
Idoxuridine-induced conjunctival cicatrization.
Four patients had idoxuridine-induced conjunctival cicatrization similar to ocular cicatricial pemphigoid develop, but in the treated eye only. Three of the four patients had chronic, recurrent herpes simplex epithelial and stromal keratitis. The fourth patient had Sjögren's syndrome. All received idoxuridine (0.1% drops and/or 0.5% ointment) and topical corticosteroids from one to 3 1/2 years. Substantial morbidity resulted that included visual loss, stromal ulceration, corneal scarring, and keratinization. Conjunctival biopsy specimens showed cicatrization with a mixed inflammatory cell reaction and absence of goblet cells. Results of direct immunofluorescent microscopy of the conjunctiva were either negative or nonspecific for autoantibody. No circulating autoantibody was detected in any of the four patients.
Conjunctival Diseases↗
Detection of human papillomavirus DNA sequences in conjunctival papilloma.
Two histologically proven conjunctival papillomas (one from a 33-month-old boy and the other from a 28-year-old woman) were examined for the presence of papillomavirus by DNA molecular hybridization. The first case, a recurrent tumor known to be positive for papillomavirus structural antigen, demonstrated human papillomavirus DNA sequences that cross-hybridized to a human papillomavirus type 11 DNA probe. The second case, an initial tumor, which was negative for papillomavirus structural antigen, demonstrated no viral DNA sequences by hybridization.
Adult↗
Papillomavirus in human conjunctival papillomas.
Forty-one human conjunctival papillomas were histopathologically examined for koilocytosis and papillomavirus common antigen with a peroxidase-antiperoxidase technique immunospecific for genus-specific papillomavirus antigen. Koilocytotic cells, typically found in other papillomavirus-induced tumors, were present in 24 of the 41 specimens. Two of the 41 specimens were positive for viral antigen. The positive reactions were intranuclear within the superficial layers of the epithelium.
Antigens, Viral↗
Topical corticosteroid therapy for corneal toxicity from systemically administered cytarabine.
Eleven patients with leukemia refractory to conventional therapy were treated with high doses of cytarabine (3 g/m2 intravenously every 12 hours for six days) followed by daunorubicin (30 mg/m2/day intravenously for three days). Each patient received, in a double-masked, randomized manner, either 1% prednisolone phosphate or placebo eyedrops in each eye 12 hours before and along with the cytarabine so that we could determine whether a topical corticosteroid prevents corneal toxicity from systemic cytarabine. Ten of the 11 patients had a significant reduction in the intensity and duration of the symptoms and signs of corneal toxicity in the corticosteroid-treated eye (P less than .0005). In the placebo-treated eye, pain, photophobia, and tearing occurred at a median time of 6.5 days after initiation of therapy but resolved in approximately one week. Patients receiving high doses of intravenously administered cytarabine should receive topical corticosteroid prophylaxis to reduce the corneal toxicity associated with this treatment.
Administration, Topical↗
Medroxyprogesterone on corneal ulceration. Its effects after alkali burns on rabbits.
The effect of medroxyprogesterone acetate treatment in preventing or retarding corneal ulceration after alkali burns was studied in rabbits in an attempt to correlate dose and response. The eyes were treated for 21 days with a 0.01% or 1% suspension administered topically four times a day or medroxyprogesterone acetate, 4 mg or 30 mg, given subconjunctivally on alternate days. None of these regimens was noticeably effective, although at times there was a trend toward retarding ulceration. Thus, it was not possible to confirm earlier reports of substantial efficacy of medroxyprogesterone. Corneal stroma with epithelial defects and/or ulcers persistently showed infiltration with neutrophils in the superficial stroma within the epithelial defect, implicating the tears as the source of the inflammatory cells.
Alkalies↗
Ocular toxicity of topical antifungal agents.
We studied, in a rabbit, the ocular toxicity of topical 1% solutions or suspensions of amphotericin B, flucytosine, miconazole nitrate, and ketoconazole. Flucytosine, miconazole, and ketoconazole did not retard the closure of 8.5-mm corneal epithelial defects; amphotericin B greatly retarded the closure of such defects. Amphotericin B produced dramatic pathologic changes in this model; these changes worsened with each day of therapy. Ketoconazole produced modest biomicroscopically and histologically detectable pathologic changes in the regenerating corneal epithelium; flucytosine and miconazole did not produce such changes.
Administration, Topical↗
Visual outcome in eight cases of Serratia marcescens keratitis.
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Aged↗
Exogenous Nocardia asteroides endophthalmitis associated with malignant glaucoma.
A 42-year-old man sustained a penetrating corneal wound with a soil-contaminated wire and developed Nocardia asteroides endophthalmitis. A month delay in diagnosis occurred while topical and systemic steroids were prescribed for persistent anterior uveitis, but the diagnosis was finally established by separate aqueous and vitreous aspirates. The patient's course was complicated by a form of malignant glaucoma that was relieved by vitreous aspiration and reformation of the anterior chamber. Surgical intervention, followed by intensive topical and systemic sulfonamide therapy, has resulted in potential visual improvement.
Adult↗
Treatment of experimental herpetic interstitial keratitis with medroxyprogesterone.
A model of herpes simplex interstitial keratitis was developed in rabbits sensitized with live herpes simplex virus (HSV) type 2 and challenged intrastromally with live virus. This model was used to evaluate the effects of subconjunctival medroxyprogesterone acetate on the course of the disease and on collagenase levels in the treated corneas. Whether treated prophylactically or therapeutically, the medroxyprogesterone-treated groups had substantially less stromal infiltration and neovascularization than the controls. The clinical effects corresponded with a marked reduction in the polymorphonuclear leukocyte infiltrate histologically, and the suppression of latent and active collagenase activity in the treated corneas cultured in vitro. However, epithelial disease was exacerbated in prophylactically treated animals. Medroxyprogesterone appears to be useful in the treatment of herpetic interstitial keratitis as an anti-inflammatory agent as well as an inhibitor of collagenase production but, like the corticosteroids, it can exacerbate epithelial disease.
Animals↗
Acyclovir topical therapy of cutaneous herpes simplex virus infection in guinea pigs.
The chemotherapeutic efficacy of acyclovir was evaluated by observing the potential of topical acyclovir to reduce the severity of herpes viral lesions and to control the multiplication of this virus in the experimentally induced primary cutaneous infection of guinea pigs. Topical acyclovir showed a substantially high therapeutic efficacy when treatment was initiated after the development of clinically overt skin lesions. The therapeutic response was dose dependent and clearly evident even when the treatment was initiated on day 2 after inoculation. Our results indicate that topical acyclovir treatment improved the cutaneous herpes simplex virus type 1 (HSV-1) infectious process by inhibiting multiplication of HSV-1 in the skin of guinea pigs.
Acyclovir↗
Herpetic ganglionic latency. Aciclovir and vidarabine therapy.
This study report the therapeutic efficacy of systemic antiviral drugs in reducing the incidence of trigeminal ganglionic latent herpes simplex virus (HSV) after ocular infection in mice. Aciclovir sodium, 60 mg/kg daily for five days starting three and 24 hours after inoculation, resulted in a significant decrease in recovery of latent HSV, 28% and 54% positive, respectively, in comparison to untreated controls, 100% positive. Initiation of similar therapy three weeks after inoculation for 5, 10, and 15 days resulted in progressive decrease in persistence of latent virus, being 100%, 33%, and 12% positive, respectively. Systemic vidarabine, 50 mg/kg daily for 15 days starting three weeks after inoculation, also resulted in a significant decrease of positive ganglionic cultures (60% positive) in comparison to the untreated controls. The results indicate that replication of HSV in the trigeminal ganglia in mice is probably continuous and that this reservoir of recurrent ocular herpes is amenable to therapy with systemic antiviral agents.
Animals↗
Aciclovir and corneal wound healing.
Masked controlled rabbit studies were done to determine the toxic effects on corneal wound healing of the antiviral drugs 3% aciclovir and 0.5% idoxuridine ointment in therapeutically effective concentrations. Aciclovir had no significant detrimental effect in comparison to controls on the quality of regenerating epithelium or the re-epithelialization of epithelial wounds. Idoxuridine treatment caused significant toxic changes in the regenerating epithelium clinically and histologically with a significant delay in epithelial wound healing in comparison to control or aciclovir treated eyes. Aciclovir had no significant effect on the collagen content of stromal wounds as measured by hydroxyproline levels. Idoxuridine caused a reduction in collagen content not significantly different from controls but significantly lower than aciclovir.
Animals↗
Timolol therapy in secondary angle-closure glaucoma post penetrating keratoplasty.
Timolol maleate (o.25% or 0.5% twice a day) was used in 13 eyes of 13 patients with secondary angle-closure glaucoma post penetrating keratoplasty uncontrolled on miotics, carbonic anhydrase inhibitors, or both. When added to each patient's current regimen, tomolol controlled 9 of the 13 eyes that no longer required cyclocryotherapy, and it was well tolerated locally and systemically. Its ocular hypotensive effect appears to supplement miotics and carbonic anhydrase inhibitors.
Carbonic Anhydrase Inhibitors↗
Quantitation of inflammation in the cornea.
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Animals↗
Ocular complications of systemic cancer chemotherapy.
Cancer chemotherapy has changed rapidly in recent years. New agents are constantly being developed. Established agents are being used with increased frequency, in new combinations, at higher dosages, and via new routes of administration. Enhanced survival, as well as increased drug toxicity, has resulted. Ocular toxicity is not uncommon and can greatly impact on quality of life. Practitioners in all fields are increasingly caring for patients who are receiving cancer chemotherapy. The recognition of eye disease resulting from chemotherapy is essential to appropriate patient management. We provide a review of the rapidly growing body of literature on the ocular toxicity of systemic cancer chemotherapy with particular attention to context, clinical course, mechanism, prevention and treatment.
Antineoplastic Agents↗
Epidermal growth factor and insulin in use in corneal preservation: study design and objectives of a multi-center trial.
This study determines whether endothelial survival after penetrating keratoplasty is improved by adding the mitogens, human epidermal growth factor (hEGF), and human insulin to a chondroitin-sulfate-based corneal storage medium. It is a multicenter, prospective, double-masked, randomized trial that compares endothelial survival of human corneal transplants using donor corneas that have been stored in one of two media: DexSol (CSM with 1% dextran) or DexSol containing recombinant hEGF and human insulin. This article describes the study design and entry characteristics of the 105 recipient pairs. Each donor pair of corneas is transplanted on the same day into recipients who are matched by diagnosis and procedure. Clinical parameters assessed on day 1, week 1, and 3, 6 and 12 months postoperatively include graft clarity, epithelial integrity, corneal thickness, visual acuity, and intraocular pressure. Postoperative endothelial survival for both groups will be determined by morphometric analysis of endothelial cell images before storage and at 3, 6, and 12 months postoperatively. Such analysis will also identify differences in polymegathism (cell size) or pleomorphism (cell shape).
Adult↗
Light microscopic and ultrastructural findings in failed epikeratoplasty.
Corneal buttons from two patients with failed epikeratoplasties requiring penetrating keratoplasty were examined by light and transmission electron microscopy. Penetrating keratoplasty was performed for lenticule scarring in the first case (adult aphakia) and inadequate best corrected visual acuity in the second case (keratoconus). Findings included decreased lenticule keratocytes and electron-dense, fibrillogranular material associated with either lenticule or recipient keratocytes in both corneas and defects in Bowman's layer in one cornea. In addition, light and electron microscopic evidence consistent with recipient keratocyte migration into the lenticule was demonstrated in one case. These findings were compared with three previous cases.
Adult↗