Biomedical subjects

Jean-Paul Adenis

Publications and source records attributed to Jean-Paul Adenis.

7 recordsLinked to original sources

PubMed2005

Specific antibody production in herpes keratitis: intraocular inflammation and corneal neovascularisation as predicting factors.

PURPOSE: The purpose of the study is to investigate whether analysis of specific antibody synthesis can aid the diagnosis of herpes keratitis. METHODS: Aqueous humor was collected from 39 patients with presumed recurrent herpes keratitis, including 23 consulting for keratitis and 16 patients scheduled for penetrating keratoplasty. Local antibody production was ascertained by analysis of paired aqueous humor/serum samples, using a modified micro-ELISA technique. RESULTS: Local production of antibodies was found in 32 patients (82%): anti-herpes simplex virus (HSV) antibodies in 26 (67%) and anti-varicella zoster virus (VZV) antibodies in 11 (28%). Twenty of 23 patients with active keratitis (87%), and 12 of 16 undergoing keratoplasty (75%), tested positive. Five patients had local production of both anti-HSV and anti-VZV antibodies, whereas seven patients tested negative. Local antibody production was significantly associated with intraocular inflammation (P<0.05), corneal neovascularisation (P<0.05), and positive response to anti-viral treatment (P<0.05). No complications were encountered in sampling aqueous humor. CONCLUSIONS: Assessment of local anti-HSV and -VZV antibody production is a safe and reliable diagnostic procedure for recurrent herpes keratitis. It might be particularly helpful in patients presenting with intraocular inflammation and neovascularisation since it discriminates between herpes and non-herpes pathologies and may therefore be useful for preventive and therapeutic strategies.

Acyclovir↗

PubMed2005

Transmission of viruses through corneal transplantation.

Transmission of viruses through transplantation has become a major concern for surgeons and tissue banks. Keratoplasty has been the first transplantation procedure in which transmission of a virus from the donor to the recipient has been proven, and recently, herpes has been suggested as a transmittable disease via corneal transplantation. In this article we review the history of viral transmission through transplantation, especially focusing on keratoplasty, and develop the recent updates on transmission of HSV through corneal grafting, its implications for surgeons and eye banks, and further insights into viral security in eye banks.

Corneal Transplantation↗

PubMed2003

Herpes simplex virus DNA in corneal transplants: prospective study of 38 recipients.

Herpes simplex virus (HSV) infection of the eye can induce epithelial and stromal keratitis and may also lead to postoperative endothelial failure in keratoplasty. Clinical symptoms and/or virus culture of corneal scrapings most frequently provide the basis for diagnosis of ocular HSV infection, and although HSV DNA has been shown to be present in the cornea, its role in success or failure of corneal grafts remains unclear. In this study, a PCR assay was used to detect HSV DNA in corneal buttons of 38 corneal graft recipients and in donor scleral remnants, retaining one-half of each sample for subsequent viral isolation. Recipients were followed up clinically for a period of 6 months after keratoplasty. All recipients but three were found to be HSV seropositive. Eight recipient corneal buttons contained detectable HSV DNA (7 HSV-1, 1 HSV-2, the latter case confirmed by viral culture). Two donor corneas were found positive for HSV-1 DNA, with negative cultures, and endothelial graft failure occurred in one of the matching recipients after 4 months. One recipient with no history of herpes contracted herpetic keratitis 4 months after keratoplasty, even though the corneal button and donor scleral remnants contained no detectable HSV DNA. The study confirms previous observations of HSV DNA in the corneal tissue of HSV seropositive patients apparently unrelated to any clinical manifestation of herpes infection. However, as demonstrated by culture, HSV remains infectious and may therefore induce donor-to-host infection in corneal recipients.

Adult↗

PubMed2002

Internal and external contamination of donor corneas before in situ excision: bacterial risk factors in 93 donors.

BACKGROUND: Most studies of corneal donor contamination concentrate on postenucleation contamination of the eyeball. The purpose of the present study was to evaluate the relative contamination of in situ excised corneal tissue and relevance to final success or rejection by recipients of the corneal grafts. METHODS: Ninety-three donors underwent anterior chamber puncture (ACP) and corneal epithelium scarification (CS) before and after disinfection with 5% povidone-iodine. Following in situ excision, corneas were preserved in culture medium at +35 degrees C. Morphological and bacteriological assessment was carried out after culture, and recipients were followed up over a 2-year period. RESULTS: Samples taken by ACP, CS before disinfection, CS after disinfection and a culture medium sample were contaminated by bacteria in, respectively, 8 (8.6%), 23 (24.7%) 4 (4.3%) and 5 (5.4%) donors. Contamination of aqueous humor was significantly associated with age, death-to-sample time and premortem systemic infection. Contamination of epithelium significantly increased culture medium contamination. CONCLUSION: External bacteria on donor cornea are mainly skin bacteria (especially Staphylococcus) and can be partially eliminated by a povidone-iodine wash. Internal bacteria are mainly gut bacteria and may be due to perimortem bacteriemia. However, bacterial infection at the time of death appears to have no effect on the incidence of endophthalmitis in recipients and should no longer prevent use of such corneal tissue in grafts.

Adult↗

PubMed2002

Multiplex detection of herpesviruses in tear fluid using the "stair primers" PCR method: prospective study of 93 patients.

Human herpesviruses can infect the eye and be excreted subsequently in tears. The aim of the present study was to use a multiplex PCR to detect herpesviruses (HSV-1, -2, VZV, CMV, EBV, HHV-6) in tears from normal subjects and from patients with pathological conditions (acute herpes, zoster, papillary conjunctivitis, and dry eye). Schirmer test strips were used to collect tear fluid from 93 patients, sampling both eyes. DNA was then extracted from the 186 samples by chromatography, and viral DNA amplified using a commercialised multiplex "stair primer" method. Thirty-four samples (18.3%) contained Taq inhibitors. The multiplex test gave positive results for HSV and VZV in tear fluid from patients with acute dendritic keratitis (3 patients) and acute ocular zoster (4 patients) and was, therefore, considered effective in testing samples from patients with acute lesions. HSV-1 and HSV-2 were found in two samples from patients with metaherpetic corneal scarring. Among 28 cases of dry eye, two were positive for HHV-6, the latter being associated with EBV in one patient. HHV-6 was also found in 4 out of 54 cases of papillary conjunctivitis. This raised occurrence of HHV-6 in dry eye or papillary conjunctivitis, suggests new clinical patterns for HHV-6 latency or reactivation. Detection of EBV in 1 out of 80 healthy eyes confirms previous evidence that lacrimal glands constitute potentially a site for latent-phase EBV.

Conjunctivitis, Viral↗

PubMedDate not supplied

Decrease of intraocular pressure after fat-removal orbital decompression in Graves disease.

PURPOSE: To address the efficacy of fat-removal orbital decompression to reduce intraocular pressure in patients with Graves disease. METHODS: This cohort study included 64 eyes of 39 patients with Graves disease. Thirteen men and 36 women, with a mean age of 52.5 years (range, 27 to 80 years), underwent fat-removal orbital decompression. Intraocular pressure (applanation) and proptosis (Hertel exophthalmometry) were prospectively investigated before surgery and 1 week and 6 months after surgery. RESULTS: The volume of resected fat was 6.4+/- 4.5 (3 to 12) ml. The intraocular pressure in primary position decreased from 19.3+/- 4.4 mm Hg to 17.0+/- 2.9 mm Hg at 1 week (p<0.001) and 15.9+/- 3.7 mm Hg at 6 months (p<0.001). Mean proptosis dropped from 24.3+/- 2.5 mm before surgery to 19.9+/-3.0 mm at 1 week (p<0.01), and 19.9+/-3.1 mm at 6 months (p<0.01). Intraocular pressure decrease neither correlated to the volume of resected fat nor to proptosis reduction. CONCLUSIONS: Fat removal reduces intraocular pressure in patients with Graves disease, with no correlation to the volume of resected fat.

Adipose Tissue↗

PubMedDate not supplied

[Surgical treatment of blepharospasm: results of a study of 138 patients using an improved disability scale].

We applied a new blepharospasm clinical disability scale to the evaluation of blepharospasm surgery in a group of 138 patients. This scale analyzes six parameters of daily life, namely reading, watching television, household tasks, walking, employment, and driving. The patients had either essential blepharospasm or pretarsal dystonia. Frontalis suspension of the eyelid gave slightly better functional results than orbicularis resection in some patient subgroups.

Activities of Daily Living↗