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Biomedical subjects

Mark J Mannis

Publications and source records attributed to Mark J Mannis.

27 records · Page 2Linked to original sources
PubMed2003

Aniridia and Brachmann-de Lange syndrome: a review of ocular surface and anterior segment findings.

PURPOSE: To review the ocular surface and anterior segment findings in Brachmann-de Lange syndrome and describe a new case involving aniridia and congenital glaucoma. METHODS: A newborn presented 2 days after birth with bilateral cloudy corneas, photophobia, and epiphora. We provide a 5-year descriptive history and clinical course with review of the literature on Brachmann-de Lange syndrome. RESULTS: Multiple ocular surgeries were performed for ocular sequelae from aniridia and congenital glaucoma including Ahmed valve placement and penetrating keratoplasties in both eyes. At 5.5 years of age, the child had a clear graft OD and amblyopia from graft failure OS following recurrent graft infections. A review of Brachmann-de Lange syndrome found 43 patients with ocular surface and anterior segment findings. The most common findings included conjunctivitis, blepharitis, microcornea, and corectopia. Aniridia and congenital glaucoma were not previously reported with Brachmann-de Lange syndrome. CONCLUSIONS: Ocular surface and anterior segment abnormalities must be considered when examining patients with Brachmann-de Lange syndrome. Ocular findings may include vision-threatening anomalies, as in our case with aniridia and congenital glaucoma. To our knowledge, these findings are previously unreported in Brachmann-de Lange syndrome.

Aniridia↗
PubMed2003

The prevalence of ocular signs in acne rosacea: comparing patients from ophthalmology and dermatology clinics.

PURPOSE: To describe and compare the ocular signs in patients diagnosed with acne rosacea by the ophthalmologist with the ocular signs in the patients diagnosed with rosacea by the dermatologist. METHODS: We reviewed the medical records of 176 randomly selected patients diagnosed with rosacea at the University of California, Davis, Medical Center: 88 patients each from the Department of Dermatology and the Department of Ophthalmology. Of the 88 patients diagnosed with acne rosacea by a dermatologist, 22 (25%) had an ophthalmologic evaluation done prior to the study. In those patients without an ophthalmologic assessment, ocular complaints noted by the dermatologist were recorded. We recorded ocular signs including lid, conjunctival, corneal, episcleral, and scleral manifestations as well as charted observations of the iris, lens, intraocular pressures (IOPs), best corrected visual acuity (VA), and funduscopic examination. Age and sex were recorded from the initial ophthalmologic evaluation. The analysis was designed to compare the prevalence of signs and symptoms in two clinical settings. RESULTS: The prevalence of documented meibomian gland dysfunction (p < 0.001), telangiectasia (p = 0.004), and anterior blepharitis (p = 0.008) was significantly higher in ophthalmology patients when compared with dermatology patients. Of the conjunctival signs evaluated, only the presence of interpalpebral conjunctival hyperemia (p = 0.005) was found to be significantly higher in ophthalmology patients. The corneal, episcleral, scleral, and lens findings did not demonstrate a statistically significant difference between groups. CONCLUSION: The major and most easily observable ocular problems in rosacea patients presenting either to ophthalmology or dermatology are lid disease-related manifestations. As might be expected, eye signs and symptoms are more commonly noted in the eye clinic. A clinician's increased awareness of the common ocular findings of rosacea, however, may aid in earlier diagnosis and treatment of ocular rosacea.

Adult↗
PubMed2003

LASIK after epikeratophakia.

PURPOSE: To present a case of successful laser in situ keratomileusis (LASIK) performed on a patient with residual hyperopic astigmatism and symptomatic anisometropia after previous epikeratoplasty (epikeratophakia). METHODS: LASIK was used successfully to treat hyperopic astigmatism after regression of epikeratophakia performed 16 years earlier. RESULTS: Visual acuity improved to 20/30 without correction, and best-corrected visual acuity was 20/25 at the 3-month postoperative visit. CONCLUSIONS: LASIK can be used successfully as an alternative treatment to correct residual refractive error after epikeratoplasty.

Aged↗
PubMed2003

Intraocular pressure-induced interlamellar keratitis after LASIK surgery.

PURPOSE: To describe a case of interlamellar stromal keratitis induced by increased intraocular pressure (IOP) after LASIK surgery. METHODS: Case report and review of the literature. RESULTS: A 53-year-old white man with a history of treated ocular hypertension underwent uncomplicated LASIK surgery. The postoperative course was complicated by markedly elevated IOP induced by topical corticosteroid drops used to treat what appeared to be diffuse lamellar keratitis. Because IOPs remained uncontrolled despite maximal therapy, topical steroids were discontinued after a total of 9 weeks. The IOP rapidly returned to normal range with complete resolution of the corneal findings. Humphrey visual field analysis, confocal scanning laser imaging of the optic nerve, and stereoscopic disc photographs all demonstrated that significant glaucomatous field loss and optic atrophy developed over this 8-week period. DISCUSSION: The IOP should be immediately evaluated in patients who present with interlamellar stromal keratitis more than 1 week after LASIK. If the IOP is elevated, corticosteroid drops should be discontinued to prevent permanent visual loss. Furthermore, if a glaucoma specialist examines a patient with a history of LASIK and unexplained visual field loss, the medical record should be reviewed to determine if the postoperative course was complicated by this diffuse lamellar keratitis-like phenomenon.

Anti-Bacterial Agents↗
PubMed2002

Efficacy and safety of recurrent pterygium surgery using human processed pericardium.

PURPOSE: To investigate the safety and efficacy of human processed pericardium used as an onlay after pterygium excision. METHODS: Twenty-five eyes of 25 patients (11 female, 14 male) with recurrent pterygium were included in this study. The median age was 50 years (range 24-89 years). Twenty-eight percent of the eyes previously had been operated on two or more times. The mean follow-up was 9.4 months (+/- 2.1 months, range 8-15 months). Following bare-sclera surgical removal of recurrent pterygium, a patch of processed human pericardium was sutured to cover the area of excision. The pericardium was not covered with conjunctiva, nor were adjuvant radiation or antimetabolite administered. All patients were treated with a combination of dexamethasone 0.1% / chloramphenicol drops three times per day for 1 month. Ketorolac tromethamine 0.5% three times per day was added to this regimen after complete corneal reepithelialization. RESULTS: Recurrence (any growth >1 mm onto the cornea) was detected in 12 patients (48%). The mean time of recurrence was 4.1 +/- 1.7 months. Three patients (12.0%) presented a regrowth of fibrovascular tissue not reaching 1 mm of the cornea. Pyogenic granulomas occurred in three patients, and all of them required surgical excision. Corneal thinning was present in one patient and was treated with a therapeutic contact lens and artificial tears with complete resolution and vascularization of the thinned area. No decrease in visual acuity was observed in any patient. CONCLUSIONS: The use of processed pericardium in pterygium surgery is a safe procedure but is associated with a relatively high rate of recurrence. It should only be considered as an option in managing recurrent pterygium when conjunctival autografting is not an available alternative.

Adult↗
PubMed2002

The relationship between first postoperative day epithelial status and eventual health of the ocular surface in penetrating keratoplasty.

PURPOSE: To determine a possible relationship between donor epithelial status on the first postoperative day after keratoplasty and the eventual health of the corneal surface. METHODS: We analyzed 91 patients who underwent penetrating corneal transplantation between January 1998 and January 2000, monitoring the epithelial status of the corneas with fluorescein staining using slit-lamp biomicroscopy. Recipient pre- and postoperative variables and donor characteristics were recorded. Macroepithelial defects were classified into three groups according to the extent of the epithelial defect. The results on the first postoperative day were compared with the first and third operative month. Donor and recipient variables were compared with the epithelial status on the first and third month as well. RESULTS: On the first postoperative day, 64.84% of the patients had epithelial defects, 10.99% had defects at the 1-month postoperative visit, and none had defects at the third month. Graft recipients with macroepithelial defects in the first postoperative month were older, had a higher prevalence of blepharitis, higher prevalence of inadequate eye hydration, and slightly increased corneal sensation compared with the group without epithelial defects; however, none of these trends were statistically significant. Patients with macroepithelial defects in the first postoperative month received older donor tissue, and the average preservation-to-surgery time was longer. These donor variables, however, were not significant statistically (p value >0.10) in determining outcome of the epithelial status at the first or third months. CONCLUSIONS: Our results suggest that the epithelial status on the first postoperative day is not predictive of surface integrity at 1-month postoperative (p value is 0.2676 for the likehood ratio test). The epithelial status on the first postoperative day is not predictive of the status of the third month after keratoplasty, because none of the 91 patients had epithelial defects after 3 months.

Age Factors↗
PubMed2002

The use of antimicrobial peptides in ophthalmology: an experimental study in corneal preservation and the management of bacterial keratitis.

PURPOSE: Bacterial keratitis is an ocular infection with the potential to cause significant visual impairment. Increasing patterns of antibiotic resistance have necessitated the development of new antimicrobial agents for use in bacterial keratitis and other serious ocular infections. With a view to exploring the use of novel antimicrobial peptides in the management of ocular infection, we performed a series of experiments using synthetic antimicrobial peptides designed for the eradication of common and serious ophthalmic pathogens. METHODS: Experiments were performed with three clinical ocular isolates--Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis--in three experimental settings: (1) in vitro in a controlled system of 10 mM sodium phosphate buffer, (2) in vitro in modified chondroitin sulfate-based corneal preservation media (Optisol), and (3) in an in vivo animal model (rabbit) simulating bacterial keratitis. In all cases, outcomes were measured by quantitative microbiological techniques. RESULTS: The candidate peptides (CCI A, B, and C and COL-1) produced a total reduction of the test pathogens in phosphate buffered saline. In modified Optisol, the peptides were effective against S epidermidis at all temperatures, demonstrated augmented activity at 23 degrees C against the gram-positive organisms, but were ineffective against P aeruginosa. The addition of EDTA to the medium augmented the killing of P aeruginosa but made no difference in the reduction of gram-positive organisms. In an in vivo rabbit model of Pseudomonas keratitis, COL-1 demonstrated neither clinical nor microbicidal efficacy and appeared to have a very narrow dosage range, outside of which it appeared to be toxic to the ocular surface. CONCLUSION: Our data indicate that the antimicrobial peptides we tested were effective in vitro but not in vivo. In an age of increasing antibiotic resistance, antimicrobial peptides, developed over millions of years as innate defense mechanisms by plants and animals, may have significant potential for development as topical agents for the management of severe bacterial keratitis. However, modifications of the peptides, the drug delivery systems, or both, will be necessary for effective clinical application.

Animals↗
PubMedDate not supplied

Glycomics analyses of tear fluid for the diagnostic detection of ocular rosacea.

A Glycomics approach to detect disease is illustrated in the analyses of human tear fluid for rosacea. The diagnosis of ocular rosacea is particularly challenging in a subgroup of patients that do not present with typical facial skin findings but have ocular signs and symptoms. Indeed, up to 90% of patients with ocular rosacea may have neither obvious roseatic skin changes nor a previous diagnosis of rosacea. Tear fluid was collected from 37 subjects (21 controls and 16 patients with ocular rosacea) after conjunctival stimulation with filter (Schirmer) paper. O-linked oligosaccharides were released from tear fluid by beta-elimination and then purified using solid-phase extraction. Mass spectra were recorded on an external source HiResMALDI with a 7.0 T magnet. Mass spectra were obtained in both the positive and negative modes. However, signals were stronger in the negative mode. Tear fluid samples from rosacea patients yielded distinctive clusters of peaks that extend to higher masses. Patients with rosacea presented several oligomeric series that were not found in the controls. To discriminate the ocular rosacea cases from the normal controls, the sum of absolute intensities of 13 series corresponding to nearly 50 identified mass spectrum peaks was used. Thirty-six out of the 37 samples were correctly classified. This yields a sensitivity of 100% (95% CI 79.5-100) and specificity of 95.2% (95% CI 76.2-99.9). The high abundance of oligosaccharides in the tear fluid of patients with rosacea may lead to an objective diagnostic marker for the disease.

Biomarkers↗