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PubMed2001

[Follicular conjunctivitis due to Chlamydia trachomatis].

During two years (1997-1999) an investigation of possible infections of chlamydial etiology in outpatients with follicular conjunctivitis was carried out, through the use of specific assays. Fifty-seven selected patients with presumptive inclusion conjunctivitis were diagnosed by means of ophthalmoscopic examination and bilateral tarsal-conjunctiva swabbing for microorganisms. The possible presence of Chlamydia trachomatis was tested by immunofluorescence microscopy and isolation in cell culture of McCoy line. Of the 57 conjunctivitis patients screened, 37 (65%) proved to be positive by cell culture (CC) and 27 (47%) by direct immunofluorescence (IFD). A good agreement between the two assays was observed, where the CC was more sensitive than IFD. Of these 37 patients with chlamydial conjunctivitis, 23 (62%) were women, with over one-third of them ranging in age from 45 to 65 years. Their clinical records revealed an evolution period of 1 to 12 months. Eighteen (78%) of these women reported previous genital pathology, while 4 (29%) of the 14 men had a history of urethritis by Chlamydia trachomatis. A high frequency of follicular conjunctivitis by Chlamydia (65%) in the screened patients was observed, without any evidence of urogenital signs and symptoms at the moment of the study.

Adolescent↗
PubMedDate not supplied

[Allergens and risk factors in pediatric patients with allergic seasonal conjunctivitis].

BACKGROUND: The seasonal allergic conjunctivitis is an inflammatory disease of the ocular surface that affects mainly children, with predominance of male sex. It is an immunological disease with a typical reaction of hypersensitivity type 1 (IgE), resulted from several biological reactions (antigen-antibody) and it's associated to several risk factors. OBJECTIVE: To determine the more frequently identified allergens and the associated risk factors to the seasonal allergic conjunctivitis in children living in Mexico City. MATERIAL AND METHODS: Ophthalmologic clinical study done to 50 patients with diagnosis of seasonal allergic conjunctivitis, during the months of March to October, 2001, at the Ophthalmology Department of the National Pediatric Institute. A control group was integrated by 50 patients of the consultation of ophthalmology with non-allergic ocular pathology, and percutaneous skin tests were made. A direct interrogation was applied to both groups to investigate associated risk factors of atopy. RESULTS: The associated risk factors to the development of allergic conjunctivitis are: family atopic background, negative antecedent of breast feeding, asthma o rhinitis (statistically significant). The most frequently identified allergens were Dermatophagoides pteronissinus, Dermatophagoides farinae, Lolium perenne and Atriplex bacteosa, of the group of dust mites and pollen, respectively. CONCLUSION: It is important to see our patients in an integral way. In the case of patients with seasonal allergic conjunctivitis, it should not be forgotten to make an interrogation of the factors associated to atopy and, if it is possible, to inform to the patient and their relatives about these, in order to prevent them.

Allergens↗
PubMed1992

[Long lasting conjunctivitis: research of etiological factors].

Forty children with long-lasting or recurrent conjunctivitis were included in this etiological study. It is well known that purulent conjunctivitis is mainly bacterial, with a major source of infection from Chlamydia; recently, however, a greater percentage of viral forms, with the exception of conjunctivitis without secretion, has been reported. The authors focused their attention on the clinical symptoms and on bacteriological studies of the forms of Chlamydia and Mycoplasma conjunctivitis, highlighting their marked sensitivity to antibiotics and the clinical response and recommending the importance of an etiological study in all cases in which conjunctivitis does not resolve within a short period of time.

Child↗
PubMed1992

[Allergic conjunctivitis].

The eye reacts to foreign substances through a variety of specific and non-specific defense mechanisms. Constantly exposed to a great variety of microorganisms, the eye is capable of protecting itself without altering its own structure and function. Its resistance relies upon anatomic and physiological properties of its external components (eyelids, tears, conjunctiva and cornea). Most of the times, the conjunctiva becomes affected, resulting in a clinical picture of conjunctivitis where allergy predominates, expressed as allergic rhinoconjunctivitis, allergic conjunctivitis, vernal keratoconjunctivitis, giant papillary conjunctivitis and flictenular conjunctivitis. The physiopathology is considered to be of type I reaction (IgE mediated). Frequent complains often associated with other allergic diseases are: pruritus, tearing, photofobia and ocular redness. The diagnosis of allergic conjunctivitis in done by means of a throughout clinical history, conjunctival citology and evaluation of specific IgE with immediate skin tests. Treatment is symptomatic (antihistamines, antibiotics and/or topic steroids), but prevention (environmental control and sodium cromoglycate) and specific immunotherapy must be considered.

Conjunctivitis, Allergic↗
PubMed1977

[A study in immunofluorescence of the plasma cells in allergic conjunctivitis, in particular of the cells forming immunoglobulin E (IgE) (author's transl)].

The relatively simple and precise technique of direct immunofluorescence on a tissue section enables the study and enumeration of all types of plasma cells including mastocytes (stained with acridine orange) in normal conjunctiva (5 cases), chronic non-allergic conjunctivitis (5 cases), allergic conjunctivitis of the educt (11 cases) and vernal conjunctivitis (11 cases). There is evidence of elevation of IgE plasma cells in type I allergic conjunctivitis where they are twice as raised as in non-allergic cases in adult forms, and three times more elevated in vernal conjunctivitis. There was no correlation between the number of IgE plasma cells in the tissues and IgE level in sera. Thus in air-borne conjunctival allergies local hypersensitivity seems to be the predominant, even exclusive, feature.

Adult↗
PubMed2004

[Seasonal allergic conjunctivitis in Hakodate].

PURPOSE: We investigated seasonal allergic conjunctivitis in Hakodate. MATERIALS AND METHODS: The clinical records of 293 patients with allergy-like symptoms who were seen at the Departments of Ophthalmology and Otolaryngology of Hakodate Municipal Hospital in 2001 and 2002 were examined for pollinosis, and evaluated. The general severity of conjunctivitis was graded as (+), (++), and (+++). The allergen was identified by AlaSTAT and nasal provocation test. RESULTS: In March, June, and September 2001, and in March, April, and June 2002, many patients were examined. In 2001, 134 patients (87.0%) had allergic conjunctivitis, and 126 patients (90.6%) had it in 2002. The severity of allergic conjunctivitis in May, June, and September was significantly (p<0.05) more severe than in February, March, and April. The major antigen rates for Cryptomeria japonica, Gramineae, Artemisia, and Betula platyphyia var. japonica were 22, 21, 8, and 3%. The specific IgE positive rates for Cryptomeria japonica, Betula platyphyia var. japonica, Gramineae and Artemisia were higher in March and April, in May, in June, and in September. CONCLUSION: The allergens of conjunctivitis in Hakodate were not the same as in the Kansai. We should consider the dispersion of pollens area by area.

Adolescent↗
PubMed2005

Direct action of platelet activating factor (PAF) induces eosinophil accumulation and enhances expression of PAF receptors in conjunctivitis.

PURPOSE: The goal of the present study was to investigate the role of platelet activating factor (PAF) and PAF receptor (PAF-R) in the recruitment of eosinophils into the conjunctiva in the course of PAF induced conjunctivitis. Eosinophils are important players in the immediate hypersensitivity reactions and in allergic conjunctivitis. PAF-R is expressed in many ocular tissues including conjunctival cells. Although it is known that PAF is one of the most potent chemotactic agents for the recruitment of eosinophils, factors responsible for it in conjunctivitis are not clear. Colocalization analysis has been employed to quantify the degree of colocalization of major basic protein (MBP) and PAF-R antigens in the course of PAF induced conjunctivitis. METHODS: A 1% solution of PAF was applied in eye drops to male Brown Norway rats. Eyes were harvested with intact conjunctivas at different time points and examined using histology, immunohistochemistry, confocal immunofluorescence microscopy, and reverse transcription-polymerase chain reaction. PAF-R and MBP (a marker of eosinophils) antibodies have been used for immunohistochemical studies. Quantitative analysis of the colocalization of PAF-R and major basic protein (MBP) antigens was performed. RESULTS: Instillation of PAF caused a time dependent recruitment of eosinophils. Eosinophils revealed PAF-R in the intact state. An influx of eosinophils into the conjunctiva was caused by the interaction of PAF with PAF-R and, possibly, with MBP antigen. PAF appeared to enhance the expression of PAF-R by eosinophils and to act toward the PAF-R directly, without chemokine mediation. CONCLUSIONS: Quantitative colocalization analysis helped to determine that the recruitment of eosinophils in PAF induced conjunctivitis is accomplished via direct action of PAF toward the PAF-R. It also ensured an objective evaluation of the changes of the degree of colocalization of MBP and PAF-R antigens and the degree of PAF-R expression in dynamics, the findings not otherwise obtainable using qualitative approaches alone.

Animals↗
PubMed2005

[New medical treatment for viral conjunctivitis].

Around one million people in Japan are suffering from adenoviral conjunctivitis every year and it is recognized as one of the major pathogens of nosocomial infection. Several complications, such as corneal erosion and conjunctival pseudomembrane, are observed in some of the cases and corneal sube- pithelial opacity may bring visual impairment. Moreover, no specific anti-adenoviral agent has been discovered and an effective treatment has not been established for adenoviral infection. We have researched new medical treatment for viral conjunctivitis based on recent findings in adenoviral conjunctivitis. Firstly, anti-adenoviral activity was evaluated in vitro in agents which could possibly act as anti-adenoviral drugs. Twelve candidates, such as zalcitabin, interferon beta, etc., were selected among antiviral drugs, adenoviral receptor inhibitors, natural products and anti-inflammatory drugs. Remarkable anti-adenoviral effect was observed in zalcitabin, sanilbudine, interferon beta and anti-osteopontin peptide. Two anti-human immunodeficiency virus (HIV) drugs with anti-adenoviral activity, zalcitabin and sanilbudine, are nucleoside reverse transcriptase inhibitors, but, in contrast, non-nucleoside reverse transcriptase inhibitors and protease inhibitors were ineffective against adenovirus. Interferon beta and anti-osteopontin peptide displayed anti-adenoviral effects by absorption inhibition. Secondly, side effects caused by possible anti-adenoviral eye drops, including cidofovir whose development as eye drops against eyeball and ocular adnexa had been suspended, were analyzed in a white rabbit model. In animals given cidofovir locally, significant narrowing of lacrimal canaliculus, redness of eyelid and conjunctival injection was observed, but obstruction of the lacrimal duct was not found. Although zalcitabin and sanilbudine eye drops induced eyelid redness, no change was observed in the lacrimal route and conjunctiva. In animals treated by cidofovir, inflammation histologically suggesting mainly allergic change was observed. These results indicate that these four drugs are possible candidate for safe eye drops against adenoviral conjunctivitis. These four agents are divided into two categories, inhibitors of adenoviral replication, zalcitabin and sanilbudine; and suppressors of adenoviral infection, interferon beta and anti-osteopontin peptide. It is expected that eye drops for specific treatment of adenoviral conjunctivitis are going to be available in the near future following investigation of therapeutic effect in adenoviral infected animals and clinical trials in humans.

Adenoviridae↗
PubMed2006

Topical prophylaxis of conjunctivitis induced by high-dose cytosine arabinoside.

We investigated the efficacy of dexamethasone plus diclofenac eye drops as prophylaxis for conjunctivitis induced by high-dose (HD) cytarabine (Ara-C). Sixty patients were randomized to receive either dexamethasone (group A, n=29) or dexamethasone plus diclofenac (group B, n=31). Conjunctivitis was experienced by 13/29 (45%) patients in group A, and 4/31 (13%) patients in group B (p<or=0.009). Twelve out of 13 patients in group A who developed ocular toxicity had grade 2-3 conjunctivitis whereas only one of four patients affected in group B experienced a similar grade of conjunctivitis. The incidence and severity of HD Ara-C-induced conjunctivitis are significantly reduced by combined dexamethasone/ diclofenac prophylaxis.

Administration, Topical↗
PubMed1991

[Neonatal conjunctivitis in a nursery and a neonatal unit].

After Credé prophylaxis was abandoned at our hospital in 1984 scrupulous clinical surveillance of all neonates for conjunctivitis, and bacterial cultures from purulent eye discharge, have become routine. During the two-year period 1 March 1987 to 28 February 1989, testing for Chlamydia trachomatis (EIA-technique) was added in all infants with clinical conjunctivitis. During the period concerned there were 332 cases of conjunctivitis among 4,520 live born infants, an incidence of 7.3%. The incidence was higher for infants staying in the nursery (8.2%) than for those admitted to the neonatal unit (3.5%) (p less than 0.01). 90% of the infections were diagnosed during the first week of life. 468 isolates were identified by routine bacteriological investigation, 452 gram-positives (96.6%), and 16 gram-negatives (3.4%). The following strains were found: Staphylococcus aureus 171 (51.5% of the patients), Staphylococcus epidermidis 153 (46.1%), Streptococcus viridans 106 (31.9%), diphteroids 11 (3.3%), beta-hemolytic streptococci seven (2.1%), Streptococcus pneumoniae two (0.6%), enterococci two (0.6%), Hemophilus influenzae six (1.8%), Escherichia coli five (1.5%), Proteus two (0.6%) and Branhamella catarrhalis one (0.3%). Not a single case of gonococcal ophthalmia was diagnosed. Positive tests for Chlamydia were found in 13 infants (3.9% of all infants with conjunctivitis), an incidence of 0.3% for the whole population of live born infants. Six of the chlamydia infections (46%) occurred within the first week of life. Expenses for chlamydia testing were estimated to be NOK 1,020 per positive test. Preventing conjunctivitis in our nursery and neonatal unit calls for strategies to protect newborn infants from colonization with pathogenic bacteria, especially S. aureus.(ABSTRACT TRUNCATED AT 250 WORDS)

Conjunctivitis, Bacterial↗
PubMed1988

An outbreak of acute hemorrhagic conjunctivitis due to Coxsackie virus type A24 variant in Japan.

An outbreak of acute conjunctivitis due to Coxsackie virus A24 (CA24) occurred in Okinawa, the southernmost island of Japan, from 1985 to 1986. From conjunctival scrapings of 85 acute hemorrhagic conjunctivitis patients, 39 isolates identified as an antigenic variant of CA24 were obtained and then cultured in HeLa cells. Paired sera taken from these patients with acute conjunctivitis in Okinawa were also tested against enterovirus 70 (EV70) and CA24 and showed rises in neutralizing antibodies to these agents. The subconjunctival hemorrhage among the clinical manifestations caused by the CA24 variant in this recent epidemic was similar to that due to EV70. EV70 conjunctivitis is more commonly known as acute hemorrhagic conjunctivitis (AHC), first named by the Japanese ophthalmologist, Prof. Seiji Sugiura. The present seroepidemiologic survey for the CA24 variant and EV70 in different districts of Japan revealed a low frequency of rise in neutralizing antibody titers against these two pathogens. The differentiation between EV70 and the CA24 variant as the agent causing AHC is very important in epidemiology, especially as there is a high possibility in Japan of outbreaks caused by these two agents.

Adolescent↗
PubMed1996

[Diagnosis and treatment of conjunctivitis].

Conjunctivitis is a frequent reason for consulting a doctor. Most often treatment consists of antibiotics, even though sensitive bacteria are only rarely demonstrated. In our part of the world conjunctivitis is self-limiting, and it may be worth considering the effect of treatment, if any. With this in mind, diagnosis and differential diagnoses are reviewed and with regard to treatment distinctions are made between neonatal conjunctivitis (gonococcus, chlamydia, virus), conjunctivitis in children (symptoms of upper respiratory tract infections), and conjunctivitis in adults and the elderly (dry eyes, epiphora in ectropion).

Administration, Topical↗
PubMed1995

Allergic conjunctivitis caused by sugi (Cryptomeria japonica D. Don) pollen out of season.

Allergic conjunctivitis caused by sugi pollen is considered to be strictly a "spring disease". However, a recent report indicated that sugi pollen is scattered not only in spring but in all seasons, especially in the autumn. We retrospectively determined the number of patients with allergic conjunctivitis caused by sugi pollen during each month for 3 consecutive years, and also investigated the growth of sugi male cones in November for four years. Diagnosis of allergic conjunctivitis was based on symptomatic complaints, clinical findings, and serum sugi pollen specific IgE measured by the Multiple Antigen Simultaneous Test 16. The annual incidence of allergic conjunctivitis peaked twice, once in spring and again in autumn. Scattering of sugi pollen occurred mostly in March and October, whilst the growth of sugi male cones was highest in November. Thus, allergy to sugi pollen can cause allergic conjunctivitis both in the spring and late autumn.

Adolescent↗
PubMed1996

Topical cyclosporine inhibits mast cell-mediated conjunctivitis.

PURPOSE: Allergic conjunctivitis is a common condition caused by a mast cell-mediated hypersensitivity reaction to immunoglobulin E-bound allergens. The purpose of this study was to investigate the effect of topical cyclosporine A on the development of mast cell-mediated conjunctivitis in mice. METHODS: Allergic conjunctivitis was induced in C57BL/6 mice by topical applications of compound 48/80, a mast cell degranulating agent. In two separate experiments, mice were treated with topical cyclosporine A (0.05%, 0.2%, or 0.4%), prednisolone acetate 1%, or phosphate-buffered saline. Twenty-four hours after compound 48/80 instillation, the number of neutrophils, eosinophils, lymphocytes, macrophages, and the number of preserved goblet cells and undegranulated mast cells in the conjunctiva were counted by a masked observer. RESULTS: In both experiments, treatment with all three doses of cyclosporine A resulted in a statistically significant reduction in the number of infiltrating neutrophils and eosinophils compared to saline-treated controls. There was no significant difference in the treatment effect of cyclosporine and prednisolone acetate. In addition, there was increased preservation of goblet cells in the cyclosporine A-treated animals. Immunohistochemical staining showed a reduction in infiltrating lymphocytes and a smaller reduction in infiltrating macrophages in animals treated with cyclosporine compared to saline-treated controls. CONCLUSIONS: Topical cyclosporine A was effective in inhibiting the development of mast cell-mediated allergic conjunctivitis in mice. This study suggests that topical cyclosporine A may be effective in treating allergic conjunctivitis in humans.

Administration, Topical↗
PubMed1997

Homozygous mutations in the plasminogen gene of two unrelated girls with ligneous conjunctivitis.

Ligneous conjunctivitis is a rare and unusual form of chronic pseudomembranous conjunctivitis that usually starts in early infancy. The disease may be associated with pseudomembranous lesions of other mucous membranes in the mouth, nasopharynx, trachea, and female genital tract. We examined two unrelated Turkish girls both suffering from ligneous conjunctivitis and occlusive hydrocephalus. Both children exhibited a severe plasminogen deficiency. Genomic DNA from both patients as well as from clinically healthy family members were screened for mutations in the plasminogen gene by polymerase chain reaction, single-strand conformation polymorphism (SSCP) analysis, and DNA sequencing. In the first girl with ligneous conjunctivitis a homozygous G-->A point mutation was identified in plasminogen exon 7 at position 780 leading to an amino acid exchange (Arg216-->His). Her healthy sister and her healthy parents were heterozygous for this mutation. The second patient revealed a homozygous G-->A point mutation in plasminogen exon 15 at position 1924 which leads to a stop-codon (Trp597-->Stop). The healthy parents were shown to be heterozygous for this mutation. In addition, the father's second allele revealed another mutation in the same codon (Trp597-->Cys) (compound heterozygosity). In conclusion, certain homozygous mutations in the plasminogen gene may cause ligneous conjunctivitis.

Adolescent↗
PubMed1997

Acute red eye. Differentiating viral conjunctivitis from other, less common causes.

Adenoviral conjuctivitis is one of the most common causes of acute red eye. Other diagnostic considerations include herpes virus conjunctivitis, chlamydial conjunctivitis, allergic conjunctivitis, and various other less common infections. Careful history taking can help in identifying a viral cause. The presentation may range from a minor conjunctivitis resulting from an upper respiratory tract infection to a serious, debilitating epidemic keratoconjunctivitis. Local care and interventions to minimize transmission are the cornerstones of management. Infection is usually self-limiting. Warm soaks and artificial tear lubricants may relieve itching and burning. Patients should be instructed to avoid touching their eyes, wash hands often, use disposable towels, and avoid group activities for as long as an ocular discharge is present. Use of topical corticosteroids or antibacterial preparations can lead to complications, and injudicious use of topical corticosteroids may mask serious conditions that require other interventions.

Acute Disease↗
PubMed1987

Incidence and bacterial aetiology of neonatal conjunctivitis.

Two hundred and twenty-nine infants born consecutively at the maternity ward of the Middelheim Hospital in Antwerp, over a period of 5 months, and an additional 55 randomly selected infants born at the same hospital were clinically and microbiologically investigated before leaving the maternity ward. All infants born at this maternity ward received argyrol eye drops immediately after birth. Twenty-six (11%) of the infants consecutively investigated had neonatal conjunctivitis diagnosed before leaving the maternity ward, where they stayed from 7-10 days. Another 29 infants were reported to have developed sticky eyes and/or red eyes after leaving the maternity hospital and before 1 month of age. The instantaneous risk of developing, a conjunctivitis was equal for each day of the first month of life. Chlamydia trachomatis was isolated from the eyes of 11 of the 229 (4.8%) consecutively born infants but only one had conjunctivitis symptoms before leaving the maternity ward. Overall one or more bacterial species could be isolated from the eyes of 143 (48%) of the infants, but only viridans streptococci and Staphylococcus aureus were cultured significantly more often from the eyes of cases with conjunctivitis than from the eyes of the infants without conjunctivitis (P less than 0.001).

Bacteria↗
PubMed2005

Conjunction errors in recognition memory: modality-free errors for older adults but not for young adults.

A dual-process theory of memory was applied to processes in normal aging, with a focus on recognition errors in the feature-conjunction paradigm (i.e., false recognition of blackbird after studying parent words blackmail and/or jailbird). Study repetition was manipulated so that some parent words occurred once and others occurred three times. Age-related differences on hit scores occurred for two experiments. The results for feature and conjunction conditions showed repetition effects but no age-related differences when participants were uninformed of the lures (Experiment 1). However, age-related differences emerged when the retrieval of modality source information created a way to evade conjunction errors (Experiment 2). In the second experiment, study repetition decreased errors for the young adults but increased errors for the older adults, and young adults were better able than older adults to avoid conjunction errors when the parent words had been repeated. For older adults, the conjunction errors were modality-free. The results provide additional evidence that older adults experience difficulty in recollecting aspects of a study experience, and the results from groups of young adults required to respond quickly on the tests provide converging evidence for this conclusion.

Adult↗