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At least 253 records · Page 14Linked to original sources
PubMed2006

A clinicopathological analysis of the efficacy of lodoxamide 0.1% eye drops on the conjunctiva of patients with vernal keratoconjunctivitis seen at Guinness Eye Centre, Lagos University Teaching Hospital.

OBJECTIVE: To ascertain the efficacy of Lodoxamide 0.1 in the reduction of Clinicopathological signs of the conjunctiva in Vernal Keratoconjunctivitis. STUDY DESIGN: Prospective, non-comparative, Convenient Interventional Case Series. PARTICIPANTS: One Hundred consecutive patients; 57 males and 43 females within age range 2-55 years diagnosed with active and untreated Vernal conjunctivitis were enrolled. Approval was obtained from Ethical committee of Lagos University Teaching Hospital, Idi- Araba, Lagos. METHODS: Patients were given a bottle of Lodoxamide 0.1 each to instill four times daily into both eyes. Pre-treatment Clinical photographs and conjunctival biopsies were taken in 15 volunteered patients. Ocular signs and symptoms were evaluated on day 1 (baseline), days 2-3 (Interim) and then weekly for 6 weeks (final). Post treatment Clinical photographs and conjunctival biopsies were done at the 6th week. The conjunctival tissues were fixed for 24 hours in 10 Neutral buffered formalin prior to paraffin wax embedding and routinely stained with Haematoxylin and Eosin (H & E) stains. MAIN OUTCOME MEASURE: Primary outcome was based on the reduction of inflammatory cells especially the eosinophils on histological micrographs. Secondary efficacy was based on the rate and extent of reduction of the severity scores of the clinical signs and symptoms. RESULTS: Lodoxamide 0.1 ophthalmic solution significantly reduced the density of the inflammatory cells especially eosinophils in the post treatment conjunctival biopsy cytology specimen. The mean physician severity scores for signs and symptoms consistently reduced from 72 hours of commencement of Lodoxamide with remarkable improvement in a week and complete resolution of all parameters at the end of 5th week. CONCLUSION: Lodoxamide 0.1 ophthalmic solution is highly effective in alleviating the clinical signs and symptoms of Vernal Keratoconjunctivitis and its antiallergic activity is exerted by inhibiting migration of inflammatory cells mainly eosinophlis.

Adolescent↗
PubMed1991

Severe allergic keratoconjunctivitis and erythema multiforme after a routine eye examination: discerning the cause.

Acute allergic dermatitis of the eyelids with keratoconjunctivitis is associated with a specific triggering factor. Therapy for the acute inflammation can complicate the search for such a factor if the process worsens. We report a case of acute contact dermatitis and keratoconjunctivitis after a routine eye examination to demonstrate the difficulty in evaluating such patients and the role of skin patch testing in determining the cause.

1-Propanol↗
PubMed1988

Treatment of severe vernal keratoconjunctivitis with cyclosporine A eyedrops.

Twenty-one children (4 to 12 years old) with severe vernal keratoconjunctivitis refractive to treatment with corticosteroid eyedrops and/or 2% disodium cromoglycate (Optic-rom, Fisons) were treated with CsA 2% eyedrops in oil solution. Eighteen patients (86%) experienced a rapid relief of their subjective symptoms three to four days after initiation of treatment. This was accompanied by objective improvement of ocular manifestations and visual acuity within a week. Sixteen of the children (76%) remained controlled during the 6-week period of treatment. However, only five patients (24%) did not need any additional therapy 2 months after discontinuation of the CsA eyedrops. These findings can be interpreted as an indication for the possible involvement of interleukin secretion in the clinical manifestations of vernal keratoconjunctivitis. Alternatively, the beneficial effects of CsA in this disease may be due to a direct effect on the mast cells preventing the release of their mediators.

Child↗
PubMed1987

Limbal vernal keratoconjunctivitis with a hypertrophic limbal mass lesion.

A case of limbal vernal keratoconjunctivitis associated with a hypertrophic mass lesion measuring 8 X 5 X 3 mm is reported. The histopathology of this mass, which consisted of hyperplastic epithelium with eosinophilic infiltration and thickened subepithelial stroma of irregular hyperplastic collagenous connective tissue interspersed with numerous eosinophils and inflammatory cells, is presented. A large limbal-mass lesion such as this has not been previously described in association with limbal vernal keratoconjunctivitis.

Child↗
PubMed1995

Topical flurbiprofen therapy in vernal keratoconjunctivitis.

A clinical study of 90 cases of vernal keratoconjunctivitis was conducted to ascertain the efficacy of the local use of flurbiprofen and compare its effect with that of betamethasone. According to this study flurbiprofen was found to be effective in vernal keratoconjunctivitis, but less so than betamethasone. Because of the side effects due to prolonged use of steroids, it is recommended that topical flurbiprofen be tried first and in case it is ineffective, it should be replaced by betamethasone.

Administration, Topical↗
PubMed1997

Elevated levels of substance P in tears of patients with allergic conjunctivitis and vernal keratoconjunctivitis.

BACKGROUND: Recent studies have suggested that the nervous system may participate in inflammatory processes. Substance P (SP) acts as a chemical mediator as well as a neurotransmitter. OBJECTIVE: In order to clarify the pathogenesis of ocular allergic diseases, we assessed the concentration of SP in tears. METHODS: Using a highly sensitive and specific double-antibody enzyme immunoassay (EIA), we determined the SP concentration in tears of 10 patients with seasonal allergic conjunctivitis, 10 with atopic dermatitis without keratoconjunctivitis (AD), 13 with vernal keratoconjunctivitis (VKC) and 65 normal controls. Giemsa's staining for brush cytology samples and histocytological study by immunocytochemical staining of giant papillary conjunctival cells from VKC and normal controls was conducted. RESULTS: The mean SP level was low in the normal controls and AD, whereas patients with seasonal allergic conjunctivitis and VKC showed significant elevation of SP (P < 0.01). Brush cytology samples showed conjunctival epithelial cells with lymphocytes, neutrophils and eosinophils that were not seen in normal subjects. Histocytological examination demonstrated SP positive cells in the conjunctiva of patients with VKC, but not in normal controls. CONCLUSION: This study suggests that the increased level of SP in tears may contribute to the pathogenesis and severity of ocular allergic diseases.

Adolescent↗
PubMed1988

Sodium hyaluronate and polyvinyl alcohol artificial tear preparations. A comparison in patients with keratoconjunctivitis sicca.

An unpreserved artificial tear substitute containing 0.1% sodium hyaluronate was compared with a preparation containing 1.4% polyvinyl alcohol and 0.5% chlorobutanol in a controlled, double-masked, randomized study in patients with moderately severe keratoconjunctivitis sicca. Patients were evaluated initially, at 1, 4, and 8 weeks. The dry-eye status was evaluated by means of tear-film osmolality, tear breakup time, rose bengal staining, Schirmer's test (without anesthesia), and ocular surface-impression cytology. In general, neither preparation was found to be superior to the other. In both study groups, the mean tear-film osmolality and rose bengal staining score improved over the eight-week study, but the degree of squamous metaplasia of the bulbar conjunctival surface, as shown by impression cytology, did not change significantly.

Clinical Trials as Topic↗
PubMed1988

Keratoconjunctivitis sicca in rheumatoid arthritis.

The prevalence of keratoconjunctivitis sicca (KCS) was studied in a randomly selected group of 104 patients with rheumatoid arthritis (RA). Symptoms of KCS were noted in 33 patients (31.7%) and they were studied further. After rose bengal staining, 22 of these patients were found to have KCS which was diagnosed by the presence of corneal or conjunctival desiccation. The overall prevalence of KCS was 21.2%. Although an abnormal Schirmer's test was noted in 21 of the 22 patients with KCS, only 8 patients had values of 5 mm or less while the remainder had a mild abnormality ranging from 6 to 15 mm. A reduced marginal tear film was noted in 15 patients (68.2%) with KCS and 13 patients (59%) had a reduced tear break-up time. The Schirmer's test alone is inadequate to make a definite diagnosis of KCS and it is essential to perform slit lamp examination to detect epithelial staining with rose bengal.

Adult↗
PubMed1988

Diagnostic tests in patients with symptoms of keratoconjunctivitis sicca.

We compared the relative value of the tear film breakup time, Schirmer test, lactoferrin immunologic assay and rose bengal staining in 156 patients with varying severity of symptoms characteristic of keratoconjunctivitis sicca and in 39 controls. Statistical analysis showed that in patients with minimal ocular irritation the Schirmer test in combination with the lactoferrin immunologic assay provided an optimal balance between high test sensitivity and low false-positive rates. In patients with moderate to severe ocular burning, foreign body sensation, or pain but with no systemic symptoms of dry mouth or arthritis, and in patients with both ocular and systemic complaints, the lactoferrin assay alone provided statistically significant results. Tear film breakup time and staining with rose bengal were not useful and the Schirmer test had limited value in measuring the rate of tear secretion in these patients.

Adult↗
PubMed1989

Keratoconjunctivitis sicca with associated secondary uveitis elicited in rats after systemic xylazine/ketamine anesthesia.

The systemic administration of an anesthetic dosage of a combination of xylazine and ketamine hydrochloride produced an acute exposure keratopathy which progressed into a syndrome resembling keratoconjunctivitis sicca. Within a few minutes corneal changes occurred that were characterized by viscous mucus, loss of corneal luster and dryness. Other acute but transient changes included development of cataracts, mydriasis and proptosis. Progressive changes were observed in the cornea within 4 days which lasted at least 8 weeks in some cases, and included punctate epithelial keratopathy progressing to devitalized or keratinized epithelial plaques. Polymorphonuclear cell infiltration of the corneal stroma associated with plaques occurred. Epithelial denudation and neovascularization of the cornea, dilation and engorgement of iridial blood vessels, as well as flare in the anterior chamber were also seen. The ocular lesions induced by xylazine/ketamine should be considered carefully when designing or interpreting research on the anterior segment. Ketamine hydrochloride with sodium pentobarbital produced excellent anesthesia without any significant ocular side-effects and may be preferred in many instances.

Animals↗
PubMed1986

Treatment of superior limbic keratoconjunctivitis by thermocauterization of the superior bulbar conjunctiva.

Superior limbic keratoconjunctivitis (SLK) is a chronic and recurrent inflammatory disease of the superior tarsal, bulbar and limbal conjunctiva that often responds to topical treatment with silver nitrate. As an alternative treatment in 11 patients (13 eyes), we applied thermal cautery to the inflamed superior bulbar conjunctiva following subconjunctival injection of 2% xylocaine. The overall positive response rate to thermocautery was 73% (8 patients). Of the positive responders, 63% (5 patients) had been considered silver nitrate treatment failures. Keratitis sicca was additionally noted in 55% of the patients studied. Impression cytology of involved superior bulbar conjunctiva was nearly devoid of goblet cells during the acute stage of the disorder. Following successful cauterization, goblet cells returned. Thus, thermocauterization of the superior bulbar conjunctiva appears to be a safe and effective mode of therapy for SLK.

Adult↗
PubMed1989

Open-label crossover study of vitamin A ointment as a treatment for keratoconjunctivitis sicca.

The authors evaluated the efficacy of all-trans retinoic acid (vitamin A) ointment as a treatment for keratoconjunctivitis sicca (KCS) in a group of 11 patients selected on the basis of clinical history, slit-lamp examination results, rose Bengal staining, and tear film osmolarity. In this open-label crossover study, vitamin A ointment was no more effective than placebo in increasing tear secretion, as indicated by Schirmer test with proparacaine or tear film osmolarity, or in decreasing ocular surface disease, as indicated by rose Bengal staining. Seven patients stated some preference for the placebo ointment, two patients for the vitamin A ointment, and two patients had no preference.

Adult↗
PubMed1990

Keratoconjunctivitis sicca in male patients infected with human immunodeficiency virus type 1.

Keratoconjunctivitis sicca (KCS) has not been reported as occurring as a single entity in the acquired immune deficiency syndrome (AIDS) population. In a survey of human immunodeficiency virus type 1 (HIV-1) infected male patients, the authors found that 21% (9/42) had signs and symptoms compatible with KCS with positive Schirmer test results. Tear osmolarity determinations were obtained from this group and from an age- and sex-matched group of HIV-infected patients without symptoms of KCS and with negative Schirmer test results. Eighty-nine percent of the suspect group had increased tear osmolarity, whereas none of the control patients had a hyperosmolar tear film (P less than 0.0001). Results strongly suggest that KCS occurs at a significantly greater rate in male individuals infected with HIV-1 than in the general population.

Adult↗
PubMed1990

A new perspective on canine keratoconjunctivitis sicca. Treatment with ophthalmic cyclosporine.

Keratoconjunctivitis sicca is the major cause of chronic or recurrent conjunctivitis in dogs. The diagnosis of KCS is often delayed or mistaken for allergic or bacterial conjunctivitis and inappropriate or insufficient treatment leads to progressive corneal scarring and blindness in many dogs. The cause of KCS in dogs has not been proven, but evidence supports an immune-mediated etiology for the majority of cases. In an attempt to specifically treat the cause of KCS, a new immunosuppressant drug, cyclosporine, has been used in a topical preparation. Treatment results using ophthalmic cyclosporine are dramatic compared with historical treatments. Resolution of corneal scarring and increased lacrimation are seen in most dogs. Investigations of the mechanism of action of ophthalmic cyclosporine suggest the efficacy may have been serendipitous. A local neuroendocrine effect of cyclosporine on the lacrimal gland may actually be responsible for the increased lacrimation. Early diagnosis of KCS and treatment with ophthalmic cyclosporine may avert a major cause of blindness in dogs.

Animals↗
PubMed1988

[Treatment of a severe course of keratoconjunctivitis sicca with eledoisin].

Cases of keratoconjunctivitis sicca with keratitis filiformis (with and without Sjögren's syndrome) with severe courses cannot be treated adequately with artificial tears. Only since the discovery of Eledoisin, which was introduced for ophthalmological therapy by Bietti, has a drug been available which directly stimulates tear secretion. Eledoisin was discovered in the salivary glands of certain Mediterranean species of octopus and can meanwhile be produced synthetically. A randomized study conducted at the University clinics in Heidelberg, Cologne, and Ulm showed that Eledoisin is significantly superior if the statistics are based on cases with severe courses. Cases with less severe courses also respond well to therapy with artificial tears.

Adult↗
PubMed1989

Sodium hyaluronate in the treatment of keratoconjunctivitis sicca. A double masked clinical trial.

The effect of sodium hyaluronate eye drops in the treatment of severe keratoconjunctivitis sicca (KCS) was evaluated in a double masked crossover trial, comparing the effect of a 0.1% solution, a 0.2% solution and placebo in 20 patients. We found significantly decreased rose bengal staining and increased break-up time following 0.2% treatment compared to placebo. No significant difference was found in the Schirmer values and the cornea sensitivity. The patients significantly preferred sodium hyaluronate treatment. We conclude that sodium hyaluronate eye drops seem to be a valuable new agent in the management of KCS.

Adult↗
PubMed1987

Diagnosis and treatment of keratoconjunctivitis sicca in the dog.

Keratoconjunctivitis sicca (KCS) is a relatively common eye disease in the dog. The diagnosis is discussed, particularly of the early or mild case. The various types of medical treatment are described, including replacement therapy with artificial tears and ocular inserts, as well as other preparations; lacrimogenics; and other forms of medical treatment, including antibiotics, corticosteroids, mucolytics and hormones. Contraindicated drugs and agents are listed. Surgical treatments, including punctal occlusion, tarsorrhaphy, conjunctival flaps, contact lenses, superficial keratectomy, as well as parotid duct transposition, are discussed and the procedure indicated which is best suited to the case. The choice of treatment according to the severity of the KCS is also given.

Animals↗
PubMed1988

Tear function parameters in keratoconjunctivitis sicca with and without the association of Sjögren's syndrome.

In a group of patients with keratoconjunctivitis sicca (KCS) associated with Sjögren's syndrome (SJ) a significant decrease in tear fluid lactoferrin concentration and tear film break-up time was demonstrated in comparison with a matched group in which KCS was not associated with any systemic disease. The Schirmer values were also lower in the SJ of patients and these differences almost reached statistical significance. None of these parameters in itself appeared to be of any clinical value to differentiate between KCS that was or was not associated with SJ. The combination of the tear fluid lactoferrin concentration, the Schirmer I test values and the tear film break-up time, however, provide a basis for differential diagnosis that is clinically of some value.

Adult↗