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PubMed2003

[Atopic keratoconjunctivitis: probably a risk factor for the development of conjuntival carcinoma].

BACKGROUND: Almost half of the patients with atopic dermatitis experience chronic inflammation of the eyelids, the conjunctiva and the cornea. Chronic inflammation is a possible cause for the development of malignancies, especially if associated with some kind of immunological defect as in atopic patients. So far, a correlation between atopic conjunctivitis and conjunctival malignancies has not yet been reported. Here, we present 7 atopic patients with conjunctival carcinoma or carcinoma in situ detected between February 2000 and August 2001. PATIENTS: All 7 patients had a long history of atopic dermatitis and chronic of inflammation of the conjunctiva and cornea. In all patients smears were examined by cytology and DNA cytometry. Furthermore, in 6 of the 7 patients a histopathological examination of conjunctival biopsies was performed. RESULTS: In 4 of the 7 patients invasive conjunctival carcinoma and in 2 carcinoma in situ were detected. Cytology and cytometry revealed conjunctival carcinoma or carcinoma in situ in the remaining patient. Histopathological examination could not be performed since the patient refused to have a conjunctival biopsy. CONCLUSIONS: These results suggest that atopic keratoconjunctivitis might be a risk factor for the development of conjunctival carcinoma.

Adult↗
PubMed1998

[Transplantation of autologous submandibular glands in very severe keratoconjunctivitis sicca. 2 year outcome].

INTRODUCTION: The conservative treatment of the most severe cases of keratoconjunctivitis sicca (KCS) can be sometimes frustrating. Especially with an underlying autoimmunologic disorder, even the application of artificial tears as often as every 5 min may not prevent further damage to the ocular surface. A microvascular transplantation of the autologous submandibular gland (SG) can be performed by a maxillo-facial surgeon as an alternative approach for those cases. We report 2 years of ophthalmological experience with the results of this procedure. MATERIAL AND METHODS: To date 27 operations have been performed in 23 patients. The SG was moved from its natural site into the temporal fossa. The secretory duct was implanted into the conjunctival fornix and the gland's vessels connected to the temporal artery and vein. A complete ophthalmological examination has been performed in 25 eyes of 21 patients up to 1 year and in 11 eyes of 9 patients 2 years after surgery. RESULTS: Three months and 1 year postoperatively 19 of 25, and 2 years postoperatively 8 of 11 transplants remained vital. The baseline secretion increased in patients with a vital transplant from an average of 1.6 +/- 1.3 mm before the operation to 16.2 +/- 11.3 mm after 3 months and 20.6 +/- 10.6 mm after 1 year. Ten of 19 vital grafts were reduced 1 year after transplantation in a minor second procedure to control an increasing epiphora. Subsequently baseline secretion was reduced to 13.6 +/- 8.2 mm 2 years after transplantation. Patients with a vital graft reported in 84% of cases (16 of 19) at 3 months, and 79% at 1 year (15 of 19) and 2 years (7 of 8), a strong relief of dry eye symptoms. In 58% (3 months), 79% (1 year) and 63% (2 years) of the eyes with a vital transplant all artificial tear substitution could be stopped. Break-up time increased significantly, resulting in reduced bengal rose staining. CONCLUSION: The transfer of the autologous SG into the temporal fossa can be used to provide patients with very severe KCS with a continuous, endogenous source of ocular lubrication. Despite surgical denervation the graft maintains a sufficient baseline secretion over a period of years. Subjective symptoms and the application of pharmaceutical lubricating substances are reduced to a large extent. If epiphora occurs, it can be controlled by surgically reducing the transplant. The influence of SG saliva on the ocular surface is the object of ongoing studies.

Adult↗
PubMed2000

[Local cyclosporin A in nummuli after keratoconjunctivitis epidemica. A pilot study].

BACKGROUND: Recurrences are common after discontinuing topical steroids against nummular infiltrates following adenoviral keratoconjunctivitis (AK). To avoid the potentially serious side effects of resumed steroid treatment at increased doses we tested topical 2% cyclosporin A (CSA). PATIENTS: We applied four drops of CSA daily to 70 eyes (48 patients) with persistent nummular infiltrates after AK. Treatment began 18.5 months (3-72) after the acute phase of AK. Dose reduction depended on resolution of the nummuli in the individual patients. RESULTS: Of the 70 eyes 40 responded positively to therapy, 16 showed no change, therapy was stopped in 4 because of ocular discomfort (burning), and in 10 eyes follow-up is still less than 3 months. CONCLUSIONS: CSA was effective in eliminating or reducing nummuli in the majority of patients. More than one-half of the responding eyes had a complete cure and did not experience recurrences after stopping therapy. We therefore consider topical CSA to be a safe and effective alternative to topical steroids for treating nummular infiltrates after AK.

Adult↗
PubMed2002

Group IIA phospholipase A2 content of tears in patients with keratoconjunctivitis sicca.

PURPOSE: To determine the concentration of group IIA phospholipase A2 (GIIAPLA(2)) in tears of patients with keratoconjunctivitis sicca (KCS) and to compare it with the GIIAPLA(2) content of tears in age-matched healthy controls. METHODS: The GIIAPLA(2)content of tears was measured with time-resolved fluoroimmunoassay in 20 patients with KCS (mean age 70.7+/-8.7 years) and in 20 normal subjects (mean age 70.2+/-9.9 years). RESULTS: The GIIAPLA(2)content of tears in patients with KCS was 75.8+/-54.2 microg/ml and in normal subjects it was 34.2+/-21.4 microg/ml. The difference was statistically significant. In patients with KCS the GIIAPLA(2) concentration slightly increased with decreasing Schirmer test values (Spearman's correlation =-0.20) CONCLUSION: The results of this study indicate that in patients with KCS the relative concentration of GIIAPLA(2) of tears was increased due to decreased aqueous production in the lacrimal glands and better preservation of the acinar cells in the central parts of the lobules of the lacrimal glands producing GIIAPLA(2).

Aged↗
PubMed1997

Conserved sequences in the fibers of epidemic keratoconjunctivitis associated human adenoviruses.

The fiber gene sequences of the human adenovirus types 19 and 37 were determined. The predicted polypeptides exposed a high homology. Ad8, Ad19, and Ad37 can cause epidemic keratoconjunctivitis (EKC), whereas Ad9 only infrequently causes acute follicular conjunctivitis. Comparison of the fiber knobs of Ad8, Ad9, Ad19, Ad37, and other previously published fiber sequences revealed that only two amino acid residues were conserved in the fiber knobs of Ad8, Ad19, and Ad37. Since the knob is responsible for interaction with the cell receptor, these two amino acid residues could play an important role in the pathogenicity of EKC causing adenoviruses.

Adenoviridae↗
PubMed2005

Identification of 9-O-acetyl-N-acetylneuraminic acid in normal canine pre-ocular tear film secreted mucins and its depletion in Keratoconjunctivitis sicca.

O-Acetylated sialic acids have been reported in many sialoglycoproteins where they mediate a variety of immune and other biological events. We have previously demonstrated that the protective mucus barrier on the surface of the canine eye contains sialoglycoproteins. We have also investigated the occurrence of O-acetylated sialic acids in these ocular mucins. Mucus aspirated from the surface of normal dog eyes and those with keratoconjunctivitis sicca (KCS) was fractionated into three pools by density gradient centrifugation. Sialic acids comprised 0.6-0.9% of the dry weight of the mucins isolated. The sialic acid profile in these pools was examined using HPLC. O-Acetylated sialic acids, mainly Neu5,9Ac2, were detected in normal animals and made up 10-30% of the total sialic acids detected. A doubling of the sialic acid content was found in KCS mucins, but the level of 9-O-acetylated sialic acid was reduced below 4% of total. Histological analysis of conjunctival tissue from normal and KCS dogs showed the presence of sialic acids, detected with the alpha(2-6) sialic acid-specific lectin Sambucus nigra, in the goblet cells and corresponding to the staining pattern for MUC5AC, the major ocular-secreted mucin gene product. In KCS animals a disruption of the normal pattern of conjunctival goblet cells was seen with preservation of the pattern of lectin binding observed in normal animals. Thus the data demonstrate the presence of mono-O-Acetylated sialic acids in normal canine ocular mucins and a loss of this population of sialic acids in dry eye disease in spite of a significant increase in total sialic acids in KCS mucin.

Animals↗
PubMed2002

Keratoconjunctivitis sicca and chronic HCV infection.

BACKGROUND: The aim of this study was to determine the prevalence of keratoconjunctivitis sicca (KCS) in Greek patients with chronic hepatitis C virus (HCV) infection and its association with HCV genotypes and liver histology. PATIENTS AND METHODS: 93 HCVAb (+) patients underwent lacrimal function testing (Schirmer-1 test, break-up time test and Rose-Bengal staining test) and estimation of serum cryoglobulins and autoantibodies. 80 healthy volunteers were included in the study as controls. RESULTS: 34 out of 93 HCV patients (36.6%) and eight out of 80 healthy subjects (10%) had at least two abnormal lacrimal function tests suggestive of KCS (p < 0.001), cryoglobulinemia was evident in 20 patients (21.5%), rheumatoid factor (RF) in 43 (46.2%), antinuclear antibodies (ANA) in 19 (20.4%), antinuclear antigens (anti-SS-A and anti-SS-B) in one (1.1%) and two (2.2%) patients, respectively. Reduced prevalence of KCS was found in patients with genotype 3a compared to those with other genotypes (5/30, 16.7% vs 20/42, 47.6%, p = 0.007), probably because of their younger age. In patients with KCS a higher staging score was noted in liver biopsy compared to those without KCS (4.50 +/- 1.65 vs 3.06 +/- 1.88, p = 0.005). CONCLUSION: Greek patients with chronic HCV infection have a high prevalence of KCS (36.6%). The low frequency of anti-SS-A and anti-SS-B antibodies in these patients denotes different pathogenetic associations from primary Sjogren's syndrome.

Adolescent↗
PubMed1975

Epidemic hemorrhagic keratoconjunctivitis.

A new type of acute keratoconjunctivitis developed throughout Southeast Asia, beginning in Singapore in the summer of 1970. It was highly contagious and probably was transmitted from person to person by the hand to eye route. Sixteen cases, diagnosed by viral isolation or serologic study, or both, were subjected to detailed clinical observation. The characteristic features included a short incubation period of one or two days, watery or serous discharge, subconjunctival hemorrhage, and pinpoint superficial keratopathy. The disease usually resolved rapidly within one to two weeks without sequelae.

Adolescent↗
PubMed1977

Conjuctivitis and keratoconjunctivitis associated with primary immunodeficiency diseases.

Nineteen patients with a variety of well-defined primary immunodeficiency diseases were examined for ocular abnormalities. Eight patients with low levels, or absence, of all the major serum immunoglobulins had conjunctivitis or keratoconjunctivitis associated with bacterial infection. The remaining 11 patients, who had at least one immunoglobulin class present in normal concentration in the serum, showed no inflammatory ocular lesion. Absence of only IgA, the major tear immunoglobulin, did not predispose the eye to these lesions.

Adolescent↗
PubMed1979

Gentian violet keratoconjunctivitis.

A case of bilateral keratoconjunctivitis caused by self-instillation of a 1% aqueous solution of gentian violet was complicated by a secondary uveitis and gram-negative conjunctivitis. The patient was treated with cycloplegics and specific antibiotics and after resolution of the bacterial infection, a mild topical corticosteroid was used. After six months the patient had completely recovered from the keratitis, but bilateral corneal vascularization, had unilateral posterior synechiae, corneal scarring, and cataract formation were present. Cationic dyes such as gentian violet appear to be toxic to the ocular surfaces and tend to produce severe intraocular inflammation.

Administration, Topical↗
PubMed1979

Chronic keratoconjunctivitis associated with ocular adenovirus infection.

Adenovirus (types 3, 4, 5) was implicated as the etiologic agent in three cases of persistent keratoconjunctivitis. In two, virus was isolated 25 and 29 months after the onset of symptoms; the third patient has suffered intermittent flares of kerato-conjunctivitis since the initial isolation of virus 13 weeks after the onset of the disease. Such patients may represent a previously unsuspected source of adenovirus in the population. All were given corticosteroids topically. This treatment may have prolonged the adenoviral disease.

Adenoviridae Infections↗
PubMed1986

Cyclosporine eyedrops for the treatment of severe vernal keratoconjunctivitis.

Twelve children with severe chronic vernal keratoconjunctivitis participated in a pilot study aimed at evaluating the effect of 2% cyclosporine eyedrops on the clinical course and symptoms of this disease. Eleven of the 12 children showed improvement after the first week of treatment. Nine patients demonstrated persistent improvement at the completion of the treatment schedule after six weeks. However, although seven of the children were symptom-free while being treated, only three were free of disease two months after cessation of the cyclosporine eyedrops. The other nine showed rapid recurrence of their symptoms.

Child↗
PubMed1982

Immunochemical determination of human tear lysozyme (muramidase) in keratoconjunctivitis sicca.

Radial immunodiffusion was tested as an alternative for the agar diffusion assay for lysozyme in tear fluid. The influence of interactions between lysozyme and agarose or filter paper, used for sample collection, on the results of the immunodiffusion test was investigated. In 100 tear samples from 50 healthy volunteers and average lysozyme concentration of 1.9 g/l was found. Lysozyme values obtained by both methods in the tear fluid of a group of 78 volunteers, ranging from healthy individuals to severe keratoconjunctivitis sicca patients were compared. A lower limit of normal at 1.1 g/l was found by the radial immunodiffusion assay.

Diffusion↗
PubMedDate not supplied

Causes of conjunctivitis and keratoconjunctivitis in Karachi, Pakistan.

The causes of conjunctivitis and keratoconjunctivitis in 388 patients who attended eye casualty departments in Karachi, Pakistan, during a 5 month period were investigated. Most of these infections were diagnosed as adenovirus (291, 75%) or bacterial (71, 18.3%). Of the remainder, 9 cases (2.3%) were caused by herpes simplex virus and 7 (1.8%) by Chalmydia trachomatis. There was no evidence of typical active trachoma in this urban population. Bacteria or Candida albicans were also grown from 44 of the adenovirus cases (15%). Many of the bacteria grown from eyes in this study were resistant to antibiotics, probably because of inadequate and/or inappropriate self-medication with antibiotics in this community.

Adenovirus Infections, Human↗
PubMedDate not supplied

Gonococcal keratoconjunctivitis.

Gonococcal keratoconjunctivitis is a potentially devastating infection, because Neisseria gonorrhoeae can cause a rapid, severe, ulcerative keratitis resulting in visual loss. The therapeutic decision making process is complicated by the necessity for prompt, effective parenteral therapy, frequent coinfection with other sexually transmitted diseases, and emergence of antibiotic resistance. Because of the evolving problem of antibiotic resistance and the need for cost containment, the current recommendations of hospitalization for intravenous penicillin may need to be modified. The third generation cephalosporin, ceftriaxone, has properties that suggest it may be the best available antimicrobial agent as a single-dose treatment of gonococcal conjunctivitis. Spectinomycin may be a useful alternative in the penicillin-allergic adult patient.

Adult↗
PubMed1995

Cellular immunity in dogs with keratoconjunctivitis sicca before and after treatment with topical 2% cyclosporine.

Peripheral cellular immunity of ten dogs with keratoconjunctivitis sicca (KCS) that had not been treated with topical corticosteroids or cyclosporine was evaluated (by use of in vitro lymphocyte proliferation assays and CD4+/CD8+ lymphocyte subset analysis) before and after 1 and 3 months of treatment with topical ocular 2% cyclosporine (CsA). In vitro lymphocyte proliferation and CD4+/CD8+ lymphocyte subset analysis was done in eight normal dogs at the 0, 1 and 3 month time periods to use for comparison. There was no significant difference in lymphocyte proliferation or numbers of CD4+ or CD8+ lymphocytes in dogs with KCS and normal dogs prior to CsA treatment. However, by 1 month's time, lymphocyte proliferation had decreased in the CsA-treated Dogs with KCS, and by 3 months there was a significant difference (P < 0.0001) from the normal dogs. These results suggest that dogs with KCS may not have altered peripheral cellular immunity and that use of topical 2% cyclosporine for treatment of KCS causes a suppression of lymphocyte proliferation after 1 to 3 months of use.

Administration, Topical↗
PubMed1992

The protective efficacy of pili from different strains of Moraxella bovis within the same serogroup against infectious bovine keratoconjunctivitis.

Three groups of ten calves were each immunised with a total of 400 micrograms pili prepared from three separate strains of Moraxella bovis in Alhydrogel-oil adjuvant as two divided, equal doses 21 days apart. Groups 1 and 2 each received a monovalent vaccine made from strain 4L and S276R respectively, which belonged to pili serogroup A. Group 3 received vaccine made from pili of strain Maff1, belonging to serogroup F. A further group of ten calves served as non-vaccinated controls. Calves in groups 1 and 2 had developed serogroup A-specific antibody and those in group 3 developed serogroup F-specific antibody, and some evidence of cross-reacting antibody was also detected when measured by an agglutination test using formalin-killed piliated cells of serogroup A strain 4L. Although antibody titres measured against purified pili by ELISA were highest with homologous serogroup antigens, cross-reactive titres to shared epitopes of M. bovis pili were also detected by this method. Ocular challenge of the 40 calves with virulent M. bovis of serogroup A strain S276R was carried out 14 days after the second vaccine dose. All non-vaccinated calves developed infectious bovine keratoconjunctivitis (IBK). The percentage protection in groups 1 (strain 4L) and 2 (strain S276R) was 60% and 80% respectively (P less than 0.05), with mean lesion scores of 0.7 and 0.3 out of a possible 6.0. The percentage protection of calves in group 3 (strain Maff1) was only 30%, with a mean lesion score of 1.4 compared with 2.2 for non-vaccinated controls. The present findings, together with other evidence indicating that immunity to IBK is serogroup-specific, suggest that inclusion of pili from one representative strain from each of the seven Australian and British serogroups in a polyvalent, subunit vaccine should effectively protect the majority of cattle against IBK caused by most field strains of M. bovis encountered in Australia and the United Kingdom.

Animals↗