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PubMedDate not supplied

Conjunctival scrapings and impression cytology in chronic conjunctivitis. Correlation with microbiology.

To assess the utility of exfoliative cytology in the diagnosis of chronic conjunctivitis, we compared its findings with microbiological examination and established the correlation between cytology and microbiology in 32 patients with conjunctivitis lasting four weeks or more, with a nonspecific clinical picture. The material for cytology was collected by scraping and by imprint of the ocular surface on Millipore filter paper. The specimens were stained with Giemsa. Material for bacterial culture and fluorescent antibody test for viruses and Chlamydia were obtained at the same time. In 12 patients neutrophils predominated in cytology, in six eosinophils were found and in four there were more lymphocytes. One patient had a basophilic intracytoplasmic inclusion specific for Chlamydia infection. In eight patients coagulase-negative Staphylococcus species and in one Staphylococcus aureus were isolated, in two the fluorescent antibody test for Chlamydia was positive and in three for viruses. In all patients with a positive bacterial culture, a predominance of neutrophils was observed. All patients with a positive test for viruses had lymphocytosis in conjunctival scrapings. In two patients microbiology detected Chlamydia, but characteristic intracytoplasmic inclusions were observed only in one. Scrapings gave more specific results, that correlated well with microbiology in bacterial and viral infection, whereas the results of impression cytology showed minor metaplastic changes of epithelial cells that were nonspecific for the type of inflammation. Cytology remains a useful non-invasive tool and is an adjunct to clinical and microbiological examination. It proved especially helpful in allergic conjunctivitis.

Antibodies, Bacterial↗
PubMed1987

An epidemic of acute hemorrhagic conjunctivitis in the city of Sao Paulo.

This is a clinical and laboratory report on 98 patients with acute viral conjunctivitis who were referred to the Eye Clinic of the Escola Paulista de Medicina of Sao Paulo, Brazil, from February 1983 to February 1984. It was planned with the objective of confirming the importance of adenovirus and enterovirus 70 as etiological agents of viral conjunctivitis. The occurrence of an outbreak of acute hemorrhagic conjunctivitis during the summer of 1984 permitted a better study of enterovirus 70. In addition, we could demonstrate that sporadic cases, from March to July 1983, were caused by the same virus. This fact confirmed the idea that the spread of the disease was not related to the recent arrival of the virus in the community, but to weather conditions of heat and high humidity.

Adenovirus Infections, Human↗
PubMed1986

Efficacy and safety of topical oxymetazoline in treating allergic and environmental conjunctivitis.

This randomized, double-masked study evaluated the safety and efficacy of oxymetazoline 0.025% topical ophthalmic solution compared with its vehicle when used to treat allergic or environmental conjunctivitis. Thirty-nine patients with moderate bilateral conjunctival hyperemia instilled one drop of either oxymetazoline 0.025% solution or its vehicle twice daily for one week. At each evaluation the signs and symptoms of conjunctivitis were evaluated, complete eye examinations were performed, and heart rate and blood pressure were measured. An overall assessment of treatment efficacy was made at each follow-up evaluation. The signs and symptoms of conjunctivitis had significantly improved in the oxymetazoline-treated group when compared with those of the vehicle-treated group, and the ocular and systemic safety of each treatment was comparable.

Administration, Topical↗
PubMed1981

Adult inclusion conjunctivitis. Clinical characteristics and corneal changes.

Twenty-five consecutive cases of adult inclusion conjunctivitis were studied. Diagnosis was based on the finding of typical Halberstaedter-Prowazek inclusion bodies on conjunctival scrapings. Corneal involvement was common (20/25 patients); most frequent was superficial epithelial keratitis (15/25). Other changes seen included subepithelial nummular keratitis (6/25), marginal keratitis (2/25), (4/25). There seemed to be a predilection for involvement of the upper half of the cornea. Conjunctival scarring occurred in one patient only. Associated genitourinary symptoms were spontaneously reported in three patients only; however, on careful questioning, an additional 12 patients were found to have a history of urethritis or cervicitis. A comparison with viral follicular conjunctivitis is made. The location and pattern of keratopathy, associated genitourinary complaints, mucopurulent nature of discharge, and lack of response to standard topical therapy would seem to suggest chlamydial cause. Conjunctival scrapings are very helpful in differential diagnosis between viral and chlamydial conjunctivitis.

Adolescent↗
PubMed1982

Laboratory studies in acute conjunctivitis.

In 84% of 700 consecutive cases of untreated acute conjunctivitis subjected to conjunctival cultures and scrapings, a presumptive etiologic diagnosis could be made based on standard microbiologic and cytologic criteria. Of these 583 cases, 264 were bacterial, 245 were viral, 51 were allergic, and 17 were chlamydial. In 75% of the cases, clinical impressions were consistent with laboratory findings. On the basis of these results, laboratory workup is recommended in (1) follicular conjunctivitis to differentiate viral from chlamydial processes, (2) purulent conjunctivitis to identify pathogens and decide on appropriate antimicrobial therapy based on sensitivity data, and (3) those cases in which the clinical picture is not sufficiently distinctive to suggest an etiologic diagnosis.

Acute Disease↗
PubMed1983

Treatment of contact lenses with papain. Increase in wearing time in keratoconic patients with papillary conjunctivitis.

In 15 Keratoconic patients with papillary conjunctivitis associated with wearing rigid polymethylmethacrylate contact lenses, the cleaning of the lenses with enzymatic contact lens cleaner (papain) increased lens wearing time in nine and diminished the symptoms of mucus and itching in 12. In 13 control, lens-wearing keratoconic subjects with papillary conjunctivitis, three had a decrease, four had an increase, and six had no change in lens wearing time and one had a diminution of symptoms. Use of the enzymatic contact lens cleaner did not, however, influence the biomicroscopic appearance of the papillary conjunctivitis. The inclusion of the enzymatic contact lens cleaner in the cleaning regimen offered an adequate improvement in wearing time and tolerance for three of four patients that previously suffered a reduction in wearing time that compromised or precluded their vocational responsibilities.

Adult↗
PubMed1999

Four new genotypes of adenovirus type 3 isolated from patients with conjunctivitis in Japan.

Adenovirus type 3 (Ad3) was the most frequently isolated serotype from patients with conjunctivitis during the period from 1989 to 1991 in Japan. All Ad3 strains isolated in 1990 had an identical genotype, Ad3f. However, in 1992, the predominant serotype was replaced by Ad4. The genome type was examined to determine whether genetic changes existed in Ad3 isolates in 1992. Ad3 isolated from 55 patients with acute conjunctivitis during the period from June 1992 to February 1993 in Japan was assessed by genome typing with restriction endonucleases BamH I, Bgl II, Hind III, and Sma I recognizing 6-base-pair sequences. The emergence of four new genotypes of Ad3 was identified; one with a new Bam HI site (one isolate), one with a new Bgl II site (two isolates), one with a new Hind III site (three isolates) and one with a new Sma I site (two isolates). This study demonstrates that the emergence of a new genotype of Ad3 may contribute to the replacement of the predominant serotype associated with adenovirus conjunctivitis in Japan.

Adenovirus Infections, Human↗
PubMed1993

Outbreak of adenovirus type 4 conjunctivitis in South Australia.

An outbreak of adenovirus type 4 conjunctivitis occurred in South Australia between April and November 1992. Eye swabs were submitted by general practitioners and ophthalmologists who had seen patients with clinical conjunctivitis or keratitis. Apart from interfamilial spread, there were no other common epidemiological factors. Adenovirus was isolated from the eye swabs of 38 patients. Isolates were typed by neutralisation tests and restriction endonuclease cleavage patterns and found to be adenovirus type 4. This report serves to illustrate an infrequent cause of epidemic conjunctivitis, namely adenovirus type 4. There was no demonstrable focus of the outbreak.

Adenovirus Infections, Human↗
PubMed2005

Outbreak of acute hemorrhagic conjunctivitis in French Guiana and West Indies caused by coxsackievirus A24 variant: phylogenetic analysis reveals Asian import.

An outbreak of acute hemorrhagic conjunctivitis occurred in French Guiana between April and July 2003, with approximately 6,000 cases in the two major cities Kourou and Cayenne. Since acute hemorrhagic conjunctivitis is not a notifiable disease in France, there was no registration of the number of cases. Therefore, these were estimated by comparing the consumption of antibiotic eye drops and ophthalmic ointments during 2002 and 2003. The outbreak rapidly spread into the Caribbean Islands, causing an outbreak in Guadeloupe in October. Viral isolates from conjunctival swabs of 16 patients were confirmed to be enterovirus by PCR directed to the 5' UTR of the genome. The isolates could not be neutralized by the Melnick intersecting pools, but were shown to be CV-A24 variant by limited sequencing within the VP1 and 3C regions of 12 strains. Phylogenetic analysis revealed that they were similar to the genotype III strains causing outbreaks in Korea 2002 and Malaysia 2003. The previous outbreak of conjunctivitis caused by CV-A24 in the Caribbean in the 1980s was also introduced from Asia, and disappeared after 3 years. This new introduction from Asia and its rapid spread into the Caribbean, where the infection disappeared after a few months, indicates that the CV-A24 variant has a different epidemiological pattern in this region compared to South East Asia, since it has not established an endemic infection. It had to be reintroduced from Asia, where it has been circulating since the 1970s.

Adult↗
PubMed1999

Blocking ICAM-1 (CD54) and LFA-1 (CD11a) inhibits experimental allergic conjunctivitis.

Cell adhesion molecules are critical for the homing and migration of leukocytes into inflamed tissues. We investigated the role of ICAM-1 and LFA-1 in a previously described experimental model of ragweed (Rw)-induced allergic conjunctivitis. SWR/J mice were treated intraperitoneally 6 and 1 h prior to topical challenge with Rw with injections of anti-ICAM-1 monoclonal antibody (mAb), anti-LFA-1 mAb, both anti-ICAM-1 and anti-LFA-mAbs, or rat IgG. Blocking ICAM-1 or LFA-1 reduced the clinical signs of allergic conjunctivitis. Treatment with anti-ICAM-1 or anti-LFA-1 mAbs also significantly inhibited cellular infiltration into the conjunctiva. The greatest inhibitory effect was achieved with the combination of antibodies against both cell adhesion molecules. Since antibodies against ICAM-1 and LFA-1 significantly inhibit the development of the clinical and histologic signs of allergic conjunctivitis, they may be useful for treating patients with ocular allergy.

Animals↗
PubMed1986

Ligneous conjunctivitis.

The case history is given of a woman of 65 (in 1973) with a granulomatous conjunctival inflammation in the right eye and chronic recurrent polyps on the vocal cords. Several times, granulomatous tissue was removed from the conjunctiva of the right eye but the result was recurrences at shorter intervals. Seven years after the onset in the right eye the left eye became affected. Various treatments, both systemic and local, were tried without success. The histological diagnosis of ligneous conjunctivitis was not made until 1981. Treatment with the known remedies for ligneous conjunctivitis was not successful. At the end of 1984 treatment with Imuran (azathioprine) was started. Since that time the patient has been practically free of recurrent granulomatous tissue on the conjunctiva and vocal cords. The treatment of ligneous conjunctivitis with Imuran has not previously been reported in the literature.

Aged↗
PubMed1995

Allergic conjunctivitis and uveitis models: reappraisal with some marketed drugs.

The purpose of this study was to assess the activity of some marketed products in ocular non-immune and immune type I hypersensitivity reactions, and during intra-ocular type III hypersensitivity. In order to compare these activities, we improved and validated three different models of ocular allergic reaction already known for their ability to reproduce allergic conjunctivitis or uveitis. Allergic conjunctivitis was induced by ocular immediate hypersensitivity after instillation of compound 48/80 in the rat, or an active anaphylaxis reaction with ovalbumin immunisation and challenge in the guinea pig. Uveitis was induced by a reverse passive anaphylaxis reaction using intra-vitreal rabbit anti-bovine IgG anti-serum sensitisation and intravenous bovine gamma-globulin challenge in the rabbit. Clinical scores and blood-tissue permeability indices were studied. Using the same schedule of ocular instillation, the effects of Livostin (levocabastine 0.05%), Almide (lodoxamide 0.1%), Opticrom (sodium cromoglycate 2%), Ocufen (flurbiprofen 0.03%), Acular (ketorolac 0.5%) and 0.3% chlorpheniramine maleate were compared to positive and negative controls. We demonstrated the potent activity of chlorpheniramine maleate 0.3% and Livostin in both allergic conjunctivitis models. Significant activity was also evidenced with Almide, which was only active in the non-immune allergy model, while Opticrom was definitely not active in these models. In the uveitis model, Acular and Ocufen are active and potent drugs, while Livostin and Almide were not active. These results are discussed with respect to the models used and the mediators involved.

Anaphylaxis↗
PubMed1994

Levels of prostaglandin E2 and leukotriene B4 in tears of vernal conjunctivitis patients during a therapeutic trial with indomethacin.

A therapeutic trial of 1% indomethacin (Indoptic) eye drops was carried out in 21 children. Looking for possible mediators of inflammation in vernal conjunctivitis, prostaglandin E2 (PGE2) and leukotriene B4 (LTB4 levels in the tears of 9 patients were measured and the effect of the treatment on them examined. A control group of 10 unaffected children was added. Out of 42 eyes in which indomethacin treatment was instilled, only 17 remained in treatment through a 6-week follow-up period. In a few of them a moderate improvement was obtained. The mean level of PGE2 in the patients before treatment was found to be slightly lower than that in the control group, and it dropped even lower during treatment. The average LTB4 level found in patients before treatment was significantly higher than the control group; it decreased somewhat following treatment, but not significantly. This is the first report of elevated LTB4 levels in vernal conjunctivitis, previously not recorded in the literature, it points to the possible role of LTB4 in the pathogenesis of the disease. A constant relationship was observed between low PGE2 levels and high LTB4 content in the patients' tears during highly inflamed states of the eye. We conclude that: (a) indomethacin did not prove to be a highly effective topical treatment for vernal conjunctivitis; (b) PGE2 does not seem to be a dominant mediator of inflammation in this disease; and (c) LTB4, on the other hand, apparently has a role in the mechanism of inflammation of the disease, thus raising hopes for future addition to therapy.

Adolescent↗
PubMed1994

Characterization of Neisseria meningitidis isolates and clinical features of meningococcal conjunctivitis in ten patients.

Cases of meningococcal conjunctivitis occurring in Denmark in the period 1982-1991 were reviewed. In a survey of laboratory reports, ten cases were identified. The meningococcal strains were characterized by serological grouping, typing and subtyping, and by antimicrobial susceptibility testing. Five cases were caused by serogroup B meningococci (B:15:P1.16, B:15:P1.6, B:4:P1.15) and five cases by serogroup C meningococci (C:2a:P1.2 (4 strains), C:14:NST). The median age of the patients was 12.5 months (range 7 days to 9 years). Signs of conjunctivitis were predominant; in addition, five of the patients had fever and general malaise. In one patient the same strain was recovered from blood and eye secretions. None of the patients had signs of meningitis. All meningococcal strains isolated from patients with meningococcal conjunctivitis were assumed to be virulent and had the same characteristics as strains causing meningococcal disease in Denmark within the same period.

Child↗
PubMed1987

The ability of salbutamol and theophylline to suppress immediate allergic conjunctivitis in the guinea pig.

Topically administered salbutamol was extremely effective in suppressing immediate allergic conjunctivitis in the guinea pig; a dose as low as 0.1% elicited 98% inhibition. Topical pretreatment with 1% propranolol completely blocked the suppressant action of 0.1% salbutamol. This was also the case after systemic propranolol (1 mg/kg SC); the beta-adrenoceptor antagonist itself has no effect on antigen-induced inflammation. The effect of 0.1% salbutamol was unaltered by pretreatment with the specific beta 1-adrenoceptor antagonist betaxolol (1 mg/kg SC). In marked contrast, the suppressant action of 0.1% salbutamol was profoundly inhibited by pretreatment with the selective beta 2-adrenoceptor antagonist ICI-118,551 (0.5 mg/kg SC). The experiments employing beta-adrenoceptor antagonists unequivocally demonstrate that the salbutamol suppression of immediate allergic conjunctivitis in the guinea pig is mediated via the activation of beta 2-adrenoceptors. The methylxanthine phosphodiesterase inhibitor theophylline was active after oral administration, 50 mg/kg eliciting an 80% inhibition. Theophylline was inactive topically at 1% and 5%, but this could be due to the fact that the compound was insoluble at these concentrations. Thus, procedures that elevate cyclic-AMP levels suppress immediate hypersensitivity reactions in the guinea pig conjunctiva. Whether or nor this offers an alternative approach to treat allergic conjunctivitis in humans remains to be determined.

Administration, Oral↗
PubMedDate not supplied

Clinico-bacteriological study of neonatal conjunctivitis.

Perinatal risk factors and bacteriological profile of conjunctivitis were studied among 245 newborns delivered at JIPMER Hospital between July 1986 and June 1988. Maternal and neonatal factors like lack of antenatal care, presence of adverse intrapartum factors, operative deliveries, birth asphyxia, pre-maturity and prolonged hospital stay significantly increased the chances of developing conjunctivitis (P less than 0.001). Bacteria were recovered from 163 (66.5%) cases. Staphylococcus was the commonest pathogenic bacteria isolated, followed by Pseudomonas aeruginosa and Klebsiella pneumoniae. Neisseria gonorrhoeae was isolated in only one case. Most of the organisms showed in vitro sensitivity to chloramphenicol, gentamycin and tetracycline. All the cases responded to topical chloramphenicol except three which required systemic antibiotics. No complications were observed. The identification and appropriate management of high risk pregnancies with minimal hospital stay can reduce the incidence of neonatal conjunctivitis.

Conjunctivitis↗
PubMedDate not supplied

Two mast cell stabilizers, pemirolast potassium 0.1% and nedocromil sodium 2%, in the treatment of seasonal allergic conjunctivitis: a comparative study.

This randomized, double-masked, active-control, parallel-group trial compared the mast cell stabilizers pemirolast potassium 0.1% and nedocromil sodium 2% in the treatment of seasonal allergic conjunctivitis. Pemirolast is currently indicated for four-times-daily administration, nedocromil, for twice-daily dosing. Both ophthalmic solutions were instilled bilaterally twice a day for 8 weeks. The study involved four office visits and two telephone contacts. Participants evaluated their symptoms daily in take-home diaries (itching was the primary efficacy variable) and completed questionnaires to assess comfort. Of a total enrollment of 80, 78 patients completed the study. No significant differences were found between pemirolast and nedocromil on any signs or symptoms of allergic conjunctivitis (redness, chemosis, itching, eyelid swelling). At each visit, pemirolast was rated significantly more comfortable than nedocromil. A significantly higher percentage of the pemirolast group experienced no signs or symptoms at work or school (58% vs 28%; P = .005). The number of adverse events did not differ significantly between groups. Twice-daily administration of pemirolast potassium was as efficacious and safe as twice-daily nedocromil sodium in the 8-week treatment of ragweed allergic conjunctivitis and was superior to nedocromil in comfort. Increased comfort with pemirolast may increase patient satisfaction and compliance with therapy.

Administration, Topical↗
PubMedDate not supplied

Effects of nedocromil sodium on antigen-induced conjunctivitis in guinea pigs.

We evaluated nedocromil sodium in a guinea pig model of allergic conjunctivitis. Ten days after the animals were passively sensitized to ovalbumin, nedocromil sodium (2 mg) or normal saline was instilled into the conjunctival sac, followed by antigen challenge with ovalbumin (100 micrograms or 300 micrograms/10 microL). Conjunctival hyperemia, edema, and eyelid edema were evaluated at 10 minutes and 4 hours in the 100-microgram ovalbumin group. Eyes with nedocromil sodium exhibited fewer early and late clinical signs of allergic conjunctivitis than control eyes. Infiltrating eosinophils were counted at 24 hours in the 300-microgram ovalbumin group. Nedocromil sodium inhibited antigen-induced eosinophil infiltration into the limbus, fornix, and eyelids by 77%, 66%, and 74%, compared with controls. Nedocromil sodium can effectively suppress early- and late-phase conjunctival hyperemia, conjunctival edema, eyelid edema, and eosinophil infiltration in the guinea pig passive-sensitization model. Nedocromil sodium may represent a versatile option for the treatment of allergic conjunctivitis.

Animals↗