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PubMed1993

[Primary localized amyloidosis of the eyelid and conjunctiva].

Report on a case of amyloidosis in the orbits of a 81-year-old women with 20 year's follow up. At first examination she presented with cystic changes of the palpebral conjunctiva and spontaneous hematoma of the lid. Preceding diagnosis by biopsy six years of unspecific local therapy with various eye drops followed then by cryotherapy and two surgical interventions. Discussion of primary localized amyloidosis and other variants of amyloidosis and therapeutic approach.

Aged↗

PubMed1990

[Malignant melanoma of the conjunctiva: histopathologic study].

The pathological features of 17 malignant melanomas of the conjunctiva, treated by local excision at the Clinique universitaire de Lausanne, were studied, and the most frequent difficulties encountered by the pathologist are presented. Cox's proportional hazards model confirmed that tumor thickness had a prognostic significance and showed that cell type was significant too.

Adult↗

PubMed1989

[Tuberculosis of the conjunctiva and eyelids].

A diagnosis of unilateral tuberculosis of the conjunctiva was established in a 75-year-old female patient eight years after the first manifestations of disease. It was clearly a case of exogenous infection. Generalized infection only became apparent months after the bulb had been removed together with the lids and the anterior portions of the orbital tissue.

Aged↗

PubMed1988

[Ultrastructural changes in the conjunctiva of Cynomolgus monkeys following pilocarpine administration?].

After a slow-release pilocarpine carrier had been applied for three months, the conjunctival epithelium of two Cynomolgus monkeys showed some remarkable changes in the structure and distribution of the cell types as defined by the authors. The goblet cells (Type I) had almost entirely disappeared, whereas the epithelial cells with secretion granules (Type II) had considerably increased in number. The morphology of the Type II cells gave clear indications of a very active metabolism. In a control experiment, in which two Cynomolgus monkeys treated with a 4% pilocarpine solution for three months, these ultrastructural changes did not occur; it must therefore be assumed that mechanical irritation of the conjunctiva was the cause.

Animals↗

PubMed1985

[Vital staining of the conjunctiva for prevention of epithelial implantation cysts].

Selective vital staining with 1% toluidine blue makes short-term intraoperative differentiation of the conjunctiva from Tenon's capsule possible. It is used with advantage in operations where the anatomical situation is unclear to avoid displacement of conjunctival epithelium into deeper tissues and subsequent growth of cysts. Examples of its application are reoperations with excessive scars after squint or detachment surgery, wound dehiscence after enucleations, lacerated wounds after accidents, and as an aid for beginners in ophthalmic surgery.

Animals↗

PubMed1983

[Lymphographic and morphological studies of the conjunctiva in onchocerciasis patients in Liberia].

Conjunctival lymphographies in patients infected with Onchocerca volvulus in Liberia showed normal or only slightly dilated lymphatics. The light-microscopical studies of conjunctival specimens revealed microfilariae predominantly in edematous dilated interstitial channels. Microfilariae in lymphatics and interstitial channels without endothelium of the conjunctivae were demonstrated by scanning and transmission electron microscopy. No signs of inflammatory cellular reaction were found in the vicinity of the parasites. In conclusion, the dilatation of lymphatics and interstitial channels as well as the pathways along which the microfilarial penetrated the cornea and the anterior segments of the eye are discussed.

Conjunctiva↗

PubMed1981

[Investigations into mucous membrane compatibility using the Endorfer Jod-Thermalsole treatment of the conjunctivae of rabbits (author's transl)].

The conjunctivae of nine rabbits of the same breed were used to compare the local compatibility of the Endorfer Jod-Thermalsole with that of a physiological NaCl solution. The neuroleptanalgesics were administered using perfusion techniques. The reddening thus caused was used to measure the degree of inflammation. The reddening was assessed subjectively according to a points system and then photographed under the same conditions for greater objectivity. The slides are archived in the Institute for Balneology and Climatology of the University of Munich. After administering the Endorfer Jod-Thermalsole to the mucous membranes for 30 and 60 minutes there was no difference in compatibility as compares to a physiological NaCl solution. No appreciable irritation occurred.

Animals↗

PubMed1980

[Reconstruction of conjunctiva on the limbus following the excision of an excessively large filtering bleb (author's transl)].

After total excision of an excessively large filtering bleb extending to the cornea, the conjunctiva was dissected from the upper half of the eyeball and fixed by sutures into a step of the corneal periphery obtained by a keratectomy of 1 mm large strip of superficial cornea tissue along the upper half of the limbus. In 10 eyes operated on in this way -- and in seven of them over four years -- the newly developed filtrating bleb is flat and shows a well vascularised wall without any signs of degeneration.

Conjunctiva↗

PubMed1992

Neuropathy with lysosomal changes in Marinesco-Sjögren syndrome: fine structural findings in skeletal muscle and conjunctiva.

The light- and electron-microscopical findings in the skeletal muscle and conjunctiva of 6 patients with Marinesco-Sjögren syndrome (MSS) were presented. All patients were related and showed the cardinal clinical symptoms of the syndrome: congenital cataracts, mental retardation, delayed statomotor development, and cerebellar ataxia. The most prominent alteration found in the skeletal muscle of four patients was extensive neurogenic atrophy with conspicuous groups of atrophic muscle fibers. Additional findings were vacuolar degeneration and secondary, unspecific changes like slight mitochondrial alterations and increased variability in muscle fiber calibers. The ultrastructural examination revealed double-membrane structures near to, but not in direct contact with the nucleus. The nuclear changes described earlier (7, 20) were not found in any of the cases. Conjunctival biopsies revealed a marked increase in the number of lysosomes in fibroblasts. In summary, to the well known myopathic damage of muscles in MSS a neurogenic component should be added. Disturbed lysosomal function is to be considered as the basic abnormality, though the enzyme defect has not yet been identified. In cases of clinically suspected MSS, examination of a conjunctival biopsy is highly recommended.

Conjunctiva↗

PubMed1997

Limbal conjunctival Langerhans cell density in ocular cicatricial pemphigoid: an indirect immunofluorescence study on Dispase-split conjunctiva.

PURPOSE: To evaluate limbal conjunctival Langerhans cell density in ocular cicatricial pemphigoid patients versus normal controls. Langerhans cells obviously play a major role in T-cell activation and are involved in corneal and conjunctival inflammatory diseases. METHODS: We used a protease (Dispase II) on inferior limbal conjunctival biopsies to separate the epithelium from the substantia propria and performed indirect immunofluorescence to analyze CD1a+ (a specific Langerhans cell surface antigen) cell density on flat-mounted epithelial sheets obtained from 30 normal controls and 11 patients presenting with ocular cicatricial pemphigoid. RESULTS: This technique was quick and reproducible. The mean Langerhans cell density in normal limbal conjunctiva was 272 +/- 37 cells/mm2. It was significantly higher in ocular cicatricial pemphigoid patients: 386 +/- 43 cells/mm2 (p = 0.001). CONCLUSIONS: Conjunctival Langerhans cell density in ocular surface inflammatory diseases can best be evaluated by indirect immunofluorescence, following epithelial sheet separation from the substantia propria, using Dispase II.

Aged↗

PubMed1999

Altered cytokine balance in the tear fluid and conjunctiva of patients with Sjögren's syndrome keratoconjunctivitis sicca.

PURPOSE: To compare epidermal growth factor (EGF) concentration in tear fluid and levels of inflammatory cytokines in the conjunctival epithelium of patients with Sjögren's syndrome keratoconjunctivitis sicca with those of normal controls. METHODS: Schirmer 1 tear testing, corneal fluorescein staining and conjunctival impression cytology for quantitation of goblet cell density were performed in ten patients with Sjögren's syndrome-associated keratoconjunctivitis sicca and ten asymptomatic normal controls. ELISA was used to detect the concentration of EGF in tear fluid and interleukin 6 in lysates of conjunctival cytology specimens obtained from all subjects. The levels of RNA transcripts encoding inflammatory cytokines [interleukin 1alpha_(IL-1alpha), interleukin 6 (IL-6), interleukin 8 (IL-8), tumor necrosis factor alpha_(TNF-alpha), and transforming growth factor beta1 (TGF-beta1)] as well as a housekeeping gene (G3PDH) were evaluated in conjunctival cytology specimens taken from all subjects by semiquantitative competitive reverse transcriptase polymerase chain reaction (RT-PCR). RESULTS: Decreased tear fluid EGF concentration was noted in Sjögren's syndrome patients (mean 0.68 +/- 0.59 ng/ml) compared to controls (mean 1.66 +/- 0.45 ng/ml, P = 0.004). Significantly increased levels of IL-1alpha, IL-6, IL-8, TNF-alpha and TGF-beta1 RNA transcripts were found in the conjunctival epithelium of Sjögren's syndrome patients compared to controls (P < 0.05), while the level of G3PDH was similar in both groups. The concentration of IL-6 protein was significantly higher in Sjögren's syndrome conjunctiva samples (P = 0.012). Tear EGF concentration correlated with Schirmer 1 scores (rho 0.767, P < 0.001), corneal fluorescein staining scores (rho -0.562, P = 0.01), conjunctival goblet cell density (rho 0.661, P = 0.001) and the levels of IL-1alpha_and IL-8 RNA in the conjunctival epithelium (rho -0.677 and -0.747, respectively, P = 0.001). Both IL-1alpha_and IL-8 RNA in the conjunctival epithelium increased as Schirmer 1 scores decreased (P </= 0.001). IL-8 RNA level correlated with corneal fluorescein staining (rho 0.690, P = 0.001) and conjunctival goblet cell density (rho -0.767, P < 0.001). A significant decrease in IL-8 RNA level, corresponding to improvement in irritation symptoms and ocular surface disease, was observed in six eyes after two weeks of topical corticosteroid therapy. CONCLUSIONS: The balance of cytokines in the tear fluid and conjunctival epithelium is altered in Sjögren's syndrome. The severity of keratoconjunctivitis sicca in this condition increases as tear fluid EGF concentration decreases and levels of inflammatory cytokines in the conjunctival epithelium increase. These findings provide new insight into the pathogenesis of keratoconjunctivitis and provide potential targets for therapy.

Adult↗

PubMed2003

Human mast cell subtypes in conjunctiva of patients with atopic keratoconjunctivitis, ocular cicatricial pemphigoid and Stevens-Johnson syndrome.

PURPOSE: Investigate mast cell (MC(S)) subtypes in atopic keratoconjunctivitis (AKC), ocular cicatrical pemphigoid (OCP), and Stevens-Johnson Syndrome (SJS). METHODS: MC(S) subtypes were determined by immunohistochemistry of conjunctiva (obtained from 34 patients--9 AKC, 9 OCP, 9 SJS and 7 normal) using monoclonal antibodies directed against chymase (MC(C)) and tryptase (MC(T)). Double staining was used to distinguish MC(S) as positive for both chymase and tryptase (MC(TC)). RESULTS: The number of MC(S) was significantly increased in AKC, OCP and SJS patients, compared to normal subjects. MC( C) were especially high in AKC, and moderately high in OCP. MC(T ) and MC(TC) were similar in each disease group. CONCLUSIONS: While the AKC findings were not surprising, the result in OCP and SJS suggests that MC(S) play an underappreciated role in the inflammatory process of these disorders. Disparate proportions of MC(S) subtypes in these diseases may imply differential functions of MC(S) in these disorders.

Adult↗

PubMedDate not supplied

Photokeratitis and other phototoxic effects on the cornea and conjunctiva.

Except when sleeping, the cornea and interpalpebral conjunctiva are exposed to the ambient environment, both natural and man-made. Levels of solar ultraviolet irradiance reaching the eye may exceed the damage threshold under a number of circumstances. The consequences of overexposure may be acute after a latent period, sequelae to an acute exposure, or long-term chronic effects. Previously derived action spectra for photokeratitis and photoconjunctivitis due to incoherent ultraviolet are presented. These reveal interspecies similarities for the levels of radiant energy reaching each tissue. The initial in vivo (clinical) signs of photokeratitis are due to lost or damaged epithelial cells with other signs produced by this primary response. The conjunctival signs include injection and chemosis. Chronic exposure to solar ultraviolet is a factor in climatic droplet keratopathy and pterygium. Phototoxic compounds or their by-products potentially can reach the cornea from the air, via the tears or aqueous humor, or from the limbal capillaries. However, the human cornea appears to be much less susceptible to the influence of phototoxic agents than the skin.

Acute Disease↗

PubMed1985

Topical anti-inflammatory activity of beta 2-adrenoceptor agonists in the conjunctiva.

Increased microvascular permeability is believed to involve the contraction of venular endothelial cells, which results in the formation of leaking gaps in the postcapillary segment of the microvasculature. Several reports have suggested that interendothelial cell gap formation caused by permeability factors may be functionally antagonized by locally administered beta 2-adrenoceptor agonists. This represents a potentially novel approach for reducing inflammatory episodes in a variety of externally accessible tissues. The studies described herein extend these findings to the conjunctiva, where the relatively selective beta 2-adrenoceptor agonists salbutamol and terbutaline reduced the microvascular permeability response to histamine. Similarly, pretreatment with salbutamol or terbutaline inhibited the increase in conjunctival microvascular permeability associated with experimental immediate hypersensitivity, which indicates potential utility for allergic conjunctivitis.

Adrenergic beta-Agonists↗

PubMed1996

Cyclic AMP modulation of active ion transport in the pigmented rabbit conjunctiva.

This study was conducted to determine whether active ion transport in the pigmented rabbit conjunctiva was subjected to cyclic AMP modulation. 8-BrcAMP and compounds that may affect intracellular cAMP levels were tested for their effects on the conjunctival short-circuit current (Isc) following mucosal application. Conjunctival Isc was increased by 1 mM 8-BrcAMP, 0.001-20 microM forskolin, 0.01-2 mM theophylline, 2 microM 1-epinephrine, and 20 microM terbutaline in a Cl(-)-containing but not in a Cl(-)-free medium. The increase in Isc induced by 1 mM 8-BrcAMP was reversed by 1 mM N-phenylanthranilic acid, suggesting enhancement of Cl- secretion by cAMP. Similarly, the increase in Isc induced by 20 microM terbutaline was blunted by 1 microM timolol, suggesting a role for beta 2 adrenergic modulation of Cl- secretion. Collectively, these results are consistent with the notion of cAMP modulation of conjunctival active ion transport.

8-Bromo Cyclic Adenosine Monophosphate↗

PubMed1994

Mucoepidermoid carcinoma of the conjunctiva.

Mucoepidermoid carcinoma of the conjunctiva (MECa) is a rare neoplasm. It resembles squamous cell carcinoma (SCCa), clinically and histologically. Nevertheless, it is characterized by a high degree of local aggressiveness. We reviewed all cases of MECa reported in the English literature for epidemiological data, characteristics of the tumor, treatment, and outcome. We found that MECa, reported predominantly in aging males (median age 71 years), arises in the limbal and perilimbal areas. Simple excision is followed by rapid recurrence, and most tumors will require enucleation or exenteration for local control. Histological stains directed to the production of mucin are essential for the diagnosis. The recommended treatment is wide local excision. Enucleation or exenteration is recommended for tumors invading the globe or orbit.

Carcinoma, Mucoepidermoid↗

PubMed1991

Sjogren's syndrome: a comparative study of impression cytology of the conjunctiva and buccal mucosa, and salivary gland biopsy.

The diagnosis of Sjogren's syndrome (SJ) as an underlying disease of keratoconjunctivitis sicca is important because of the many ocular and systemic complications. We compared the results of impression cytology of conjunctiva (ICC) and the results of labial salivary gland biopsy (LSB) with impression cytology of buccal mucosa (ICB) in 33 patients with SJ. LSB, ICC, and ICB were considered positive in all patients. Moderate to severe changes were graded in 85% of the biopsy specimens, 94% of the conjunctival specimens, and 76% of the buccal mucosa specimens. The rate of agreement between LSB and ICB was 97%. The use of ICB in the clinical ophthalmological examination may be helpful in patients with consistent history, and clinical and ocular findings, before the biopsy procedure.

Adolescent↗

PubMed1991

Shape of the cornea and conjunctiva.

An apparatus for investigating the surface shape of the eye, including the region beyond the limbus, has been developed. Formerly, we applied a three-parameter model to describe the eye profile. Recently we have found that two parameters, e.g., the keratometric radius, KE, and the slope, beta E, of the conjunctiva are sufficient for this purpose. The measurement of 690 unselected human eyes indicates that variation of both these values is statistically significant and that both of them may be useful in contact lens fitting.

Anthropometry↗