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PubMed1994

Treatment of chronic nonbacterial conjunctivitis with a cyclo-oxygenase inhibitor or a corticosteroid. Pranoprofen Study Group.

A multicenter, double-masked, parallel-group clinical trial was carried out in 151 patients with moderate to severe chronic conjunctivitis. The study compared the antiinflammatory efficacy and safety of pranoprofen 0.1%, a new cyclo-oxygenase inhibitor, with fluorometholone 0.1%, after topical doses four times a day for 15 days. The basal mean score for the signs and symptoms of inflammation, was significantly reduced (P < .001), with no significant difference between the two groups, at days 8 and 15. There was a statistically significant difference of approximately 1.0 mm Hg (P < .05) in the mean intraocular pressure between treatment, which was a decrease of 0.3 mm Hg with pranoprofen and an increase of 0.8 mm Hg with fluorometholone. One patient in the pranoprofen group had an adverse experience, compared to nine patients in the fluorometholone group (P < .03). Our data suggest that pranoprofen has efficacy equivalent to a moderate-potency corticosteroid with a better safety profile. It should be considered for the treatment of chronic conjunctivitis of presumed nonbacterial origin.

Administration, Topical↗
PubMed1997

Floppy eyelid syndrome in a child with chronic unilateral conjunctivitis.

PURPOSE: To report a 2-year-old child who had chronic unilateral conjunctivitis and spontaneous left upper eyelid eversion during sleep consistent with the floppy eyelid syndrome. METHODS: The patient's parents used a video camera to document nocturnal ectropion of the left upper eyelid. Examination demonstrated left upper eyelid swelling and left palpebral conjunctival hyperemia with papillary hypertrophy. RESULTS: All signs and symptoms of the floppy eyelid syndrome resolved with taping of the left upper and lower eyelids to close the palpebral fissure and to prevent ectropion during sleep, and with application of ocular lubricants. CONCLUSIONS: Floppy eyelid syndrome may manifest in childhood without other contributing conditions and should be considered in the differential diagnosis of chronic papillary conjunctivitis in patients at any age.

Child, Preschool↗
PubMed1996

Detection of enterovirus 70 by polymerase chain reaction in acute hemorrhagic conjunctivitis.

PURPOSE: We have developed and applied reverse transcription-polymerase chain reaction for the detection of enterovirus 70 from conjunctival swabs of patients among the population of an acute hemorrhagic conjunctivitis epidemic on Okinawa, Japan, in 1994. METHODS: The primers used were selected from the VP1, VP2, and VP3 regions of the enterovirus 70 nucleotide sequence. RESULTS: Twelve of 27 culture-negative specimens were positive by reverse transcription-polymerase chain reaction. CONCLUSIONS: The reverse transcription-polymerase chain reaction test provides a reliable diagnostic method that readily allows specific detection of enterovirus 70 in patients with acute hemorrhagic conjunctivitis in whom low enterovirus 70 recovery rates have been obtained recently by cell culture.

Conjunctiva↗
PubMed2000

Vascular permeability in allergic conjunctivitis in mice lacking histamine H1 receptors.

To clarify the role of histamine H1 receptors in allergic conjunctivitis, changes in vascular permeability of the conjunctiva were measured in histamine H1 receptor deficient mice. Wild-type mice showed a significant increase in vascular permeability of the conjunctiva induced by histamine. However, no such increase was found in histamine H1 receptor deficient mice. On the other hand, no differences were observed between wild-type and histamine H1 receptor deficient mice in response to serotonin. A significant increase in vascular permeability was observed in actively sensitized wild-type mice, whereas no increase was observed in histamine H1 receptor deficient mice. Similar findings were noted in passively sensitized animals. Histamine contents of the conjunctiva were significantly decreased by topical application of antigen in both wild-type and histamine H1 receptor deficient mice after active sensitization with antigen. These findings suggested that vascular permeability in the conjunctiva in allergic conjunctivitis is entirely regulated through histamine H1 receptor.

Animals↗
PubMedDate not supplied

Local ocular immunotherapy for experimental allergic conjunctivitis.

PURPOSE: We studied the efficacy of eyedrops as local ocular immunotherapy against experimental allergic conjunctivitis. METHODS: Guinea pigs were sensitized with an intraperitoneal injection of ovalbumin (OA). Three weeks after the sensitization, a low concentration (10 microg/mL) of OA eyedrops was administered once a day for 3 weeks. Six weeks after the sensitization, an allergic inflammation was provoked with 20 mg/mL of OA eyedrops. RESULTS: In conjunctival clinical scores 30 minutes after the allergen challenge, there was no significant difference between the controls and the treated group. The total number of inflammatory cells in the conjunctiva 8 hours after the allergen challenge was significantly decreased in the treated group (60.8 +/- 23.2 cells/field) compared with the control group (199.1 +/- 83.4 cells/field). Eosinophils in the conjunctiva 24 hours after the allergen challenge were also significantly decreased in the treated group (22.1 +/- 15.5 cells/field) compared with the control group (50.3 +/- 15.0 cells/field). CONCLUSIONS: In this study, local ocular immunotherapy mainly suppressed the late phase reaction of allergic inflammation. These results coincide with previous studies of immunotherapy in which a subcutaneous injection was used. Local ocular immunotherapy is effective against experimental allergic conjunctivitis.

Allergens↗
PubMedDate not supplied

Flow cytometry tear analysis in patients with chronic allergic conjunctivitis.

Tears from patients with chronic allergic conjunctivitis were analyzed with flow cytometry to determine the function of the T lymphocyte-related immunological reactions in the disease pathogenesis. Twenty-eight patients and 22 normal volunteers were studied; tears were obtained with capillary tubes. T helper/T suppressor ratios and the percentages of HLA DR+, CD23+, and CD3+ cells were significantly higher in patients than in controls. This study provides support for the hypothesis that chronic allergic conjunctivitis results from T lymphocyte-related immunological reactions.

Adolescent↗
PubMedDate not supplied

Genome analysis of adenovirus type 4 strains isolated from acute conjunctivitis in Japan.

Strains of adenovirus type 4 (Ad4) isolated from patients with acute conjunctivitis were studied by DNA restriction analysis. The strains were isolated between July and December 1990 in Japan. All 63 isolates of Ad4 were identified as the genome type Ad4a. This study showed that the same Ad4 genome type, Ad4a, caused acute viral conjunctivitis, even in different areas of Japan.

Acute Disease↗
PubMedDate not supplied

Chronic dacryoadenitis misdiagnosed as eyelid edema and allergic conjunctivitis.

PURPOSE: To report the case of a 53-year-old woman with a 2-year history of episodic upper eyelid swelling and nonspecific complaints, who was diagnosed as having allergic conjunctivitis. METHODS: A complete ocular examination, orbital computerized tomographic (CT) scans followed by complete physical and systemic examinations. RESULTS: The results of physical and systemic examinations were unremarkable for systemic lymphoma and a primary focus of cancer. The results of the ocular examination were normal. CT scans demonstrated well-defined lesions bilaterally with a homogeneous internal structure in the lacrimal gland fossa, which suggested a diagnosis of chronic dacryoadenitis. The differential diagnosis included lymphoma and orbital metastases. The patient refused a biopsy and was started on a tapering dose of 60 mg oral prednisolone daily. The follow-up CT scans 1 month after cessation of 6-week oral corticosteroid treatment showed near complete resolution of the orbital lesions. CONCLUSION: This case demonstrates that orbital inflammation can be misdiagnosed as refractory allergic conjunctivitis.

Chronic Disease↗
PubMedDate not supplied

Seasonal allergic conjunctivitis induced by Japanese pear pollen.

PURPOSE: To evaluate the ocular findings in patients with Japanese pear (Pyrus pyrifolia Nakai) pollinosis. METHODS: Twenty-two farmers working on artificial pollination in Japanese pear orchards were examined for ocular itching, conjunctival conditions, presence of eosinophils in the conjunctival specimen, and nasal symptoms. Serum IgE antibody to Japanese pear pollen was determined in 16 farmers. RESULTS: Of the 22 subjects, 3 (Nos. 3, 4, and 13) exhibited ocular itching, conjunctival hyperemia, eosinophils in the conjunctival specimen, and positive serum IgE antibodies to Japanese pear pollen. In these patients, the conjunctivitis disappeared after treatment with topical cromoglycate. CONCLUSION: The present study demonstrated that seasonal allergic conjunctivitis may be induced by Japanese pear pollen (entomophilous flower pollen).

Adult↗
PubMed1987

Conjunctivitis in children.

Conjunctivitis is a common, usually mild, self-limited problem. Pathogens vary at different ages. Conjunctivitis occurs alone or as a manifestation of a systemic infection or a systemic disease. Diagnosis can usually be established by the combination of clinical and laboratory findings. Topical, systemic or combination therapy is used, depending on the agent and extent of infection.

Bacterial Infections↗
PubMed1999

Comparison of topical nedocromil sodium and oral terfenadine for the treatment of seasonal allergic conjunctivitis.

This double-masked, comparative, multicenter study was conducted to assess the onset of action and tolerability of nedocromil sodium 2% ophthalmic solution BID, 60-mg terfenadine tablets BID, and placebo in the treatment of seasonal allergic conjunctivitis. Two hundred sixty-eight patients in whom seasonal allergic conjunctivitis was diagnosed were assigned to 1 of 3 groups and administered study medication for 4 weeks. Patients' mean age was 33 years (range, 12 to 68 years); 57.8% (155 of 268) were female. Demographic characteristics were similar in all 3 groups. Although all 3 groups showed improvement in ocular symptoms, nedocromil sodium was associated with a statistically significantly faster onset of action than was terfenadine or placebo (P = 0.038). During the study, 29 nedocromil sodium-treated patients (36.7%) achieved control of symptoms in < or =2 minutes, and 61 (77.2%) achieved control in < or =15 minutes. The corresponding numbers were 21 (24.7%) and 50 (58.8%) in the terfenadine group and 25 (29.1%) and 48 (55.8%) in the placebo group. The frequency of adverse events was low and similar between groups (nedocromil sodium, 26; terfenadine, 32; placebo, 32). No severe treatment-related adverse events were reported. In conclusion, nedocromil sodium had a significantly faster onset of action than did terfenadine or placebo.

Administration, Oral↗
PubMed2004

Efficacy and tolerability of ophthalmic epinastine assessed using the conjunctival antigen challenge model in patients with a history of allergic conjunctivitis.

BACKGROUND: Epinastine hydrochloride is a nonsedating antihistamine with a high affinity for histamine H(1) receptors, together with mast cell-stabilizing and anti-inflammatory activities. OBJECTIVE: The aim of this study was to assess the efficacy and tolerability of topically administered ophthalmic epinastine using the conjunctival antigen challenge (CAC) model in patients with a history of allergic conjunctivitis. METHODS: This prospective, single-center, randomized, double-masked, vehicle-controlled, Phase III clinical trial was conducted at the Ophthalmic Research Associates study center (North Andover, Massachusetts) from November 2000 to January 2001. Eligible participants were asymptomatic but had a history of allergic conjunctivitis and had positive CAC reactions at the initial screening (week 0) and at a confirmation visit (week 1). Patients were randomly assigned by eye to receive epinastine hydrochloride 0.05% ophthalmic solution in 1 eye and vehicle in the contralateral eye. Each eye received 1 drop of study medication 15 minutes before antigen application (onset challenge; week 3) or 8 hours before antigen application (duration challenge; week 5). Primary end points were ocular itching and conjunctival hyperemia. Itching was recorded 3, 5, and 10 minutes after antigen challenge. Hyperemia was recorded 5, 10, and 20 minutes after antigen challenge, as were secondary end points, which included eyelid swelling, episcleral and ciliary hyperemia, chemosis, tearing, and ocular mucous discharge. Tolerability was assessed by patient interview and slit-lamp biomicroscopy. RESULTS: Sixty-seven patients (37 females, 30 males; mean [SD] age, 38.4 [14.2] years [range, 12-67 years]) were included in the study. Mean severity scores for the following signs and symptoms were significantly lower with epinastine compared with vehicle at all time points after onset and duration challenges: ocular itching (P<0.001); eyelid swelling (P<0.001); conjunctival ( P<0.001), episcleral ( P<0.001), and ciliary hyperemia (P<0.001); and chemosis (P or=8 hours). The tolerability of epinastine was similar to that of vehicle.

Adolescent↗
PubMed1984

Vernal conjunctivitis in the hyperimmunoglobulinemia E syndrome.

Hyper-IgE syndrome (HIE) appears to be related to an immunoregulatory imbalance characterized by severe deficiency of suppressor T cells, elevated levels of IgE antibodies, and repeated infection of various organ systems. We report the association of HIE syndrome in two definite cases and one probable case of vernal conjunctivitis. This association suggests that T cell-mediated imbalance may be one factor in the pathogenesis of vernal conjunctivitis.

Adolescent↗
PubMed1985

"Blue-body" epithelial cell inclusions in conjunctivitis.

In 10.4% of conjunctival scrapings received from 1731 patients with conjunctivitis during the years 1970 through 1980, basophilic cytoplasmic inclusions of unknown etiology were found in the epithelial cells when Giemsa stained. These "blue-bodies" differed in morphology from bacteria, chlamydia, and other frequent cytoplasmic inclusions. By electron microscopy, they consisted of a variety of dense bodies and phagolysosomal vacuoles containing complex lipids, indicating injury to the epithelial cells. The presence of these inclusions had a statistically significant association with the use of topical medications, especially Neosporin. Administration of other antibiotics and medications was less frequently related. Patients with the most prolific "blue-body" inclusions usually showed a clinical picture of subacute to chronic conjunctivitis or blepharoconjunctivitis thought to represent hypersensitivity. Recognizing the nature of these easily seen inclusions is important to distinguish them from infectious organisms, and may also support the diagnosis of a drug-related reaction.

Adolescent↗
PubMed1988

Immunodiagnosis of adult chlamydial conjunctivitis.

This study presents data from a prospective comparison of four currently available diagnostic tests for Chlamydia trachomatis infection. Seventy-six patients clinically suspicious for chlamydial conjunctivitis were all tested with Giemsa stain cytology, direct monoclonal fluorescent antibody (DFA) microscopy, enzyme immunosorbent assay (EIA) for chlamydial antigens, and standard McCoy cell culture. When compared with primary cell culture, diagnostic Giemsa inclusions had a sensitivity and specificity of 43 and 100%, respectively, supportive Giemsa cytology 71 and 67%, the enzyme immunoassay 71 and 97%, and the monoclonal fluorescent antibody 57 and 81%. Each nonculture method has distinct advantages in terms of cost, technical difficulty, speed, and accuracy, which dictate selection of the most appropriate test for office or laboratory diagnosis of chlamydial conjunctivitis.

Adult↗
PubMed1995

Evaluation of the Kodak Surecell Chlamydia test for the laboratory diagnosis of adult inclusion conjunctivitis.

PURPOSE: The Kodak Surecell Chlamydia test, a rapid enzyme immunoassay, has been reported to be highly sensitive (93%) and specific (96%) for detecting chlamydial lipopolysaccharide antigen in conjunctival specimens from infants, but has not been evaluated previously in adult conjunctival specimens. This study was designed to determine the efficacy of the Kodak Surecell Chlamydia test for the laboratory diagnosis of adult inclusion conjunctivitis. METHODS: Twenty Chlamydia culture-positive conjunctival specimens from adults (true-positives) and 20 true-negative specimens were tested with the Kodak Surecell Chlamydia test. RESULTS: The Kodak Surecell Chlamydia test was 40% (8/20) sensitive, 100% (20/20) specific, and 70% (28/40) efficient. CONCLUSIONS: This study indicates that the Kodak Surecell Chlamydia test, though highly specific, is less sensitive in its ability to diagnose chlamydial conjunctivitis in adults than has been reported previously in infants.

Adult↗
PubMed2001

Allergic conjunctivitis as a risk factor for laser in situ keratomileusis.

PURPOSE: To analyze the effect of allergic conjunctivitis (AC) on the outcome of laser in situ keratomileusis (LASIK) in myopic eyes. SETTING: Minamiaoyama Eye Clinic, Tokyo, Japan. METHODS: Patients who had LASIK were divided into 2 groups: those with AC (84 eyes of 49 patients; the allergic group) and those without AC (140 eyes of 77 patients; the nonallergic group). Allergic conjunctivitis was diagnosed clinically by symptoms of eye itching and clinical findings such as papillary proliferation on the tarsal conjunctiva. Preoperative and postoperative uncorrected visual acuity (UCVA) and refraction and intraoperative and postoperative complications were compared. RESULTS: There were no significant differences in UCVA and refraction between the 2 groups. No complications were observed in the allergic group. Intraoperative conjunctival chemosis (3 eyes of 2 patients) and a postoperative epithelial defect that resulted in epithelial ingrowth (1 eye) were observed in the nonallergic group. CONCLUSION: The findings suggest that AC is not a risk factor for LASIK.

Adult↗
PubMed2004

[Bacterial conjunctivitis: most prevalent pathogens and their antibiotic sensitivity].

INTRODUCTION: Bacterial conjunctivitis is a self-limiting process, but topical antibiotic treatment is recommended to eradicate the pathogen and reduce symptom duration. Since this treatment is usually empirical and prior cultures are not normally taken, the etiological agents involved in the process are unknown. PATIENTS AND METHODS: A total of 596 conjunctival exudates from pediatric outpatients with a diagnosis of acute conjunctivitis in Medical Area 6 of Madrid, Spain, were studied over 3 years (from 2000 to 2002 inclusive). The patients were divided into three age groups: group 1 (infants), group 2 (2- to 6-year-olds) and group 3 (7- to 14-year-olds). RESULTS: A total of 428 bacteria were isolated. The most prevalent bacteria were Haemophilus influenzae (44.8 %) and Streptococcus pneumoniae (30.6 %) followed by Staphylococcus aureus (7.5 %), S. viridans (7.2 %), Moraxella catarrhalis (6.8 %) and Enterobacteriaceae (4.2 %). In 56 exudates (15.1 %), two or more bacteria were isolated and S. pneumoniae 1 H. influenzae were found in 8.1 % of the cases. By age group, S. aureus was significantly more prevalent (p < 0.0001) in group 3 than in groups 1 and 2. Isolation of Enterobacteriaceae, S. viridans and non-fermentative Gram negative bacilli was significantly more frequent (p < 0.05) in group 1 and isolation of S. pneumoniae (p < 0.05) was significantly more frequent in group 2. S. pneumoniae showed the greatest level of resistance to antibiotics used in eye drops and ophthalmic ointments. Ciprofloxacin, chloramphenicol and rifampin were active in the most prevalent pathogens. CONCLUSIONS: The most prevalent bacteria were H. influenzae and S. pneumoniae. The most active antibiotics in these pathogens were ciprofloxacin, chloramphenicol and rifampin.

Adolescent↗