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At least 127 records · Page 7Linked to original sources
PubMed1998

Non-Acanthamoeba amebic keratitis.

PURPOSE: To describe the clinical presentation and outcome of two cases with presumed non-Acanthamoeba amebic keratitis. METHODS: Case reports. RESULTS: Both patients presented with typical symptoms and signs of Acanthamoeba keratitis. The patients' soft contact lenses, lens cases, open solutions, and conjunctival samples were cultured. Diagnosis of non-Acanthamoeba amebic keratitis was based on the presence of keratitis and amebic growth from patients' contact lenses of the affected eyes. Amebic culture from the contralateral contact lens was negative. Vahlkampfia cysts were identified in case 1, and Naegleria cysts in case 2. Topical treatment with polyhexamethylene biguanide and propamidine resolved the keratitis in case 1. Case 2 was lost to follow-up. CONCLUSION: Non-Acanthamoeba amebic keratitis was diagnosed in two patients based on the clinical presentation (resembling Acanthamoeba keratitis), culture of the contact lens, and response to antiamebic treatment (in one case). Keratitis associated with Naegleria contamination of contact lenses has not been previously reported.

Adolescent↗
PubMed2005

Comparative efficacy of topical moxifloxacin versus ciprofloxacin and vancomycin in the treatment of P. aeruginosa and ciprofloxacin-resistant MRSA keratitis in rabbits.

PURPOSE: To evaluate the in vivo efficacy of topical moxifloxacin 0.5% versus ciprofloxacin 0.3% in the treatment of Pseudomonas aeruginosa keratitis and topical moxifloxacin 0.5% versus vancomycin 50 mg/mL in the treatment of ciprofloxacin-resistant, methicillin-resistant Staphylococcus aureus (MRSA) keratitis in rabbits. METHODS: Experimental bacterial keratitis was induced in rabbits by corneal intrastromal injection. Infection proceeded for 12 hours, after which topical antibiotics were applied hourly for 12 hours. Corneal homogenates were plated with serial dilutions for quantitative bacteriology. RESULTS: Both moxifloxacin and ciprofloxacin performed significantly better than control in the treatment of Pseudomonas aeruginosa keratitis (P=0.0046 and 0.0069, respectively); there were no significant differences between these 2 drugs in bactericidal activity (P=0.1120). Moxifloxacin performed significantly better than control in the treatment of ciprofloxacin-resistant MRSA (P=0.0321) keratitis, and vancomycin showed a trend toward statistical significance in performing better than control (P=0.0576); there were no significant differences between these 2 drugs in bactericidal activity (P=0.5205). CONCLUSIONS: Topical moxifloxacin 0.5% and ciprofloxacin 0.3% have similar efficacy in the treatment of Pseudomonas aeruginosa keratitis in rabbits. Topical moxifloxacin 0.5% and vancomycin 50 mg/mL have similar efficacy in the treatment of ciprofloxacin-resistant MRSA keratitis in rabbits. These results suggest a potential value for topical moxifloxacin as a broad-spectrum agent in the treatment of bacterial keratitis.

Administration, Topical↗
PubMed2003

Use of 18S rRNA gene-based PCR assay for diagnosis of acanthamoeba keratitis in non-contact lens wearers in India.

Identification of Acanthamoeba cysts and trophozoites in ocular tissues requires considerable expertise and is often time-consuming. An 18S rRNA gene-based PCR test, highly specific for the genus Acanthamoeba, has recently been reported in the molecular diagnosis of Acanthamoeba keratitis. This PCR assay was compared with conventional microbiological tests for the diagnosis of Acanthamoeba keratitis. In a pilot study, the PCR conditions with modifications were first tested on corneal scrapings from patients with culture-proven non-contact lens-related Acanthamoeba, bacterial, and fungal keratitis. This was followed by testing of corneal scrapings from 53 consecutive cases of microbial keratitis to determine sensitivity, specificity, and predictive values of the assay. All corneal scrapings from patients with proven Acanthamoeba keratitis showed a 463-bp amplicon, while no amplicon was obtained from patients with bacterial or fungal keratitis. Some of these amplified products were sequenced and compared with EMBL database reference sequences to validate these to be of Acanthamoeba origin. Out of 53 consecutive cases of microbial keratitis included for evaluating the PCR, 10 (18.9%) cases were diagnosed as Acanthamoeba keratitis on the basis of combined results of culture, smear, and PCR of corneal scrapings. Based on culture results as the "gold standard," the sensitivity of PCR was the same as that of the smear (87.5%); however, the specificity and the positive and negative predictive values of PCR were marginally higher than the smear examination (97.8 versus 95.6%, 87.5 versus 77.8%, and 97.8 versus 97.7%) although the difference was not significant. This study confirms the efficacy of the PCR assay and is the first study to evaluate a PCR-based assay against conventional methods of diagnosis in a clinical setting.

Acanthamoeba↗
PubMed1987

Herpetic keratitis therapy to reduce recurrence.

Since the herpes simplex virus locates latently in the ganglia and is reactivated by certain triggers, the important problem in treatment is to prevent or reduce recurrence. The present study investigates the role of mechanical debridement in lessening the recurrence of dendritic keratitis in patients with herpetic epithelial keratitis. Group A was treated with mechanical debridement plus IDU, Group B with IDU alone. Also studied was the effect of steroid subconjunctival injection on herpetic recurrence in patients with herpetic stromal keratitis: Group C was treated with intravenous infusion of pepsin-treated gamma-globulin (PTGG) and steroid subconjunctival injection, Group D with steroid subconjunctival injection alone and Group E with intravenous infusion of PTGG alone. The recurrence rates of dendritic keratitis were 19% in Group A and 40% in Group B (average follow-up periods: 24 and 25 months). The recurrence rates of stromal keratitis were 61% in Group C, 64% in Group D, and 36% in Group E (average follow-up periods: 20, 19 and 15 months). The difference between Groups D and E was statistically significant (chi 2 test, P less than 0.05). The recurrence rates of dendritic keratitis were 18% in Group C, 21% in Group D and 7% in Group E. In conclusion, mechanical debridement tended to reduce the recurrence of herpetic epithelial keratitis and steroid subconjunctival injection to increase the recurrence of epithelial or stromal keratitis.

Administration, Topical↗
PubMed1999

Experimental autoimmune keratitis induced in rats by anti-cornea T-cell lines.

PURPOSE: Idiopathic inflammation of the cornea, keratitis, has been proposed to result from an autoimmune process, but thus far no convenient animal model of keratitis exists. An attempt was made to establish an animal model for keratitis, to investigate possible autoimmune mechanisms. METHODS: T-cell lines were established from lymph node cells removed from rats immunized with bovine corneal epithelium (BCE) extract. After restimulation in vitro with BCE or a specific corneal antigen, the cells were transferred by intraperitoneal injection into naive rats, rats subjected to total body irradiation, or rats in which only one eye was irradiated. RESULTS: Neither direct immunization with corneal antigens nor transfer of activated anti-corneal T-cells into naive rats gave any signs of keratitis. Irradiation alone did not induce corneal inflammation. Transfer of corneal-specific activated T cells into irradiated rats produced keratitis starting around day 4 and culminating around day 8. The disease was self-limiting and the severity dependent on the dose and site of radiation. Keratitis was characterized by corneal haze, conjunctival and episcleral hyperemia, episcleral hemorrhages, chemosis, corneal infiltrates, and vascularization. Immunohistochemistry showed T-cell and macrophage infiltration of epithelium and stroma in the affected corneas. CONCLUSIONS: Thus, keratitis may be produced by T cells reactive to corneal antigens, provided that the target tissue has been made susceptible by irradiation. The effectiveness of T-cell vaccination in preventing adoptive keratitis suggests that systemic as well as local tissue factors may regulate the disease process.

Adoptive Transfer↗
PubMed2000

The diagnosis and management of Acanthamoeba keratitis.

PURPOSE: The purpose of this study was to evaluate the immunology, pathogenesis and therapy of Acanthamoeba keratitis. METHODS: The recent development of an animal model of Acanthamoeba keratitis and its impact on the medical treatment and immunology of Acanthamoeba keratitis was reviewed. RESULTS: After initial reports, Acanthamoeba infection of the cornea remained a rare disease until an association with contact lens wear was first recognized. Although the disease is closely associated with contact lens wear, it appeared that the contaminated solutions that were coming into contact with the lenses caused the disease. All types of contact lenses can be associated with development of Acanthamoeba keratitis. Therefore, the contact lens serves as a carrier of Acanthamoeba to the surface of the eye. The typical patient with Acanthamoeba keratitis is a young healthy individual who is either a contact lens wearer or has had significant exposure to water contaminated with Acanthamoeba. There are several risk factors such as corneal trauma, contaminated solution and contact lenses that have been reported to be associated with Acanthamoeba keratitis. In spite of significant improvement in the diagnosis of Acanthamoeba keratitis, progress in developing and utilizing effective antimicrobial agents for treating this disease have been disappointing. A growing body of evidence suggests that the mammalian immune system, if properly activated, is capable of preventing and controlling ocular infections. CONCLUSIONS: In order to develop effective immunotherapeutic modalities, and to better understand the immune effector mechanisms that protect the cornea against Acanthamoeba infection, it is necessary to fully characterize and evaluate the immunobiology of Acanthamoeba keratitis.

Acanthamoeba↗
PubMed2006

[Therapeutic penetrating keratoplasty for microbial keratitis].

BACKGROUND: Microbial keratitis is a potentially sight threatening disease. Most cases respond well to antimicrobial therapy. However, in cases that progress despite intensive medical therapy, an urgent therapeutic penetrating keratoplasty (TPKP) is required. AIM: To evaluate the indications and results of TPKP in Israel. METHODS: A retrospective study reviewed the TPKP performed at the Goldschleger Eye Institute, Sheba Medical Center, between 1990-2003. The study included 18 cases of at least one-year follow-up. RESULTS: The indications for TPKP included severe infectious keratitis unresponsive to medical treatment in 33% of the patients and severe corneal destruction in 66% of them. The infectious keratitis was diagnosed as bacterial keratitis in 44% of the patients, unidentified pathogen in 39%, mycotic in 11% and acanthamoeba in 6% of the patients. Risk factors in the patients with microbial keratitis requiring TPKP included: previous ocular disease in 39%, previous ocular surgery in 66%, systemic disorders in 28% and ocular risk factors in 28% patients. TPKP was successful in bacterial and acanthamoeba keratitis as far as the transparency of the graft and elimination of the infection and improvement of visual acuity. However, TPKP failed in mycotic and unidentified keratitis. The risk factors for failure included: previous ocular disease or surgeries, systemic disorders or large corneal grafts. CONCLUSIONS: Therapeutic penetrating keratoplasty is an important and effective therapeutic tool for intractable bacterial and acanthamoeba keratitis. Prognostic factors for graft success include lack of ocular disease or previous surgeries, lack of systemic disorders or small corneal graft size.

Adolescent↗
PubMed1997

[Herpetic keratitis: clinical-virological correlation].

BACKGROUND: Herpetic keratitis is the main infectious cause of corneal opacity. The existence of effective antiviral agents underscores the need of an early diagnosis. AIM: To correlate clinical features of herpetic keratitis with virological studies. PATIENTS AND METHODS: Forty one patients with a clinical diagnosis of herpetic keratitis were studied. Viral isolation, polymerase chain reaction (PCR) and typification were done in a sample taken by swabbing the ocular lesion. RESULTS: Twenty six patients (31% female) had epithelial keratitis, that was mild or moderate in 88% of cases and acute in 77% of them. In 20 patients (77%), viral isolation and PCR were positive (HSV-2 in one case). Fifteen patients (67% female) had stromal keratitis, 93% of cases were moderate or severe and 53% were acute. Viral isolation was negative in all cases and in 20% PCR was positive. CONCLUSIONS: Viral isolation and PCR were equally sensitive in epithelial keratitis, but in stromal keratitis only PCR could detect the virus. Moderate acute dendrite was the predominant clinical manifestation. The higher proportion of women with stromal keratitis supports its possibly autoimmune etiology. HSV-2 is seldomly isolated and possibly associated to vertical transmission.

Acute Disease↗
PubMed1993

Incidence of ulcerative keratitis in a defined population from 1950 through 1988.

OBJECTIVE: To determine the incidence of ulcerative keratitis and to assess trends in risk factors leading to ulcerative keratitis. DESIGN: Retrospective incidence cohort study. SETTING: General community. PATIENTS: Population-based sample of residents of Olmsted County, Minnesota, in the 39-year period between 1950 and 1988. MAIN OUTCOME MEASURE: Cases of ulcerative keratitis. RESULTS: One hundred forty-one cases of ulcerative keratitis were diagnosed among 131 residents (64 men and 67 women) of Olmsted County. The mean annual age-adjusted incidence per 100,000 people was 5.3 (95% confidence interval, 4.4 to 6.2). A 435% increase in the incidence of ulcerative keratitis was observed in Olmsted County residents from the 1950s (2.5 per 100,000 people) to the 1980s (11.0 per 100,000 people) (P = .001). The cases of ulcerative keratitis associated with contact lens wear increased from 0% in the 1950s and 1960s to 32% in the 1970s and 52% in the 1980s. CONCLUSION: The incidence of ulcerative keratitis has increased significantly in this community. Contact lens wear was the most important risk factor for the development of ulcerative keratitis during the last decade.

Adolescent↗
PubMed2005

The incidence of microbial keratitis among wearers of a 30-day silicone hydrogel extended-wear contact lens.

PURPOSE: To estimate the incidence of presumed microbial keratitis with and without loss of visual acuity among wearers of a silicone hydrogel contact lens (Lotrafilcon A, Night & Day, CIBA Vision, Inc., Duluth, GA), recently approved for up to 30 days of continuous wear. DESIGN: Prospective cohort postmarket surveillance study. PARTICIPANTS: Contact lens wearers (recruited from 131 practices) who had been prescribed the lens for intended continuous wear of as many as 30 nights. METHODS: The occurrence of a corneal infiltrate was ascertained through a combination of center report and direct contact with participants at 3 and 12 months. Whenever a corneal infiltrate was suspected, study and treatment medical records were systematically reviewed by an Endpoints Committee using a predetermined classification scheme for corneal infiltration. Cases of presumed microbial keratitis were determined based on the constellation of presenting signs and symptoms and clinical course. MAIN OUTCOME MEASURES: The incidence of presumed microbial keratitis with and without loss of visual acuity. RESULTS: A total of 6245 participants were recruited between August 13, 2002 and July 2, 2003. Of these, 4999 subjects (80%) completed 12 months of follow-up, and these participants contributed a total of 5561 person years of lens wearing experience. Approximately 80% of participants routinely wore their lenses continuously for 3 or more weeks. The overall annual rate of presumed microbial keratitis was 18 per 10,000 (95% confidence interval (CI): 8.5-33.1). There were 2 cases of presumed microbial keratitis with loss of visual acuity, an annual rate of 3.6 per 10,000 (95% CI: 0.4-12.9), and an additional 8 cases without loss of visual acuity, an annual rate of 14.4 per 10000 (95% CI: 6.1-28.4). The rate of presumed microbial keratitis was lower for users reporting typical wear of 3 or more weeks than for those wearing the lens for less than a 3-week continuous period (P = 0.02). CONCLUSIONS: The incidence of loss of visual acuity due to microbial keratitis among users of the silicone hydrogel contact lens was low. The overall rate of presumed microbial keratitis with the wearing schedule of as many as 30 nights was similar to that previously reported for conventional extended-wear soft lenses worn for fewer consecutive nights.

Adolescent↗
PubMed2000

The effectiveness of a topical antibiotic irrigating solution in a model of staphylococcal keratitis after lamellar keratectomy.

PURPOSE: To create a model of Staphylococcus aureus keratitis after lamellar keratectomy; to assess the toxicity of an antibiotic irrigating solution on the corneal stromal bed; and to test the chemotherapeutic effectiveness of a topical antibiotic, both alone and with an antibiotic-containing irrigating solution in preventing S. aureus keratitis after lamellar keratectomy. METHODS: The right eye of each of 38 rabbits were used in this study. In 18 eyes, a lamellar flap was created with a microkeratome, and an inoculum of S. aureus (either 1,000, 5,000, or 50,000 CFUs) was instilled under each flap; the eyes were examined for signs of infection and inflammation at 24 and 48 hours. In another five eyes, a lamellar flap was created in the same manner and the stromal bed was irrigated with 0.3% ofloxacin; the eyes were assessed for ocular inflammatory changes and evidence of crystalline deposits. Finally, in each of 15 additional eyes, 1,000 CFUs of S. aureus were instilled under a lamellar flap to create experimental infectious keratitis. The keratitis was treated according to three regimens: irrigation of the stromal bed with sterile balanced salt solution; irrigation of the stromal bed with 0.3% ofloxacin, followed by application of topical ofloxacin four times a day; application of topical ofloxacin only, four times a day. Eyes were examined for infection and ocular inflammatory changes at 24 and 48 hours. RESULTS: Staphylococcus aureus keratitis can consistently be produced under the stromal flap by inoculation of relatively few organisms. Irrigation of the stromal bed with commercial-strength topical ofloxacin does not appear to be toxic to the stromal bed, with no evidence of crystalline precipitates of the antibiotic. In our model of infectious keratitis after lamellar keratectomy, both topical ofloxacin alone and the combination of topical ofloxacin and irrigation of the stromal bed with 0.3% ofloxacin were effective at preventing S. aureus keratitis. However, the combined treatment of antibiotic irrigation plus topical antibiotic was more effective at preventing inflammation than topical ofloxacin alone. CONCLUSIONS: In this model of S. aureus keratitis after lamellar keratectomy, irrigation of the stromal bed with antibiotic plus topical antibiotic appears to be both safe and effective for preventing infection.

Administration, Topical↗
PubMed1999

Fungal keratitis as an indicator of HIV infection in Africa.

A 1-year hospital-based study was undertaken on 212 patients at Muhimbili Medical Centre (MMC) from October 1994 to October 1995. The objective was to determine the aetiology of corneal ulceration. A comparison of the prevalence of HIV infection between patients with fungal keratitis and those with non-fungal keratitis was included. Bacterial infection (32.1%), and mycotic infection (15.1%) were the leading causes of corneal ulceration. There were 32 patients with fungal keratitis and 180 patients with non-fungal keratitis. The male:female ratio for patients with fungal keratitis was 1.7:1 and the peak age group was 20-50 years. Fusarium solani was the commonest organism accounting for 75% of cases with fungal keratitis. Twenty of 32 (81.2%) cases with fungal keratitis were found to be HIV positive; 33% of those with non-fungal keratitis were HIV positive (P-value was < 0.001).

AIDS-Related Opportunistic Infections↗
PubMed2002

Therapeutic keratoplasty for infectious keratitis: a review of the literature.

PURPOSE: This article provides a review of the literature on various aspects of therapeutic keratoplasty, including indications, techniques, complications and outcome, and its application in cases of infectious keratitis. METHODS: Various articles on therapeutic keratoplasty (including English- and non-English-language publications) were analyzed. Selection of the articles was based on a Medline search for articles using the key words therapeutic keratoplasty, penetrating keratoplasty, therapeutic keratoplasty for infectious keratitis, non-healing corneal ulcer, microbial keratitis, and perforated corneal ulcer. Abstracts in English were used for non-English articles. RESULTS: Therapeutic keratoplasty has a definitive role in the management of progressive bacterial, fungal, Acanthamoeba, and viral keratitis refractory to medical treatment. Management of bacterial keratitis has higher functional success and anatomic cure rate compared with fungal, viral and Acanthamoeba keratitis. Therapeutic keratoplasty offers a cure rate of up to 100% in bacterial and fungal keratitis, whereas the recurrence of infection after Acanthamoeba keratitis is frequent. Visual outcome depends on various factors such as the causative agent, timing of surgery, degree of inflammation, type of donor material used, and size of the graft used. For example, larger grafts have a higher incidence of graft rejection and failure compared to smaller grafts. The primary aim of the procedure is to reestablish the integrity of the globe and to eliminate the infectious disease process. Visual rehabilitation is a secondary outcome. CONCLUSIONS: This review helps to elucidate the various aspects of therapeutic keratoplasty, including indications, preoperative assessment, surgical techniques, postoperative management, complications, and anatomic and functional outcome.

Corneal Ulcer↗
PubMed1996

Outbreak of keratitis presumed to be caused by Acanthamoeba.

PURPOSE: A sharp increase of Acanthamoeba keratitis from two cases per year to 30 cases per year at our institution prompted this study to determine whether there was a change in the clinical characteristics, basic epidemiology, and outcome of this disease. METHODS: We reviewed all cases of Acanthamoeba keratitis diagnosed at the University of Iowa Hospitals and Clinics from mid-1993 through 1994. RESULTS: We screened 217 patients with keratitis by tandem scanning confocal microscopy and suspected Acanthamoeba in 51 patients. Diagnosis was confirmed by cytology in 43 patients (48 eyes). There were no positive cultures. Patients examined within four weeks of onset of symptoms were younger (mean age, 32.6 +/- 15.4 years) and wore contact lenses (11 of 18 patients), and infrequently herpes simplex keratitis (four of 18 patients) was diagnosed. Patients examined after four weeks were older (mean age, 54.0 +/- 19.5 years), infrequently wore contact lenses (six of 25 patients), and often had herpes simplex keratitis (12 of 25 patients). CONCLUSIONS: Corneal examination with tandem scanning confocal microscopy was associated with a marked increase in the detection of Acanthamoeba, strongly suggesting that the disease is more prevalent than suspected. Acanthamoeba may account for many cases of clinically presumed herpes simplex keratitis, the leading cause of corneal blindness in the United States. Acanthamoeba should be considered in the differential diagnosis of any unexplained keratitis, even those of short duration.

Acanthamoeba↗
PubMed1999

Oral acyclovir after penetrating keratoplasty for herpes simplex keratitis.

OBJECTIVE: To determine the efficacy of systemic acyclovir in decreasing complications and improving the outcome of penetrating keratoplasty for herpes simplex virus (HSV) keratitis. METHODS: Retrospective study of 53 primary penetrating keratoplasties for HSV keratitis at an eye hospital from January 1, 1989, through December 31, 1996. Medical records were analyzed for history of HSV keratitis, preoperative neovascularization, and disease activity. Postoperative use of acyclovir, recurrence of HSV keratitis, rejection, uveitis or edema, and graft failure were evaluated. RESULTS: Twenty-four patients (mean +/- SD follow-up, 44.7 +/- 32.6 months) received no acyclovir and were compared with 20 patients, (mean +/- SD follow-up, 28.8 +/- 16.7 months), who received 400 mg acyclovir twice a day for at least 1 year. No patient in the acyclovir group had a recurrence of dendritic keratitis in the first year compared with 5 (21%) of the patients who did not receive acyclovir (P = .03). No patient had graft failure in the acyclovir group compared with 4 (17%) in the group without acyclovir after 1 year of follow-up (P = .06). CONCLUSION: Postoperative systemic acyclovir therapy after penetrating keratoplasty for HSV keratitis is associated with a reduced rate of recurrent HSV dendritic keratitis and possible graft failure at 1 year of follow-up.

Acyclovir↗
PubMed2006

An outbreak of Fusarium keratitis associated with contact lens wear in Singapore.

CONTEXT: Fungal keratitis is a potentially blinding condition that is rarely seen with contact lens wear. OBJECTIVE: To describe a nationwide outbreak of fungal keratitis caused by Fusarium species among contact lens wearers in Singapore. DESIGN, SETTING, AND PATIENTS: Nationwide, hospital-based case series. All cases of fungal keratitis among contact lens wearers in all ophthalmology departments in Singapore were reviewed along with the charts of all contact lens wearers with culture-proven fungal keratitis from March 2005 through May 2006. A standardized telephone interview was conducted to obtain additional clinical information. MAIN OUTCOME MEASURE: Diagnosis of Fusarium keratitis associated with contact lens wear. RESULTS: During the study period, 66 patients (68 affected eyes) were diagnosed with Fusarium keratitis associated with contact lens wear; the estimated annual national incidence is 2.35 cases per 10,000 contact lens wearers (95% confidence interval, 0.62-7.22). Patients ranged in age from 13 to 44 years (mean [SD], 27.1 [8.4] years), of which 32 (48.5%) were men. The vast majority (65 patients; 98.5%) wore soft, disposable contact lenses; 62 patients (93.9%) reported using 1 brand of contact lens cleaning solution (ReNu, Bausch & Lomb, Rochester, NY), including 42 patients (63.6%) who recalled using ReNu with MoistureLoc. Most patients (81.8%) reported poor contact lens hygiene practices, including overnight use of daily wear contact lenses (19.7%), and use of contact lenses past the replacement date (43.9%). The final best-corrected visual acuity ranged from 20/20 to 20/80. Five patients (5 eyes; 7.4%) required emergency therapeutic or tectonic corneal transplantation. CONCLUSIONS: A new and evolving epidemic of Fusarium keratitis associated with contact lens wear was found in Singapore. Physicians and eye care practitioners worldwide need to be aware of the likelihood of similar outbreaks emerging among contact lens wearers.

Adolescent↗
PubMedDate not supplied

Study of a polymerase chain reaction-based method for detection of herpes simplex virus type 1 DNA among Iranian patients with ocular herpetic keratitis infection.

PURPOSE: To study the presence of the herpes simplex virus type 1 (HSV-1) glycoprotein D gene in tear films of Iranian patients with herpetic keratitis. METHODS: Twenty-five tear film and eye swab specimens from 25 herpetic keratitis patients and 10 specimens from 10 healthy volunteers were collected in the Farabi Eye Hospital, Tehran, Iran. HSV-1 DNA was detected by using the nested polymerase chain reaction (nPCR) method. Viral isolation was done using conventional viral techniques. A monoclonal antibody-based enzyme-linked immunosorbent assay (ELISA) was used for confirmation of positive cytopathic effect cell culture. The results of a diagnosis by an ophthalmologist team were compared with those of nPCR. RESULTS: HSV-1 DNA was identified in tear films of 88% (23/25) of suspected herpetic keratitis patients. All healthy controls (100%) had negative PCR results. HSV-1 was isolated in cell culture and confirmed by ELISA in 12% (3/25) of herpetic keratitis patients who had epithelial keratitis. The kappa value showed a high level of agreement between ophthalmologist team diagnosis and the PCR results (kappa = 0.86, P < 0.0001). CONCLUSIONS: nPCR is a sensitive, rapid, and powerful tool for detection of HSV-1 DNA in tear films of ocular herpetic keratitis patients and can serve as a supplemental method for diagnosis of herpetic keratitis infection.

Animals↗
PubMed1991

Contact lenses and other risk factors in microbial keratitis.

Microbial keratitis is a potentially binding disease that is rare in normal eyes unless associated with contact lens (CL) wear. To assess the risks of CL use, and other major causes, for keratitis, a case-control study of 91 cases of keratitis including 60 CL users was done. Relative risks (RR) and population attributable risk percentages (PAR%) for keratitis were estimated for different causes and for the different types of CL. The RR (95% confidence intervals) for CL wear was 80 (38-166) and for trauma cases 14 (6-32) compared with cases of keratitis without a predisposing condition. The PAR% for microbial keratitis attributed to CL wear was 65%. The RR for overnight wear soft lenses was 21 (7-60), for daily-wear soft lenses 3.6 (1-14), and for polymethylmethacrylate hard lenses 1.3 (0-9) compared with gas-permeable hard lenses. Continuous periods of CL wear for more than 6 days was associated with increased risk. CL wear is now the commonest cause, and has the highest risk, for new cases of microbial keratitis at Moorfields Eye Hospital. Soft CLs, especially extended-wear lenses, carry a significantly higher risk than do hard lenses for this disease.

Adult↗