摘要:

Purpose.Herpes simplex virus (HSV) can cause corneal infections in humans and lead to permanent scarring, loss of vision, and blindness. Current treatment of epithelial HSV keratitis consists of using antiviral DNA analogs. In this study, we used in vitro and in vivo models to evaluate the efficacy of six polyclonal antibodies to HSV recombinant surface glycoprotein D in treating ocular epithelial HSV.Methods.Confluent cultures of African Green monkey kidney fibroblasts (Vero cells) and normal 3-to 5-lb female New Zealand White rabbits were infected with HSV type 1, strain RE. In vitro virucidal and antiviral assays were performed, and the best of the compounds was chosen for the in vivo stage. Animals were carefully monitored until day 5 after HSV-1 inoculation, then arbitrarily divided into groups receiving, for 14 days, varying doses of: polyclonal antibodies four times a day, polyclonal antibodies three times a day, trifluorothymidine (current treatment of choice and the positive control) nine times a day, or 0.9% physiologic saline nine times a day. The animals were followed up in a masked fashion and carefully monitored for severity and resolution of the HSV infection by biomicroscopy (slit lamp) examination and viral cultures using standardized plaque assays.Results.All six of the compounds tested were effective in vitro, but one compound in particular, SP-510-50, was superior. It was used for the in vivo testing and showed antiviral efficacy in a dose-dependent manner, and at dosing four times a day, it was of comparable efficacy to trifluorothymidine (nine times a day).Conclusions.We conclude that polyclonal antibodies to glycoprotein D appear to be effective antiviral agents in vitro and in vivo in a rabbit model of HSV-1 keratitis and show promise as a new antiviral treatment for ophthalmic use.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To compare corneal endothelial cell function by measuring corneal thickness during temperature reversal between corneas stored in two different storage media, Optisol GS and Chen Medium (CM).Methods.Twenty paired corneas from 10 human donors were randomly assigned for storage at 4°C in Optisol GS (10 corneas) or CM (10 corneas). The storage media were masked, and measurements were done in a masked fashion. After storage for 48 hours, corneal thickness was measured by ultrasonic pachymetry at 2-hour intervals for 12 hours, during which time the corneas were perfused with BSS (balanced salt solution) Plus at 37°C. Scanning electron microscopy of two pairs of corneas from two donors was performed to assess ultrastructural change after 12 hours of warming.Results.Corneal thickness decreased during the first 4 hours of the warming period and then increased during the 6-to 12-hour warming period. These changes in corneal thickness over time were similar for the two storage media (p= 0.212). Scanning electron microscopy showed greater amounts of endothelial cell disruption in Optisol GS–stored corneas than those stored in CM after 12 hours of warming and perfusion.Conclusions.The endothelial pump of corneas stored in CM appear to be as well-preserved as those stored in Optisol GS, although greater endothelial disruption may be present with Optisol GS by scanning electron microscopy. Further studies are required to compare the clinical effectiveness of these two media.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To investigate the permeation of cyclosporin A (CsA) through fresh and frozen human corneas in the presence and absence of three penetration enhancers: benzalkonium chloride (BZCl), dimethylsulfoxide (DMSO), and Cremophor-EL.Methods.Human corneas, unsuitable for transplantation, were either freshly used for permeability experiments or snap-frozen in liquid nitrogen and stored at −85°C. CsA permeation through either fresh or thawed frozen corneal tissue was determined using a flow-through diffusion apparatus (20°C for 24 hours). Flux rates for CsA were determined in the presence and absence of the penetration enhancers 0.01% BZCl, 20% DMSO, and Cremophor-EL (10% and 20%). Analysis of variance and Duncan's multiple-range test were used to test for steady state, and an unpaired Studentttest with Welch's correction was used to test for differences between the mean flux values at each time point. A significance level of 5% was used for all of the statistical tests.Results.No statistically significant differences in flux values of CsA could be detected between fresh and frozen corneas. In the presence of Cremophor-EL (10% and 20%) and 0.01% BZCl, statistically significant increases in flux values of CsA before 16 hours and after 16 hours, respectively, could be observed. In the presence of 20% DMSO, no statistically significant increases in flux values could be detected.Conclusions.The permeation of CsA through human corneas appeared to be enhanced by the presence of BZCl and Cremophor-EL. Additionally, it was shown that the flux rate of CsA across fresh and frozen corneas was not significantly different.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.Photorefractive keratectomy (PRK) is still a widely used method for the correction of refractive error despite the advent of laser in situ keratomileusis (LASIK). However, both procedures are associated with significant side effects such as corneal haze and regression. Several factors have been implicated in the etiology of haze, one of which is thermal loading of the cornea. The purpose of this study was to investigate the temperature changes occurring during PRK when performed at different ablation depths.Methods.Noncontact, color-coded ocular thermography was performed with an infrared detector apparatus during PRK ablation on 19 ovine corneas. Five different refractive corrections were carried out ranging from −2.00 diopters (D) (ablation depth, 31.2 &mgr;m) to −10.00 D (ablation depth, 137.9 &mgr;m).Results.A temperature rise at the corneal surface was demonstrated in all 19 corneas. The mean rise in temperature was 7.35 ± 1.13°C with a maximum rise in temperature of 8.97°C. A positive correlation was found between the refractive correction and the peak rise in temperature (r2= 0.57,p< 0.0001). The rate of temperature change was greater for smaller treatments than for larger treatments (r2= 0.79,p< 0.0001). Corneas undergoing larger treatments were subject to greater rises in temperature for longer periods of time.Conclusions.This study suggests that the cornea undergoes a significant rise in temperature as a result of the PRK process. Further investigation is required to determine what effect this thermal loading has on the corneal wound healing response after PRK.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.The eicosanoid, 15-(S)-hydroxyeicosa-5Z, 8Z-11Z, 13E-tetraenoic acid (15-(S)-HETE), is known to stimulate production of mucin glycoprotein by airway epithelium. This study investigated the effect of 15-(S)-HETE on the mucin glycoprotein secretion by the corneal epithelium.Methods.To determine the effect of dose, corneas of anesthetized New Zealand White rabbits were treated with 50, 500, or 5,000 nM 15-(S)-HETE in artificial tears for 120 minutes. To determine the time to onset of the response, corneas were treated with 500 or 1,000 nM 15-(S)-HETE in balanced salt solution for periods ranging from 5 to 120 minutes. Corneas were fixed for electron microscopy in fixative containing 0.5% cetylpyridinium chloride (CPC) to stabilize the layer of mucin-like glycoprotein on the corneal surface. The mucin layer thickness was measured by image analysis of electron micrographs.Results.The layer of CPC-fixed mucin-like glycoprotein on the surface of control corneas was 0.46 ± 0.04 &mgr;m thick. After treatment with 15-(S)-HETE, the thickness of the mucin layer increased to 0.64 ± 0.1 &mgr;m at 50 or 5,000 nM HETE and as much as 1.02 ± 0.2 &mgr;m in response to 500 nM HETE. Mucin thickness reached a statistical maximum of 0.59 ± 0.1 &mgr;m after only 5 minutes of exposure to 500 or 1,000 nM HETE.Conclusions.Exposure of the cornea to 15-(S)-HETE causes a rapid-onset increase in the thickness of a layer of mucin-like glycoprotein on the surface of the corneal epithelium. This supports previous reports that corneal epithelial cells produce mucin and suggests that treatment with topical 15-(S)-HETE may be effective in treating ocular surface mucin deficiency in dry eye syndrome.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To report a 16-year-old woman who had peripheral keratitis as a presenting sign of microscopic polyangiitis (MPA), which rapidly progressed to acute renal failure.Method.Case report.Results.The patient's vasculitis was diagnosed by renal biopsy, which was evaluated with histologic, immunofluorescence, and electron microscopy. The diagnosis was confirmed by laboratory study, which showed a positive antimyeloperoxidase antibody.Conclusion.MPA may rarely present with ocular findings and should be considered in the differential diagnosis when a patient has peripheral keratitis.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To report two Japanese patients who were clinically diagnosed with late-onset and sporadic lattice corneal dystrophy (LCD) in whom a Leu527Arg mutation in theTGFBIgene was found.Methods.Molecular genetic analysis was performed on DNA extracted from peripheral leukocytes from the patients. Exons 4, 11, and 12 of theTGFBIgene were amplified by polymerase chain reaction and directly sequenced. Histopathologic study was performed on the corneal tissue obtained during deep lamellar keratoplasty (DLK) from one of the patients.Results.Patient 1 was a 74-year-old man who noticed a visual disturbance at the age of 72 years. Deep stromal opacities with nodular deposits and thick lattice lines were observed only in the right cornea, and DLK was performed. Patient 2 was an 82-year-old man who had LCD (similar in appearance to that in patient 1) in both eyes without visual disturbance. Neither of the patients had a family history of corneal problems and had no episode of corneal erosion. A heterozygous single base-pair transition (CTG to CGG, leucine to arginin) was detected in codon 527 of theTGFBIgene in both patients. No mutation was found in codons 124, 501, 518, 546, or 555. Histopathologically, relatively large amyloid deposits in the deep corneal stroma and ribbons of amyloid deposits just beneath the Bowman's layer were observed in the corneal tissue of patient 1.Conclusions.Clinical features and pathologic findings of the late-onset form of LCD with an L527R mutation in theTGFBIgene were made clear.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To report a patient with lattice corneal dystrophy type I (LCDI) who developed a triple anterior chamber after full-thickness lamellar keratoplasty (LKP).Methods.A 46-year-old woman underwent a full-thickness LKP in her right eye for visual disturbances caused by LCDI. Her visual acuity was 20/200 OD before surgery. A complete ophthalmic examination, including slit lamp biomicroscopy and optical coherence tomography (OCT), was performed before and after surgery. Molecular genetic analysis was performed on DNA extracted from the peripheral leukocytes.Results.The surgery was performed uneventfully; however, extra spaces posterior to the graft, along with the severe graft edema, were observed to form a triple anterior chamber a few days after surgery. The extra spaces resolved in 3 weeks with no surgical treatment, and her visual acuity improved to 20/20 OD without correction 3 months after surgery. The triple anterior chamber was clearly demonstrated by OCT, but not by slit lamp biomicroscopy. A heterozygous single base-pair transition (CGC to TGC, arginin to cysteine) was detected in codon 124 of theTGFBIgene in the patient.Conclusion.The separation of the graft and the host's deep corneal tissue and a Descemet's membrane detachment in the host's cornea caused the triple anterior chamber. The Descemet's membrane detachment demonstrated the weak adhesion of the stroma and the Descemet's membrane, probably resulting from a dysfunction of the TGFBI protein caused by the mutation of theTGFBIgene. OCT is useful for the objective documentation of the posterior corneal region even with severe corneal edema.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To report a case ofAspergillus fumigatuskeratitis with clinical features simulatingNocardiakeratitis and to highlight the utility of microbiologic investigation in the successful management of infectious keratitis.Method.Case report.Results.A 62-year-old man presented with complaints of pain, redness, and watering of 10 days' duration in his right eye. Direct microscopic observation of smears of corneal scrapings revealed a fungal etiology. The patient was treated with 5% natamycin eye drops and 1% atropine sulphate eye drops and was advised to visit the hospital for observation. During his visit to the hospital on day 10 after medication, the eye demonstrated a wreath pattern corneal infiltrate that simulatedNocardiakeratitis. The fungus grown from culture of corneal scraping was identified asA. fumigatus.Conclusion.This report highlights the significance of subjecting corneal scrapings from suspected cases of infectious keratitis to microbiologic evaluation and emphasizes the fact that a complete microbiologic work-up helps in establishing a definitive etiologic diagnosis and initiating specific antimicrobial therapy.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.We report an unusual case of mucolipidosis IV in a patient of African ancestry, with intracytoplasmic inclusions of the corneal endothelium found on electron microscopy.Method.Clinical description with light and electron microscopy.Results.We describe a case of mucolipidosis IV diagnosed in a patient of African ancestry after penetrating keratoplasty. Electron microscopic evaluation revealed intracytoplasmic inclusions in both the corneal epithelium and endothelium.Conclusion.The diagnosis of mucolipidosis in a patient of African ancestry is unusual, as this genetic disorder is found predominantly in individuals of Jewish descent. Corneal endothelial involvement in mucolipidosis IV has not previously been reported.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID