摘要:

Purpose.Acute keratoconjunctivitis with prominent subconjunctival hemorrhage (SCH) is usually perceived by a clinician as acute hemorrhagic conjunctivitis (AHC) associated with enteroviruses; however, SCH can also be an adenoviruses infection. A rapid and sensitive laboratory diagnosis is helpful for differential diagnosis. Therefore, the sensitivity and applicability of polymerase chain reaction (PCR) and reverse transcription (RT)-PCR diagnoses were evaluated for keratoconjunctivitis associated with viral infection.Methods.Conjunctival swabs from patients with acute conjunctivitis were tested using a PCR-restriction fragment length polymorphism (PCR-RFLP) for adenovirus detection and RT-PCR for enterovirus detection. The results were compared with those using the culture isolation and neutralization test; also, the clinical findings of the patients were analyzed with special attention to SCH patterns.Results.Neither coxsackievirus A type 24 variant (CA24v) nor enterovirus type 70 (EV70) was detected in 113 patients with acute conjunctivitis. The positive results of adenovirus (Ad) were 39.9% by the PCR method and 37.1% by culture isolation. For the patients with adenoviral conjunctivitis, 68.1% was owing to Ad37 and 19.2% was owing to Ad19. SCH was present in 51.5% of the positive cases, and 44.7% of the Ad-positive patients had secondary illnesses.Conclusions.SCH can be a predominant presentation of Ad19 and Ad37 keratoconjunctivitis and may herald a new stage in the evolution of adenoviruses. PCR and PCR-RFLP are rapid and reliable methods for Ad detection and typing; however, if the amplified genes and restriction enzymes are not properly selected, they may not be able to detect new genotypes of adenoviruses or the evolution of these viruses.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To evaluate and compare the in vitro antimicrobial activity of levofloxacin versus ciprofloxacin and ofloxacin against ocular isolates from patients with bacterial conjunctivitis.Methods.The in vitro antimicrobial susceptibilities of ocular isolates to levofloxacin, ofloxacin, and ciprofloxacin were determined using both the agar disk diffusion and broth dilution methods.Results.Disk diffusion susceptibility testing disclosed that 99% (100 of 101 isolates) of Gram-negative isolates and 98% (127 of 129 isolates) of Gram-positive isolates were susceptible to levofloxacin; 96% (97 of 101 isolates) of Gram-negative isolates and 78% (100 of 129 isolates) of Gram-positive isolates were susceptible to ofloxacin; and 94% (95 of 101 isolates) of Gram-negative isolates and 61% (79 of 129 isolates) of Gram-positive isolates were susceptible to ciprofloxacin. Broth dilution testing disclosed that 99% (72 of 73 isolates) of Gram-negative isolates and 98% (111 of 113 isolates) of Gram-positive isolates were susceptible to levofloxacin; 96% (70 of 73 isolates) of Gram-negative isolates and 92% (104 of 113 isolates) of Gram-positive isolates were susceptible to ofloxacin; and 95% (69 of 73 isolates) of Gram-negative isolates and 82% (93 of 113 isolates) of Gram-positive isolates were susceptible to ciprofloxacin.Conclusions.In this study, levofloxacin demonstrated superior in vitro activity against human bacterial conjunctival isolates compared with either ofloxacin or ciprofloxacin (levofloxacin > ofloxacin > ciprofloxacin).

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.Lomefloxacin was evaluated as a potential topical therapy for bacterial keratitis.Methods.Lomefloxacin was compared with ciprofloxacin in different rabbit keratitis models. A total of 216 corneas were infected withStaphylococcus aureus(ciprofloxacin-susceptible and -resistant),Streptococcus viridans,Streptococcus pneumoniae,Pseudomonas aeruginosa, and Serratia marcescens and were treated with lomefloxacin (0.3%), ciprofloxacin (0.3% Ciloxan), and the control phosphate-buffered saline (PBS), respectively. The data were analyzed statistically comparing the decrease in the number of recovered viable bacteria.Results.Compared with PBS-treated control corneas, the colony counts for all bacterial isolates were significantly reduced (p< 0.05) after topical treatment with either lomefloxacin or ciprofloxacin. For Gram-positive bacteria, lomefloxacin and ciprofloxacin were equally effective. For Gram-negative bacteria, lomefloxacin, while effective, was less so than ciprofloxacin under experimental conditions (p< 0.05).Conclusion.Our data, using multiple bacterial keratitis models, suggest that lomefloxacin is promising for therapy of bacterial keratitis. Further clinical studies are needed to expand its use for keratitis therapy.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.Activated myofibroblasts and macrophages are often found in corneal wound models. The current study was performed to determine whether human diseased corneas that had active tissue remodeling and enzyme activities also possessed myofibroblasts, macrophages, major histocompatibility complex class II cells, and/or CD-68–positive cells.Methods.Normal, keratoconus, keratoconus with hydrops, bullous keratopathy, map-dot-fingerprint dystrophy, failed grafts, and acid burn/neovascularized corneas were collected, frozen in OCT, sectioned, and stained with antibodies to alpha smooth muscle actin (myofibroblast marker), CD14 (macrophage marker), CD68 (lysosomal membrane marker), and HLA-DR (major histocompatibility complex class II cells). Selective histochemical stains identified lysosomal enzymes.Results.Normal and map-dot-fingerprint dystrophy corneas lacked antibody and enzyme staining. Keratoconus corneas were positive for CD68, HLA-DR, and lysosomal enzymes but were negative for CD14 and smooth muscle actin. Bullous keratopathy corneas had CD68-, CD14-, and HLA-DR–positive cells, relatively normal enzyme levels, and were smooth muscle actin-negative. Failed graft corneas had significant numbers of CD68-, CD14-, and HLA-DR–positive cells and increased acid phosphatase, but these corneas were smooth muscle actin-negative. Ulcerated and vascularized corneas had positive staining with all antibodies that were examined. Cultured stromal cells from normal corneas were CD68-positive, CD14-negative, and alpha smooth muscle actin-negative, and they produced lysosomal enzymes.Conclusions.The current study demonstrates that increased presence of lysosomal enzymes, corneal remodeling, and fibrosis can occur in the absence of myofibroblasts and/or macrophages.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To evaluate the efficacy of dextran in balanced salt solution (BSS) as a preparation of eye bank corneas for experimental surgeries.Methods.We used 12 eye bank eyes that were unsuitable for transplant. The corneas were removed from the globe and affixed to a Hanna artificial anterior chamber. Four concentrations of dextran–BSS (10%, 15%, 20%, and 30% [± 0.56%]) were used to dehydrate the corneas, and corneal thickness was assessed with an ultrasonic pachymeter (±5 &mgr;m) at varying time-intervals over 3 hours.Results.The corneas were thinned to an average thickness of 477 ± 54 &mgr;m, 430 ± 54 &mgr;m, 406 ± 61 &mgr;m, and 391 ± 52 &mgr;m at average times of 75 ± 0 minutes, 85 ± 23 minutes, 60 ± 12 minutes, and 45 ± 0 minutes for the 10%, 15%, 20%, and 30% concentrations, respectively. Corneal thickness was stabilized in both a 15% and a 20% solution. The data was fit to exponential curves until a minimum value was reached, after which linear regression analysis was used to determine the slopes of the data. The slopes for the 15% and 20% concentrations were not significantly different from 0 (p= 0.5 andp= 0.4, respectively). The slopes for each set of data from the 10% and 30% concentrations were significantly different from each other (p= 0.010 andp= 0.001, respectively).Conclusions.A solution of 20% dextran in BSS is effective for dehydrating eye bank corneas to a quasi-normal physiologic thickness and for maintaining the thickness for a sufficient amount of time. Both the posterior and anterior sides of the cornea should be exposed to the solution for 60 minutes.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.To investigate the impact of corticosteroids on subepithelial hyaluronan deposition and corneal epithelium thickness in the first 10 days after photorefractive keratectomy (PRK) and to analyze a possible contralateral effect of corticosteroids.Methods.Thirty-two New Zealand white rabbits were assigned into two groups and had a transepithelial 5.0-mm diameter, 8.00-diopter myopic PRK performed on one eye. The corticosteroid treatment group (16 animals) received 0.1 mL of methylprednisolone 4% subconjunctivally on the operation table, followed by 0.1% dexamethasone eye drops six times a day during the postoperative period. The sodium chloride (NaCl) treatment group received topical isotonic NaCl eye drops six times a day. In each treatment group, eight animals were killed after 3 and 9 days, respectively. The harvested specimens were stained for hyaluronan and the epithelial thickness was measured.Results.In contrast to the epithelial thickness, the subepithelial hyaluronan did not show a significant increase during the observation period. The corticosteroid treated group showed at both time-points significantly less subepithelial hyaluronan formation as well as a significantly thinner epithelium, when compared with the NaCl-treated group. At 9 days, the corticosteroid-treated group showed a mild epithelial hyperplasia in only one of eight eyes, whereas this was a common finding in the NaCl-treated group. We detected no hyaluronan deposits in any contralateral-untreated eye, and the epithelial thickness did not differ significantly between any of the four contralateral-untreated eye groups.Conclusions.Corticosteroid medication during the first 10 days after operation reduces the amount of subepithelial hyaluronan production and inhibits the epithelial proliferation, and epithelial hyperplasia is prevented. Neither a contralateral hyaluronan deposition nor a contralateral corticosteroid effect could be detected.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.The effects of varying the incision length and depth were analyzed using pig eyes to acquire information for realizing an ideal method of astigmatic keratotomy (AK).Methods.Single and paired arcuate incisions were made on pig corneas using a diamond knife. Incisions with varying lengths of 40°, 60°, and 90° were made with the incision depth fixed at 90% of corneal thickness. Next, paired incisions with varying incision depth from 20% to 95% of corneal thickness were made with the incision length fixed at 90°. The changes in corneal shape were analyzed using corneal topography and the degrees of astigmatic change were measured using a surgical keratometer.Results.For short single and paired incisions (40° or 60° in length), narrow areas of flattenings occurred, and steepenings were observed on both sides adjacent to the flattened areas. For long paired incisions of 90° length, wide areas of flattenings and steepenings were observed with an approximately 1:1 coupling ratio, and a positive linear relationship between the incision depth and degree of astigmatic change was observed in the range of incision depth between 40% and 80% of corneal thickness.Conclusion.This experimental study suggests that for achieving ideal corneal sphericity after AK, long incisions covering the entire steep areas (paired 90° incisions for regular astigmatism) should be used and the degree of astigmatic correction may be controlled by varying the incision depth.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.Leukocytoclastic vasculitis (LCCV) is an immune complex-mediated, small vessel disease that is clinically characterized by the presence of palpable purpuric lesions, most often in association with rheumatic diseases. Ocular manifestations of LCCV are rare.Methods.We describe a patient with an unusual granulomatous pattern of erythema elevatum diutinum (EED) associated with autoimmune keratolysis.Results.We studied a 64-year-old man with decreased visual acuity and nodular lesions in both hands. Ocular examination revealed bilateral superior corneal melting with perforation in the left eye and conjunctival thickening in both eyes, in association with a severe inflammatory reaction. Histopathologic examination of the conjunctiva revealed granulomatous vasculitis with neutrophilic infiltrate, giant cells, and fibroblastic proliferation. A punch biopsy taken from his skin showed similar characteristics that suggested EED; however, there were no giant cells.Conclusion.To our knowledge, autoimmune keratolysis secondary to cutaneous LCCV (EED) has not been described previously, and there has been no description of granulomatous reaction (in the conjunctiva) in EED.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Purpose.Maroteaux–Lamy syndrome is one of the mucopolysaccharidoses caused by enzyme deficiency (arylsulfatase B) that leads to incomplete degradation and storage of dermatan sulfate. We report a case of mucopolysaccharidosis type VI (MPS VI; Maroteaux–Lamy syndrome) with corneal involvement and introduce ultrasound biomicroscopy (UBM) as an examination with which to follow disease progression in relation to deposition in cornea, angle, and iris.Methods.We describe a 11-year-old boy with a clinical and laboratorial diagnosis of MPS VI who developed increasing bilateral corneal opacification and decreased visual acuity. He underwent two seriate UBM (50-MHz transducer) evaluations.Results.UBM examination showed diffuse and homogeneous stromal hyper-reflective deposit in both eyes and an increase in peripheral corneal thickness throughout time.Conclusion.High-frequency ultrasound documentation of corneal deposit and anterior segment involvement in a patient with Maroteaux–Lamy syndrome is unique, and follow-up revealed thickening of the corneal periphery, which may be related to the progression of the disease (continuous mucopolysaccharide deposits in corneal stroma). UBM was used to locate and document the deposit, as well as to accompany the deposit's evolution, characterizing corneal changes and angle structure involvement.

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0277-3740    

出版商:OVID    

年代:2001

数据来源: OVID