Sample records for ocular adnexal igg4-related

  1. IgG4-related disease mimicking chalazion in the upper eyelid with skin manifestations on the trunk.

    PubMed

    Leivo, Tiina; Koskenmies, Sari; Uusitalo, Marita; Tynninen, Olli

    2015-08-01

    IgG4-related disease is a recently defined inflammatory process characterized by IgG4-bearing plasma cells in the involved tissues. The most common sites of involvement are the pancreas, hepatobiliary tract, salivary glands, lymph nodes, retroperitoneum and orbit, especially the lacrimal glands. Other ocular or ocular adnexal sites are rare. To our knowledge, there is one reported case of a conjunctival involvement. We describe a patient, who had an IgG4-RD mimicking chalazion in the upper eyelid, confined to the tarsus, with multiple skin lesions on the trunk. This is a case report of a 55-year-old female. A 55-year-old female presented with an upper eyelid lesion, which was clinically diagnosed as chalazion and drained three times. Histopathological diagnoses were chalazion and inflammation with mixed cells, respectively. Additionally, the patient had had skin nodules on the trunk for several years. Finally, after a third recurrence, the tarsal eyelid lesion was completely excised. The tarsal pathology specimen showed 85 IgG4 positive plasma cells per HPF and the IgG4/IgG ratio was 0.64, suggesting a probable IgG4-related disease. The re-examined skin lesions resembled histologically the eyelid lesion. It is essential to be aware of IgG4-related disease, including in recurrent chalazia. PMID:25834990

  2. IgG4-related ophthalmic disease

    PubMed Central

    Mejico, Luis J.

    2014-01-01

    IgG4-related disease is a fibro-inflammatory condition with tendency to form tumors with inflammatory infiltrate with IgG4 rich plasma cells and elevation of IgG4 level in serum, which may affect virtually every organ and tissue in the organism. IgG4-related ophthalmic disease may present as dacryoadenitis, myositis, other orbital tissues, hypophysitis or pachymeningitis causing cranial neuropathies. The diagnosis of IgG4-related disease is based on a typical clinical scenario, supportive laboratory data, expected radiological characteristics and distinct histopathological and immunohistochemical features. Corticosteroid followed by the use of long-term immunosuppressive therapy is the most commonly attempted treatment. PMID:25859140

  3. IgG4-related cardiovascular disorders.

    PubMed

    Tajima, Miyu; Nagai, Ryozo; Hiroi, Yukio

    2014-01-01

    Immunoglobulin4 (IgG4)-related disease is a systemic inflammatory disease characterized by elevation of serum IgG4. It involves various organs such as the pancreas (autoimmune pancreatitis), lacrimal gland (Mikulicz's disease), retroperitoneum (retroperitoneal fibrosis), aorta (aortic aneurysm and aortitis), heart (constrictive pericarditis), and pseudotumors around the coronary arteries. These disorders often coexist in accordance with progression of the disease. Because IgG4-related cardiovascular disorder affects the patient's prognosis, early detection and treatment is important. Coronary CT imaging and echocardiography accidentally detect IgG4-related disorders and (18)FDG-PET imaging can identify active inflammation in the lesions. Measurement of serum IgG4 levels and tissue biopsy are necessary for diagnosis. Minor salivary gland biopsy is recommended even though (18)FDG uptake is not detected when it is difficult to obtain a biopsy specimen from IgG4-related cardiovascular lesions. The first-line treatment is high-dose corticosteroid therapy, however, relapse is often reported. Corticosteroids suppress the development of active inflammatory diseases such as aortitis, pericarditis, and pseudotumors, but already-developed lesions do not respond. A large developed aneurysm can rupture even during or after corticosteroid therapy, therefore, additional surgical treatment may be needed. Treatment of IgG4-related cardiovascular disorders might require higher doses of corticosteroids than IgG4-related extracardiovascular disorders. The adequate dose of corticosteroid, type and dose of immunosuppressant, and surgical intervention should be carefully considered on a case-by-case basis. PMID:24898599

  4. [IgG4-related sclerosing disease].

    PubMed

    Kazantsev, I A; Lishchuk, S V

    2011-01-01

    IgG4-related sclerosing disease (IgG4-RSD) is a systemic one in which IgG4-positive plasma cells and T lymphocytes extensively infiltrate various organs. The clinical manifestations of the disease include autoimmune pancreatitis, sclerosing cholangitis, cholecystitis, sialodenitis, retroperitoneal fibrosis, tubulointestitial nephritis, interstitial pneumonia, prostatitis, inflammatory pseudotumors and lymphadenopathy, all related with significantly elevated serum IgG4 levels. Tissue fibrosis with obliterative phlebitis of the affected organs is pathologically induced. The disease occurs predominantly in elderly men and responds well to steroid therapy. Since malignant tumors are frequently suspected on initial presentation, IgG4-RSD should be considered in the differential diagnosis to avoid unnecessary surgery. PMID:21853923

  5. IgG4-related inflammatory pseudotumors mimicking multiple meningiomas.

    PubMed

    Nishino, Takayoshi; Toda, Joe; Nakatsuka, Tomoya; Kimura, Tomo; Inaoka, Tsutomu; Terada, Hitoshi

    2013-06-01

    IgG4-related disease is an emerging clinicopathologic entity. Hypophysitis, diffuse thickening of dura, and enlargement of the trigeminal nerve are well-known intracranial involvements of IgG4-related disease. This report of a case of systemic IgG4-related disease is the first to present neuroimaging of apparent supratentorial meningioma-like lesions and thickening and contrast enhancement of the walls of the intracranial internal carotid arteries. It is important to recognize IgG4-related intracranial pseudotumors so that patients do not undergo unnecessary surgical procedures. PMID:23456546

  6. A case of IgG4-related sclerosing mesenteritis

    Microsoft Academic Search

    Yoriko Nomura; Yoshiki Naito; Naofumi Eriguchi; Toru Kume; Noriaki Itai; Hirokuni Sonoda; Shigeru Hayashida; Shigetoshi Naito; Hisanori Naito; Makiko Yasumoto; Jun Akiba; Hisafumi Kinoshita; Hirohisa Yano; Masayoshi Kage

    2011-01-01

    IgG4-related disease has been recognized as a systemic syndrome characterized by mass-forming lesions with lymphoplasmacytic infiltration and sclerosis. This disease has been identified in various sites, including the pancreas, retroperitoneum, lung, head, and neck. Herein we report a case of IgG4-related sclerosing mesenteritis. An 82-year-old woman was admitted to our hospital due to persistent abdominal pain. Abdominal computed tomography demonstrated

  7. Organ Correlation in IgG4-Related Diseases.

    PubMed

    Koizumi, Satomi; Kamisawa, Terumi; Kuruma, Sawako; Tabata, Taku; Chiba, Kazuro; Iwasaki, Susumu; Kuwata, Go; Fujiwara, Takashi; Fujiwara, Junko; Arakawa, Takeo; Koizumi, Koichi; Momma, Kumiko

    2015-06-01

    IgG4-related disease (IgG4-RD) is a potentially multiorgan disorder. In this study, clinical and serological features from 132 IgG4-RD patients were compared about organ correlations. Underlying pathologies comprised autoimmune pancreatitis (AIP) in 85 cases, IgG4-related sclerosing cholangitis (IgG4-SC) in 12, IgG4-related sialadenitis (IgG4-SIA) in 56, IgG4-related dacryoadenitis (IgG4-DAC) in 38, IgG4-related lymphadenopathy (IgG4-LYM) in 20, IgG4-related retroperitoneal fibrosis (IgG4-RF) in 19, IgG4-related kidney disease (IgG4-KD) in 6, IgG4-related pseudotumor (IgG4-PT) in 3. Sixty-five patients (49%) had multiple IgG4-RD (two affected organs in 36 patients, three in 19, four in 8, five in 1, and six in 1). Serum IgG4 levels were significantly higher with multiple lesions than with a single lesion (P<0.001). The proportion of association with other IgG4-RD was 42% in AIP, the lowest of all IgG4-RDs. Serum IgG4 level was lower in AIP than in other IgG4-RDs. Frequently associated IgG4-RDs were SIA (25%) and DAC (12%) for AIP; AIP (75%) for IgG4-SC; DAC (57%), AIP (38%) and LYM (27%) for IgG4-SIA; AIP (26%) and LYM (26%) for IgG4-DAC; SIA (75%), DAC (50%) and AIP (45%) for IgG4-LYM; SIA (58%), AIP (42%) and LYM (32%) for IgG4-RF; AIP (100%) and SIA (67%) for IgG4-KID; and DAC (67%) and SIA (67%) for IgG4-PT. Most associated IgG4-RD lesions were diagnosed simultaneously, but IgG4-SIA and IgG4-DAC were sometimes identified before other lesions. About half of IgG4-RD patients had multiple IgG4-RD lesions, and some associations were seen between specific organs. PMID:26028927

  8. Cerebral involvement in IgG4-related disease.

    PubMed

    Joshi, Deepak; Jager, Rolf; Hurel, Steven; Pereira, Stephen P; Johnson, Gavin J; Chapman, Michael; Fowler, Robert; Winstanley, Alison; Losseff, Nicholas; Webster, George Jm

    2015-04-01

    IgG4-related disease is a recently recognised multi-system disease. Common organ involvement includes the pancreas, biliary tree and salivary glands. Central nervous system involvement has been infrequently reported. In a single-centre cohort of 84 patients, we report cerebral involvement in three (4%) patients. Details of cerebral involvement in these patients are outlined, including pituitary involvement in two patients and a diffuse autoimmune-like encephalopathy in the other. PMID:25824063

  9. A case of IgG4-related sclerosing mesenteritis.

    PubMed

    Nomura, Yoriko; Naito, Yoshiki; Eriguchi, Naofumi; Kume, Toru; Itai, Noriaki; Sonoda, Hirokuni; Hayashida, Shigeru; Naito, Shigetoshi; Naito, Hisanori; Yasumoto, Makiko; Akiba, Jun; Kinoshita, Hisafumi; Yano, Hirohisa; Kage, Masayoshi

    2011-08-15

    IgG4-related disease has been recognized as a systemic syndrome characterized by mass-forming lesions with lymphoplasmacytic infiltration and sclerosis. This disease has been identified in various sites, including the pancreas, retroperitoneum, lung, head, and neck. Herein we report a case of IgG4-related sclerosing mesenteritis. An 82-year-old woman was admitted to our hospital due to persistent abdominal pain. Abdominal computed tomography demonstrated a solitary mass with a maximal diameter of 11.7cm in mesentrium of the small intestine. On her laboratory examination, only C-reactive protein level was elevated. Although the pre-operative diagnosis was indefinite, she underwent ileocecectomy. Grossly, an elastic soft mass with foci of hemorrhage was seen in the mesentrium. Microscopically, the lesion was composed of fibroblastic or myofibroblastic spindle cells with abundant stromal fibrosis and inflammatory infiltrate, such as lymphocytes and plasma cells accompanied by lymphoid follicles with a germinal center. Obstructive phlebitis was observed. Immunohistochemically, numerous IgG4-positive plasma cells were observed, and the IgG4/IgG ratio was 75.9%. The serum level of IgG4 examined at post-operation was high. These findings suggested that this lesion was consistent with IgG4-related sclerosing mesenteritis. PMID:21752555

  10. Autoimmune pancreatitis and IgG4-related systemic diseases

    PubMed Central

    Zhang, Lizhi; Smyrk, Thomas C

    2010-01-01

    Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis that is characterized by lymphoplasmacytic infiltrate, storiform fibrosis, obliterative phlebitis, and increased IgG4+ plasma cells. Serum IgG4 levels usually are elevated. Patients with AIP frequently have disease affecting other organs or sites; these tissues show similar histologic changes, including increased IgG4+ plasma cell infiltrate and response to corticosteroid therapy. A new clinicopathologic concept of IgG4-related systemic disease (ISD) has been proposed. These diseases often are not limited to the pancreas, and the pancreas may not be involved at all. In this article, we review the literature and our own experience to detail the clinicopathologic features of AIP and extrapancreatic lesions in ISD. PMID:20606730

  11. Clinicopathological Analysis of Ocular Adnexal Extranodal Marginal Zone B-Cell Lymphoma with IgG4-Positive Cells

    PubMed Central

    Lee, Min Joung; Kim, Namju; Choe, Ji-Young; Khwarg, Sang In; Jeon, Yoon Kyung

    2015-01-01

    This study aims to analyze clinical and pathological characteristics of ocular adnexal extranodal marginal zone B-cell lymphoma (EMZL) accompanying IgG4-positive cells. Fifty patients with a diagnosis of primary non-conjunctival ocular adnexal EMZL were enrolled in this study. The number of IgG4-positive cells and the ratio of IgG/IgG4 were evaluated by immunohistochemistry in the biopsy specimens. The patients were divided into two groups based on the absolute number and the ratio of IgG4-positive cells (IgG4-posivite vs IgG4-negative groups). The demographic data, clinical staging at diagnosis, histopathological characteristics, and response to initial treatment were comparatively analyzed between the 2 groups. Five (10%) of 50 patients were defined as IgG4-positive group, and all the cases showed characteristic histological features such as extensive plasma cell infiltration and dense fibrosis. Most of these patients (4 of 5 patients) had lymphoma of the lacrimal gland. The patients from the IgG4-positive group showed a lower response rate to initial treatment (87.5 vs 33%, p = 0.03) than IgG4-negative group with a median follow-up period of 38 months. A part of the ocular adnexal EMZLs were accompanied with IgG4-positive cells. Significantly, most IgG4-positive ocular adnexal EMZLs occurred in the lacrimal gland, and can be related with a more frequent treatment failure. PMID:26111022

  12. Diagnosis of IgG4-related sclerosing cholangitis

    PubMed Central

    Nakazawa, Takahiro; Naitoh, Itaru; Hayashi, Kazuki; Miyabe, Katsuyuki; Simizu, Shuya; Joh, Takashi

    2013-01-01

    IgG4-related sclerosing cholangitis (IgG4-SC) is often associated with autoimmune pancreatitis. However, the diffuse cholangiographic abnormalities observed in IgG4-SC may resemble those observed in primary sclerosing cholangitis (PSC), and the presence of segmental stenosis suggests cholangiocarcinoma (CC). IgG4-SC responds well to steroid therapy, whereas PSC is only effectively treated with liver transplantation and CC requires surgical intervention. Since IgG4-SC was first described, it has become a third distinct clinical entity of sclerosing cholangitis. The aim of this review was to introduce the diagnostic methods for IgG4-SC. IgG4-SC should be carefully diagnosed based on a combination of characteristic clinical, serological, morphological, and histopathological features after cholangiographic classification and targeting of a disease for differential diagnosis. When intrapancreatic stenosis is detected, pancreatic cancer or CC should be ruled out. If multiple intrahepatic stenoses are evident, PSC should be distinguished on the basis of cholangiographic findings and liver biopsy with IgG4 immunostaining. Associated inflammatory bowel disease is suggestive of PSC. If stenosis is demonstrated in the hepatic hilar region, CC should be discriminated by ultrasonography, intraductal ultrasonography, bile duct biopsy, and a higher cutoff serum IgG4 level of 182 mg/dL. PMID:24282356

  13. IgG4-related disease in the abdomen: a great mimicker.

    PubMed

    Al Zahrani, Hassan; Kyoung Kim, Tae; Khalili, Korosh; Vlachou, Paraskevi; Yu, Hojun; Jang, Hyun-Jung

    2014-06-01

    IgG4-related disease is a systemic disorder that can involve various abdominal organs. Abdominal manifestations include autoimmune pancreatitis, sclerosing cholangitis, gallbladder pseudotumours, multifocal renal abnormalities, retroperitoneal fibrosis, and sclerosing mesenteritis. Radiological appearances of the IgG4-related disease often resemble malignant tumors and other inflammatory processes, potentially leading to unnecessary invasive procedures. Moreover, a timely diagnosis of IgG4-related disease leads to an effective treatment with steroids. Therefore, it is important to understand the spectrum of imaging manifestations of IgG4-related disease and their differentiating features from other diagnoses. PMID:24929264

  14. The emerging mysteries of IgG4-related disease.

    PubMed

    Smit, Wouter; Barnes, Eleanor

    2014-12-01

    IgG4-related disease (IgG4-RD) is increasingly recognised in Western societies as a multi-system, inflammatory, fibrosing disease of unknown aetiology that typically, though not exclusively, presents in older men. The clinical manifestations are diverse and almost any organ may be affected. The cardinal histological features are a lymphoplasmacytic infiltrate, storiform fibrosis, obliterative phlebitis and an abundance of IgG4+ plasma cells in affected organs. Serum IgG4 levels are elevated in approximately 70% of patients and are a useful biomarker when present. IgG4-RD is frequently misdiagnosed as malignancy. Making the correct diagnosis is important as the disease is usually steroid responsive, although relapse rates are high. Second-line immunosuppressive agents and B-cell depletion therapy have also been used in retreatment strategies. Recent data suggests that the disease is associated with both progressive organ failure and malignancy. The biological mechanisms driving IgG4-RD remain unclear but this is currently an area of intense scientific investigation. Broadly, IgG4+ B cells are thought to exhibit a regulatory phenotype, but it is not known if these are pathogenic or simply represent a bystander effect. Extending our understanding of the role of IgG4 immunoglobulins in health and disease, the assessment of B and T cell immune phenotype, and large genetic studies of IgG4-RD may enhance our understanding of disease pathogenesis. Ultimately it may be that there is not a single, simple unifying aetiology and so careful stratification of disease by clinical phenotype will be required in multi-centre prospective clinical cohorts. These cohorts will also be essential for the study of treatment outcomes with novel therapies. PMID:25468921

  15. Retroperitoneal disorders associated with IgG4-related autoimmune pancreatitis.

    PubMed

    Hara, Noboru; Kawaguchi, Makoto; Takeda, Keisuke; Zen, Yoh

    2014-11-28

    IgG4-related autoimmune pancreatitis is frequently accompanied by relevant lesions in the genitourinary tract and retroperitoneal organs, which cause various clinical problems, ranging from non-specific back pain or bladder outlet obstruction to renal failure. The diagnosis of IgG4-related retroperitoneal fibrosis requires a multidisciplinary approach, including serological tests, histological examination, imaging analysis, and susceptibility to steroid therapy. Radiological examinations are helpful to diagnose this condition, but surgical resection is occasionally unavoidable to exclude malignancy, particularly for patients with isolated retroperitoneal involvement. Steroid therapy is the treatment of choice for this condition, the same as for other manifestations of IgG4-related disease. For patients with severe ureteral obstruction, additional ureteral stenting needs to be considered prior to steroid therapy to preserve the renal function. Some papers have suggested that IgG4-related disease can affect male reproductive organs including the prostate and testis. IgG4-related prostatitis usually causes lower urinary tract symptoms, such as dysuria and pollakisuria. Patients sometimes state that corticosteroids given for IgG4-related disease at other sites relieve their lower urinary tract symptoms, which leads us to suspect prostatic involvement in this condition. Because of the limited number of publications available, further studies are warranted to better characterize IgG4-related disease in male reproductive organs. PMID:25469023

  16. Retroperitoneal disorders associated with IgG4-related autoimmune pancreatitis

    PubMed Central

    Hara, Noboru; Kawaguchi, Makoto; Takeda, Keisuke; Zen, Yoh

    2014-01-01

    IgG4-related autoimmune pancreatitis is frequently accompanied by relevant lesions in the genitourinary tract and retroperitoneal organs, which cause various clinical problems, ranging from non-specific back pain or bladder outlet obstruction to renal failure. The diagnosis of IgG4-related retroperitoneal fibrosis requires a multidisciplinary approach, including serological tests, histological examination, imaging analysis, and susceptibility to steroid therapy. Radiological examinations are helpful to diagnose this condition, but surgical resection is occasionally unavoidable to exclude malignancy, particularly for patients with isolated retroperitoneal involvement. Steroid therapy is the treatment of choice for this condition, the same as for other manifestations of IgG4-related disease. For patients with severe ureteral obstruction, additional ureteral stenting needs to be considered prior to steroid therapy to preserve the renal function. Some papers have suggested that IgG4-related disease can affect male reproductive organs including the prostate and testis. IgG4-related prostatitis usually causes lower urinary tract symptoms, such as dysuria and pollakisuria. Patients sometimes state that corticosteroids given for IgG4-related disease at other sites relieve their lower urinary tract symptoms, which leads us to suspect prostatic involvement in this condition. Because of the limited number of publications available, further studies are warranted to better characterize IgG4-related disease in male reproductive organs. PMID:25469023

  17. A Case of IgG4-Related Lung Disease Presenting as Interstitial Lung Disease

    PubMed Central

    Ahn, Jee Hwan; Hong, Sun In; Cho, Dong Hui; Chae, Eun Jin; Song, Joon Seon

    2014-01-01

    Intrathoracic involvement of immunoglobulin G4 (IgG4)-related disease has recently been reported. However, a subset of the disease presenting as interstitial lung disease is rare. Here, we report a case of a 35-year-old man with IgG4-related lung disease with manifestations similar to those of interstitial lung disease. Chest computed tomography showed diffuse ground glass opacities and rapidly progressive pleural and subpleural fibrosis in both upper lobes. Histological findings showed diffuse interstitial lymphoplasmacytic infiltration with an increased number of IgG4-positive plasma cells. Serum levels of IgG and IgG4 were also increased. The patient was diagnosed with IgG4-related lung disease, treated with anti-inflammatory agents, and showed improvement. Lung involvement of IgG4-related disease can present as interstitial lung disease and, therefore, should be differentiated when evaluating interstitial lung disease. PMID:25237380

  18. Membranous nephropathy as a rare renal manifestation of IgG4-related disease

    PubMed Central

    Kurien, A. A.; Raychaudhury, A.; Walker, P. D.

    2015-01-01

    IgG4-related disease, a newly described immune-mediated disorder with tissue infiltration of IgG4-positive plasma cells, has been reported in nearly every organ. In the kidney, it manifests as IgG4-related tubulointerstitial nephritis (TIN) but may also present as membranous nephropathy. We report a patient with IgG4 renal disease who had membranous nephropathy as well as TIN.

  19. IgG4-Related Disease without Overexpression of IgG4: Pathogenesis Implications.

    PubMed

    Nishina, Naoshi; Kaneko, Yuko; Kuwana, Masataka; Hanaoka, Hironari; Kameda, Hideto; Mikami, Shuji; Takeuchi, Tsutomu

    2012-01-01

    IgG4-related disease is a new disease group that affects multiple organs. It is characterized by high serum IgG4 and abundant infiltration of IgG4-bearing plasma cells in the affected organ. Here, we describe an intriguing case that suggested that IgG4-related disease might present without IgG4 overexpression or infiltration, at least during a relapse. A 47-year-old man had been diagnosed with systemic lupus erythematosus 15 years. He was admitted due to a pituitary mass, systemic lymphadenopathy, and multiple nodules in the lungs and kidneys. The serum IgG4 level was normal and histopathological examination of the pituitary mass showed abundant lymphocyte and plasma cell infiltration with very few IgG4-positive cells. When we examined specimens preserved from 15 years ago, we found high serum IgG4 levels and IgG4-bearing plasma cell infiltration. This resulted in a diagnosis of IgG4-related disease, and we considered the current episode to be a relapse without IgG4 overexpression. This case indicated that, to clarify the pathogenesis of IgG4-related disease, current cases should repeat specimen evaluations over the course of IgG4-related disease to define diagnostic markers. PMID:22937457

  20. [Two cases of IgG4-related systemic disease arising from urinary tract].

    PubMed

    Takata, Masayuki; Miyoshi, Mitsuru; Kohno, Masanori; Ito, Masanori; Komatsu, Kazuto; Tsukahara, Kenji

    2012-11-01

    Case 1: The patient was a 68-year-old man. Abdominal computed tomography performed during hospitalization for the close observation of a pituitary gland tumor, showed a right renal mass. Percutaneus needle biopsy revealed IgG4-related disease of the kidney. Pituitary gland tumor biopsy also indicated that the lesion was associated with IgG4-related disease. The pancreas did not show abnormalities. The patient was treated with prednisolone, and both renal and pituitary lesions markedly decreased in size. Case 2: the patient was an 80-year-old man. Right hydronephrosis was observed, and computed tomography showed a right pelvic tumor. Right renal pelvic tumor was diagnosed, and the patient underwent right nephroureterectomy. Pathological examination showed that this tumor was also associated with IgG4-related sclerotic disease. IgG4-related disease tends to occur in multiple organs. This condition should be considered when treating patients with multiple sclerotic diseases. However, in some patients, the disease may be localized to a single site. Further studies are required to elucidate the characteristics of IgG4-related disease. PMID:23254786

  1. IgG4-related disease manifesting as an acute gastric-pericardial fistula

    PubMed Central

    Frydman, James; Grunner, Shahar; Kluger, Yoram

    2014-01-01

    IgG4-related disease is a recently recognized entity linked initially to autoimmune pancreatitis and has been subsequently described in nearly every organ system. Men over the age of 50 represent the most affected demographic group and a comprehensive set of diagnostic criteria has been developed to aid treating clinicians. Though elevated levels of IgG4 in the serum are suggestive of the disease, definitive diagnosis is made on histopathology. Treatment is tailored to the clinical presentation with corticosteroid therapy known to have proven efficacy. Gastric manifestations of the IgG4-related disease primarily come in two varieties, notably chronic ulceration or pseudotumor formation. Autoimmune pancreatitis conveys increased risk for IgG4-related disease of the stomach, which is independent of Helicobacter pylori status. In this case report, we present an acute gastric-pericardial fistula secondary to IgG4-related disease that required urgent operative management. To our knowledge, this is the first report in the medical literature describing this complication of IgG4-related disease. PMID:25469052

  2. IgG4-related sclerosing disease clinically mimicking oral squamous cell carcinoma.

    PubMed

    Khurram, Syed Ali; Fernando, Malee; Smith, Austen T; Hunter, Keith D

    2013-02-01

    IgG4-related sclerosing disease is a distinct clinicopathologic entity known to involve the maxillofacial region, particularly the salivary, lacrimal, and pituitary glands. We report a case with lesions involving the tongue and palatine tonsil with associated skin lesions. A 45-year-old female patient presented with a history of soreness, dysphagia, and an asymptomatic rash involving the upper trunk. The initial clinical diagnosis of her oral lesions was squamous cell carcinoma. The diagnosis of an IgG4-related lesion was confirmed by histologic examination of the oral and skin lesions as well as confirmation of raised serum IgG4 levels. Tapering systemic corticosteroid therapy resulted in complete resolution of the lesions. This is the first report of IgG4-related sclerosing disease presenting as concurrent oral and skin lesions, with the oral lesion clinically resembling oral squamous cell carcinoma. Such lesions present a diagnostic challenge, but the outcome is very favorable. PMID:22901649

  3. Paraplegia in a Patient With IgG4-Related Sclerosing Disease: A Case Report

    PubMed Central

    Kim, Sung Heon; Oh, Sung Han; Paik, Soya; Kim, Joo Sup

    2014-01-01

    Immunoglobulin G4 (IgG4)-related sclerosing disease is a systemic disease, characterized by mass forming inflammatory lesions which respond well to steroid therapy. Pancreas is the most common site of involvement, and other organ involvements are also common. However, there are only a few reports about central nervous system involvement. We report a case of IgG4-related sclerosing disease which involves spinal cord causing paraplegia. A middle-aged female presented with sudden lower limb weakness. Magnetic resonance imaging showed a soft tissue mass which was diffusely compressing spinal cord along the C7 to T5 levels. Intravenous steroid pulse therapy and emergent operation was performed. The immunopathologic findings revealed IgG4-related sclerosing pachymeningitis postoperatively. There was no evidence of other organ involvement. Her neurologic deficit remained unchanged after two months of comprehensive rehabilitation therapy. PMID:25566488

  4. Histologically confirmed isolated IgG4-related hypophysitis: two case reports in young women

    PubMed Central

    Sosa, Gabriela Alejandra; Bell, Soledad; Christiansen, Silvia Beatriz; Pietrani, Marcelo; Glerean, Mariela; Loto, Monica; Lovazzano, Soledad; Carrizo, Antonio; Ajler, Pablo

    2014-01-01

    Summary IgG4-related hypophysitis is a recently described entity belonging to the group of IgG4-related diseases. Many other organs can also be affected, and it is more common in older men. To date, 32 cases of IgG4-related hypophysitis have been reported in the literature, 11 of which included confirmatory tissue biopsy and the majority affecting multiple organs. The aim of this report is to present two cases of biopsy-proven IgG4-related hypophysitis occurring in two young female patients with no evidence of involvement of other organs at the time of diagnosis. Learning points IgG4-related hypophysitis belongs to the group of IgG4-related diseases, and is a fibro-inflammatory condition characterized by dense lymphoplasmacytic infiltrates rich in IgG4-positive plasma cells and storiform fibrosis.It is more common in older men, but young women may also present this type of hypophysitis.Although involvement of other organs is frequent, isolated pituitary disease is possible.Frequent clinical manifestations include anterior hypopituitarism and/or diabetes insipidus.The diagnosis may be confirmed with any of the following criteria: a pituitary biopsy with lymphoplasmacytic infiltrates, with more than ten IgG4-positive cells; a sellar mass and/or thickened pituitary stalk and a biopsy-proven involvement of another organ; a sellar mass and/or thickened pituitary stalk and IgG4 serum levels >140?mg/dl and sellar mass reduction and symptom improvement after corticosteroid treatment.Glucocorticoids are recommended as first-line therapy. PMID:25298883

  5. IgG4-related disease of the head and neck: CT and MR imaging manifestations.

    PubMed

    Fujita, Akifumi; Sakai, Osamu; Chapman, Margaret N; Sugimoto, Hideharu

    2012-01-01

    Immunoglobulin G4 (IgG4)-related disease is a recently established systemic disease that commonly involves the head and neck, including the salivary glands, lacrimal glands, orbits, thyroid gland, lymph nodes, sinonasal cavities, pituitary gland, and larynx. Although the definitive diagnosis of IgG4-related disease requires histopathologic analysis, elevated serum IgG4 levels are helpful in making the diagnosis. Because of the proposed clinical diagnostic criteria for this disease, cross-sectional imaging modalities such as computed tomography (CT) and magnetic resonance (MR) imaging play an important diagnostic role. CT and MR imaging findings of IgG4-related disease are usually nonspecific. At CT, involved organs may demonstrate enlargement or decreased attenuation; at T2-weighted MR imaging, they may have relatively low signal intensity owing to their increased cellularity and amount of fibrosis. Some pathologic entities involving the head and neck are now considered to be part of the IgG4-related disease spectrum, including idiopathic orbital inflammatory syndrome (inflammatory pseudotumor), orbital lymphoid hyperplasia, Mikulicz disease, Küttner tumor, Hashimoto thyroiditis, Riedel thyroiditis, and pituitary hypophysitis. Because involvement of multiple sites is common in IgG4-related disease, radiologists should be familiar with manifestations of this systemic process outside the head and neck, in organs such as the pancreas, bile ducts, gallbladder, kidneys, retroperitoneum, mesentery, lungs, gastrointestinal tract, and blood vessels. Moreover, IgG4-related disease usually demonstrates a dramatic response to corticosteroid therapy, and radiologists should be familiar with its clinical and imaging manifestations to avoid a delay in diagnosis or unnecessary invasive interventions. PMID:23150850

  6. IgG4-Related Esophageal Disease Presenting as Esophagitis Dissecans Superficialis With Chronic Strictures.

    PubMed

    Dumas-Campagna, Myriam; Bouchard, Simon; Soucy, Genevieve; Bouin, Mickael

    2014-08-01

    IgG4-related disease is a recently recognized autoimmune systemic disorder that has been described in various organs. The disease is characterized histologically by a dense lymphoplasmocytic infiltrate of IgG4-positive cells, storiform fibrosis and can be associated with tumefactive lesions. IgG4-related disease involving the upper gastrointestinal tract is rare and only two previous case reports have reported IgG4-related esophageal disease. We report the case of a 63-year-old female patient with a long-standing history of severe dysphagia and odynophagia with an initial diagnosis of reflux esophagitis. Symptoms persisted despite anti-acid therapy and control esophagogastroduodenoscopy (EGD) revealed endoscopic images consistent with esophagitis dissecans superficialis (sloughing esophagitis). An underlying autoimmune process was suspected and immunosuppressant agents were tried to control her disease. The patient eventually developed disabling dysphagia secondary to multiple chronic esophageal strictures. A diagnosis of IgG4-related disease was eventually made after reviewing esophageal biopsies and performing an immunohistochemical study with an anti-IgG4 antibody. Treatment attempts with corticosteroids and rituximab was not associated with a significant improvement of the symptoms of dysphagia and odynophagia, possibly because of the chronic nature of the disease associated with a high fibrotic component. Our case report describes this unique case of IgG4-related esophageal disease presenting as chronic esophagitis dissecans with strictures. We also briefly review the main histopathological features and treatment options in IgG4-related disease. PMID:24883156

  7. IgG4-Related Disease Presenting as a Solitary Neck Mass

    PubMed Central

    McKinnon, Tyler; Randazzo, William T.; Kim, Brian D.; Biddinger, Paul; Forseen, Scott

    2015-01-01

    IgG4-related disease is a newly recognized entity associated with autoimmune conditions involving almost every organ system. It is characterized by elevated serum IgG4 as well as mass like tissue infiltration by IgG4-positive plasma cells. Imaging findings are nonspecific, vary depending on the site of disease, and include mass like enlargement of the salivary or lacrimal glands and enlarged lymph nodes. Radiographic findings often mimic malignancy, necessitating tissue sampling to confirm the diagnosis. Distinguishing IgG4-related disease from malignancy is important as IgG4 responds well to steroids and conservative management. PMID:25926922

  8. [A case of IgG4-related sclerosing mesenteritis associated with Crohn's disease].

    PubMed

    Kim, Eui Jung; Kim, Eun Young; Song, Jung Eun; Lee, Hyeon Chul; Bae, Gyu Hwan; Oh, Hoon Kyu; Lee, Tae Sung

    2014-03-25

    Sclerosing mesenteritis (SM) is a rare disease characterized by chronic nonspecific mesenteric inflammation and fibrosis of unknown etiology. Some tumefactive SM shows diffuse accumulation of IgG4-positive plasma cells and is considered as a part of the spectrum of IgG4-related disease. An association between inflammatory bowel disease and IgG4-related disease has been indicated. A 45-year-old woman visited our hospital due to weight loss with intermittent lower abdominal discomfort. Pelvic ultrasound revealed a mass-like lesion in the abdominal wall and pelvis MRI demonstrated a 5.9 cm sized wall-enhancing mass with heterogeneous signal intensity from right adnexa to the abdominal wall. Tumor resection and adhesiolysis was done because of severe adhesion with the small bowel, colon, bladder, uterus, and abdominal wall. Appendectomy was also performed due to adhesion and edematous change. Histological examination of the resected mass showed findings that were compatible with IgG4-related SM. The resected appendix showed chronic granulomatous inflammation without evidence of tuberculosis. She was diagnosed with Crohn's disease after undergoing colonoscopy and CT enterography. Herein, we report a rare case of IgG4-related SM that occurred in conjunction with Crohn's disease. PMID:24651591

  9. IgG4-Related Intracranial Hypertrophic Pachymeningitis : A Case Report and Review of the Literature

    PubMed Central

    Osada, Hideo; Seno, Soichiro; Nawashiro, Hiroshi

    2014-01-01

    Hypertrophic pachymeningitis is an uncommon disorder that causes a localized or diffuse thickening of the dura mater. Recently, the possibility that IgG4-related sclerosing disease may underlie some cases of intracranial hypertrophic pachymeningitis has been suggested. We herein report the tenth case of IgG4-related intracranial hypertrophic pachymeningitis and review the previous literature. A 45-year-old male presented with left-sided focal seizures with generalization. Magnetic resonance imaging (MRI) revealed a diffuse thickening and enhancement of the right convexity dura matter and falx with focal nodularity. The surgically resected specimens exhibited the proliferation of fibroblast-like spindle cells and an infiltration of mononuclear cells, including predominantly plasma cells. The ratio of IgG4-positive plasma cells to the overall IgG-positive cells was 45% in the area containing the highest infiltration of plasma cells. On the basis of the above findings, IgG4-related sclerosing disease arising from the dura mater was suspected. IgG4-related sclerosing disease should be added to the pachymeningitis spectrum. PMID:25132941

  10. IgG4-related tubulointerstitial nephritis accompanied with cystic formation

    PubMed Central

    2014-01-01

    Background An immunoglobulin G4 (IgG4)-related disease is important disease in differential diagnosis of tumors in kidney, pancreas, lung and other organs. The imaging findings of IgG4-related kidney diseases are usually expressed as defect contrast region, while cystic formation in kidney is extremely rare. Here, we report a case of IgG4-related tubulointerstitial nephritis with renal cystic change caused by the narrowing or obstruction of collecting duct in renal medulla. Case presentation Abdominal contrasted CT scan showed a 31 × 24 mm cystic tumor at the upper pole of the right kidney and multiple low-attenuation areas in the left kidney. 18?F-fluorodeoxyglucose (FDG)-PET/CT scan showed moderate FDG accumulation of cystic tumor in marginal lesion. In addition, FDG-PET/CT scan also showed moderate FDG accumulation in the pancreatic body. Laparoscopic right nephrectomy was performed. Histological examination was revealed lymphoplasmacytic infiltrate with focal fibrosis and severe narrowing or obstruction of lumen of collecting duct in renal medulla. Furthermore, the IgG4 positive plasma cells infiltrated exceeding 10 cells per one high-power field in renal medulla. The ratio of IgG4-plasma cells to IgG-positive plasma cells was about 50%. The serum level of IgG4 was also elevated (218 mg/dl). Based on these findings, we finally diagnosed IgG4-related tubulointerstitial nephritis with renal cystic change. Conclusion IgG4-related kidney disease might cause cystic formation by severe narrowing and obstruction of collecting duct. PMID:25038818

  11. Long-term clinical course of IgG4-related systemic disease accompanied by hypophysitis.

    PubMed

    Hori, Michiko; Makita, Noriko; Andoh, Takahiro; Takiyama, Hirotoshi; Yajima, Yuki; Sakatani, Takashi; Fukumoto, Seiji; Iiri, Taroh; Fujita, Toshiro

    2010-01-01

    A 70-year old man with a 14 year history of Sjögren syndrome, interstitial pneumonia, and autoimmune hepatitis (AIH) was admitted to our hospital due to hyponatremia with a one month history of fatigue, thirst, and nausea. Laboratory tests on admission revealed that this patient had a central adrenal insufficiency. Pituitary magnetic resonance imaging (MRI) further showed swelling of the stalk and posterior lobe of his pituitary, suggesting infundibulo-hypophysitis. Based on his past history of autoimmune disease, his serum IgG4 levels were measured and found to be remarkably high (924 mg/ dL). Previous biopsy specimens from his liver, lung, and parotid gland were immunostained for IgG4, which revealed a marked infiltration of IgG4-positive plasma cells. As a result of our tests, we made a diagnosis of IgG4-related systemic disease. Interestingly, a subsequent MRI scan at three weeks after the patient commenced glucocorticoid replacement therapy for adrenal insufficiency showed that the swelling of his pituitary stalk was reduced. This finding suggested that IgG4-related hypophysitis may improve either as a result of a supplemental dose of glucocorticoid or possibly spontaneously. Although six cases of IgG4-related hypophysitis have been reported in the scientific literature published in English, our current case is the first in which IgG4-related hypophysitis likely occurred as a result of a long-term history of IgG4-related systemic disease. We report this case herein and review the relevant literature. PMID:20371985

  12. IgG4-related lung disease with atypical CT imaging: a case report

    PubMed Central

    Zhou, Jiaxuan; Li, Xian

    2014-01-01

    IgG4-related lung disease is a rare disease, diagnosed when typical pathologic features are seen in the context of increased serum levels of IgG4 and the elevated tissue’s IgG4-positive plasma cells. Here we reported the case of a 24-year-old woman with IgG4-related lung disease. This patient presented with fever, cough and shortness of breath. Thoracic computed tomography (CT) images demonstrated multiple nodules or masses with high density in both lungs, and thickened interlobular septa. The ‘halo sign’ was observed around the high-density lesions of the upper lobes. This range of CT images’ characteristics is atypical, which differs from previous reports of this condition. PMID:25590008

  13. [IgG4-related disease treatment in 2014: Update and literature review].

    PubMed

    Grados, A; Ebbo, M; Jean, E; Bernit, E; Harlé, J-R; Schleinitz, N

    2015-06-01

    IgG4-related disease is an inflammatory disorder characterized by a polyclonal lymphoplasmacytic tissue infiltrate, with numerous IgG4+ plasmocytes, evolving toward fibrosis. The disease is heterogeneous and affects several tissues and organs synchroneously or metachroneously. Both the fibrosis and the tumor forming characteristics of the disease can be responsible of irreversible tissue damage. For these reasons treatment is usually necessary. A dramatic response is usually observed with steroid treatment but relapses are frequent. Immunosuppressive agents and rituximab are used as second line treatments. We review here previous studies on treatment and suggest general recommendations for the treatment and follow up of patients with IgG4-related disease. PMID:25595874

  14. Acute Interstitial Nephritis and Membranous Nephropathy in the Context of IgG4-Related Disease

    PubMed Central

    Stylianou, Kostas; Maragkaki, Eleftheria; Tzanakakis, Michael; Stratakis, Stavros; Gakiopoulou, Hariklia; Daphnis, Eugene

    2015-01-01

    We present the case of a patient with IgG4-related disease, which manifested in an asynchronous manner as vitiligo, cholecystitis, sialadenitis, lymphadenopathy, facial palsy and kidney dysfunction. The patient underwent a renal biopsy, and a presumptive diagnosis of lupus nephritis was made due to compatible clinical and immunological findings. The biopsy revealed IgG4-related kidney disease with severe interstitial nephritis and membranous nephropathy. Corticosteroids treatment restored all disease manifestations. We bring this case to the attention of the nephrologists because of the protean, asynchronous, multisystemic nature of the disease that necessitates a multidisciplinary approach, a low threshold for kidney biopsy and a high index of suspicion for making the correct diagnosis and treatment. PMID:25849674

  15. IgG4-related systemic disease in a Native American man.

    PubMed

    Patel, Sandeep M; Szostek, Jason H

    2011-01-01

    IgG4-related systemic disease is a recently described entity that can elude even the most astute diagnostician. Patients with the disease, characterized by the infiltration of polyclonal IgG4-positive plasmacytes, can present with single or multi-organ involvement. Manifestations include dacryoadenitis, sialadenitis, thyroiditis, pneumonitis, retroperitoneal fibrosis, pancreatitis, sclerosing cholangitis, tubulointerstitial nephritis, prostatitis, and hypophysitis. We describe a biopsy-confirmed case with extensive multi-organ involvement, including hypophysitis, dacryoadenitis, retroperitoneal fibrosis and tubulointerstitial nephritis. By reporting this case, we hope to bring IgG4-related systemic disease to the attention of the broader medical community as it is an elusive disease that commonly responds to systemic corticosteroids. PMID:21498945

  16. IgG4-related systemic sclerosing disease: a diagnosis to be considered

    PubMed Central

    Dasari, Bobby V M; McElvanna, Kevin; Loughrey, Maurice; Diamond, Tom

    2013-01-01

    IgG4-related systemic sclerosing disease is a chronic autoimmune disorder with diverse clinical presentation. We report a 56-year-old patient who has presented with obstructive jaundice, bulky pancreas and mesenteric lymph node mass. He was later diagnosed to have IgG4-sclerosing disease involving pancreas, small bowel mesentery, common bile duct, liver, gallbladder and submandibular salivary glands and has required multiple surgical interventions. IgG4-related systemic sclerosing disease appears to be more commonly encountered than it was once thought and needs considered in patients presenting with pancreatitis of no obvious underlying cause. Although the disease is primarily managed by medical therapy, there is a role for surgical intervention in order to obtain tissue for diagnosis, exclude other possible neoplastic aetiology and to manage disease-related complications. PMID:23542646

  17. Bilateral Vision Loss Secondary to Pachymeningitis in a Patient with IgG4-Related Disease

    PubMed Central

    Ramirez, Lucas; D’Auria, Andrea; Popalzai, Adeel; Sanossian, Nerses

    2014-01-01

    IgG4-related disease (IgG4-RD) is a recently recognized fibroinflammatory condition associated with disease in nearly every organ, including the meninges. A proportion of idiopathic hypertrophic pachymeningitis cases may involve a component of meningeal IgG4-RD. We present a patient with severe bilateral vision loss found to have thickening of the dura mater on MRI, and subsequently diagnosed with IgG4-RD after dural biopsy. PMID:25352825

  18. IgG4-related meningeal disease: clinico-pathological features and proposal for diagnostic criteria

    Microsoft Academic Search

    Katherine M. Lindstrom; John B. Cousar; M. Beatriz S. Lopes

    2010-01-01

    IgG4-related disease has evolved from originally being recognized as a form of pancreatitis to encompass diseases of numerous\\u000a organs including the hypophysis and one reported case of dural involvement. A search of the University of Virginia, Division\\u000a of Neuropathology files for 10 years identified ten cases of unexplained lymphoplasmacytic meningeal inflammation that we\\u000a then evaluated using immunohistochemical stains for IgG4 and

  19. IgG4-related hypophysitis presenting as a pituitary adenoma with systemic disease.

    PubMed

    Hsing, Ming-Tai; Hsu, Hui-Ting; Cheng, Chun-Yuan; Chen, Chien-Min

    2013-04-01

    Hypophysitis is a rare inflammatory disorder that can mimic a pituitary tumor clinically or radiologically. Furthermore, immunoglobulin G4 (IgG4)-related systemic disease is only a just recently characterized disorder. It can manifest as a systemic disease involving multiple organs, including the pancreas, salivary glands, lungs, liver, bile duct, gallbladder, kidneys, and retroperitoneum. It is characterized by a high serum level of IgG4 clinically and dense lymphoplasmacytic infiltration with sclerosis and phlebitis histologically. Herein, we report the case of a man 66 years of age who presented with nausea, vomiting, and poor appetite with a body weight loss of 4 kg. Image study revealed a pituitary infundibulum mass, right-posterior mediastinal and paraspinal masses, as well as infiltrating masses in bilateral kidneys. Therefore, he received a thoracoscopic biopsy for the right-posterior mediastinal and paraspinal masses and a pathologic examination reported an IgG4-related inflammatory pseudotumor. Then, transsphenoidal removal of the infundibulum mass was performed. Histologically, the infundibulum mass represented a IgG4-related hypophysitis manifested as an infiltration of plasma cells, lymphocytes, histiocytes, and some eosinophils with a fair number of IgG4-immunoreactive plasma cells. After the operation was complete, the patient took 5 mg of prednisolone every 2 days for 3 months. A follow-up computed tomography scan revealed improvement of the infiltrating masses in the bilateral kidneys. PMID:23522762

  20. A case of IgG4-related multifocal fibrosclerosis complicated by central diabetes insipidus.

    PubMed

    Isaka, Yoshihiro; Yoshioka, Katsunobu; Nishio, Minako; Yamagami, Keiko; Konishi, Yoshio; Inoue, Takeshi; Hirano, Ayako; Hosoi, Masayuki; Imanishi, Masahito

    2008-08-01

    A 55-years-old man was admitted to our hospital with a 6-month history of general fatigue, purulent nasal discharge, polyuria, and polydipsia. Endocrinological findings revealed central diabetes insipidus (CDI) with mild anterior pituitary dysfunction. Imaging studies revealed thickening of the proximal end of the pituitary stalk just below the third ventricle, a mass in the paranasal sinus, and a mass encompassing the abdominal aorta. Histopathology of the mass in the paranasal sinus revealed abundant IgG4-positive plasma cells, and the IgG4 serum level was markedly elevated. Thus, he was diagnosed with IgG4-related multifocal fibrosclerosis. Therapy with prednisolone resulted in complete resolution of clinical symptoms and reduction in size of the masses in the affected organs. However, CDI remained unchanged. This is the first case in which the cause of CDI was IgG4-related multifocal fibrosclerosis. IgG4-related sclerosing disease should be included in the differential diagnosis of thickening of the pituitary stalk with CDI, and a search for extra-pituitary involvement is essential. PMID:18493105

  1. Autoimmune pancreatitis in the context of IgG4-related disease: Review of imaging findings

    PubMed Central

    Lee, Leslie K; Sahani, Dushyant V

    2014-01-01

    Current understanding of autoimmune pancreatitis (AIP) recognizes a histopathological subtype of the disease to fall within the spectrum of IgG4-related disease. Along with clinical, laboratory, and histopathological data, imaging plays an important role in the diagnosis and management of AIP, and more broadly, within the spectrum of IgG4-related disease. In addition to the defined role of imaging in consensus diagnostic protocols, an array of imaging modalities can provide complementary data to address specific clinical concerns. These include contrast-enhanced computed tomography (CT) and magnetic resonance (MR) imaging for pancreatic parenchymal lesion localization and characterization, endoscopic retrograde and magnetic resonance cholangiopancreatography (ERCP and MRCP) to assess for duct involvement, and more recently, positron emission tomography (PET) imaging to assess for extra-pancreatic sites of involvement. While the imaging appearance of AIP varies widely, certain imaging features are more likely to represent AIP than alternate diagnoses, such as pancreatic cancer. While nonspecific, imaging findings which favor a diagnosis of AIP rather than pancreatic cancer include: delayed enhancement of affected pancreas, mild dilatation of the main pancreatic duct over a long segment, the “capsule” and “penetrating duct” signs, and responsiveness to corticosteroid therapy. Systemic, extra-pancreatic sites of involvement are also often seen in AIP and IgG4-related disease, and typically respond to corticosteroid therapy. Imaging by CT, MR, and PET also play a role in the diagnosis and monitoring after treatment of involved sites. PMID:25386067

  2. IgG4-Related Hypophysitis: A New Addition to the Hypophysitis Spectrum

    PubMed Central

    Leporati, Paola; Landek-Salgado, Melissa A.; Lupi, Isabella; Chiovato, Luca

    2011-01-01

    Context: Hypophysitis is a chronic inflammation of the pituitary gland that comprises an increasingly complex clinicopathological spectrum. Within this spectrum, lymphocytic and granulomatous hypophysitis are the most common forms, but newer variants have recently been reported. Objective: The aims of the study were to describe a new patient with IgG4-related hypophysitis, review the published literature, and provide diagnostic criteria. Setting: A 75-yr-old man presented with a 1-yr history of frontal headache. Initial studies revealed panhypopituitarism and a mass in both the sella turcica and the sphenoidal sinus. The patient underwent transphenoidal surgery, initiated high-dose prednisone followed by hormone replacement therapy, and was closely monitored for 3 yr. Results: Symptoms improved after prednisone, along with shrinkage of the pituitary and sphenoidal masses, but recurred when prednisone dose was lowered. Histopathology showed a marked mononuclear infiltrate in both the pituitary and sphenoidal specimens, mainly characterized by increased numbers of plasma cells. Many of the infiltrating plasma cells (>10 per high-power field) were IgG4-positive. Review of the literature identified 11 cases of IgG4-related hypophysitis (two diagnosed based on pituitary histopathology). Conclusions: We describe the first Caucasian patient with biopsy-proven IgG4-related hypophysitis and provide classification criteria for this disease. PMID:21593109

  3. Azathioprine as successful maintenance therapy in IgG4-related tubulointerstitial nephritis

    PubMed Central

    Brochériou, Isabelle; Demetter, Pieter; Matos, Celso; Delhaye, Myriam; Devière, Jacques; Nortier, Joëlle L.

    2012-01-01

    A 65-year-old man presented with a progressive increase in plasma creatinine (PCr). Two years before, diffusion-weighted magnetic resonance imaging had revealed a relapse of immunoglobulin G4 (IgG4)-related autoimmune pancreatitis (AIP) associated with sclerosing cholangitis. Bilateral hypointense renal cortical nodules were also described. Kidney biopsy showed patchy disappearance of tubules, sparse interstitial fibrosis and IgG4+ plasma cells (>30 per high power field) leading to the diagnosis of IgG4-related tubulointerstitial nephritis (TIN). Despite methylprednisolone, PCr and serum IgG4 levels remained elevated. Starting azathioprine (AZA) normalized IgG4 levels, which elicited corticosteroid withdrawal after 17 months. One year later, renal function remains stable. Our clinical observation underlines the importance of biological and radiological long-term follow-up of patients with previous AIP in order to early detect IgG4-related renal involvement. Corticosteroids are the first choice, but in the case of adverse effects or partial remission, AZA could be a useful and safe alternative therapy.

  4. Clinicopathologic characteristics of IgG4-related retroperitoneal fibrosis among patients initially diagnosed as having idiopathic retroperitoneal fibrosis.

    PubMed

    Koo, Bon San; Koh, Young Wha; Hong, Seokchan; Kim, You Jae; Kim, Yong-Gil; Lee, Chang-Keun; Yoo, Bin

    2015-03-01

    Abstract Objective. The purpose of our study was to determine the number of IgG4-related retroperitoneal fibrosis (RPF) cases that were initially diagnosed as idiopathic RPF and to investigate clinical characteristics of IgG4-related RPF. Methods. We retrospectively reviewed the medical records of 41 RPF patients who were treated at our tertiary care medical center in South Korea between January 2000 and January 2013. We identified cases of 19 patients in which a diagnosis was made based on percutaneous biopsy or surgery and selected these cases for further analysis. Immunostaining for IgG4 and histopathologic examinations were performed for pathology specimens. Results. In the 19 RPF patients, more than 30 IgG4-positive plasma cells per specimen were identified in 9 cases with dense lymphoplasmacytic infiltrates, storiform fibrosis, or obliterative phlebitis (IgG4-related RPF group). The recurrence rate of IgG4-related RPF was significantly higher than that of idiopathic RPF (67% vs. 10%, p = 0.015). Initial and cumulative steroid dosages were not different between the two groups. Conclusions. We found that 47% of the patients initially diagnosed with idiopathic RPF showed IgG4-related RPF evidence according to the pathology and IgG4-related RPF patients showed higher recurrence rate than idiopathic RPF patients. We suggest that maintenance immunosuppressive therapy is required in IgG4-related RPF patients. PMID:25036229

  5. Association between IgG4-related disease and progressively transformed germinal centers of lymph nodes.

    PubMed

    Sato, Yasuharu; Inoue, Dai; Asano, Naoko; Takata, Katsuyoshi; Asaoku, Hideki; Maeda, Yoshinobu; Morito, Toshiaki; Okumura, Hirokazu; Ishizawa, Shin; Matsui, Shoko; Miyazono, Takayoshi; Takeuchi, Tamotsu; Kuroda, Naoto; Orita, Yorihisa; Takagawa, Kiyoshi; Kojima, Masaru; Yoshino, Tadashi

    2012-07-01

    Progressively transformed germinal centers is a benign condition of unknown pathogenesis characterized by a distinctive variant form of reactive follicular hyperplasia in lymph nodes. We recently reported Ig G4-related disease in progressively transformed germinal centers. However, no large case series has been reported and clinicopathologic findings remain unclear. Here, we report 40 Japanese patients (28 men, 12 women; median age, 56 years) with progressively transformed germinal centers of the lymph nodes who fulfilled the histological diagnostic criteria for IgG4-related disease (IgG4(+) progressively transformed germinal centers), with asymptomatic localized lymphadenopathy involving the submandibular nodes in 24, submandibular and cervical nodes in 14, cervical nodes only in 1, and cervical and supraclavicular nodes in 1. In all, 16 (52%) of 31 examined patients had allergic disease. Histologically, the lymph nodes demonstrated uniform histological findings, namely marked follicular hyperplasia with progressively transformed germinal centers, and localization of the majority of IgG4(+) plasma cells in the germinal centers. Serum IgG4, serum IgE and peripheral blood eosinophils were elevated in 87%, 92% and 53% of examined patients, respectively. Eighteen patients subsequently developed extranodal lesions (including five who developed systemic disease), which on histological examination were consistent with IgG4-related disease. IgG4(+) progressively transformed germinal centers presents with uniform clinicopathological features of asymptomatic localized submandibular lymphadenopathy, which persists and/or relapses, and sometimes progresses to extranodal lesions or systemic disease. Nine patients were administered steroid therapy when the lesions progressed, to which all responded well. We suggest that IgG4(+) progressively transformed germinal centers should be included in the IgG4-related disease spectrum. PMID:22481280

  6. Mitochondrial-dependent Autoimmunity in Membranous Nephropathy of IgG4-related Disease

    PubMed Central

    Buelli, Simona; Perico, Luca; Galbusera, Miriam; Abbate, Mauro; Morigi, Marina; Novelli, Rubina; Gagliardini, Elena; Tentori, Chiara; Rottoli, Daniela; Sabadini, Ettore; Saito, Takao; Kawano, Mitsuhiro; Saeki, Takako; Zoja, Carlamaria; Remuzzi, Giuseppe; Benigni, Ariela

    2015-01-01

    The pathophysiology of glomerular lesions of membranous nephropathy (MN), including seldom-reported IgG4-related disease, is still elusive. Unlike in idiopathic MN where IgG4 prevails, in this patient IgG3 was predominant in glomerular deposits in the absence of circulating anti-phospholipase A2 receptor antibodies, suggesting a distinct pathologic process. Here we documented that IgG4 retrieved from the serum of our propositus reacted against carbonic anhydrase II (CAII) at the podocyte surface. In patient's biopsy, glomerular CAII staining increased and co-localized with subepithelial IgG4 deposits along the capillary walls. Patient's IgG4 caused a drop in cell pH followed by mitochondrial dysfunction, excessive ROS production and cytoskeletal reorganization in cultured podocytes. These events promoted mitochondrial superoxide-dismutase-2 (SOD2) externalization on the plasma membrane, becoming recognizable by complement-binding IgG3 anti-SOD2. Among patients with IgG4-related disease only sera of those with IgG4 anti-CAII antibodies caused low intracellular pH and mitochondrial alterations underlying SOD2 externalization. Circulating IgG4 anti-CAII can cause podocyte injury through processes of intracellular acidification, mitochondrial oxidative stress and neoantigen induction in patients with IgG4 related disease. The onset of MN in a subset of patients could be due to IgG4 antibodies recognizing CAII with consequent exposure of mitochondrial neoantigen in the context of multifactorial pathogenesis of disease. PMID:26137589

  7. IgG4-related renal disease: clinical and pathological characteristics

    PubMed Central

    Kuroda, Naoto; Nao, Tomoya; Fukuhara, Hideo; Karashima, Takashi; Inoue, Keiji; Taniguchi, Yoshinori; Takeuchi, Mai; Zen, Yoh; Sato, Yasuharu; Notohara, Kenji; Yoshino, Tadashi

    2014-01-01

    IgG4-related disease is a recently established systemic condition. Tubulointerstitial nephritis is the most common renal manifestation. Glomerular lesions, particularly membranous glomerulonephritis, can develop simultaneously. Some patients present with serological renal dysfunction associated with elevated IgG or IgE levels and hypocomplementemia, while others are incidentally found to have abnormalities in kidneys on imaging. A majority of patients with IgG4-related kidney disease have similar lesions at other anatomical sites, which help us to suspect this condition. Serum IgG4 elevation (>135 mg/dL) is the most, although not entirely, specific marker for the diagnosis. Imaging findings varies from small nodules to bilateral diffuse abnormalities. In addition to the renal parenchyma, the renal pelvis and perirenal adipose tissue can be affected. Histological features include dense lymphoplasmacytic infiltration, storiform or “bird’s eye” fibrosis (highlighted by PAM stain), and IgG4-positive plasma cell infiltration (>10 cells/high-power field and IgG4/IgG-positive cell ratio >40%). Immune complex deposition is detectable in the tubular basement membrane by immunofluorescence and/or electron microscopy. Patients usually respond well to corticosteroids, but highly active diseases may require other immunosuppressive therapies. Further investigations will be required to fully understand pathophysiology underlying this emerging condition. PMID:25337295

  8. IgG4-Related Disease of the Gastrointestinal Tract: A 21st Century Chameleon.

    PubMed

    Deshpande, Vikram

    2015-06-01

    Context .- Immunoglobulin G4 (IgG4)-related disease is a systemic fibroinflammatory disease capable of affecting virtually any organ. Although the pancreas and hepatobiliary system are commonly affected, involvement of the tubular gut is unusual. The pancreatic manifestations of this disease (autoimmune pancreatitis) often mimic pancreatic carcinoma, whereas the hepatobiliary manifestations are mistaken for cholangiocarcinoma or primary sclerosing cholangitis. The characteristic histologic features include a dense lymphoplasmacytic infiltrate, storiform-type fibrosis, and obliterative phlebitis. An increase in IgG4(+) plasma cells and an IgG4 to IgG ratio of more than 40% are considered obligatory components of the diagnostic algorithm. Objective .- To review the challenges associated with the diagnosis of IgG4-related disease of the gastrointestinal tract. Data Sources .- A review of pertinent literature, along with the author's personal experience, based on institutional and consultation materials. Conclusion .- The complete spectrum of histologic changes is seldom captured in a biopsy specimen, and thus, the histopathology findings are best interpreted within the overall clinical context. Increased IgG4(+) plasma cells are identified in a variety of benign and malignant diseases of the gastrointestinal tract. PMID:26030243

  9. IgG4-related skin lesions: case report and review of the literature.

    PubMed

    Kempeneers, D; Hauben, E; De Haes, P

    2014-06-01

    IgG4-related disease (IgG4-RD) is a systemic disease, mostly affecting the pancreas. It presents as accumulation of IgG4-producing plasma cells in various tissues. Other possible affected organs include the lacrimal glands, salivary glands, lungs, kidneys, liver, bile duct, retroperitoneum, breast, aorta, pituitary gland and prostate. A cutaneous presentation has also been described in the literature, and might be the initial presenting feature of IgG4-RD. We describe a 73-year-old white man who presented with two infiltrated, erythematous nodules on his abdomen. The histopathological characteristics were highly suggestive of IgG4-related cutaneous disease. Immunohistochemical stains were positive for IgG4. In the past, the patient's other organs had also been affected by IgG4-RD. Cutaneous presentation of IgG4-RD has been described previously in the literature but only in Asian patients (both East and South Asian). We also provide an overview of previously reported cutaneous manifestations of IgG4-RD. PMID:24758575

  10. Multiple IgG4-related sclerosing lesions in the maxillary sinus, parotid gland and nasal septum.

    PubMed

    Ishida, Mitsuaki; Hotta, Machiko; Kushima, Ryoji; Shibayama, Masayuki; Shimizu, Takeshi; Okabe, Hidetoshi

    2009-09-01

    IgG4-related sclerosing disease is recognized as a distinct clinicopathological entity. It is well known that this disease can occur in the salivary, lacrimal and pituitary glands, in the head and neck region. The nasal cavity is an extremely rare site of involvement of IgG4-related sclerosing disease. Herein is reported a case of multiple IgG4-related sclerosing lesions in the maxillary sinus, parotid gland and nasal septum. A 73-year-old Japanese man presented with nasal obstruction and tumors of the right maxillary sinus and parotid gland were detected, after which resections of these tumors were performed. One year after the last surgery, he noted swelling of the nasal septum, and the tumor was resected. These three tumors had similar histopathology, such as conspicuous fibrosclerotic changes with dense lymphoplasmacytic infiltration and occasional obliterative phlebitis. Immunohistochemistry indicated abundant IgG4-positive plasma cell infiltration and high ratios of IgG4-positive/IgG-positive plasma cells (>70%) in all three lesions. The diagnosis of multiple IgG4-related sclerosing lesions was made. The present case suggests that IgG4-related sclerosing lesion can occur in the maxillary sinus and nasal septum, and represents an extension of the spectrum of IgG4-related sclerosing disease. PMID:19712137

  11. Nasal manifestations of IgG4-related disease: A report of two cases.

    PubMed

    Ohno, Keiko; Matsuda, Yoko; Arai, Tomio; Kimura, Yurika

    2015-12-01

    IgG4-related disease (IgG4-RD) is a recently recognized clinical disease entity characterized by elevated serum IgG4, tumefaction, tissue infiltration of IgG4-positive plasma cells and fibrosis. IgG4-RD may occur, either synchronously or metachronously, in a variety of organs throughout the body. We describe herein two representative cases of the nasal manifestations of IgG4-RD, characterized by diffuse, crusty, erosive lesions on nasal mucosa. Oral steroid administration was effective in treating these nasal manifestations. We report a decrease in IgG4 positive plasma cell infiltrates in nasal mucosa biopsy specimens after steroid therapy, demonstrating that infiltration of IgG4-positive cells is reversible. PMID:26060132

  12. [A case of IgG4-related sclerosing disease with lymphadenopathy and thymus involvement].

    PubMed

    Kazantseva, I A; Lishchuk, S V; Gurevich, L E; Bobrov, M A; Terpigorov, S A

    2012-01-01

    The paper describes a case of generalized lymphadenopathy clinically recognized as malignant lymphoma in a 59-year-old woman. Her death occurred from bilateral pneumonia. Autopsy also showed a tumor-like mass in the thymus. On histological examination, the lymph nodes, thymus, and spleen exhibited an intensive polyclonal IgG4+ plasma cell infiltration. Lymphoid plasma cell infiltration with increased count of IgG+ plasma cells, progressive sclerosis, and phlebitis obliterans were found in the pancreas and peripancreatic adipose tissue, liver, kidney, epicardium, thyroid, pituitary, skin, and other organs. The case was regarded as IgG4-related sclerosing disease manifesting itself as lymphadenopathy and thymus enlargement. PMID:22997955

  13. IgG4-related Sclerosing Mesenteritis in a 7-year-old Saudi Girl

    PubMed Central

    Hasosah, Mohammed Y.; Satti, Mohamed B.; Yousef, Yasmin A.; Alzahrani, Daifullah M.; Almutairi, Sajdi A.; Alsahafi, Ashraf F.; Sukkar, Ghassan A.; Alzaben, Abdullah A.

    2014-01-01

    Sclerosing mesenteritis (SM) is a rare, benign inflammatory disorder of unknown etiology, affecting the membranes of the digestive tract that involves lymphoplasmacytic inflammation, fat necrosis, and fibrosis of the mesentery. We report a child patient with a history of recurrent abdominal pain and fever who was found to have an intra-abdominal mass suspicious for malignancy. A tissue biopsy revealed the diagnosis of SM associated with IgG4-related systemic disease. The patient is currently maintained on 5 mg prednisone daily and no recurrence of symptoms was noted during the 24-month follow-up period. We emphasize, therefore, that SM can present clinical challenges and the presence of SM should cue clinicians to search for other coexisting autoimmune disorders that can have various outcomes. PMID:25434322

  14. IgG4-related sclerosing mesenteritis in a 7-year-old Saudi girl.

    PubMed

    Hasosah, Mohammed Y; Satti, Mohamed B; Yousef, Yasmin A; Alzahrani, Daifullah M; Almutairi, Sajdi A; Alsahafi, Ashraf F; Sukkar, Ghassan A; Alzaben, Abdullah A

    2014-01-01

    Sclerosing mesenteritis (SM) is a rare, benign inflammatory disorder of unknown etiology, affecting the membranes of the digestive tract that involves lymphoplasmacytic inflammation, fat necrosis, and fibrosis of the mesentery. We report a child patient with a history of recurrent abdominal pain and fever who was found to have an intra-abdominal mass suspicious for malignancy. A tissue biopsy revealed the diagnosis of SM associated with IgG4-related systemic disease. The patient is currently maintained on 5 mg prednisone daily and no recurrence of symptoms was noted during the 24-month follow-up period. We emphasize, therefore, that SM can present clinical challenges and the presence of SM should cue clinicians to search for other coexisting autoimmune disorders that can have various outcomes. PMID:25434322

  15. Orbital Pseudotumor: Uncommon Initial Presentation of IgG4-Related Disease

    PubMed Central

    Carbone, Teresa; Azêdo Montes, Ricardo; Andrade, Beatriz; Lanzieri, Pedro; Mocarzel, Luis

    2015-01-01

    IgG4-related disease (IgG4-RD) encompasses a group of fibroinflammatory conditions recognized in recent times. The main clinical features include variable degrees of tissue fibrosis, tumorlike expansions, perivascular lymphocytic infiltration rich in IgG4-positive plasma cells, and elevated serum IgG4. A case has been reported of an elderly patient with an unexplained unilateral exophthalmia; biopsy was performed and revealed lymphocytic infiltration, suggesting IgG4-RD. High serum levels of IgG4, in association with a good response to steroid therapy and to the exclusion of other diagnoses, confirmed the hypothesis of orbital pseudotumor by IgG4-RD. PMID:25838962

  16. Hypermethylation of MST1 in IgG4-related autoimmune pancreatitis and rheumatoid arthritis.

    PubMed

    Fukuhara, Takataro; Tomiyama, Takashi; Yasuda, Kaneki; Ueda, Yoshihiro; Ozaki, Yoshio; Son, Yonsu; Nomura, Shosaku; Uchida, Kazushige; Okazaki, Kazuichi; Kinashi, Tatsuo

    2015-08-01

    The serine/threonine kinase Mst1 plays important roles in the control of immune cell trafficking, proliferation, and differentiation. Previously, we reported that Mst1 was required for thymocyte selection and regulatory T-cell functions, thereby the prevention of autoimmunity in mice. In humans, MST1 null mutations cause T-cell immunodeficiency and hypergammaglobulinemia with autoantibody production. RASSF5C(RAPL) is an activator of MST1 and it is frequently methylated in some tumors. Herein, we investigated methylation of the promoter regions of MST1 and RASSF5C(RAPL) in leukocytes from patients with IgG4-related autoimmune pancreatitis (AIP) and rheumatoid arthritis (RA). Increased number of CpG methylation in the 5' region of MST1 was detected in AIP patients with extrapancreatic lesions, whereas AIP patients without extrapancreatic lesions were similar to controls. In RA patients, we detected a slight increased CpG methylation in MST1, although the overall number of methylation sites was lower than that of AIP patients with extrapancreatic lesions. There were no significant changes of the methylation levels of the CpG islands in the 5' region of RASSF5C(RAPL) in leukocytes from AIP and RA patients. Consistently, we found a significantly down-regulated expression of MST1 in regulatory T cells of AIP patients. Our results suggest that the decreased expression of MST1 in regulatory T cells due to hypermethylation of the promoter contributes to the pathogenesis of IgG4-related AIP. PMID:26056943

  17. IgG4-related disease of the aortic valve: a report of two cases and review of the literature.

    PubMed

    Maleszewski, Joseph J; Tazelaar, Henry D; Horcher, Heidi M; Hinkamp, Thomas J; Conte, John V; Porterfield, James K; Halushka, Marc K

    2015-01-01

    IgG4-related disease (IgG4-RD) is a relatively recently described disorder that can affect multiple organ systems, including the cardiovascular system. While most reported cases of cardiovascular involvement are of the aorta, usually the abdominal aorta, rare isolated reports of involvement of the heart proper have been described. Herein, we describe two cases of IgG4-RD involving the aortic valve. Each case was found to be associated with increased levels of IgG4 in the tissue and one case resulted in the subsequent discovery of IgG4-related pancreatitis. PMID:25283128

  18. An Overlapping Case of Lupus Nephritis and IgG4-Related Kidney Disease

    PubMed Central

    Zaarour, Mazen; Weerasinghe, Chanudi; Eter, Ahmad; El-Sayegh, Suzanne; El-Charabaty, Elie

    2015-01-01

    We report a case of a 71-year-old Filipino female who was admitted to the hospital for abdominal pain, vomiting and diarrhea of 8 days duration. The patient was found to have marked acute kidney injury (AKI), which required hemodialysis in the next 3 days. Extensive workup revealed hematuria, subnephrotic range proteinuria, elevated anti-nuclear antibody (ANA) and elevated total immunoglobulin G (IgG) levels, with normal IgG4 and anti-dsDNA levels. On kidney biopsy, mild membranous glomerulonephritis was found, along with autoimmune tubulointerstitial nephritis (TIN) with a “full-house” pattern of immune deposits. These findings were suggestive of lupus interstitial nephritis. However, IgG4+ plasma cells were detected in the interstitium by immunostaining, favoring a diagnosis of IgG4-related kidney disease (IgG4-RKD). Our case highlights the difficulty in differentiating lupus nephritis (LN) from IgG4-RKD in some patients, raising the suspicion that these two entities can co-exist. PMID:26015827

  19. An Overlapping Case of Lupus Nephritis and IgG4-Related Kidney Disease.

    PubMed

    Zaarour, Mazen; Weerasinghe, Chanudi; Eter, Ahmad; El-Sayegh, Suzanne; El-Charabaty, Elie

    2015-07-01

    We report a case of a 71-year-old Filipino female who was admitted to the hospital for abdominal pain, vomiting and diarrhea of 8 days duration. The patient was found to have marked acute kidney injury (AKI), which required hemodialysis in the next 3 days. Extensive workup revealed hematuria, subnephrotic range proteinuria, elevated anti-nuclear antibody (ANA) and elevated total immunoglobulin G (IgG) levels, with normal IgG4 and anti-dsDNA levels. On kidney biopsy, mild membranous glomerulonephritis was found, along with autoimmune tubulointerstitial nephritis (TIN) with a "full-house" pattern of immune deposits. These findings were suggestive of lupus interstitial nephritis. However, IgG4+ plasma cells were detected in the interstitium by immunostaining, favoring a diagnosis of IgG4-related kidney disease (IgG4-RKD). Our case highlights the difficulty in differentiating lupus nephritis (LN) from IgG4-RKD in some patients, raising the suspicion that these two entities can co-exist. PMID:26015827

  20. IgG4-related lung disease manifested as pneumonia in puerperium: a case report

    PubMed Central

    Wang, Jinlin; Zeng, Yunxiang; Gu, Yingying; Li, Shiyue

    2015-01-01

    IgG4-related lung disease (IgG4-RLD) is recently emerging entity. Several reports concerned with the clinicopathologic feature have been described, but this disease in puerperium has not been reported previously. Here, we report a 24-year-old woman diagnosed as IgG4-RLD in puerperium, who developed dry cough, low fever and exertional dyspnea following the delivery. The inflammatory markers and pulmonary lesions of the patient suggested pneumonia. However, there was no improvement after antibiotic treatment. The infiltration of IgG4-positive lymphoplasmacytes was found in lung biopsy by video-assisted thoracic surgery (VATS). And the serum IgG4 level was high. The patient was effectively treated with corticosteroids. This unique case highlights the occurrence of IgG4-RLD in puerperium and underscores it should be taken into consideration as a possible differential diagnosis when dense lymphoplasmacytic infiltration was found in pulmonary consolidation in complex puerperal respiratory cases.

  1. IgG4-related sclerosing mesenteritis: a rare mesenteric disease of unknown etiology.

    PubMed

    Minato, Hiroshi; Shimizu, Junzo; Arano, Yoshihiko; Saito, Kenichiro; Masunaga, Takaharu; Sakashita, Toshiki; Nojima, Takayuki

    2012-04-01

    Sclerosing mesenteritis is a rare inflammatory and fibrosing disorder of unknown etiology, while IgG4-related disease (IgG4-RD) consists of mass-forming, fibroinflammatory lesions characterized by high serum IgG4 levels and tissue infiltration of many IgG4-positive plasma cells; obliterative phlebitis is common. This report describes a case of sclerosing mesenteritis that was considered a manifestation of IgG4-RD. A 53-year-old man underwent right hemicolectomy because of an ileocecal mass that did not improve with conservative therapy. The ill-defined fibroinflammatory lesion extended in the mesentery with storiform fibrosis, obliterative phlebitis, and infiltration of many IgG4-positive plasma cells. The ratio of IgG4-positive/IgG-positive cells was 64%, and the ratio of forkhead box protein 3 (FOXP3)-positive/CD4-positive cells was elevated (13%). It is likely that at least some cases of sclerosing mesenteritis are a manifestation of IgG4-RD. It is important to investigate this relationship because steroid therapy may benefit such cases. PMID:22449233

  2. Prohibitin Is Involved in Patients with IgG4 Related Disease

    PubMed Central

    Du, Hongwu; Shi, Lili; Chen, Peng; Yang, Weikang; Xun, Yiping; Yang, Chunhe; Zhao, Lanqing; Zhou, Yabin; Chen, Guangyu

    2015-01-01

    Objective IgG4-related disease (IgG4-RD) is a chronic systemic disease involved in many organs and tissues. As only limited autoantigens have been found since the beginning of this century, the aim of this study was to reveal new candidate autoantigens of IgG4-RD. Methods Multiple cell lines including HT-29, EA.hy926, HEK 293 and HepG2 were used to test the binding ability of circulating autoantibodies from IgG4-RD sera. The amino-acid sequence was then analyzed by matrix-assisted laser desorption/ionization time-of-flight tandem (MALDI-TOF/TOF) mass spectrometry. After the cloning and expression of recombinant putative autoantigen in a bacterial expression system, the corresponding immuno assay was set up and utilized to observe the prevalence of serum autoantibodies in a large set of confirmed clinical samples. Results One positive autoantigen was identified as prohibitin. ELISA analysis showed that a majority of patients with IgG4-RD have antibodies against prohibitin. Anti-prohibitin antibodies were present in the sera of patients with definite autoimmune pancreatitis (25/34; 73.5%), Mikulicz’s disease (8/15; 53.3%), retroperitoneal fibrosis (6/11; 54.5%), other probable IgG4-RD (26/29; 89.7%) and Sjögren’s syndrome (4/30; 13.3%) but not in apparently healthy donors (1/70; 1.4%). Conclusions An association between prohibitin and patients with some IgG4-RD was observed, although the results were quite heterogeneous among different individuals within autoimmune pancreatitis, Mikulicz’s disease and retroperitoneal fibrosis. PMID:25932630

  3. Occurrence of IgG4-related hypophysitis lacking IgG4-bearing plasma cell infiltration during steroid therapy.

    PubMed

    Ohkubo, Yohsuke; Sekido, Takashi; Takeshige, Keiko; Ishi, Hiroaki; Takei, Masahiro; Nishio, Shin-ichi; Yamazaki, Masanori; Komatsu, Mitsuhisa; Kawa, Shigeyuki; Suzuki, Satoru

    2014-01-01

    Eight years after an episode of multiple IgG4-related disease, a pituitary mass with panhypopituitarism and a visual disturbance developed in a 70-year-old man under low-dose steroid therapy. A pituitary biopsy revealed findings of lymphocytic hypophysitis with the absence of IgG4-positive plasma cell infiltration. The serum IgG4 level was unremarkable. Although performing a pituitary biopsy and measuring the serum IgG4 level is crucial for making a diagnosis of IgG4-related hypophysitis, it is occasionally difficult to diagnose the disease in patients treated with steroid therapy, as observed in the present case. Based on a review of the diagnosis, conducting a careful assessment is required, especially in men and elderly patients thought to have solitary hypophysitis. PMID:24694491

  4. Pericardiobiliary Fistulation: A Rare Complication of Therapeutic ERCP in a Patient With IgG4-Related Sclerosing Cholangitis

    PubMed Central

    Paranandi, Bharat; Joshi, Deepak; Johnson, Gavin J.

    2015-01-01

    A 70-year-old man presented with acute coronary syndrome 3 weeks after plastic stent insertion for hilar biliary stricturing secondary to IgG4-related sclerosing cholangitis (IgG4-SC). Imaging demonstrated haemopericardium due to proximal migration of the plastic biliary stent through the liver capsule and diaphragm into the pericardial sac. The stent was endoscopically removed and a pericardiocentesis was performed. The patient's clinical condition rapidly improved. We illustrate an unusual but potentially serious complication that may arise from migration of a biliary stent and discuss a management strategy.

  5. [IgG4-related disease that presented cranial, cervical, lumbar and sacral hypertrophic pachymeningitis associated with infundibulo-hypophysitis].

    PubMed

    Sakai, Toshiyuki; Kondo, Masahide; Yoshii, Shintaro; Tomimoto, Hidekazu

    2014-01-01

    We report a patient of 32-year-old female with central IgG4-related disease. She developed headache and visual disturbance. On examination, she revealed diabetes insipidus, retrobulbar neuritis, hyperreflexia and limb weakness. Her laboratory findings showed serum IgG4 elevation, pleocytosis and protein elevation in cerebrospinal fluid. Chest CT showed a nodular lesion in the S8 of the left lung. Cranial and spinal magnetic resonance images with gadolinium contrast material showed cranial, cervical and lumbosacral hypertrophic pachymeningitis associated with infundibulo-hypophysitis. Pathological findings of the left frontal dura mater revealed lymphoplasmacytic inflammatory cell infiltrate with dense fibrosis. IgG4 immunohistochemistry showed no IgG4 + plasma cells within the inflammatory infiltrate. During treatment with intravenous pulse methylprednisolone followed by oral prednisolone, she revealed recovery of visual acuity with improvement of hypertrophic pachymeningitis and normalization of serum IgG4. This is a first report of IgG4-related hypertrophic pachymeningitis which involved cranial, cervical and lumbosacral regions as well as infundibulo-hypophysitis in a young female. PMID:25142540

  6. Rare case of Helicobacter pylori-positive multiorgan IgG4-related disease and gastric cancer

    PubMed Central

    Li, Min; Zhou, Qiang; Yang, Kun; Brigstock, David R; Zhang, Lu; Xiu, Ming; Sun, Li; Gao, Run-Ping

    2015-01-01

    A 61-year-old male from Northeast China presented with a 2-mo history of abdominal distension, pruritus and jaundice. Laboratory testing revealed an elevated serum IgG4 level. A computed tomography scan showed a typical feature of autoimmune pancreatitis (AIP) and cholecystocholangitis. Early gastric cancer was incidentally discovered when endoscopic untrasound-guided fine needle aspiration (EUS-FNA) of the pancreas was carried out. The patient underwent radical subtotal gastrectomy for gastric cancer combined with cholecystectomy. Helicobacter pylori (H. pylori) and IgG4-positive plasmacytes were detected in gastric cancer tissue, pancreatic EUS-FNA sample and resected gallbladder specimen by immunohistochemistry. The patient was diagnosed with H. pylori-positive IgG4-related AIP and sclerosing cholecystocholangitis as well as H. pylori-positive gastric cancer. He responded well to steroid therapy and remains healthy with no signs of recurrence at one year follow-up. We speculate that H. pylori might act as a trigger via direct or indirect action in the initiation of onset of gastric cancer and multiorgan IgG4-related disease. PMID:25805956

  7. Rare case of Helicobacter pylori-positive multiorgan IgG4-related disease and gastric cancer.

    PubMed

    Li, Min; Zhou, Qiang; Yang, Kun; Brigstock, David R; Zhang, Lu; Xiu, Ming; Sun, Li; Gao, Run-Ping

    2015-03-21

    A 61-year-old male from Northeast China presented with a 2-mo history of abdominal distension, pruritus and jaundice. Laboratory testing revealed an elevated serum IgG4 level. A computed tomography scan showed a typical feature of autoimmune pancreatitis (AIP) and cholecystocholangitis. Early gastric cancer was incidentally discovered when endoscopic untrasound-guided fine needle aspiration (EUS-FNA) of the pancreas was carried out. The patient underwent radical subtotal gastrectomy for gastric cancer combined with cholecystectomy. Helicobacter pylori (H. pylori) and IgG4-positive plasmacytes were detected in gastric cancer tissue, pancreatic EUS-FNA sample and resected gallbladder specimen by immunohistochemistry. The patient was diagnosed with H. pylori-positive IgG4-related AIP and sclerosing cholecystocholangitis as well as H. pylori-positive gastric cancer. He responded well to steroid therapy and remains healthy with no signs of recurrence at one year follow-up. We speculate that H. pylori might act as a trigger via direct or indirect action in the initiation of onset of gastric cancer and multiorgan IgG4-related disease. PMID:25805956

  8. IgG4-related disease with atypical laryngeal presentation and Behçet/granulomatous polyangiitis mimicking features

    PubMed Central

    Shaib, Yasmin; Ton, Evelien; Goldschmeding, Roel; Tekstra, Janneke

    2013-01-01

    The following report describes two male patients with an ongoing medical history with a predominant laryngeal focus, who were finally diagnosed with IgG4-related disease (IgG4-RD). Their primary symptoms included hoarseness and pain of the throat, and they had undergone multiple laryngeal surgeries and laser treatments due to tumorous growth with limited success. Due to the onset of additional symptoms, they initially received the diagnoses granulomatous polyangiitis (GPA) and Behçet's disease. However, further analysis showed elevated IgG4 levels in serum and infiltration of IgG4-positive plasma cells upon biopsy of laryngeal and pulmonary tissue. Treatment was started with moderate doses of prednisone, leading to a rapid resolution of symptoms. PMID:23813505

  9. IgG4-related disease and its pathogenesis—cross-talk between innate and acquired immunity

    PubMed Central

    Nakajima, Akio; Nakamura, Takuji; Kawanami, Takafumi; Tanaka, Masao; Dong, Lingli; Kawano, Mitsuhiro

    2014-01-01

    IgG4-related disease (IgG4-RD) is a novel clinical entity proposed in Japan in the 21th century and is attracting strong attention over the world. The characteristic manifestations of IgG4-RD are increased serum IgG4 concentration and tumefaction by IgG4+ plasma cells. Although the clinical manifestations in various organs have been established, the pathogenesis of IgG4-RD is still unknown. Recently, many reports of aberrant acquired immunity such as Th2-diminated immune responses have been published. However, many questions still remain, including questions about the pathogenesis of IgG4-RD and the roles of IgG4. In this review, we discuss the pathogenesis of IgG4-RD by focusing on the cross-talk between innate and acquired immunity. PMID:25024397

  10. A novel clinical entity, IgG4-related disease (IgG4RD): general concept and details.

    PubMed

    Umehara, Hisanori; Okazaki, Kazuichi; Masaki, Yasufumi; Kawano, Mitsuhiro; Yamamoto, Motohisa; Saeki, Takako; Matsui, Shoko; Sumida, Takayuki; Mimori, Tsuneyo; Tanaka, Yoshiya; Tsubota, Kazuo; Yoshino, Tadashi; Kawa, Shigeyuki; Suzuki, Ritsuro; Takegami, Tsutomu; Tomosugi, Naohisa; Kurose, Nozomu; Ishigaki, Yasuhito; Azumi, Atsushi; Kojima, Masaru; Nakamura, Shigeo; Inoue, Dai

    2012-02-01

    IgG4-related disease (IgG4RD) is a novel clinical disease entity characterized by elevated serum IgG4 concentration and tumefaction or tissue infiltration by IgG4-positive plasma cells. IgG4RD may be present in a certain proportion of patients with a wide variety of diseases, including Mikulicz's disease, autoimmune pancreatitis, hypophysitis, Riedel thyroiditis, interstitial pneumonitis, interstitial nephritis, prostatitis, lymphadenopathy, retroperitoneal fibrosis, inflammatory aortic aneurysm, and inflammatory pseudotumor. Although IgG4RD forms a distinct, clinically independent disease category and is attracting strong attention as a new clinical entity, many questions and problems still remain to be elucidated, including its pathogenesis, the establishment of diagnostic criteria, and the role of IgG4. Here we describe the concept of IgG4RD and up-to-date information on this emerging disease entity. PMID:21881964

  11. IgG4-Related Disease Combined with Autoimmune Hemolytic Anemia and Steroid-Responsive Transient Hypercalcemia

    PubMed Central

    Hasegawa, Sho; Mine, Sohtaro; Hagiwara, Shotaro

    2015-01-01

    A 67-year-old man with elevated serum immunoglobulin G4 (IgG4) levels, systemic lymphadenopathy infiltrated by IgG4-positive plasma cells, and Coombs-positive autoimmune hemolytic anemia (AIHA) showed marked hypercalcemia. Although the intact parathyroid hormone (PTH) level was elevated, 99mTc-MIBI scintigraphy and thyroid ultrasonography revealed no evidence of primary hyperparathyroidism. Liver biopsy showed marked infiltration of IgG4-positive plasma cells, which confirmed the diagnosis of IgG4-related disease (IgG4-RD). Corticosteroid therapy was initiated, and subsequently, intact PTH and serum calcium levels gradually normalized. Transient hypercalcemia in a patient with AIHA may therefore be associated with IgG4-RD.

  12. Development of IgG4-related disease 10 years after chemotherapy for diffuse large B cell lymphoma and longstanding bronchial asthma.

    PubMed

    Mitsui, Takeki; Yokohama, Akihiko; Koiso, Hiromi; Ishizaki, Takuma; Uchiumi, Hideki; Saitoh, Takayuki; Handa, Hiroshi; Hirato, Junko; Karasawa, Masamitsu; Murakami, Hirokazu; Kojima, Masaru; Nojima, Yoshihisa; Tsukamoto, Norifumi

    2013-07-01

    Reported is a rare case IgG4-related disease that developed 10 years after combination chemotherapy for non-Hodgkin lymphoma. A 59-year-old Japanese man with longstanding bronchial asthma was referred to our hospital for bilateral hilar lymph node enlargement. The initial diagnosis was diffuse large B cell lymphoma (DLBCL) by supraclavicular lymph node biopsy. Serum IgG was high (4550 mg/dL) at diagnosis. The patient achieved complete response following six cycles of combination chemotherapy. Ten years later, bilateral submaxillary gland swelling was observed. Serum IgG and IgG4 were 2909 and 1470 mg/dL, respectively. The patient was diagnosed with IgG4-related disease by submandibular lymph node biopsy. Due to the difficulty in distinguishing IgG4-related disease from DLBCL through imaging findings alone, pathological confirmation of such lesions by biopsy is mandatory before proceeding to treatment. PMID:23666666

  13. Serum trypsin and TCR as novel markers for predicting disease activity in IgG4-related disease

    PubMed Central

    Fengqing, Wang; Qiang, Yi; Feng, Gao; Zehao, Zhuang; Yuefei, Ma; Jing, Chen; Guina, Wang; Bing, Hu; Jing, Zheng; Jingjing, Zhang; Danfeng, Lu; Rui, Ha

    2014-01-01

    Background IgG4-related disease (IgG4-RD) is a novel disease named in recent years. Because of its varied clinical manifestations, like tumor but not tumor, it brings a great challenge to clinical diagnosis. Trypsin and T-cell receptor (TCR) are thought to mediate the regulation of B cell maturation, survival and antibody production. In this study, we investigated the clinical features and important novel markers of IgG4-RD. Material and methods A prospective cohort study of 22 patients with IgG4-RD was carried out from May 2009 to December 2012, and 65 cases with acute pancreatitis, 60 cases with pancreatic cancer and 120 healthy individuals were studied as controls. Serum TCR, trypsin and IgG4 levels were measured during pre- and post-treatment in the patients with IgG4-RD and their correlations with IgG4 were also assessed. Results Serum IgG4 and IgE levels in all patients were significantly increased, and tumor markers (carbohydrate antigen 19-9 and/or carbohydrate antigen 125) were also increased (12/22). Serum trypsin in patients with IgG4-RD was lower than in the ones with acute pancreatitis, pancreatic cancer, and healthy individuals. But serum TCR of IgG4-RD was significantly higher than in the pancreatic cancer group and normal controls and it was inversely correlated with the levels of IgG4 (r = –3.160, p = 0.042). Conclusions The results indicate that serum TCR and trypsin might be useful markers for predicting disease activity in IgG4-RD.

  14. IgG4-Related Sclerosing Disease, an Emerging Entity: A Review of a Multi-System Disease

    PubMed Central

    Divatia, Mukul; Kim, Sun A

    2012-01-01

    Immunoglobulin G4-related systemic disease (IgG4-RSD) is a recently defined emerging entity characterized by a diffuse or mass forming inflammatory reaction rich in IgG4-positive plasma cells associated with fibrosclerosis and obliterative phlebitis. IgG4-RSD usually affects middle aged and elderly patients, with a male predominance. It is associated with an elevated serum titer of IgG4, which acts as a marker for this recently characterized entity. The prototype is IgG4-related sclerosing pancreatitis or autoimmune pancreatitis (AIP). Other common sites of involvement are the hepatobiliary tract, salivary gland, orbit, and lymph node, however practically any organ can be involved, including upper aerodigestive tract, lung, aorta, mediastinum, retroperitoneum, soft tissue, skin, central nervous system, breast, kidney, and prostate. Fever or constitutional symptoms usually do not comprise part of the clinical picture. Laboratory findings detected include raised serum globulin, IgG and IgG4. An association with autoantibody detection (such as antinuclear antibodies and rheumatoid factor) is seen in some cases. Steroid therapy comprises the mainstay of treatment. Disease progression with involvement of multiple organ-sites may be encountered in a subset of cases and may follow a relapsing-remitting course. The principal histopathologic findings in several extranodal sites include lymphoplasmacytic infiltration, lymphoid follicle formation, sclerosis and obliterative phlebitis, along with atrophy and destruction of tissues. Immunohistochemical staining shows increased IgG4+ cells in the involved tissues (>50 per high-power field, with IgG4/IgG ratio >40%). IgG4-RSD may potentially be rarely associated with the development of lymphoma and carcinoma. However, the nature and pathogenesis of IgG4-RSD are yet to be fully elucidated and provide immense scope for further studies. PMID:22187229

  15. Detection of Serum IgG4 Levels in Patients with IgG4-Related Disease and Other Disorders

    PubMed Central

    Wang, Chenqiong; Wu, Xuefen; Miao, Ye; Xiong, Hui; Bai, Lin; Dong, Lingli

    2015-01-01

    Objective Elevated serum IgG4 levels are an important hallmark for diagnosing IgG4-related disease (IgG4-RD), but can also be observed in other diseases. This study aimed to compare two different testing methods for IgG4: ELISA and nephelometric assay. Both assays were used to measure serum IgG4 concentrations, and to assess the prevalence of high serum IgG4 levels in both IgG4-RD and non-IgG4-RD diseases. Methods A total of 80 serum samples were tested using the nephelometric assay and ELISA method that we established. Serum IgG4 concentrations were determined by ELISA for 957 patients with distinct diseases, including 12 cases of IgG4-RD and 945 cases of non-IgG4-RD. Results IgG4 levels from 80 selected serum samples examined by ELISA were in agreement with those detected using the nephelometry assay. Meanwhile, the serum IgG4 concentrations measured by ELISA were also consistent with the clinical diagnoses of patients with IgG4-RD during the course of disease. The Elevated levels of serum IgG4 (>1.35 g/L) were detected in all IgG4-RD (12/12) patients, and the prevalence of high IgG4 serum levels was 3.39% in non-IgG4-RD cases. Among them, the positive rates of serum IgG4 were 2.06% in patients with carcinoma and 6.3% in patients with other non-IgG4 autoimmune diseases. Conclusion Our established ELISA method is a reliable and convenient technique, which could be extensively used in the clinic to measure serum IgG4 levels. High levels of IgG4 were observed in IgG4-RD. However, this phenomenon could also be observed in other diseases, such as carcinomas and other autoimmune diseases. Thus, a diagnosis of IgG4 disease cannot only be dependent on the detection of elevated serum IgG4 levels. PMID:25885536

  16. Putative IgG4-related pituitary disease with hypopituitarism and/or diabetes insipidus accompanied with elevated serum levels of IgG4.

    PubMed

    Haraguchi, Ai; Era, Ai; Yasui, Junichi; Ando, Takao; Ueki, Ikuko; Horie, Ichiro; Imaizumi, Misa; Usa, Toshiro; Abe, Kuniko; Origuchi, Tomoki; Eguchi, Katsumi

    2010-01-01

    IgG4-positive plasma cell infiltration into multiple organs or tissues, such as the pancreas and salivary glands, associated with increased serum levels of IgG4 is a characteristic finding seen in IgG4-related disease. Affected organs may appear tumorous as a result of chronic inflammatory processes accompanied with progressive fibrosis. Recent cases of this disorder in which the pituitary gland was affected include cases of diffuse enlargement of the pituitary and/or its stalk associated with central diabetes insipidus and/or impaired anterior hormone production. Here we report two such cases, as well as two additional previously undiagnosed cases found in our database. In order to make a correct diagnosis of pituitary lesion involvement with IgG4-related disease, the clinical background and concomitant disorders should be carefully taken into consideration and the measurement of serum levels of IgG4 seems to be useful. PMID:20467161

  17. Growth hormone and proopiomelanocortin are targeted by autoantibodies in a patient with biopsy-proven IgG4-related hypophysitis

    Microsoft Academic Search

    M. A. Landek-SalgadoP; P. Leporati; I. Lupi; A. Geis; P. Caturegli

    Hypophysitis is a chronic inflammation of the pituitary gland often caused by autoimmunity. Among the autoimmune diseases\\u000a it is one of the few where the autoantigens remain to be identified. The goal of the paper was to characterize the antigenic\\u000a profile in a previously reported patient with IgG4-related hypophysitis. Immunofluorescence and immunoblotting were performed\\u000a to detect antibodies to human pituitary

  18. Growth hormone and proopiomelanocortin are targeted by autoantibodies in a patient with biopsy-proven IgG4-related hypophysitis.

    PubMed

    Landek-Salgado, M A; Leporati, P; Lupi, I; Geis, A; Caturegli, P

    2012-09-01

    Hypophysitis is a chronic inflammation of the pituitary gland often caused by autoimmunity. Among the autoimmune diseases it is one of the few where the autoantigens remain to be identified. The goal of the paper was to characterize the antigenic profile in a previously reported patient with IgG4-related hypophysitis. Immunofluorescence and immunoblotting were performed to detect antibodies to human pituitary proteins. The proteins recognized by western blotting were then submitted to mass spectrometry for sequencing. The patient's autoantibodies recognized two unique bands around 40 and 30 kDa on immunoblotting. Sequencing revealed one peptide from proopiomelanocortin in the 40 kDa band and four peptides from growth hormone in the 30 kDa band. This work represents the first antigenic profile in IgG4-related hypophysitis, and the first recognition of proopiomelanocortin as a possible pituitary autoantigen. In addition, the work supports previous suggestions of growth hormone as a pituitary autoantigen. Further studies are needed to prove the pathogenicity and diagnostic utility of these two pituitary proteins. PMID:21861119

  19. [A case of IgG4-related disease with deterioration in pulmonary and pituitary involvements during a 10-year clinical course of inflammatory pseudotumor].

    PubMed

    Nagai, Kenjiro; Hara, Yuu; Shinkai, Masaharu; Goto, Hideto; Hoshino, Masako; Watanabe, Keisuke; Yamaguchi, Nobuhiro; Kawana, Akihiko; Ishigatsubo, Yoshiaki; Kaneko, Takeshi

    2011-12-01

    A 71-year-old man underwent pleural biopsy due to left pleural effusion and pleural thickening in August, 2001. An inflammatory pseudotumor (IPT) was diagnosed, and therefore systemic oral steroid therapy (prednisolone [PSL] 30 mg/day) was initiated. However, after tapering PSL to 7.5 mg/day, a complication of secondary central diabetes insipidus due to hypophysitis developed in 2008. As his pulmonary condition deteriorated over time and he began to experience exertional dyspnea, he was admitted to our hospital for re-evaluation of the disease in October, 2010. High-resolution CT (HRCT) revealed pulmonary involvements distributed in the interstitium and a high serum IgG4 level (240 mg/dl). Upon re-evaluating the pleural biopsy specimens of the first visit, we found lymphoplasmacytic-type IPT with approximately 10% IgG4-positive plasma cells in the affected areas. After increasing the PSL dose up to 0.6 mg/kg/day, his serum IgG4 levels decreased, his dyspnea improved, and the radiological findings of his pulmonary and pituitary involvements improved. This case was diagnosed as lymphoplasmacytic type IPT which appeared to be highly homologous with IgG4-related disease due to high serum levels of IgG4, pituitary involvements and the observed efficacy of PSL. PMID:22352054

  20. IgG4-related systemic disease as a cause of "idiopathic" orbital inflammation, including orbital myositis, and trigeminal nerve involvement.

    PubMed

    Wallace, Zachary S; Khosroshahi, Arezou; Jakobiec, Frederick A; Deshpande, Vikram; Hatton, Mark P; Ritter, Jill; Ferry, Judith A; Stone, John H

    2012-01-01

    IgG4-related systemic disease (IgG4-RD) is an inflammatory condition of unknown etiology that has been identified as the cause of tumefactive lesions in a number of tissues and organs. The role of the IgG4 remains to be clarified fully, but the histopathologic diagnosis hinges upon the finding of IgG4-bearing plasma cells in addition to characteristic morphologic features, with or without elevated seum IgG4. We present a 56-year-old man with orbital pseudotumor in whom, after 30 years of intractable disease, biopsy showed IgG4-RD involving the lacrimal gland, extraocular muscles, intraconal fat, and trigeminal nerve. Six months after initiating treatment with rituximab, his disease remained dormant, with improvement in his proptosis and normalization of serum IgG4 levels. We review the differential of idiopathic orbital inflammatory disease, including IgG4-RD, and emphasize the need for biopsy for accurate diagnosis and to guide appropriate treatment. PMID:22018678

  1. Prednisolone markedly reduced serum IgG4 levels along with the improvement of pituitary mass and anterior pituitary function in a patient with IgG4-related infundibulo-hypophysitis.

    PubMed

    Iseda, Izumi; Hida, Kazuyuki; Tone, Atsuhiko; Tenta, Masafumi; Shibata, Yusuke; Matsuo, Kiyoshi; Yamadori, Ichiro; Hashimoto, Kozo

    2014-01-01

    In 2011 a 76 year-old man with a medical history of diabetes, hypertension and autoimmune pancreatitis was admitted to our hospital because of anorexia, general malaise and repeated hypoglycemia. When he was 72 years old, he suffered from pancreatitis, and pancreas head tumor was operated. IgG4-related pancreatitis was diagnosed histopathologically. On admission anterior pituitary function test revealed impaired response of ACTH and cortisol to CRH, and no response of GH, TSH and gonadotropin to GHRH, TRH and LHRH, respectively. Baseline PRL level was elevated. Serum IgG and IgG4 levels were markedly elevated. Pituitary MRI showed significant enlargement of pituitary gland and stalk. Chest CT suggested IgG4-related lung disease. IgG4-related infundibulo-hypophysitis was diagnosed based on the above mentioned past history and results of present examinations. Twenty mg of hydrocortisone, followed by 20 mg of prednisolone (PSL) and 25 ?g of levothyroxine markedly reduced serum IgG4 levels and ameliorated the symptom, the size of pituitary and stalk, and anterior pituitary function (TSH, GH and gonadotropin), although diabetes insipidus became apparent due to glucocorticoid administration. This is a typical case of IgG4-related hypophysitis in which PSL causes marked improvement of pituitary mass and pituitary function along with the reduction of serum IgG4 levels. PMID:24335007

  2. Management of ocular, orbital, and adnexal trauma

    SciTech Connect

    Spoor, T.C.; Nesi, F.A.

    1988-01-01

    This book contains 20 chapters. Some of the chapter titles are: The Ruptured Globe: Primary Care; Corneal Trauma, Endophthalmitis; Antibiotic Usage; Radiology of Orbital Trauma; Maxillofacial Fractures; Orbital Infections; and Basic Management of Soft Tissue Injury.

  3. Decreased Expression of Innate Immunity-Related Genes in Peripheral Blood Mononuclear Cells from Patients with IgG4-Related Disease

    PubMed Central

    Nakajima, Akio; Masaki, Yasufumi; Nakamura, Takuji; Kawanami, Takafumi; Ishigaki, Yasuhito; Takegami, Tsutomu; Kawano, Mitsuhiro; Yamada, Kazunori; Tsukamoto, Norifumi; Matsui, Shoko; Saeki, Takako; Okazaki, Kazuichi; Kamisawa, Terumi; Miyashita, Taiichiro; Yakushijin, Yoshihiro; Fujikawa, Keita; Yamamoto, Motohisa; Hamano, Hideaki; Origuchi, Tomoki; Hirata, Shintaro; Tsuboi, Hiroto; Sumida, Takayuki; Morimoto, Hisanori; Sato, Tomomi; Iwao, Haruka; Miki, Miyuki; Sakai, Tomoyuki; Fujita, Yoshimasa; Tanaka, Masao; Fukushima, Toshihiro; Okazaki, Toshiro; Umehara, Hisanori

    2015-01-01

    Background IgG4-related disease (IgG4-RD) is a new clinical entity of unknown etiology characterized by elevated serum IgG4 and tissue infiltration by IgG4-positive plasma cells. Although aberrancies in acquired immune system functions, including increases in Th2 and Treg cytokines observed in patients with IgG4-RD, its true etiology remains unclear. To investigate the pathogenesis of IgG4-RD, this study compared the expression of genes related to innate immunity in patients with IgG4-RD and healthy controls. Materials and Methods Peripheral blood mononuclear cells (PBMCs) were obtained from patients with IgG4-RD before and after steroid therapy and from healthy controls. Total RNA was extracted and DNA microarray analysis was performed in two IgG4-RD patients to screen for genes showing changes in expression. Candidate genes were validated by real-time RT-PCR in 27 patients with IgG4-RD and 13 healthy controls. Results DNA microarray analysis identified 21 genes that showed a greater than 3-fold difference in expression between IgG4-RD patients and healthy controls and 30 genes that showed a greater than 3-fold change in IgG4-RD patients following steroid therapy. Candidate genes related to innate immunity, including those encoding Charcot–Leyden crystal protein (CLC), membrane-spanning 4-domain subfamily A member 3 (MS4A3), defensin alpha (DEFA) 3 and 4, and interleukin-8 receptors (IL8R), were validated by real-time RT-PCR. Expression of all genes was significantly lower in IgG4-RD patients than in healthy controls. Steroid therapy significantly increased the expression of DEFA3, DEFA4 and MS4A3, but had no effect on the expression of CLC, IL8RA and IL8RB. Conclusions The expression of genes related to allergy or innate immunity, including CLC, MS4A3, DEFA3, DEFA4, IL8RA and IL8RB, was lower in PBMCs from patients with IgG4-RD than from healthy controls. Although there is the limitation in the number of patients applied in DNA microarray, impaired expression of genes related to innate immunity may be involved in the pathogenesis of IgG4-RD as well as in abnormalities of acquired immunity. PMID:25973893

  4. A Mass in the Junction of the Body and Tail of the Pancreas with Negative IgG4 Serology: IgG4-Related Disease with Negative Serology

    PubMed Central

    Rodriguez, Eduardo A.; Williams, Frederick K.

    2015-01-01

    Patient:Female, 55 Final Diagnosis: Autoimmune pancreatitis Symptoms: Abdominal pain • weight loss Medication: Prednisone Clinical Procedure: Admitted to the hospital Specialty: Gastroenterology and Hepatology Objective: Challenging differential diagnosis Background: Autoimmune pancreatitis is an IgG4-related fibroinflammatory condition often associated with obstructive jaundice, as most lesions are located at the head of the pancreas. IgG4 level can help in the diagnosis, but it is normal in nearly 30% of affected patients. Case Report: A 55-year-old woman presented with a 5-month history of 20-pound unintentional weight loss and intermittent abdominal pain. She had an unremarkable abdominal exam and significant findings included a small, non-mobile rubbery left axillary lymph node. Complete blood count, complete metabolic panel, amylase, anti-smooth muscle antibody, antimitochondrial antibody, carcinoembryonic antigen, Ca 19-9, complement C3 and C4, antinuclear antibody, anti-Smith double-strand antibody, and IgG4 were all within normal limits. CT of the abdomen showed a mass in the junction of the body and tail of the pancreas and endoscopic ultrasound showed it as encasing the splenic artery. Fine-needle aspiration cytology demonstrated follicular hyperplasia, obliterative phlebitis, storiform fibrosis, and negative staining for IgG4 and malignancy. Left axillary lymph node biopsy demonstrated follicular hyperplasia. PET scan revealed hypermetabolic uptake of the pancreas tail, bone marrow, and spleen, as well as diffuse lymphadenopathy. Bone marrow biopsy showed follicular hyperplasia and was negative for malignancy. The patient was started on 40 mg of oral prednisone for possible autoimmune disease. During follow-up, she reported progressive improvement and a repeat PET scan 6 months later showed marked improvement. Conclusions: A normal IgG4 value should not decrease the clinical suspicion of IgG4-related disease. If clinical, histological, and radiological findings coincide, glucocorticoids should be initiated with subsequent follow-up to evaluate for a response. PMID:26001036

  5. Adnexal masses in children and adolescents.

    PubMed

    Kelleher, Cassandra M; Goldstein, Allan M

    2015-03-01

    Adnexal masses in children encompass a variety of lesions of the ovaries and fallopian tubes, including ovarian cysts and tumors (benign or malignant), fallopian tube cysts and abscesses, paratubal cysts, and endometriomas. When developing a differential diagnosis for adnexal masses in childhood, the clinician must have a broad understanding of adnexal pathology and consider the patient's age, presenting complaints, physical examination findings, and imaging results to generate a list of possible diagnoses and the appropriate treatment plan. We review the clinical presentation of these lesions and discuss the current recommendations for their management. PMID:25551698

  6. Solitary lesions with fibrosis and increased IgG4+ plasma cells: part of the expanding spectrum of IgG4-related disease or a nonspecific inflammatory response?

    PubMed

    Lee, Lik Hang; Shaffer, Eldon A; Falck, Vincent; Kelly, Margaret M

    2014-04-01

    We assessed 6 cases acquired during routine surgical sign-out for IgG4-related disease (IRD) according to criteria from a recent consensus meeting. These cases fulfilled the morphologic criteria-that is, dense lymphoplasmacytic infiltrates, IgG4:IgG ratio greater than or equal to 0.4, and fibrosis (storiform in 4 cases-but were associated with malignancy or did not fulfill the criteria for a new site. These criteria include increased serum IgG4 (normal in the majority of IRD) and a response to glucocorticoids, which is not appropriate treatment for resectable lesions as in our cases. Until more is known about the natural history of the disease, we propose that the possibility of an early, localized, or forme fruste of IRD should be considered and that cases associated with malignancy should at least be documented. Although we acknowledge the value of the consensus criteria, their strict application may result in missed opportunities to study the disease. PMID:24344155

  7. Extranodal Rosai-Dorfman disease involving appendix and mesenteric nodes with a protracted course: report of a rare case lacking relationship to IgG4-related disease and review of the literature

    PubMed Central

    Zhao, Ming; Li, Changshui; Zheng, Jiangjiang; Yu, Jingjing; Sha, Hongcun; Yan, Minghui; Jin, Jie; Sun, Ke; Wang, Zhaoming

    2013-01-01

    Rosai-Dorfman disease (RDD), also known as sinus histiocytosis with massive lymphadenopathy, is a rare disease of unknown etiology that typically presents as nodal disease in young children. However, it also can present in various extranodal sites and can be difficult to recognize if not considered in the differential diagnosis. Here, we report a case of appendix involvement by extranodal RDD, which occurred in a 69-year-old woman with a long duration of 12 years for intermittent right lower quadrant pain. The patient underwent a right hemicolectomy for a clinical diagnosis of appendiceal cancer. A mixed inflammatory infiltration of mature lymphocytes, plasma cells and histiocytes exhibiting emperipolesis were indentified. Other areas had storiform fibrosis and sclerosis admixed with numerous plasma cells. These histologic features combination with immunoreactivity for CD68 and S100 protein were indicative of a diagnosis of extranodal RDD. We discuss the clinical, pathologic findings as well as differential diagnoses and consideration of a possible relationship of this entity to IgG4-related lesion. PMID:24228122

  8. Increased IgG4 responses to multiple food and animal antigens indicate a polyclonal expansion and differentiation of pre-existing B cells in IgG4-related disease

    PubMed Central

    Culver, Emma L; Vermeulen, Ellen; Makuch, Mateusz; van Leeuwen, Astrid; Sadler, Ross; Cargill, Tamsin; Klenerman, Paul; Aalberse, Rob C; van Ham, S Marieke; Barnes, Eleanor; Rispens, Theo

    2015-01-01

    Background IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory condition, characterised by an elevated serum IgG4 concentration and abundant IgG4-positive plasma cells in the involved organs. An important question is whether the elevated IgG4 response is causal or a reflection of immune-regulatory mechanisms of the disease. Objectives To investigate if the IgG4 response in IgG4-RD represents a generalised polyclonal amplification by examining the response to common environmental antigens. Methods Serum from 24 patients with IgG4-RD (14 treatment-naive, 10 treatment-experienced), 9 patients with primary sclerosing cholangitis and an elevated serum IgG4 (PSC-high IgG4), and 18 healthy controls were tested against egg white and yolk, milk, banana, cat, peanut, rice and wheat antigens by radioimmunoassay. Results We demonstrated an elevated polyclonal IgG4 response to multiple antigens in patients with IgG4-RD and in PSC-high IgG4, compared with healthy controls. There was a strong correlation between serum IgG4 and antigen-specific responses. Responses to antigens were higher in treatment-naive compared with treatment-experienced patients with IgG4-RD. Serum electrophoresis and immunofixation demonstrated polyclonality. Conclusions This is the first study to show enhanced levels of polyclonal IgG4 to multiple antigens in IgG4-RD. This supports that elevated IgG4 levels reflect an aberrant immunological regulation of the overall IgG4 response, but does not exclude that causality of disease could be antigen-driven. PMID:25646372

  9. Surgical intervention for adnexal masses during pregnancy

    PubMed Central

    Telli, E; Yalcin, O T; Ozalp, S S; Hassa, H

    2013-01-01

    We aimed to evaluate the influence of surgical intervention on gestational and neonatal outcomes in women who underwent elective surgery in the second trimester of gestation because of an adnexal mass. We retrospectively reviewed the hospital records of women who underwent elective surgery for adnexal masses in the second trimester of gestation between 2006 and 2012. The ages of the women ranged between 17 and 33?years. Eight women underwent a laparotomy, and one woman, who aborted on the day of the operation, underwent a laparoscopy. Dermoid cysts, cystadenoma and borderline ovarian tumours were present in four, two and two of the women, respectively. Eight women had no complications after surgery and delivered healthy newborns at term. We concluded that elective surgery on an adnexal mass in the second trimester of gestation is safe for both the mother and the fetus. PMID:23814228

  10. Surgical Management of Adnexal Masses in Pregnancy

    PubMed Central

    Cheung, Vincent Y. T.; Pun, Ting-Chung

    2014-01-01

    Background and Objectives: Our objective was to review the surgical management, surgical outcomes, and obstetric outcomes of adnexal masses in pregnancy. Methods: A retrospective review was performed of pregnant women before 20 weeks of gestation who underwent laparoscopy or laparotomy for management of an adnexal mass during the period of January 2005 to June 2012 at a university-affiliated hospital. Results: Thirty-five pregnant women underwent surgical removal of adnexal masses during the 7.5-year study period: 21 (60.0%) underwent laparoscopic surgery, and 14 (40.0%) underwent laparotomy. The left upper quadrant entry technique was used in 20 women. Conversion to laparotomy was required in 2 women because of extensive pelvic adhesions. The mean gestational age at surgery was 15.2 ± 1.9 weeks. All women had undergone ovarian cystectomy. A malignant mass was found in 3 (8.6%) women. The laparoscopy group had a significantly less blood loss (67.4 ± 55.8 vs 153.6 ± 181.0 mL, P = .048) and shorter mean hospital stay (2.8 ± 1.0 vs 3.8 ± 1.1 days, P = .006) than the laparotomy group. One woman miscarried soon after surgery. There was no significant difference in obstetric outcomes between the laparoscopy and laparotomy groups. Conclusion: Surgical management of adnexal masses during pregnancy appears to have favorable outcomes for the mother and the fetus. PMID:24680147

  11. [Clinical presentation of cutaneous adnexal tumors].

    PubMed

    Zelger, B; Kazakov, D V; Zelger, B G

    2014-09-01

    Cutaneous adnexal lesions can sometimes be clinically diagnosed even by an experienced clinician or a differential diagnosis can at least be narrowed down. However, clinical findings alone cannot replace histological investigations and diagnosis or make them superfluous. This expertise is based on an algorithm which first differentiates inflammatory pseudo-tumors, such as ruptured infundibular cysts (atheroma) from authentic neoplastic adnexal lesions. In a second step criteria of regularity and/or chaos, such as asymmetry, irregular border, color variation and/or destruction with exulceration help to evaluate the dignity. In a third step criteria of differentiation allow the characterization of lesions varying in size from macules to papules, plaques, nodules and tumors to the subgroups of adnexal differentiation. Infundibular differentiation is characterized by comedones and is skin-colored, yellow or white and hard. Follicular differentiation notifies hair and is skin-colored, pearl-like to occasionally brown-black and variably hard. Sebaceous differentiation signifies lobulation and is yellow to skin-colored or red and soft. Apocrine lesions are reddish and fleshy. Eccrine differentiation shows either papillary reddish-brown (differential diagnosis viral warts) or skin-colored hard lesions. Multiple, monomorphous lesions are characteristic of syndromes, such as Spiegler-Brooke-Fend, Birt-Hogg-Dubé, Muir-Torre, and Gorlin-Goltz.One peculiarity of adnexal lesions is their potential to form cysts. Cysts with horny or hairy material are skin-colored to yellow, with glandular fluid fluctuation, a bluish character, and with illumination a Tyndall phenomenon becomes obvious, while ruptured cysts reveal an erythematous-reddish, ill-defined foreign body reaction. Brown to bluish-gray and black color is seen by the presence of melanocytes with melanin in lesions with mostly follicular differentiation. Strong vascularization and bleeding are reddish, soft, spongy and compressible and in due course variably dark due to the presence of hemosiderin. PMID:25154603

  12. Isolated intrapancreatic IgG4-related sclerosing cholangitis

    PubMed Central

    Nakazawa, Takahiro; Ikeda, Yushi; Kawaguchi, Yoshiaki; Kitagawa, Hirohisa; Takada, Hiroki; Takeda, Yutaka; Makino, Isamu; Makino, Naohiko; Naitoh, Itaru; Tanaka, Atsushi

    2015-01-01

    Immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) is frequently associated with type 1 autoimmune pancreatitis (AIP). Association with AIP can be utilized in the diagnosis of IgG4-SC. However, some cases of IgG4-SC are isolated from AIP, which complicates the diagnosis. Most of the reported cases of isolated IgG4-SC displayed hilar biliary strictures, whereas isolated IgG4-SC with intrapancreatic biliary stricture is very rare. Recently, we have encountered 5 isolated intrapancreatic IgG4-SC cases that were not associated with AIP, three of which were pathologically investigated after surgical operation. They all were males with a mean age of 74.2 years. The pancreas was not enlarged in any of these cases. No irregular narrowing of the main pancreatic duct was found. Bile duct wall thickening in lesions without luminal stenosis was detected by abdominal computed tomography in all five cases, by endoscopic ultrasonography in two out of four cases and by intraductal ultrasonography in all three cases. In three cases, serum IgG4 levels were within the normal limits. The mean serum IgG4 level measured before surgery was 202.1 mg/dL (4 cases). Isolated intrapancreatic IgG4-SC is difficult to diagnose, especially if the IgG4 level remains normal. Thus, this type of IgG4-SC should be suspected in addition to cholangiocarcinoma and pancreatic cancer if stenosis of intrapancreatic bile duct is present. PMID:25632210

  13. Autoimmune pancreatitis and IgG4-related sclerosing disease

    Microsoft Academic Search

    Kensuke Takuma; Naoto Egawa; Koji Tsuruta; Tsuneo Sasaki; Terumi Kamisawa

    2010-01-01

    Autoimmune pancreatitis (AIP) is a unique form of pancreatitis in which the pathogenesis is suspected to involve autoimmune mechanisms. AIP sometimes mimics pancreatic cancer in its presentation, but as AIP responds dramatically to steroid therapy, accurate diagnosis is necessary. AIP is currently diagnosed on the basis of a combination of characteristic clinical, serological, morphological and histopathological features. However, its diagnosis

  14. Nontuberculous Mycobacterial Ocular Infections: A Systematic Review of the Literature

    PubMed Central

    Kheir, Wajiha J.; Sheheitli, Huda; Abdul Fattah, Maamoun; Hamam, Rola N.

    2015-01-01

    Nontuberculous or atypical mycobacterial ocular infections have been increasing in prevalence over the past few decades. They are known to cause periocular, adnexal, ocular surface and intraocular infections and are often recalcitrant to medical therapy. These infections can potentially cause detrimental outcomes, in part due to a delay in diagnosis. We review 174 case reports and series on nontuberculous mycobacterial (NTM) ocular infections and discuss etiology, microbiology, risk factors, diagnosis, clinical presentation, and treatment of these infections. History of interventions, trauma, foreign bodies, implants, contact lenses, and steroids are linked to NTM ocular infections. Steroid use may prolong the duration of the infection and cause poorer visual outcomes. Early diagnosis and initiation of treatment with multiple antibiotics are necessary to achieve the best visual outcome.

  15. Perineural cysts resembling complex cystic adnexal masses on transvaginal sonography.

    PubMed

    Saboo, Sachin S; Di Salvo, Donald

    2013-01-01

    Perineural cysts may be discovered incidentally on pelvic sonography and can easily mimic more common gynecologic masses. We report the complex cystic adnexal mass like appearance of these incidentally noted cysts which mimicked malignancy on sonography in a postmenopausal female, with stage I breast cancer and vaginal spotting. PMID:22105304

  16. Optical coherence tomography imaging of ocular and periocular tumours

    PubMed Central

    Medina, Carlos A; Plesec, Thomas; Singh, Arun D

    2014-01-01

    Optical coherence tomography (OCT) has become pivotal in the practice of ophthalmology. Similar to other ophthalmic subspecialties, ophthalmic oncology has also incorporated OCT into practice. Anterior segment OCT (AS-OCT), ultra-high resolution OCT (UHR-OCT), spectral domain OCT (SD-OCT) and enhanced depth imaging OCT (EDI-OCT), have all been described to be helpful in the diagnosis, treatment planning and monitoring response of ocular and periocular tumours. Herein we discuss the role of OCT including the advantages and limitations of its use in the setting of common intraocular and adnexal tumours. PMID:24599420

  17. Added Value of Using a CT Coronal Reformation to Diagnose Adnexal Torsion

    PubMed Central

    Jung, Sung Il; Park, Hee Sun; Yim, Younghee; Jeon, Hae Jeong; Yu, Mi Hye; Kim, Young Jun

    2015-01-01

    Objective To evaluate the increased value of using coronal reformation of a transverse computed tomography (CT) scan for detecting adnexal torsion. Materials and Methods This study included 106 woman suspected of having adnexal torsion who underwent CT with coronal reformations and subsequent surgical exploration. Two readers independently recorded the CT findings, such as the thickening of a fallopian tube, twisting of the adnexal pedicle, eccentric smooth wall thickening of the torsed adnexal mass, eccentric septal thickening of the torsed adnexal mass, eccentric poor enhancement of the torsed adnexal mass, uterine deviation to the twisted side, ascites or infiltration of pelvic fat, and the overall impression of adnexal torsion with a transverse scan alone or combined with coronal reformation and a transverse scan. The areas under the receiver operating characteristic curves (AUCs), sensitivity, specificity, and positive predictive value were used to compare diagnostic performance. Results Fifty-two patients were confirmed to have adnexal torsion. The addition of coronal reformations to the transverse scan improved AUCs for readers 1 and 2 from 0.74 and 0.75 to 0.92 and 0.87, respectively, for detecting adnexal torsion (p < 0.001 and p = 0.004, respectively). Sensitivity of CT for detecting twisting of the adnexal pedicle increased significantly for readers 1 and 2 from 0.27 and 0.29 with a transverse scan alone to 0.79 and 0.77 with a combined coronal reformation and a transverse scan, respectively (p < 0.001 and p < 0.001, respectively). Conclusion Use of a coronal reformation with transverse CT images improves detection of adnexal torsion.

  18. Ocular sarcoidosis.

    PubMed

    Bodaghi, Bahram; Touitou, Valérie; Fardeau, Christine; Chapelon, Catherine; LeHoang, Phuc

    2012-06-01

    Sarcoidosis, a chronic multisystem disease, is a common cause of ocular inflammation. Even though clinical features are well-established, diagnosis requires histological confirmation, which remains difficult in patients with uveitis. Thus, the frequency of ocular sarcoidosis is overestimated. A set of criteria has been recently established in order to improve the diagnostic procedure. New imaging tools will enable the ophthalmologist to evaluate the level of ocular inflammation and to monitor its resolution after treatment initiation. Indocyanine green angiography and optical coherence tomography have dramatically improved our understanding of choroidal granulomas and macular edema. Treatment is based on topical and systemic corticosteroids in most of the cases, but immuno-suppressive agents may be necessary. The visual outcome remains favorable but severe complications, including glaucoma, cystoid macular edema and choroidal neovascularization, may need a prompt and aggressive management. PMID:22595776

  19. A Clinicopathological Study of Women with Adnexal Masses Presenting with Acute Symptoms

    PubMed Central

    Al-Shukri, M; Mathew, M; Al-Ghafri, W; Al-Kalbani, M; Al-Kharusi, L; Gowri, V

    2014-01-01

    Background: Abdominal pain is one of the most common presentations of adnexal pathology in gynecology. Early diagnosis and intervention is essential especially in adolescent girls and reproductive age group women to conserve reproductive function. Aim: The purpose of the following study is to assess the clinicopathologic outcome of women with adnexal masses presenting with acute pain. Subjects and Methods: A retrospective study of women with adnexal masses who had surgical intervention for acute symptoms from June 2007 to May 2012 was undertaken. During the study period, a total of 57 women were operated for adnexal masses as emergency. Results: Of the 57 women operated for adnexal masses as emergency, the most common pathology was teratoma 26% (15/57) followed by corpus luteal hemorrhage (16%) and endometriosis (14%). Laparoscopy was the initial surgical approach in just over 50% of patients, but surgery was completed laparoscopically only in about one-third of patients. Conservative surgery in the form of ovarian cystectomy was possible in 70% of patients. Conclusion: Complications of adnexal masses such as torsion and hemorrhage are common causes of acute abdominal pain. Timely diagnosis of the adnexal pathology and surgical intervention will help to preserve the reproductive outcome. Conservative surgery was possible in 70% of our study group. PMID:24761256

  20. Ocular onchocerciasis

    PubMed Central

    Thylefors, B.

    1978-01-01

    Well over 20 million people in the world are infected with Onchocerca volvulus and it is probable that 200 000-500 000 people are blind as a result of this infection, which is the most important cause of blindness in certain areas of Africa and Latin America. Treatment of the disease is difficult and often produces serious adverse reactions in the patient. Combined use of diethylcarbamazine citrate and suramin is still the most suitable form of treatment. Screening for the early detection of cases at high risk of ocular manifestations must be organized, and their treatment undertaken, if blindness is to be avoided. Prevention of ocular onchocerciasis is feasible, using vector control methods to reduce transmission, but the procedures are costly and may have to be maintained for many years. Research is needed to improve treatment and to find a chemoprophylactic agent or a preventive vaccine. PMID:307448

  1. Adnexal Torsion during Pregnancy after Oocyte In Vitro Maturation and Intracytoplasmic Sperm Injection Cycle

    PubMed Central

    Giulini, Simone; Dante, Giulia; Xella, Susanna; La Marca, Antonio; Marsella, Tiziana; Volpe, Annibale

    2010-01-01

    We report a case of right adnexal torsion during pregnancy after an oocyte in vitro maturation and intracitoplasmic sperm injection cycle in patient with polycystic ovary syndrome. A 31-year-old woman with a typical clinical disorder of polycystic ovarian syndrome was included in an oocyte in vitro maturation program. Right adnexal torsion occurred two days after embryo transfer, and laparoscopy detorsion was successfully performed with preservation of adnexa. The patient had a full-term pregnancy and delivered a healthy infant at 40 weeks of gestation. To our knowledge this is the first report of adnexal torsion after an oocyte in vitro maturation and intracitoplasmic sperm injection program. PMID:20814540

  2. 76 FR 22322 - Medical Devices; Immunology and Microbiology Devices; Classification of Ovarian Adnexal Mass...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-21

    ...SERVICES Food and Drug Administration 21 CFR Part 866 [Docket No. FDA-2010-N-0026] Medical Devices; Immunology and Microbiology Devices; Classification of Ovarian Adnexal Mass Assessment Score Test System; Correction AGENCY: Food and Drug...

  3. Ocular neuromyotonia.

    PubMed Central

    Ezra, E; Spalton, D; Sanders, M D; Graham, E M; Plant, G T

    1996-01-01

    AIMS/BACKGROUND: Ocular neuromyotonia is characterised by spontaneous spasm of extraocular muscles and has been described in only 14 patients. Three further cases, two with unique features, are described, and the underlying mechanism reviewed in the light of recent experimental evidence implicating extracellular potassium concentration in causing spontaneous firing in normal and demyelinated axons. METHODS: Two patients had third nerve neuromyotonia, one due to compression by an internal carotid artery aneurysm, which has not been reported previously, while the other followed irradiation of a pituitary tumour, a common association in the published reports. Selective activation occurred in both, where neuromyotonic activity was triggered by prolonged voluntary activation of specific extraocular muscles with or without spread of activity to other third nerve muscles. The other patient had fourth nerve involvement, where spasms of the superior oblique muscle were induced only by alcohol, a phenomenon which has not been described. RESULTS: The two patients with third nerve involvement responded to carbamazepine and in one, an improvement in a chronic partial third nerve paresis occurred. The other has not required treatment and remains asymptomatic by refraining from alcohol. CONCLUSIONS: A careful examination, including the effects of prolonged voluntary muscle action is required to initiate episodes and to demonstrate selective activation. Imaging is mandatory to exclude compressive intracranial lesions, particularly where there is no history of pituitary fossa irradiation. A trial of anticonvulsants should be considered in all patients. Extracellular potassium may play a role in spontaneous firing and ephatic transmission in ocular neuromyotonia. Images PMID:8703889

  4. Ocular dispersion

    NASA Astrophysics Data System (ADS)

    Hammer, Daniel X.; Noojin, Gary D.; Thomas, Robert J.; Stolarski, David J.; Rockwell, Benjamin A.; Welch, Ashley J.

    1999-06-01

    Spectrally resolved white-light interferometry (SRWLI) was used to measure the wavelength dependence of refractive index (i.e., dispersion) for various ocular components. The accuracy of the technique was assessed by measurement of fused silica and water, the refractive indices of which have been measured at several different wavelengths. The dispersion of bovine and rabbit aqueous and vitreous humor was measured from 400 to 1100 nm. Also, the dispersion was measured from 400 to 700 nm for aqueous and vitreous humor extracted from goat and rhesus monkey eyes. For the humors, the dispersion did not deviate significantly from water. In an additional experiment, the dispersion of aqueous and vitreous humor that had aged up to a month was compared to freshly harvested material. No difference was found between the fresh and aged media. An unsuccessful attempt was also made to use the technique for dispersion measurement of bovine cornea and lens. Future refinement may allow measurement of the dispersion of cornea and lens across the entire visible and near-infrared wavelength band. The principles of white- light interferometry including image analysis, measurement accuracy, and limitations of the technique, are discussed. In addition, alternate techniques and previous measurements of ocular dispersion are reviewed.

  5. Ocular allergy.

    PubMed

    Bielory, Leonard

    2011-01-01

    The eye is probably the most common site for the development of allergic inflammatory disorders, because it has no mechanical barrier to prevent the impact of allergens such as pollen on its surface. Physicians in various specialties and subspecialties who provide some form of primary care frequently encounter various forms of inflammation of the anterior surface of the eye that present as "red eye." However, the eye is rarely the only target for an immediate allergic-type response. Typically, many patients have other combinations of allergic disorders, such as rhinoconjunctivitis, rhinosinusitis, asthma, urticaria, or eczema. Even so, ocular signs and symptoms can frequently be the most prominent features of the entire allergic response for which a patient visits his or her physician. An improved differential diagnosis provides the basis for improved treatment algorithms. Over the past 20 years, we have witnessed an astonishing growth in therapeutic advances, ranging essentially from derivatives of simple aspirin to various newly developed biologic immunomodulatory agents, utilizing implantable drug-delivery devices that exceed the safety and efficacy of those available for other organ systems, and resorting to advanced surgical techniques for the correction of sight-threatening, disease-related complications. Overall, with the expanding knowledge base, the intricacy of ocular inflammation appears to be becoming ever more manageable and, with the team approach between the primary care physician, the ophthalmologist, and the clinical allergist/immunologist, the new "immuno-ophthalmology" approach improves patient outcomes. PMID:21913203

  6. Ocular Pentastomiasis in the Democratic Republic of the Congo

    PubMed Central

    Sulyok, Mihály; Rózsa, Lajos; Bodó, Imre

    2014-01-01

    Ocular pentastomiasis is a rare infection caused by the larval stage of pentastomids, an unusual group of crustacean-related parasites. Zoonotic pentastomids have a distinct geographical distribution and utilize reptiles or canids as final hosts. Recently, an increasing number of human abdominal infections have been reported in Africa, where pentastomiasis is an emerging, though severely neglected, tropical disease. Here we describe four ocular infections caused by pentastomids from the Democratic Republic of the Congo. Two cases underwent surgery and an Armillifer grandis infection was detected by morphological and molecular approaches. Thus far, 15 other cases of ocular pentastomiasis have been reported worldwide. Twelve cases were caused by Armillifer sp., recorded almost exclusively in Africa, where such infections occur as a consequence of hunting and consuming snakes, their final hosts. Seven further cases were caused by Linguatula serrata, a cosmopolitan pentastomid whose final hosts are usually canids. Intraocular infections caused permanent visual damage in 69% and a total loss of vision in 31% of reported cases. In contrast, ocular adnexal cases had a benign clinical course. Further research is required to estimate the burden, therapeutic options and pathogenesis of this neglected disease. PMID:25058608

  7. A 44-year-old man with bilateral eyelid swelling.

    PubMed

    Ricketti, Anthony J; Cleri, Dennis J; Moser, Robert L; Bilyk, Jurij R; Vernaleo, John R; Unkle, David W

    2012-01-01

    Swollen eyelids are commonly ascribed to allergic conjunctivitis, contact dermatitis, eczema, angioedema, or acute sinusitis. The differential diagnosis extends to thyroid eye disease; blepharitis; Sjögren's syndrome; Churg-Strauss vasculitis; Wegener's granulomatosis; Gleich syndrome; orbital and ocular lymphoid hyperplasia or adnexal lymphoma; idiopathic orbital inflammatory disease/idiopathic sclerosing orbital inflammation; rarely, orbital parasitosis; and IgG4-related diseases. The likely diagnosis proceeds from the more to the less common in patients without a history of allergy or infection. Both ocular lymphoid hyperplasia and ocular adnexal lymphoma must be considered in the differential diagnosis of persistent disease, and neither of these entities can be recognized or differentiated from one another clinically or radiologically. Early diagnosis is essential because therapy may consist of frequent follow-up and/or active intervention. Outcomes in patients treated early and appropriately are often favorable. PMID:22525399

  8. Laparoscopic Treatment of 1522 Adnexal Masses: An 8-Year Experience

    PubMed Central

    Grammatikakis, I.; Trompoukis, P.; Zervoudis, S.; Mavrelos, C.; Economides, P.; Tziortzioti, V.; Evangelinakis, N.; Kassanos, D.

    2015-01-01

    Objective. To reevaluate the long-term effectiveness and safety of laparoscopy in benign ovarian pathology. Materials and Methods. 1522 women with benign adnexal cysts, laparoscopically treated in the 3rd Department of Ob/Gyn, General University hospital “Attikon” and “Lito” Maternity Hospital between July 1998 and December 2006, were included. Results. The diagnosis in 1222 (80,6%) cases was endometriosis of the ovary, 60 (4%) hydrosalpinx, 51 (3,3%) serous cystadenomas, 44 (2,9%) dermoid ovarian cyst, 38 (2,5%) borderline tumors, 35 (2,3%) unruptured follicles, and 33 (2,2%) paraovarian cysts. In 174 cases (11,5%) laparoscopy was converted to laparotomy due to technical difficulties or suspicion of cancer. In particular, laparotomy was performed in 119 (8%) women due to severe adhesions and 18 (1,2%) women due to bleeding that could not be controlled safely by laparoscopy. In 36 (2,4%) women frozen section during operation revealed malignancy and laparoscopy was converted to laparotomy. A few operative complications were recorded like post-op fever, small hematomas at the trocar entries. Conclusions. Laparoscopic surgery seems to offer significant advantages such as reduced hospital stay, less adverse effects, better quality of life, and superior vision especially on surgical treatment of cases like endometriosis. PMID:25762854

  9. Skin adnexal neoplasms—part 2: An approach to tumours of cutaneous sweat glands

    PubMed Central

    Obaidat, Nidal A; Alsaad, Khaled O; Ghazarian, Danny

    2007-01-01

    Tumours of cutaneous sweat glands are uncommon, with a wide histological spectrum, complex classification and many different terms often used to describe the same tumour. Furthermore, many eccrine/apocrine lesions coexist within hamartomas or within lesions with composite/mixed differentiation. In addition to the eccrine and apocrine glands, two other skin sweat glands have recently been described: the apoeccrine and the mammary?like glands of the anogenital area. In this review (the second of two articles on skin adnexal neoplasms), common as well as important benign and malignant lesions of cutaneous sweat glands are described, and a summary for differentiating primary adnexal neoplasms from metastatic carcinoma is outlined, striving to maintain a common and acceptable terminology in this complex subject. Composite/mixed adnexal tumours are also discussed briefly. PMID:16882695

  10. Ocular pathology for clinicians. 6. Lymphoid tumor of the lid.

    PubMed

    Jakobiec, F A; Gibralter, R A; Knowles, D M; Iwamoto, T

    1980-10-01

    A 56-year-old white man presented with bilateral inferior lid tumors with a rubbery consistency suggesting lymphoid lesions. An excisional biopsy specimen of the larger lesion in the left lower lid led to routine pathologic, immunologic, histochemical, and electron microscopic investigations. The tumor displayed a diffuse pattern microscopically and was composed of atypical lymphocytes with intermediate differentiation. The immunologic and histochemical marker studies revealed that 90% of the constituent lymphocytes were B-lymphocytes bearing IgM-IgD immunoglobulins on their surface membranes; the remaining 10% of the cells being reactive T-lymphocytes. A diagnosis of a monoclonal proliferation was established and a systemic workup revealed disseminated lymphoma. The use of immunoglobulin and histochemical analyses of ocular adnexal lymphoid tumors is outlined. PMID:6972500

  11. Unidirectional ocular flutter

    Microsoft Academic Search

    S Verhaeghe; R Diallo; T Nyffeler; S Rivaud-Pe?choux; B Gaymard

    2007-01-01

    Ocular flutter is a rare abnormal eye movement consisting of irregular bursts of to-and-fro bidirectional horizontal saccades and is frequently encountered in association with cerebellar symptoms. We present a patient with a probable post-infectious ocular flutter that exhibited characteristics not previously reported in the literature. Bursts of ocular flutter consisted almost exclusively of initial rightward saccades and were clearly influenced

  12. Transvaginal single-port natural orifice transluminal endoscopic surgery for benign uterine adnexal pathologies.

    PubMed

    Ahn, Ki Hoon; Song, Jae Yun; Kim, Sun Haeng; Lee, Kyu Wan; Kim, Tak

    2012-01-01

    Transvaginal natural orifice transluminal endoscopic surgery (NOTES) with pneumoperitoneum has been used in cholecystectomies, appendectomies, and nephrectomies, but transvaginal NOTES using a single port in gynecologic procedures has not been described despite gynecologist familiarity with the vaginal approach. We performed transvaginal single-port NOTES in 10 women with benign uterine adnexal disease: oophorectomy in 3 patients, salpingostomy and salpingectomy in 2 each, and ovarian cystectomy, paratubal cystectomy, and ovarian wedge resection in 1 each. The patients were discharged at 1 or 2 days postoperatively, and were satisfied, with minimal pain, no abdominal scar, and no complications at 2-month follow-up. We conclude that transvaginal single-port NOTES to treat benign uterine adnexal disease is a feasible and attractive option. PMID:22763314

  13. Laparoendoscopic Single-Site Surgery for the Treatment of Benign Adnexal Disease: A Prospective Trial

    PubMed Central

    Fagotti, Anna; Fanfani, Francesco; Rossitto, Cristiano; Marocco, Francesco; Gallotta, Valerio; Romano, Federico; Scambia, Giovanni

    2010-01-01

    Background. To validate feasibility, efficacy, and safeness of laparoscopic treatment of benign adnexal diseases through a single transumbilical access (LESS) in a prospective series of patients. Methods. A prospective clinical trial including 30 women has been conducted at the Division of Gynecology of Catholic University of Sacred Hearth of Rome. Patients underwent different laparoscopic procedures by LESS utilizing a multiport trocar and conventional straight laparoscopic instrumentation. Intra and perioperative outcome has been reported. Results. Ten mono/bilateral adnexectomies and 20 cystectomies have been performed by LESS approach. Laparoscopic procedures were completed through a single access in 28 cases (93.4%). No major intra- or postoperative complications were observed. Mean hospital stay was 1.3 days. Conclusions. LESS approach is feasible to treat benign adnexal disease with a very low conversion rate and no early or late complications. More clinical data are needed to confirm these advantages compared to standard laparoscopic technique. PMID:20169051

  14. Laparoendoscopic single-site surgery for the treatment of benign adnexal disease: a prospective trial.

    PubMed

    Fagotti, Anna; Fanfani, Francesco; Rossitto, Cristiano; Marocco, Francesco; Gallotta, Valerio; Romano, Federico; Scambia, Giovanni

    2010-01-01

    Background. To validate feasibility, efficacy, and safeness of laparoscopic treatment of benign adnexal diseases through a single transumbilical access (LESS) in a prospective series of patients. Methods. A prospective clinical trial including 30 women has been conducted at the Division of Gynecology of Catholic University of Sacred Hearth of Rome. Patients underwent different laparoscopic procedures by LESS utilizing a multiport trocar and conventional straight laparoscopic instrumentation. Intra and perioperative outcome has been reported. Results. Ten mono/bilateral adnexectomies and 20 cystectomies have been performed by LESS approach. Laparoscopic procedures were completed through a single access in 28 cases (93.4%). No major intra- or postoperative complications were observed. Mean hospital stay was 1.3 days. Conclusions. LESS approach is feasible to treat benign adnexal disease with a very low conversion rate and no early or late complications. More clinical data are needed to confirm these advantages compared to standard laparoscopic technique. PMID:20169051

  15. A case of adenoid cystic carcinoma associated with IgG4-related disease

    PubMed Central

    Shimo, Tsuyoshi; Yao, Mayumi; Takebe, Yuichiro; Ono, Yuko; Obata, Kyoichi; Kurio, Naito; Ibaragi, Soichiro; Yoshioka, Norie; Kishimoto, Koji; Yanagi, Yoshinobu; Nagatsuka, Hitoshi; Sasaki, Akira

    2015-01-01

    Introduction Immunoglobulin G4-related disease (IgG4-RD) is an inflammatory condition associated with elevated serum IgG4 levels and tissue infiltration by IgG4-expressing plasma cells. We present a case of adenoid cystic carcinoma (ACC) of the submandibular gland with possible involvement of IgG4-RD. Presentation of case The patient was a 59-year-old man presenting with a swollen right submandibular gland. Laboratory tests revealed IgG4 levels of 176 mg/dl (reference range: 4.8–105). An initial open biopsy for histological diagnosis showed chronic sialadenitis. The region was monitored on an outpatient basis, and finally the right submandibular was totally resected because malignant tumor could not be excluded. Histological examination of the submandibular gland showed an ACC with lymphocytic infiltration containing many IgG4-positive plasma cells in the tumor stroma. Discussion We have described a case that indicated a possible involvement of ACC with IgG4-RD. This allows us to speculate that longstanding IgG4-RD may progress to malignancy or infiltration of IgG4-positive plasma cells through the signals of tumor stimuli. Further investigations are required to determine the potential pathogenic mechanism underlying this unique tumor. Conclusion This case underscores that caution is needed in the diagnosis of masses with high serum IgG4 levels, as the differential diagnosis includes malignancy. PMID:25781921

  16. A new clinicopathological entity of IgG4-related autoimmune disease

    Microsoft Academic Search

    Terumi Kamisawa; Nobuaki Funata; Yukiko Hayashi; Yoshinobu Eishi; Morio Koike; Kouji Tsuruta; Atsutake Okamoto; Naoto Egawa; Hitoshi Nakajima

    2003-01-01

    Background Autoimmune pancreatitis (AIP) is occasionally associated with other autoimmune diseases. Methods To investigate the pathophysiology of AIP, we immunohistochemically examined the pancreas and other organs in eight patients with AIP, and in controls, using anti-CD4-T and CD8-T cell subsets, as well as IgG4 antibodies. Results In AIP patients, severe or moderate infiltration of IgG4-positive plasma cells associated with CD4-

  17. IgG4-Related Systemic Disease Can Be Easily Mistaken as a Uroepithelial Tumor

    PubMed Central

    Han, Song Yi; Lee, Seung Ik; Lee, Yeon Hee; Kim, Ae Jin; Lim, Hye Jin; Ro, Han; Chang, Jae Hyun; Lee, Hyun Hee; Chung, Wookyung

    2015-01-01

    Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized systemic syndrome characterized by elevated serum IgG4 concentrations and tumefaction or tissue infiltration by IgG4-positive plasma cells. We experienced a case of IgG4-RD involving multiple organs in a 64-year-old female who was referred for a suspected uroepithelial tumor. A mass biopsy confirmed dense lymphoplasmacytic infiltration with an increased number of IgG4-positive plasma cells. We discuss this case and review the literature to bring IgG4-RD to the attention to clinicians because it responds dramatically well to steroid therapy and should be kept in mind as a differential diagnosis to avoid unnecessary surgery. PMID:25914879

  18. Severe IgG4-Related Disease in a Young Child: A Diagnosis Challenge

    PubMed Central

    Ferraz, Catarina; Nunes, Teresa; Fonseca, Elsa; Vaz, Luísa Guedes

    2015-01-01

    Immunoglobulin G4-related disease (IgG4-RD) is an increasingly recognized syndrome that can appear with multiple organ involvement, typically with tumor-like swelling, lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, and elevated serum IgG4 concentrations. We report the case of a 22-month-old female child with failure to thrive and recurrent respiratory tract infections since 8 months of age. Physical examination was normal except for pulmonary auscultation with bilateral crackles and wheezes. Laboratory tests revealed elevated erythrocyte sedimentation rate, and elevated serum IgG and IgG4 with polyclonal hypergammaglobulinemia. Thoracic CT and MRI showed multiple mediastinal lymphadenopathies and a nodular posterior mediastinal mass in right paratracheal location with bronchial compression. Initial fine needle aspiration biopsy was compatible with reactive lymphadenopathy but after clinical worsening a thoracoscopic partial resection of the mass was performed and tissue biopsy revealed lymphoplasmacytic infiltrate and increased number of IgG4-positive plasma cells and a ratio of IgG4/IgG positive cells above 40%. Glucocorticoids therapy was started with symptomatic improvement, reduction in the size of the mass, and decrease of serum IgG4 levels after 6 weeks. There are very few reports of IgG4-RD in children. Long-term follow-up is necessary to monitor relapses and additional organ involvement. PMID:25705537

  19. IgG4-related disease of the ileocecal region mimicking malignancy: A case report

    PubMed Central

    Hiyoshi, Yukiharu; Oki, Eiji; Zaitsu, Yoko; Ando, Koji; Ito, Shuhei; Saeki, Hiroshi; Morita, Masaru; Yamamoto, Hidetaka; Baba, Hideo; Maehara, Yoshihiko

    2014-01-01

    INTRODUCTION Immunoglobulin G4-related disease (IgG4-RD) is a systemic disease characterized by chronic fibrosing inflammation with abundant IgG4-positive plasma cells, and responds well to steroids. Previous reports of IgG4-RD have focused on pancreatic and extrapancreatic including the gastrointestinal tract, however, the colonic IgG4-RD is rare. PRESENTATION OF CASE We herein report the case of a 74-year-old female with edematous wall thickening of the terminal ileum to the lower ascending colon confirmed by several preoperative imaging studies, who underwent right hemi-colectomy for suspected malignant lymphoma. The resected specimen showed an irregular wall thickness with subserosal sclerosis, and the lesion was 10 cm in length from the terminal ileum to the ascending colon. The patient was diagnosed with IgG4-RD by pathological examinations, which demonstrated an increased number of IgG4-positive plasma cells (150/HPF), and an elevated IgG4/IgG ratio (50%). DISCUSSION Gastrointestinal IgG4-RD appears to be difficult to diagnose prior to surgical resection because of its rarity, and the similarity of its features to malignancy. The measurement of the serum IgG4 levels, immunohistochemical examination of biopsy specimens and use of several imaging modalities might help us to diagnose the disease without surgical resection, and this disease can generally be treated with steroid therapy. However, surgical resection for IgG4-RD may still be also necessary for patients with concerns regarding malignancy or with intractable gastrointestinal obstruction caused by this disease. CONCLUSION Gastrointestinal IgG4-RD often mimics malignancy, and we should therefore consider this disease in the differential diagnosis of colonic lesions in order to optimize the treatment. PMID:25194601

  20. IgG4- related disease: an orphan disease with many faces

    PubMed Central

    2014-01-01

    Immunoglobulin G4- related disease (IgG4-RD) is a rare systemic fibro-inflammatory disorder (ORPHA284264). Although patients have been described more than 100 years ago, the systemic nature of this disease has been recognized in the 21st century only. Type 1 autoimmune pancreatitis is the most frequent manifestation of IgG4-RD. However, IgG4-RD can affect any organ such as salivary glands, orbits, retroperitoneum and many others. Recent research enabled a clear clinical and histopathological description of IgG4-RD. Typically, lymphoplasmacellular inflammation, storiform fibrosis and obliterative phlebitis are found in IgG4-RD biopsies and the tissue invading plasma cells largely produce IgG4. Elevated serum IgG4 levels are found in many but not all patients. Consequently, diagnostic criteria for IgG4-RD have been proposed recently. Treatment is largely based on clinical experience and retrospective case series. Glucocorticoids are the mainstay of therapy, although adjunctive immunosuppressive agents are used in relapsing patients. This review summarizes current knowledge on clinical manifestations, pathophysiology and treatment of IgG4-RD. PMID:25026959

  1. Application of tele-ophthalmology in remote diagnosis and management of adnexal and orbital diseases

    PubMed Central

    Verma, Malay; Raman, Rajiv; Mohan, Ravindra E

    2009-01-01

    Purpose: To assess the feasibility of making a diagnosis of adnexal and orbital diseases by Tele-ophthalmological means. Materials and Methods: Tele-consultation for eye diseases was done for 3497 patients from remote areas of Tamilnadu as part of the rural tele-ophthalmology project of a tertiary eye care hospital during a period of nine months from October 2004 to June 2005. These patients were comprehensively examined on-site by optometrists. Using digitized images sent by store and forward technique and videoconferencing, the ophthalmologist made a diagnosis and advised treatment. Results: Adnexal or orbital diseases were detected in 101 out of 3497 patients (2.88%). Medical treatment was advised to 13 of 101 patients (12.8%). Surgery was advised in 62 of 101 patients (61.28%) whereas 18 of 101 patients (17.8%) required further investigations at a tertiary center. Conclusion: It was feasible to apply the satellite based tele-ophthalmology set-up for making a presumptive diagnosis and planning further management of adnexal and orbital diseases based on live interaction and digital still images of the patients. PMID:19700877

  2. Prognosis of ocular myasthenia.

    PubMed

    Bever, C T; Aquino, A V; Penn, A S; Lovelace, R E; Rowland, L P

    1983-11-01

    A retrospective study of 108 patients with myasthenia gravis who had solely ocular symptoms and signs at onset was carried out to identify factors influencing prognosis. Increasing duration of pure ocular myasthenia was associated with a decreasing risk of late generalized symptoms; only 9 (15%) of the observed generalizations occurred after more than 2 years of solely ocular symptoms. Increasing age at onset was associated with greater risk of respiratory crisis or death caused by myasthenia, whereas patients younger at onset had a greater chance of a benign outcome. Neither systemic curare tests nor responses to repetitive nerve stimulation had prognostic value. PMID:6651238

  3. CYFRA 21-1 serum levels in women with adnexal masses and inflammatory diseases.

    PubMed Central

    Tempfer, C.; Hefler, L.; Heinzl, H.; Loesch, A.; Gitsch, G.; Rumpold, H.; Kainz, C.

    1998-01-01

    The aim of the present study was to evaluate the clinical usefulness of the cytokeratin marker CYFRA 21-1 as a screening marker for ovarian cancer, as a predictive marker in patients with adnexal masses and as a prognostic marker in women suffering from ovarian cancer. In order to determine the specificity of the CYFRA 21-1 test, we have investigated CYFRA 21-1 serum levels in several benign conditions. This retrospective study comprises 37 patients suffering from ovarian cancer FIGO stages Ia-III. Sera from patients with benign ovarian cysts, endometriosis, pelvic inflammatory disease, inflammatory bowel disease and liver cirrhosis were evaluated in 90, 10, 38, 10 and 20 cases respectively. With a sensitivity of 41% and a specificity of 95%, CYFRA 21-1 was not suitable as a screening marker for ovarian cancer. Although CYFRA 21-1 was able to discriminate between ovarian cancer and benign adnexal tumours (univariate regression model, P = 0.0001), CYFRA 21-1 did not reveal additional information to CA 125 in a multivariate regression analysis (P = 0.06). CYFRA 21-1 serum levels were elevated in benign conditions such as liver cirrhosis, but not in endometriosis and inflammatory diseases. In ovarian cancer patients, elevated CYFRA 21-1 serum levels before therapy were associated with a poor overall and disease-free survival (log-rank test, P = 0.02 and log-rank test, P = 0.005 respectively). CYFRA 21-1, while obviously not suitable for screening or differential diagnosis of adnexal masses, could be useful as an additional prognostic factor in ovarian cancer patients. PMID:9792159

  4. Large Mucocele of the Appendix at Laparoscopy Presenting as an Adnexal Mass in a Postmenopausal Woman: A Case Report

    PubMed Central

    Paladino, Elvira; Bellantone, Maria; Sesti, Francesco; Piccione, Emilio; Pietropolli, Adalgisa

    2014-01-01

    A 79-year-old female was referred to our Gynecologic Department presenting with a pelvic magnetic resonance imaging (MRI), showing an adnexal mass, later confirmed at the pelvic examination. The patient's routine laboratory tests were normal. A sonographic examination was performed with inconclusive results. Although the ultrasonography excluded the presence of vascularization and malignant degeneration, the adnexal localization appeared to be dubious. The laparoscopy and the subsequent histologic examination revealed the presence of a mucocele of the appendix. The following case report focuses the attention on a misdiagnosis of appendiceal mucocele. The misdiagnosis caused no negative impact on the treatment that in this case was adequate and successful. PMID:24804128

  5. Large mucocele of the appendix at laparoscopy presenting as an adnexal mass in a postmenopausal woman: a case report.

    PubMed

    Paladino, Elvira; Bellantone, Maria; Conway, Francesca; Sesti, Francesco; Piccione, Emilio; Pietropolli, Adalgisa

    2014-01-01

    A 79-year-old female was referred to our Gynecologic Department presenting with a pelvic magnetic resonance imaging (MRI), showing an adnexal mass, later confirmed at the pelvic examination. The patient's routine laboratory tests were normal. A sonographic examination was performed with inconclusive results. Although the ultrasonography excluded the presence of vascularization and malignant degeneration, the adnexal localization appeared to be dubious. The laparoscopy and the subsequent histologic examination revealed the presence of a mucocele of the appendix. The following case report focuses the attention on a misdiagnosis of appendiceal mucocele. The misdiagnosis caused no negative impact on the treatment that in this case was adequate and successful. PMID:24804128

  6. Sclerosing ductal carcinoma of the clitoris with microcystic adnexal carcinoma-like features.

    PubMed

    DuPont, Nefertiti C; Mabuchi, Seiji; Ries, Savita; Berman, Michael L

    2009-03-01

    Primary clitoral malignancies are rare and most are invasive squamous cell carcinomas. Microcystic adnexal carcinoma (MAC) is an indolent, rare dermatologic carcinoma that typically affects the head and neck region. A 23-year-old nulligravid Hispanic female presented with a 9-month history of an enlarging periclitoral mass. After surgical resection, the mass was diagnosed as a MAC. MAC is a cutaneous carcinoma rarely found on the vulva. It is a slow growing but locally aggressive carcinoma that is best treated with surgical resection. Sclerosing ductal carcinomas may have MAC-like features, and the diagnosis and management of one case is provided here. PMID:19220633

  7. Laparoendoscopic single-site surgery for the treatment of benign adnexal diseases: a pilot study

    Microsoft Academic Search

    Anna Fagotti; Francesco Fanfani; Francesco Marocco; Cristiano Rossitto; Valerio Gallotta; Elisabetta Marana; Giovanni Scambia

    2011-01-01

    Background  This study aimed to validate the feasibility, efficacy, and safeness of laparoscopic treatment for benign adnexal diseases\\u000a through a single transumbilical access in a prospective series of patients.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A prospective clinical trial including 30 women was conducted in our teaching and research division. Patients underwent different\\u000a laparoscopic procedures by the laparoendoscopic single-site (LESS) approach using a multiport trocar, conventional laparoscopic

  8. Ultrasound findings of incidental adnexal and ovarian lesions on emergency CT scans.

    PubMed

    Lin, Roger Chin; Maliyekkel, Anil Thomas; Paspulati, Raj Mohan

    2015-01-01

    A search through 6076 nontraumatic emergency computed tomography (CT) scans of female patients yielded 266 (4.4%) CT scans with an incidentally detected adnexal lesion and ultrasound follow-up within 7days. The population was 87% premenopausal and 13% postmenopausal. Follow-up ultrasound yielded an ultrasound diagnosis 32% of the time. Potentially serious diagnoses included pelvic infection (3%) and suspected malignancy (2%). Benign diagnoses included normal ovaries (16%), hemorrhagic cyst (6%), and benign cyst (5%). The remaining 68% of cases were equivocal, requiring further evaluation. PMID:25920533

  9. Ocular injuries in Malawi.

    PubMed Central

    Ilsar, M; Chirambo, M; Belkin, M

    1982-01-01

    A survey was made of 205 patients admitted to hospital for ocular trauma in Malawi in south-east Africa from January 1976 to December 1977. Results of the survey show that eye trauma is a relatively common problem in this developing country, occurring most frequently in children, young adults, and males. Most eye injuries in Malawi occurred under domestic circumstances; the major cause of ocular trauma was associated with chopping and gathering wood. Industrial injuries were rare. The most common injury was contusion and the most frequent complication was traumatic cataract. Most treated eyes retained useful vision. PMID:7059557

  10. Ocular surface squamous neoplasia

    Microsoft Academic Search

    Graham A. Lee; Lawrence W. Hirst

    1995-01-01

    Ocular surface squamous neoplasia presents as a spectrum from simple dysplasia to carcinoma in situ to invasive squamous cell carcinoma involving the conjunctiva as well as the cornea. It is a distinct clinical entity, although it has been known by a variety of different names thorughout the literature. Most commonly it arises in the limbal region, occurring particularly in elderly

  11. Correlation between ocular perfusion pressure and ocular pulse amplitude in glaucoma, ocular hypertension, and normal eyes

    PubMed Central

    Figueiredo, Bruno P; Cronemberger, Sebastião; Kanadani, Fabio N

    2013-01-01

    Background The purpose of this study was to investigate the correlation between ocular perfusion pressure and ocular pulse amplitude in glaucoma, ocular hypertension, and normal eyes. Methods Ninety eyes from 90 patients were included. Thirty patients had been recently diagnosed with glaucoma and had no previous history of treatment for ocular hypotension, 30 had elevated intraocular pressure (IOP) without evidence of glaucoma, and 30 had normal IOP (<21 mmHg) with no detectable glaucomatous damage. Goldmann applanation tonometry (GAT), dynamic contour tonometry (DCT), blood pressure measurement, pachymetry, Humphrey visual field, and routine ophthalmic examination was performed in each patient. Ocular perfusion pressure was calculated as the difference between mean arterial pressure and IOP. The ocular pulse amplitude was given by DCT. The Pearson correlation coefficient was used to compare the glaucomatous and ocular hypertensive groups, and comparisons with the normal IOP group were done using the Spearman’s rank correlation coefficient. Results Mean IOP by DCT was 22.7 ± 4.3 mmHg in the glaucoma group, 22.3 ± 2.8 mmHg in the ocular hypertension group, and 14.3 ± 1.6 mmHg in the control group. Mean IOP by GAT was 19.0 ± 5.1 mmHg for glaucoma, 22.4 ± 2.1 mmHg for ocular hypertension, and 12.9 ± 2.2 mmHg for controls. Mean ocular pulse amplitude was 3.4 ± 1.2 mmHg in the glaucoma group, 3.5 ± 1.2 mmHg in the ocular hypertension group, and 2.6 ± 0.9 mmHg in the control group. Mean ocular perfusion pressure was 46.3 ± 7.9 mmHg in the glaucoma group, 46.3 ± 7.9 mmHg in the ocular hypertension group, and 50.2 ± 7.0 mmHg in controls. No significant correlation between ocular perfusion pressure and ocular pulse amplitude was found in any of the groups (P = 0.865 and r = ?0.032, P = 0.403 and r = ?0.156, P = 0.082 and ? = ?0.307 for glaucoma, ocular hypertension, and normal eyes, respectively). Conclusion There is no significant correlation between ocular perfusion pressure and ocular pulse amplitude values in glaucoma, ocular hypertension, or normal eyes. IOP values measured by GAT correlate with those measured by DCT. PMID:23966769

  12. Human ocular anatomy.

    PubMed

    Kels, Barry D; Grzybowski, Andrzej; Grant-Kels, Jane M

    2015-01-01

    We review the normal anatomy of the human globe, eyelids, and lacrimal system. This contribution explores both the form and function of numerous anatomic features of the human ocular system, which are vital to a comprehensive understanding of the pathophysiology of many oculocutaneous diseases. The review concludes with a reference glossary of selective ophthalmologic terms that are relevant to a thorough understanding of many oculocutaneous disease processes. PMID:25704934

  13. Bilateral ocular osseous choristomas.

    PubMed

    Moon, Jeung Hee; Yoon, Dae Young; Choi, Chul Soon; Yun, Eun Joo; Yoon, Eun Joo; Park, Sang Joon; Seo, Young Lan; Kim, Byoung Jin

    2005-11-01

    Choristoma is a benign tumour defined as normal tissue in an ectopic location. Osseous choristoma, one subtype of this entity, occurring within the orbit has rarely been reported in the world literature. We report a 6-year-old girl with bilateral ocular osseous choristomas who presented with palpable nodules protruding from both upper lids. The radiological and clinical findings are described and previous reports are reviewed. PMID:16001272

  14. Tumefactive intramural gossypiboma of the urinary bladder mimicking an invasive adnexal malignancy.

    PubMed

    Jain, Shivi; Verma, Ashish; Jain, Madhu; Trivedi, Sameer; Shukla, Ram C; Srivastava, Arvind

    2015-01-01

    A surgical swab retained in the body after surgery is known as 'Gossypiboma'. The purpose of this report is to highlight an intramural vesical gossypiboma mimicking an invasive adnexal malignancy. A 28-year-old multiparous, with open-tubal ligation three years ago, presented with painless hematuria and a nontender mass on vaginal examination. USG suggested 'pelvic endometriosis' infiltrating into the bladder and cystoscopy showed no intraluminal extension of the mass. Contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI) misdiagnosed it as invasive malignancy of the fallopian tube. Exploratory laparotomy found it to be an intramural vesical gossypiboma. A pelvic gossypiboma infiltrating into the wall of the urinary bladder may easily be misinterpreted as an invasive pelvic malignancy on imaging and may make one consider unwarranted radical surgery. PMID:25969644

  15. Adnexal Torsion

    MedlinePLUS

    ... Live Longer Health Care Workers Harbor Biases About Sexual Orientation: Study ALL NEWS > Resources First Aid Videos & Animations Figures Images Audio Pronunciations The One-Page Manual of ... the risk of undiagnosed type 2 diabetes compared to men without such sexual problems, a new study suggests. "This effect was ...

  16. [Ocular biometry using Orbscan].

    PubMed

    Touzeau, O; Allouch, C; Borderie, V; Laroche, L

    2005-06-01

    Orbscan is a recent optical device that combines the Placido disk of the videokeratoscope and a scanning slit. The scanning slit measures the elevation of both the corneal surface (anterior and posterior) and the anterior iris-lens surface. Biometric measures of the anterior segment such as corneal thickness, anterior chamber depth, corneal diameter, and iridocorneal angle are obtained using spatial coordinates of various ocular surfaces. Orbscan is not only a corneal topograph but a versatile device capable of measuring the biometry of the anterior segment of the eye. PMID:16141934

  17. Vestibular-Ocular Reflex

    NSDL National Science Digital Library

    Marlene Y. MacLeish, Ed.D.

    2013-01-30

    In this activity, learners will perform various investigations to understand the vestibular-ocular reflex and learn about the importance of visual cues in maintaining balance. During the two-part activity, learners will compare the stability of a moving image under two conditions as well as compare the effects of rotation on the sensation of spinning under varying conditions. This lesson guide includes background information, review and critical thinking questions with answers, and handouts. Educators can also use this activity to discuss how the brain functions in space and how researchers study the vestibular function in space.

  18. Ocular drug delivery.

    PubMed

    Gaudana, Ripal; Ananthula, Hari Krishna; Parenky, Ashwin; Mitra, Ashim K

    2010-09-01

    Ocular drug delivery has been a major challenge to pharmacologists and drug delivery scientists due to its unique anatomy and physiology. Static barriers (different layers of cornea, sclera, and retina including blood aqueous and blood-retinal barriers), dynamic barriers (choroidal and conjunctival blood flow, lymphatic clearance, and tear dilution), and efflux pumps in conjunction pose a significant challenge for delivery of a drug alone or in a dosage form, especially to the posterior segment. Identification of influx transporters on various ocular tissues and designing a transporter-targeted delivery of a parent drug has gathered momentum in recent years. Parallelly, colloidal dosage forms such as nanoparticles, nanomicelles, liposomes, and microemulsions have been widely explored to overcome various static and dynamic barriers. Novel drug delivery strategies such as bioadhesive gels and fibrin sealant-based approaches were developed to sustain drug levels at the target site. Designing noninvasive sustained drug delivery systems and exploring the feasibility of topical application to deliver drugs to the posterior segment may drastically improve drug delivery in the years to come. Current developments in the field of ophthalmic drug delivery promise a significant improvement in overcoming the challenges posed by various anterior and posterior segment diseases. PMID:20437123

  19. Evaluation of primary adnexal masses by 3T MRI: categorization with conventional MR imaging and diffusion-weighted imaging

    PubMed Central

    2012-01-01

    Background To investigate the 3.0-Tesla (3 T) magnetic resonance imaging (MRI) characteristics of primary adnexal lesions for discriminating benign from malignant lesions. Methods One hundred thirty-nine patients with pathologically proven primary adnexal masses referred for 3 T MRI assessment preoperatively were included. Baseline characteristics, components, and conventional MRI and diffusion-weighted imaging (DWI-MRI) signals were recorded and compared. Results There were 22 ovarian cysts, 33 endometriomas, 43 benign tumors and 42 malignant tumors. When ovarian cyst and endometrioma were excluded, there were no significant differences in patients’ age between benign and malignant tumor (P = 0.235). There were no significant differences (P = 0.606) in the conventional MRI signals and significant difference (P = 0.008) in DWI-MRI signal between the non-malignant and malignant lesions. There was a significant difference (P = 0.000) in the apparent diffusion coefficient values (ADCs) between the non-malignant and malignant lesions. Conclusions 3 T MRI categorized the characteristics of primary adnexal lesions. Conventional MRI signals were not useful for characterizing between benign and malignant lesions. DWI-MRI and ADCs were helpful for distinguishing malignant from benign ovarian lesions. PMID:23148860

  20. Ocular involvement and visual outcome of herpes zoster ophthalmicus: review of 45 patients from Tunisia, North Africa

    PubMed Central

    2014-01-01

    Background Ocular complications of herpes zoster ophthalmicus (HZO) may lead to substantial visual impairment. The purpose of this study was to characterize and analyze ocular involvement and visual outcome of HZO in patients from Tunisia, North Africa. This study is a retrospective chart review of 51 eyes of 45 patients with HZO. Results Mean age was 44.5 years. Thirty patients (66.7%) were aged over 50 years. Twenty-four patients (53.3%) were male and 21 patients were female (46.7%). There was no statistically significant difference in gender distribution. Initial mean best corrected visual acuity (BCVA) was 20/50. Ocular manifestations included adnexal involvement (58.8%), keratitis (31.4%), keratouveitis (31.4%), isolated anterior uveitis (AU) (29.4%), intraocular pressure elevation (23.5%), oculomotor nerve palsy (5.8%), and optic neuritis (1.9%). Isolated AU (p < 0.001), isolated keratitis (p = 0.001), and intraocular pressure elevation (p = 0.013) were more likely to be concomitant to HZO active skin disease, while keratouveitis occurred more likely more than 1 month after HZO eruption (p < 0.001). AU and keratouveitis were more likely to be associated with age ? 50 years (p = 0.001 and p = 0.02, respectively). Ocular complications included neurotrophic keratopathy (1.9%), corneal opacity (5.9%), secondary glaucoma (7.8%), optic atrophy (1.9%), and postherpetic neuralgia (13.3%). Mean follow-up was 12 months. Mean final BCVA was 20/32; it was ? 20/40 in 78.4% of the eyes. Conclusions Our study provided epidemiologic and clinical data of HZO in a Tunisian population. AU and keratitis were the most common ocular complications. Neurotrophic keratopathy was scarce. The overall visual outcome is good, with about three quarters of the treated patients maintaining VA of 20/40 or better. PMID:25246984

  1. Ocular myasthenia gravis: A review

    PubMed Central

    Nair, Akshay Gopinathan; Patil-Chhablani, Preeti; Venkatramani, Devendra V; Gandhi, Rashmin Anilkumar

    2014-01-01

    Myasthenia gravis (MG) is a disease that affects the neuro-muscular junction resulting in classical symptoms of variable muscle weakness and fatigability. It is called the great masquerader owing to its varied clinical presentations. Very often, a patient of MG may present to the ophthalmologist given that a large proportion of patients with systemic myasthenia have ocular involvement either at presentation or during the later course of the disease. The treatment of ocular MG involves both the neurologist and ophthalmologist. Thus, the aim of this review was to highlight the current diagnosis, investigations, and treatment of ocular MG. PMID:25449931

  2. Ocular Screening System

    NASA Technical Reports Server (NTRS)

    1987-01-01

    Used to detect eye problems in children through analysis of retinal reflexes, the system incorporates image processing techniques. VISISCREEN's photorefractor is basically a 35 millimeter camera with a telephoto lens and an electronic flash. By making a color photograph, the system can test the human eye for refractive error and obstruction in the cornea or lens. Ocular alignment problems are detected by imaging both eyes simultaneously. Electronic flash sends light into the eyes and the light is reflected from the retina back to the camera lens. Photorefractor analyzes the retinal reflexes generated by the subject's response to the flash and produces an image of the subject's eyes in which the pupils are variously colored. The nature of a defect, where such exists, is identifiable by atrained observer's visual examination.

  3. Photorefractor ocular screening system

    NASA Technical Reports Server (NTRS)

    Richardson, John R. (inventor); Kerr, Joseph H. (inventor)

    1987-01-01

    A method and apparatus for detecting human eye defects, particularly detection of refractive error is presented. Eye reflex is recorded on color film when the eyes are exposed to a flash of light. The photographs are compared with predetermined standards to detect eye defects. The base structure of the ocular screening system is a folding interconnect structure, comprising hinged sections. Attached to one end of the structure is a head positioning station which comprises vertical support, a head positioning bracket having one end attached to the top of the support, and two head positioning lamps to verify precise head positioning. At the opposite end of the interconnect structure is a camera station with camera, electronic flash unit, and blinking fixation lamp, for photographing the eyes of persons being evaluated.

  4. Ocular leech infestation.

    PubMed

    Lee, Yueh-Chang; Chiu, Cheng-Jen

    2015-01-01

    This case report describes a female toddler with manifestations of ocular leech infestation. A 2-year-old girl was brought to our outpatient clinic with a complaint of irritable crying after being taken to a stream in Hualien 1 day previous, where she played in the water. The parents noticed that she rubbed her right eye a lot. Upon examination, the girl had good fix and follow in either eye. Slit-lamp examination showed conjunctival injection with a moving dark black-brown foreign body partly attached in the lower conjunctiva. After applying topical anesthetics, the leech, measuring 1 cm in length, was extracted under a microscope. The patient began using topical antibiotic and corticosteroid agents. By 1 week after extraction, the patient had no obvious symptoms or signs, except for a limited subconjunctival hemorrhage, and no corneal/scleral involvement was observed. PMID:25784786

  5. Ocular leech infestation

    PubMed Central

    Lee, Yueh-Chang; Chiu, Cheng-Jen

    2015-01-01

    This case report describes a female toddler with manifestations of ocular leech infestation. A 2-year-old girl was brought to our outpatient clinic with a complaint of irritable crying after being taken to a stream in Hualien 1 day previous, where she played in the water. The parents noticed that she rubbed her right eye a lot. Upon examination, the girl had good fix and follow in either eye. Slit-lamp examination showed conjunctival injection with a moving dark black–brown foreign body partly attached in the lower conjunctiva. After applying topical anesthetics, the leech, measuring 1 cm in length, was extracted under a microscope. The patient began using topical antibiotic and corticosteroid agents. By 1 week after extraction, the patient had no obvious symptoms or signs, except for a limited subconjunctival hemorrhage, and no corneal/scleral involvement was observed. PMID:25784786

  6. Uncommon Implantation Sites of Ectopic Pregnancy: Thinking beyond the Complex Adnexal Mass.

    PubMed

    Chukus, Anjeza; Tirada, Nikki; Restrepo, Ricardo; Reddy, Neelima I

    2015-01-01

    Ectopic pregnancy occurs when implantation of the blastocyst takes place in a site other than the endometrium of the uterine cavity. Uncommon implantation sites of ectopic pregnancy include the cervix, interstitial segment of the fallopian tube, scar from a prior cesarean delivery, uterine myometrium, ovary, and peritoneal cavity. Heterotopic and twin ectopic pregnancies are other rare manifestations. Ultrasonography (US) plays a central role in diagnosis of uncommon ectopic pregnancies. US features of an interstitial ectopic pregnancy include an echogenic interstitial line and abnormal bulging of the myometrial contour. A gestational sac that is located below the internal os of the cervix and that contains an embryo with a fetal heartbeat is indicative of a cervical ectopic pregnancy. In a cesarean scar ectopic pregnancy, the gestational sac is implanted in the anterior lower uterine segment at the site of the cesarean scar, with thinning of the myometrium seen anterior to the gestational sac. An intramural gestational sac implants in the uterine myometrium, separate from the uterine cavity and fallopian tubes. In an ovarian ectopic pregnancy, a gestational sac with a thick hyperechoic circumferential rim is located in or on the ovarian parenchyma. An intraperitoneal gestational sac is present in an abdominal ectopic pregnancy. Intra- and extrauterine gestational sacs are seen in a heterotopic pregnancy. Two adnexal heartbeats suggest a live twin ectopic pregnancy. Recognition of the specific US features will help radiologists diagnose these uncommon types of ectopic pregnancy. (©)RSNA, 2015. PMID:25860721

  7. Cicatricial changes in ocular pemphigus

    PubMed Central

    Chirinos-Saldaña, P; Zuñiga-Gonzalez, I; Hernandez-Camarena, J C; Navas, A; Ramirez-Luquin, T; Robles-Contreras, A; Jimenez-Martinez, M C; Ramirez-Miranda, A; Bautista-de Lucio, V M; Graue-Hernandez, E O

    2014-01-01

    Purpose To describe the clinical characteristics of ocular involvement in patients with pemphigus at an ophthalmological referral center. Methods A retrospective review was conducted on patients with the immunopathological diagnosis of pemphigus examined between 1 January 2000 and 1 April 2010. Uncorrected distance visual acuity (UDVA), best corrected distance visual acuity (BCVA), ocular symptoms, and ocular surface inflammatory and scarring changes were assessed. Results A total of 15 patients were identified, with a mean age of 68.27±14.35 years, and 80% (n=12) were female. Extraocular involvement was reported in one patient. All of the eyes showed cicatricial changes in the conjunctiva. In all, 6 eyes (20%) were classified as stage I; 12 eyes (40%) as stage II; 10 eyes (33%) as stage III; and 2 eyes (7%) as stage IV. A statistically significant association was found between BCVA and the severity of ocular involvement. The mean BCVA logMAR was 1.66 (20/914), with a range from logMAR 0 (20/20) to logMAR 4 (NLP). Other ocular diseases were found in 8 (53.3%), systemic diseases in 10 (66.7%), and the use of pemphigus-inducing drugs in 10 patients (66.7%). Conclusions The present report represents the largest series of ocular involvement in pemphigus confirmed by immunopathology. The clinical manifestations varied from conjunctival hyperemia to corneal scarring and perforation. There was a strong association between scarring changes and low BCVA. Ocular and systemic diseases as well as the use of pemphigus-inducing drugs may predispose to ocular cicatricial changes observed in this series. PMID:24480839

  8. The Ocular Surface Chemical Burns

    PubMed Central

    Baradaran-Rafii, Alireza; Djalilian, Ali R.

    2014-01-01

    Ocular chemical burns are common and serious ocular emergencies that require immediate and intensive evaluation and care. The victims of such incidents are usually young, and therefore loss of vision and disfigurement could dramatically affect their lives. The clinical course can be divided into immediate, acute, early, and late reparative phases. The degree of limbal, corneal, and conjunctival involvement at the time of injury is critically associated with prognosis. The treatment starts with simple but vision saving steps and is continued with complicated surgical procedures later in the course of the disease. The goal of treatment is to restore the normal ocular surface anatomy and function. Limbal stem cell transplantation, amniotic membrane transplantation, and ultimately keratoprosthesis may be indicated depending on the patients' needs. PMID:25105018

  9. Ocular complications of neurological therapy.

    PubMed

    Hadjikoutis, S; Morgan, J E; Wild, J M; Smith, P E M

    2005-07-01

    Treatments used for several neurological conditions may adversely affect the eye. Vigabatrin-related retinal toxicity leads to a visual field defect. Optic neuropathy may result from ethambutol and isoniazid, and from radiation therapy. Posterior subcapsular cataract is associated with systemic corticosteroids. Transient refractive error changes may follow treatment with acetazolamide or topiramate, and corneal deposits and keratitis with amandatine. Intraocular pressure can be elevated in susceptible individuals by anticholinergic drugs, including oxybutynin, tolterodine, benzhexol, propantheline, atropine and amitriptyline, and also by systemic corticosteroids and by topiramate. Nystagmus, diplopia and extraocular muscle palsies can occur with antiepileptic drugs, particularly phenytoin and carbamazepine. Ocular neuromyotonia can follow parasellar radiation. Congenital ocular malformations can result from in utero exposure to maternally prescribed sodium valproate, phenytoin and carbamazepine. Neurologists must be aware of potential ocular toxicity of these drugs, and appropriately monitor for potential adverse events. PMID:15958088

  10. Air bags and ocular injuries.

    PubMed Central

    Stein, J D; Jaeger, E A; Jeffers, J B

    1999-01-01

    PURPOSE: This investigation retrospectively examined ocular injuries associated with air bag deployment to gain a better appreciation of potential risk factors in motor vehicle accidents. National statistics regarding the efficacy of air bags were reviewed. METHODS: Review of the literature from 1991 to 1998 identified 44 articles describing 97 patients with air-bag-induced ocular injuries. Variables extracted from each case were age, sex, height, position in the car, eye wear, vehicle impact speed, visual acuity, and specific ocular injuries. RESULTS: Corneal abrasions occurred in 49% of occupants, hyphemas in 43%, vitreous or retinal hemorrhages in 25%, and retinal tears or detachments in 15%. The globe was ruptured in 10 patients. Patients involved in higher-speed accidents (over 30 mph) sustained a greater percentage of vitreous or retinal hemorrhages and traumatic cataracts, while those at slower speeds were more prone to retinal tears or detachments. In a subset of 14 patients with serious ocular injuries, the impact speed of 11 patients was recorded at 30 mph or less. Slower speed may be a risk factor for some ocular injuries. Occupant height was not a significant factor. National statistics confirm that air bags reduce fatalities in motor vehicle accidents. However, children sitting in the front seat without a seat belt and infants in passenger-side rear-facing car seats are at risk for fatal injury. CONCLUSION: Air bags combined with seat belts are an effective means of reducing injury and death in adults during motor vehicle accidents. However, this study has documented a wide variety of ocular injuries associated with air bag deployment. It is hoped that researchers can develop modifications that continue to save lives while minimizing additional harm. Images FIGURE 1 FIGURE 2A FIGURE 2B FIGURE 2C FIGURE 2D FIGURE 3A FIGURE 3B FIGURE 4 FIGURE 5 FIGURE 7 FIGURE 8 PMID:10703118

  11. Spectral imaging of the human ocular fundus

    Microsoft Academic Search

    Paul Wiley Truitt

    1999-01-01

    Introduction. The objective of this work was to demonstrate a high spectral and spatial resolution fundus imager and to assess its utility in visualizing and characterizing normal anatomical and pathological tissue classes in the human ocular fundus. The ocular fundus (posterior portion of the eye) affords a unique opportunity to directly observe neural and vascular tissue in vivo. Many ocular

  12. Handbook of Ocular Disease Management

    NSDL National Science Digital Library

    Gurwood, Andrew S.

    For the last ten years, doctors Joseph W. Sowka, Andrew S. Gurwood, and Alan G. Kabat have updated and revised the Handbook of Ocular Disease Management, a \\"quick & dirty\\" handbook of the fifty most common ocular diseases. Here visitors can browse it in its seventh edition. The work is divided up into seven sections by part of the eye (\\"Cornea\\") or by disease (\\"Oculosystemic Disease\\"), and each section contains information on the signs and symptoms of each disease as well as management recommendations for treatment. This is a very helpful and up-to-date reference tool for practicing optometrists or students studying optometry.

  13. Granular cell tumor of hand presenting as subcutaneous nodule mimicking dermal adnexal tumor: A diagnosis by cytology

    PubMed Central

    Nasit, Jitendra G.; Chauhan, Sanjaykumar; Dhruva, Gauravi

    2013-01-01

    Granular cell tumor (GCT) is an uncommon tumor and is believed to be of schwannian origin. GCT is benign but rare malignant cases are recorded. GCT occurs in almost any part of the body. The common sites are the tongue, skin, and subcutaneous tissue. GCT of hand is an extremely rare. Till date only 17 cases are reported in the literature. Preoperative diagnosis of GCT is important, because GCT mimics dermal adnexal tumor in subcutaneous tissue, other soft tissue tumor or inflammatory lesions. GCT is composed of large polygonal cells with eosinophilic granular cytoplasm and these cells are often immunoreactive for the S-100 protein. Fine-needle aspiration cytology has been suggested to be diagnostic modality of choice and this would undoubtedly aid the correct diagnosis. Excision with wide surgical margins is curative for benign GCT. Recurrence and malignant transformation requires regular follow-up. Here, this communication documents a case of cytological diagnosis of the granular cell tumor of hand in a 21-year-old female, clinically suspected to be a dermal adnexal tumor. PMID:23439997

  14. Ocular Fibroblast Diversity: Implications for Inflammation and Ocular Wound Healing

    PubMed Central

    Xi, Xia; McMillan, David H.; Lehmann, Geniece M.; Sime, Patricia J.; Libby, Richard T.; Huxlin, Krystel R.; Feldon, Steven E.

    2011-01-01

    Purpose. Various ocular and orbital tissues differ in their manifestations of inflammation, although the reasons for this are unclear. Such differences may be due to behaviors exhibited by resident cell types, including fibroblasts. Fibroblasts mediate immune function and produce inflammatory mediators. Chronic stimulation of ocular fibroblasts can lead to prolonged inflammation and, in turn, to impaired vision and blindness. Interleukin (IL)-1?, which is produced by various cells during inflammation, is a potent activator of fibroblasts and inducer of the expression of inflammatory mediators. The hypothesis for this study was that that human fibroblasts derived from distinct ocular tissues differ in their responses to IL-1? and that variations in the IL-1 signaling pathway account for these differences. Methods. Human fibroblasts were isolated from the lacrimal gland, cornea, and Tenon's capsule and treated with IL-1? in vitro. Cytokine and prostaglandin (PG)E2 production were measured by ELISA and EIA. Cyclooxygenase (Cox)-2 expression was detected by Western blot. Components of the IL-1 signaling pathway were detected by flow cytometry, ELISA, Western blot, and immunofluorescence. Results. Cytokine and PGE2 production and Cox-2 expression were greatest in corneal fibroblasts. VEGF production was greatest in Tenon's capsule fibroblasts. Variations in IL-1 receptor and receptor antagonist expression, I?B? degradation and p65 nuclear translocation, however, did not account for these differences, but overexpression of the NF-?B member RelB dampened Cox-2 expression in all three fibroblast types. Conclusions. The results highlight the inherent differences between ocular fibroblast strains and provide crucial insight into novel, tissue-specific treatments for ocular inflammation and disease, such as RelB overexpression. PMID:21571679

  15. Adnexal Masses Treated Using a Combination of the SILS Port and Noncurved Straight Laparoscopic Instruments: Turkish Experience and Review of the Literature

    PubMed Central

    Dursun, Polat; Tezcaner, Tugan; Zeyneloglu, Hulusi B.; Alyaz?c?, Irem; Haberal, Ali; Ayhan, Ali

    2013-01-01

    Objective. To report our experience treating adnexal masses using a combination of the SILS port and straight nonroticulating laparoscopic instruments. Study Design. This prospective feasibility study included 14 women with symptomatic and persistent adnexal masses. Removal of adnexal masses via single-incision laparoscopic surgery using a combination of the SILS port and straight nonroticulating laparoscopic instruments was performed. Results. All of the patients had symptomatic complex adnexal masses. Mean age of the patients was 38.4 years (range: 21–61 years) and mean duration of surgery was 71?min (range: 45–130?min). All surgeries were performed using nonroticulating straight laparoscopic instruments. Mean tumor diameter was 6?cm (range: 5–12?cm). All patient pathology reports were benign. None of the patients converted to laparotomy. All the patients were discharged on postoperative d1. Postoperatively, all the patients were satisfied with their incision and cosmetic results. Conclusion. All 14 patients were successfully treated using standard, straight nonroticulating laparoscopic instruments via the SILS port. This procedure can reduce the cost of treatment, which may eventually lead to more widespread use of the SILS port approach. Furthermore, concomitant surgical procedures are possible using this approach. However, properly designed comparative studies with single port and classic laparoscopic surgery are urgently needed. PMID:24307944

  16. [Role of ocular pulse amplitude in glaucoma].

    PubMed

    Stürmer, J P E; Kniestedt, C

    2015-02-01

    The ocular pulse amplitude is defined as the difference between diastolic and systolic intraocular pressure. The ocular pulse is generated by the pulsatile ocular blood flow in the choroid. It is dependent on the dynamics of the cardiovascular system, the rigidity of the ocular vessels on one side and the biomechanical properties of the eye on the other side. In addition the influence of outflow facility of the aqueous humor, the level of the intraocular pressure itself and last but not least the rigidity of the sclera on the ocular pulse amplitude is until now not clear. Dynamic contour tonometry (Pascal®) does not only measure intraocular pressure almost independent of corneal thickness and curvature but also allows easy and fast measurement of ocular pulse amplitude on the slit lamp. The ocular pulse amplitude in healthy subjects is between 1.2 and 4?mmHg. If the ocular pulse amplitude is larger than 1.2?mmHg spontaneous pulsations of the central retinal vein are visible on fundoscopy. In patients with ocular hypertension the ocular pulse amplitude is larger than in normal subjects but this is mainly due to higher IOP levels. In patients with manifest open-angle glaucoma the ocular pulse amplitude stays initially within the normal range. In more advanced stages of the disease and especially in patients with ocular perfusion pressure dependent optic neuropathy the ocular pulse amplitude is gradually reduced. Due to the various factors influencing ocular pulse amplitude a direct correlation between reduced ocular pulse amplitude and reduced ocular perfusion pressure has not been established as yet. New approaches investigating the variations of the ocular pressure Fourier spectral analysis are promising, especially when simultaneous analysis of the arterial blood pressure is performed. These techniques may allow a fast and easy discrimination between healthy and glaucomatous patients in the near future. If ocular pulse amplitude exhibits a massive inter-ocular asymmetry in the presence of symmetrical ocular findings of extraocular vascular pathologies (i.e. carotid stenosis) are the most likely cause and therefore should be excluded. PMID:25700254

  17. Ocular Vestibular Evoked Myogenic Potentials

    PubMed Central

    Felipe, Lilian; Kingma, Herman

    2013-01-01

    Introduction?Diagnostic testing of the vestibular system is an essential component of treating patients with balance dysfunction. Until recently, testing methods primarily evaluated the integrity of the horizontal semicircular canal, which is only a portion of the vestibular system. Recent advances in technology have afforded clinicians the ability to assess otolith function through vestibular evoked myogenic potential (VEMP) testing. VEMP testing from the inferior extraocular muscles of the eye has been the subject of interest of recent research. Objective?To summarize recent developments in ocular VEMP testing. Results?Recent studies suggest that the ocular VEMP is produced by otolith afferents in the superior division of the vestibular nerve. The ocular VEMP is a short latency potential, composed of extraocular myogenic responses activated by sound stimulation and registered by surface electromyography via ipsilateral otolithic and contralateral extraocular muscle activation. The inferior oblique muscle is the most superficial of the six extraocular muscles responsible for eye movement. Therefore, measurement of ocular VEMPs can be performed easily by using surface electrodes on the skin below the eyes contralateral to the stimulated side. Conclusion?This new variation of the VEMP procedure may supplement conventional testing in difficult to test populations. It may also be possible to use this technique to evaluate previously inaccessible information on the vestibular system. PMID:25992068

  18. Ocular vestibular evoked myogenic potentials.

    PubMed

    Felipe, Lilian; Kingma, Herman

    2014-01-01

    Introduction?Diagnostic testing of the vestibular system is an essential component of treating patients with balance dysfunction. Until recently, testing methods primarily evaluated the integrity of the horizontal semicircular canal, which is only a portion of the vestibular system. Recent advances in technology have afforded clinicians the ability to assess otolith function through vestibular evoked myogenic potential (VEMP) testing. VEMP testing from the inferior extraocular muscles of the eye has been the subject of interest of recent research. Objective?To summarize recent developments in ocular VEMP testing. Results?Recent studies suggest that the ocular VEMP is produced by otolith afferents in the superior division of the vestibular nerve. The ocular VEMP is a short latency potential, composed of extraocular myogenic responses activated by sound stimulation and registered by surface electromyography via ipsilateral otolithic and contralateral extraocular muscle activation. The inferior oblique muscle is the most superficial of the six extraocular muscles responsible for eye movement. Therefore, measurement of ocular VEMPs can be performed easily by using surface electrodes on the skin below the eyes contralateral to the stimulated side. Conclusion?This new variation of the VEMP procedure may supplement conventional testing in difficult to test populations. It may also be possible to use this technique to evaluate previously inaccessible information on the vestibular system. PMID:25992068

  19. Ocular infection secondary to gemella

    Microsoft Academic Search

    Pedram Hamrah; David Ritterband; John Seedor; Richard A. Eiferman

    2006-01-01

    Purpose  To report four cases of ocular infection caused by Gemella species.Methods  Microbial identification was carried out using the MicroScan Walkaway system (Dade Behring) and\\/or Vitek-2 (bioMérieux) and susceptibility testing with either Kirby–Bauer disc diffusion and\\/or Vitek-2. The paper is presented as an interventional case report.Results  Four patients developed infection due to Gemella species. All responded to vancomycin or fortified aminoglycosides and broad-spectrum

  20. Ciprofloxacin as Ocular Liposomal Hydrogel

    Microsoft Academic Search

    Khaled Mohamed Hosny

    2010-01-01

    The purpose of this study was to prepare and characterize an ocular effective prolonged-release liposomal hydrogel formulation\\u000a containing ciprofloxacin. Reverse-phase evaporation was used for preparation of liposomes consisting of soybean phosphatidylcholine\\u000a (PC) and cholesterol (CH). The effect of PC\\/CH molar ratio on the percentage drug encapsulation was investigated. The effect\\u000a of additives such as stearylamine (SA) or dicetyl phosphate (DP)

  1. Ocular Findings of Beals Syndrome

    Microsoft Academic Search

    Sugie Takaesu-Miyagi; Hiroshi Sakai; Tadashi Shiroma; Kazuhisa Hayakawa; Yusei Funakoshi; Shoichi Sawaguchi

    2004-01-01

    Background In this report of two Okinawan patients with Beals syndrome and accompanying ocular complications, the symptoms of Beals syndrome and Marfan syndrome are compared. The etiology of these two syndromes is considered in relation to fibrillin. Cases Case 1 was a 5-year-old boy who showed blue sclera and bilateral enlargement of optic disc cupping. Case 2 was a 24-year-old

  2. Topical ocular delivery of NSAIDs.

    PubMed

    Ahuja, Munish; Dhake, Avinash S; Sharma, Surendra K; Majumdar, Dipak K

    2008-06-01

    In ocular tissue, arachidonic acid is metabolized by cyclooxygenase to prostaglandins which are the most important lipid derived mediators of inflammation. Presently nonsteroidal anti-inflammatory drugs (NSAIDs) which are cyclooxygenase (COX) inhibitors are being used for the treatment of inflammatory disorders. NSAIDs used in ophthalmology, topically, are salicylic-, indole acetic-, aryl acetic-, aryl propionic- and enolic acid derivatives. NSAIDs are weak acids with pKa mostly between 3.5 and 4.5, and are poorly soluble in water. Aqueous ophthalmic solutions of NSAIDs have been made using sodium, potassium, tromethamine and lysine salts or complexing with cyclodextrins/solubilizer. Ocular penetration of NSAID demands an acidic ophthalmic solution where cyclodextrin could prevent precipitation of drug and minimize its ocular irritation potential. The incompatibility of NSAID with benzalkonium chloride is avoided by using polysorbate 80, cyclodextrins or tromethamine. Lysine salts and alpha-tocopheryl polyethylene glycol succinate disrupt corneal integrity, and their use requires caution. Thus a nonirritating ophthalmic solution of NSAID could be formulated by dissolving an appropriate water-soluble salt, in the presence of cyclodextrin or tromethamine (if needed) in mildly acidified purified water (if stability permits) with or without benzalkonium chloride and polyvinyl alcohol. Amide prodrugs met with mixed success due to incomplete intraocular hydrolysis. Suspension and ocular inserts appear irritating to the inflamed eye. Oil drop may be a suitable option for insoluble drugs and ointment may be used for sustained effect. Recent studies showed that the use of colloidal nanoparticle formulations and the potent COX 2 inhibitor bromfenac may enhance NSAID efficacy in eye preparations. PMID:18437583

  3. Recent Overview of Ocular Patents

    PubMed Central

    Gaudana, Ripal J.; Gokulgandhi, Mitan R.; Boddu, Sai H.S.; Mitra, Ashim K.

    2015-01-01

    Ocular drug therapy has always been considered as a major challenge in the field of drug delivery. The presence of blood ocular barriers and efflux pumps has imposed a great concern as well. Various vision threatening disorders require a long term therapy of drug molecules, especially for the diseases that affect the posterior segment. Pharmaceutical companies and other research institutes have adopted a multidisciplinary approach to meet the current challenges which is evidenced by the trends seen in the published and filed U.S. patents. Various strategies have been employed to achieve long term sustained and targeted delivery for both the anterior and the posterior segments of the ocular diseases. These strategies include formulating drugs into implant, micro or nanoparticulate systems and hydrogel-based systems. Transporter targeted approach has also allowed scientists to deliver drugs to both the segments of the eye. Recent developments such as delivery of drugs utilizing ultrasound, iontophoresis and microneedle based devices have been promising. Gene-based therapeutics has opened a new avenue for vision threatening disorders. In all, the current developments in the entire field have been very exciting for finding out new strategies to treat vision threatening disorders. PMID:22493994

  4. Towards an evidence-based approach for diagnosis and management of adnexal masses: findings of the International Ovarian Tumour Analysis (IOTA) studies

    PubMed Central

    Kaijser, J.

    2015-01-01

    Whilst the outcomes for patients with ovarian cancer clearly benefit from centralised, comprehensive care in dedicated cancer centres, unfortunately the majority of patients still do not receive appropriate specialist treatment. Any improvement in the accuracy of current triaging and referral pathways whether using new imaging tests or biomarkers would therefore be of value in order to optimise the appropriate selection of patients for such care. An analysis of current evidence shows that such tests are now available, but still await recognition, acceptance and widespread adoption. It is therefore to be hoped that present guidance relating to the classification of ovarian masses will soon become more “evidence-based”. These promising tests include the International Ovarian Tumour Analysis (IOTA) LR2 model and ultrasound-based Simple Rules (SR). Based on a comprehensive recent meta-analysis both currently offer the optimal “evidence-based” approach to discriminating between cancer and benign conditions in women with adnexal tumours needing surgery. LR2 and SR are reliable tests having been shown to maintain a high sensitivity for cancer after independent external and temporal validation by the IOTA group in the hands of examiners with various levels of ultrasound expertise. They also offer more accurate triage compared to the existing Risk of Malignancy Index (RMI). The development of the IOTA ADNEX model represents an important step forward towards more individualised patient care in this area. ADNEX is a novel test that enables the more specific subtyping of adnexal cancers (i.e. borderline, stage 1 invasive, stage II-IV invasive, and secondary metastatic malignant tumours) and shares similar levels of accuracy to IOTA LR2 and SR for basic discrimination between cancer and benign disease. The IOTA study has made significant progress in relation to the classification of adnexal masses, however what is now needed is to see if these or new diagnostic tools can assist clinicians to select patients with adnexal masses that are suitable for expectant management, and that will work in all health care settings (i.e. primary vs secondary vs tertiary care). These important themes will likely control the future agenda of the IOTA project. PMID:25897371

  5. Tumors of the ocular surface: A review

    PubMed Central

    Honavar, Santosh G; Manjandavida, Fairooz P

    2015-01-01

    Tumors of the Ocular Surface clinically manifest with a very wide spectrum and include several forms of epithelial, stromal, caruncular, and secondary tumors. As a group, these tumors are seen commonly in the clinical practice of a comprehensive ophthalmologist, cornea specialist, and an ocular oncologist. This review is aimed to discuss the common tumors of the ocular surface and emphasize on their clinical diagnosis and appropriate management. PMID:25971163

  6. Ocular lipid deposition and hyperlipoproteinaemia.

    PubMed

    Crispin, Sheila

    2002-03-01

    In all species there are potential ocular manifestations when circulating lipoproteins are raised and these may be transient or permanent Many factors, both systemic and local, influence lipid influx and accumulation (progression) and lipid mobilisation and efflux (regression). In both humans and animals some types of lipid deposition will regress if the local and systemic factors involved in pathogenesis can be modified. There are inescapable parallels with the same phenomena in other tissues.Three types of corneal lipid deposition have been linked with hyperlipoproteinaemia. In corneal arcus, lipid is deposited preferentially in the warmest part of the cornea initially and, in people, the lipid remains almost exclusively extracellular. In animals, corneal arcus is associated with initial extracellular lipid deposition followed by the appearance of intracellular lipid and vascularisation, so that established corneal arcus tends to become more typical of lipid keratopathy. In humans, hyperlipoproteinaemia may be an associated systemic factor and early onset corneal arcus is a recognised feature of certain primary hyperlipoproteinaemias and their secondary phenotypes. In dogs, corneal arcus is always associated with hyperlipoproteinaemia. Corneal vascularisation is a ubiquitous feature of lipid keratopathy in all species and both necrotic fibroblasts and foam cells are common in progressive lesions. The extent and position of lipid deposition and the evolution of lipid keratopathy can be related to local ocular disease and circulating lipids and lipoproteins. Many aspects of the pathogenesis of lipid keratopathy are similar to those of atherogenesis. Hyperlipoproteinaemia, especially hypercholesterolaemia is the commonest systemic abnormality. In crystalline stromal dystrophy (Schnyder's crystalline stromal dystrophy) of the cornea there is no inflammatory element and no vascularisation. The dystrophy is associated with accumulation of lipid within the corneal fibroblasts, but typical foam cells are absent, the crystalline opacity involves the coolest part of the cornea, correlates with local fibroblast death, and is always bilateral. Hyperlipoproteinaemia, may be present, but this is not universally so.The objective of this paper is to evaluate the factors that may influence ocular involvement in hyperlipoproteinaemia. A comparative approach, utilising information available from studies of both ocular and non-ocular tissues, aids elucidation of the complex pathogenesis. PMID:12062534

  7. Effect of Carotid Artery Stenting on Ocular Circulation and Chronic Ocular Ischemic Syndrome

    Microsoft Academic Search

    Shoichiro Kawaguchi; Toshisuke Sakaki; Hideaki Iwahashi; Kenta Fujimoto; Jun-ichi Iida; Hideaki Mishima; Norikiyo Nishikawa

    2006-01-01

    Background: The authors evaluated the effect of carotid artery stenting (CAS) on ocular circulation and chronic ocular ischemic syndrome. Methods: We examined 38 patients with carotid artery stenosis (>80%) at its origin treated with CAS. Ocular circulation and symptoms were examined before, within 24 h, and 1 week, 1 month, and 3 months after CAS based on ophthalmic artery color

  8. Paratesticular cystadenomas with ovarian stroma, metaplastic serous Müllerian epithelium, and male adnexal tumor of probable wolffian origin: A series of 5 hitherto poorly recognized testicular tumors.

    PubMed

    Michal, Michal; Kazakov, Dmitry V; Kacerovska, Denisa; Kuroda, Naoto; Lovric, Eva; Wachter, David L; Agaimy, Abbas; Hes, Ondrej

    2013-04-01

    We present 5 paratesticular tumors, which manifested ovarian-type stroma and various serous müllerian epithelial structures including serous fallopian-like epithelium and proliferations closely mimicking cystic serous borderline tumors of the ovary. In addition, 3 of the tumors in our series revealed a solid epithelial component, which was morphologically and immunohistochemically similar to so called "female adnexal tumor of probable wolffian origin," which is a rare neoplasm described so far only in the female genital tract, retroperitoneum, and the pelvic cavity. In analogy with mixed epithelial and stromal tumors of the kidney, which are renal neoplasms producing ovarian-type stroma, we suggest to designate the above paratesticular tumors containing ovarian-type stroma as "mixed epithelial and stromal tumors of the paratestis with features of cystic serous borderline tumor" (cases 1 and 2) and "mixed epithelial and stromal tumors of the paratestis with male adnexal tumor of probable wolffian origin" (cases 3-5). PMID:23020997

  9. Ocular drug delivery systems: An overview

    PubMed Central

    Patel, Ashaben; Cholkar, Kishore; Agrahari, Vibhuti; Mitra, Ashim K

    2014-01-01

    The major challenge faced by today’s pharmacologist and formulation scientist is ocular drug delivery. Topical eye drop is the most convenient and patient compliant route of drug administration, especially for the treatment of anterior segment diseases. Delivery of drugs to the targeted ocular tissues is restricted by various precorneal, dynamic and static ocular barriers. Also, therapeutic drug levels are not maintained for longer duration in target tissues. In the past two decades, ocular drug delivery research acceleratedly advanced towards developing a novel, safe and patient compliant formulation and drug delivery devices/techniques, which may surpass these barriers and maintain drug levels in tissues. Anterior segment drug delivery advances are witnessed by modulation of conventional topical solutions with permeation and viscosity enhancers. Also, it includes development of conventional topical formulations such as suspensions, emulsions and ointments. Various nanoformulations have also been introduced for anterior segment ocular drug delivery. On the other hand, for posterior ocular delivery, research has been immensely focused towards development of drug releasing devices and nanoformulations for treating chronic vitreoretinal diseases. These novel devices and/or formulations may help to surpass ocular barriers and associated side effects with conventional topical drops. Also, these novel devices and/or formulations are easy to formulate, no/negligibly irritating, possess high precorneal residence time, sustain the drug release, and enhance ocular bioavailability of therapeutics. An update of current research advancement in ocular drug delivery necessitates and helps drug delivery scientists to modulate their think process and develop novel and safe drug delivery strategies. Current review intends to summarize the existing conventional formulations for ocular delivery and their advancements followed by current nanotechnology based formulation developments. Also, recent developments with other ocular drug delivery strategies employing in situ gels, implants, contact lens and microneedles have been discussed. PMID:25590022

  10. Ocular perfusion pressure and ocular blood flow in glaucoma

    PubMed Central

    Cherecheanu, A Popa; Garhofer, G; Schmidl, D; Werkmeister, R; Schmetterer, L

    2013-01-01

    Glaucoma is a progressive optic neuropathy of unknown origin. It has been hypothesized that a vascular component is involved in glaucoma pathophysiology. This hypothesis has gained support from studies showing that reduced ocular perfusion pressure is a risk factor for the disease. The exact nature of the involvement is, however, still a matter of debate. Based on recent evidence we propose a model including primary and secondary insults in glaucoma. The primary insult appears to happen at the optic nerve head. Increased intraocular pressure and ischemia at the post-laminar optic nerve head affects retinal ganglion cell axons. Modulating factors are the biomechanical properties of the tissues and cerebrospinal fluid pressure. After this primary insult retinal ganglion cells function at a reduced energy level and are sensitive to secondary insults. These secondary insults may happen if ocular perfusion pressure falls below the lower limit of autoregulation or if neurovascular coupling fails. Evidence for both faulty autoregulation and reduced hyperemic response to neuronal stimulation has been provided in glaucoma patients. The mechanisms appear to involve vascular endothelial dysfunction and impaired astrocyte-vessel signaling. A more detailed understanding of these pathways is required to direct neuroprotective strategies via the neurovascular pathway. PMID:23009741

  11. Relation between Axial Length and Ocular Parameters

    Microsoft Academic Search

    Sang Hoon Park; Ki Ho Park; Joon Mo Kim; Chul Young Choi

    2010-01-01

    Purpose: To investigate the relation between axial length (AL) and ocular parameters. Methods: Measurements of ocular biometric parameters were performed with an optical biometer, pachymeter, optical coherence tomography, and an automatic refractometer. AL, refractive error (RE), central corneal thickness, anterior chamber depth (ACD), corneal curvature (CC), white-to-white distance (WWD), and retinal nerve fiber layer (RNFL) thickness were measured. AL was

  12. Ocular drug delivery in veterinary medicine

    Microsoft Academic Search

    Vincent Baeyens; Christine Percicot; Monia Zignani; Arati A Deshpande; Vassilios Kaltsatos; Robert Gurny

    1997-01-01

    This paper provides a comprehensive overview of the various approaches currently used in the development of ocular drug delivery systems for the treatment of ocular diseases in animals. It is obvious from the literature that most of the products that are currently available are derived from human medicine without consideration given to the differences which exist between the anatomy and

  13. Influence of refractive correction on ocular dominance

    NASA Astrophysics Data System (ADS)

    Nakayama, Nanami; Kawamorita, Takushi; Uozato, Hiroshi

    2010-07-01

    We investigated the effects of refractive correction and refractive defocus on the assessment of sensory ocular dominance. In 25 healthy subjects (4 males and 21 females) aged between 20 and 31 years, a quantitative measurement of sensory ocular dominance was performed with refractive correction and the addition of a positive lens on the dominant eye. Sensory ocular dominance was measured with a chart using binocular rivalry targets. The reversal point changed after the addition of a +1.00 D lens on the dominant eye in all subjects. However, sighting ocular dominance and stereopsis did not change after the addition of a positive lens on the dominant eye ( P > 0:05, Wilcoxon test). These results suggest that refractive correction affects sensory ocular dominance, indicating the possible development of a new type of occlusion for amblyopia in the future.

  14. Custom Ocular Prosthesis: A Palliative Approach

    PubMed Central

    Thakkar, Prachi; Patel, JR; Sethuraman, Rajesh; Nirmal, Narendra

    2012-01-01

    The goal of palliative care is the achievement of the best quality of life for patients and their families. Eyes are generally the first features of the face to be noticed. Loss of an eye is a traumatic event which has a crippling effect on the psychology of the patient. Several ocular and orbital disorders require surgical intervention that may result in ocular defects. An ocular prosthesis is fabricated to restore the structure, function, and cosmetics of the defects created by such conditions. Although an implant eye prosthesis has a superior outcome, due to economic factors it may not be a feasible option for all patients. Therefore, a custom-made ocular prosthesis is a good alternative. This case report presents a palliative treatment for a patient with an enucleated eye by fabricating a custom ocular prosthesis which improved his psychological, physical, social, functional, emotional and spiritual needs. PMID:22837616

  15. Presurgical diagnosis of adnexal tumours using mathematical models and scoring systems: a systematic review and meta-analysis.

    PubMed

    Kaijser, Jeroen; Sayasneh, Ahmad; Van Hoorde, Kirsten; Ghaem-Maghami, Sadaf; Bourne, Tom; Timmerman, Dirk; Van Calster, Ben

    2014-01-01

    BACKGROUND Characterizing ovarian pathology is fundamental to optimizing management in both pre- and post-menopausal women. Inappropriate referral to oncology services can lead to unnecessary surgery or overly radical interventions compromising fertility in young women, whilst the consequences of failing to recognize cancer significantly impact on prognosis. By reflecting on recent developments of new diagnostic tests for preoperative identification of malignant disease in women with adnexal masses, we aimed to update a previous systematic review and meta-analysis. METHODS An extended search was performed in MEDLINE (PubMed) and EMBASE (OvidSp) from March 2008 to October 2013. Eligible studies provided information on diagnostic test performance of models, designed to predict ovarian cancer in a preoperative setting, that contained at least two variables. Study selection and extraction of study characteristics, types of bias, and test performance was performed independently by two reviewers. Quality was assessed using a modified version of the QUADAS assessment tool. A bivariate hierarchical random effects model was used to produce summary estimates of sensitivity and specificity with 95% confidence intervals or plot summary ROC curves for all models considered. RESULTS Our extended search identified a total of 1542 new primary articles. In total, 195 studies were eligible for qualitative data synthesis, and 96 validation studies reporting on 19 different prediction models met the predefined criteria for quantitative data synthesis. These models were tested on 26 438 adnexal masses, including 7199 (27%) malignant and 19 239 (73%) benign masses. The Risk of Malignancy Index (RMI) was the most frequently validated model. The logistic regression model LR2 with a risk cut-off of 10% and Simple Rules (SR), both developed by the International Ovarian Tumor Analysis (IOTA) study, performed better than all other included models with a pooled sensitivity and specificity, respectively, of 0.92 [95% CI 0.88-0.95] and 0.83 [95% CI 0.77-0.88] for LR2 and 0.93 [95% CI 0.89-0.95] and 0.81 [95% CI 0.76-0.85] for SR. A meta-analysis of centre-specific results stratified for menopausal status of two multicentre cohorts comparing LR2, SR and RMI-1 (using a cut-off of 200) showed a pooled sensitivity and specificity in premenopausal women for LR2 of 0.85 [95% CI 0.75-0.91] and 0.91 [95% CI 0.83-0.96] compared with 0.93 [95% CI 0.84-0.97] and 0.83 [95% CI 0.73-0.90] for SR and 0.44 [95% CI 0.28-0.62] and 0.95 [95% CI 0.90-0.97] for RMI-1. In post-menopausal women, sensitivity and specificity of LR2, SR and RMI-1 were 0.94 [95% CI 0.89-0.97] and 0.70 [95% CI 0.62-0.77], 0.93 [95% CI 0.88-0.96] and 0.76 [95% CI 0.69-0.82], and 0.79 [95% CI 0.72-0.85] and 0.90 [95% CI 0.84-0.94], respectively. CONCLUSIONS An evidence-based approach to the preoperative characterization of any adnexal mass should incorporate the use of IOTA Simple Rules or the LR2 model, particularly for women of reproductive age. PMID:24327552

  16. Canine ocular onchocercosis in Hungary.

    PubMed

    Széll, Z; Erdélyi, I; Sréter, T; Albert, M; Varga, I

    2001-06-12

    An adult male mongrel dog that had spent its entire life in Hungary, was found to have infection with filaroid nematodes of the genus Onchocerca. The gravid male and female parasites were embedded in bean-sized granulomatous masses on the conjunctiva and the sclera of both eyes. The cuticle of females consisted of two separated layers in longitudinal sections, the external layer bearing ridges and the internal layer showing striations. The ridges were marked, rounded in shape, and the ratio of body diameter to the distance between ridges varied between 7:1 and 10:1. At midbody of the worms, two striations could be seen between each pair of ridges: one under every ridge and one between neighbouring ridges. Numerous exceptionally small (96.4 microm x 6.4 microm) microfilariae were seen in the uteri of females and the surrounding tissues and isolated from skin biopsy materials. The morphology and location of the parasite and histopathological lesions of the Hungarian case were similar to that described in dogs in the United States. This case is the first documented ocular Onchocerca infection in dogs outside the western United States. Thus, onchocercosis should be considered in the differential diagnosis of ocular and periocular nodules in dogs also in Europe. PMID:11390077

  17. Ocular manifestations of frontonasal dysplasia.

    PubMed

    Roarty, J D; Pron, G E; Siegel-Bartelt, J; Posnick, J C; Buncic, J R

    1994-01-01

    The ophthalmologic findings associated with frontonasal dysplasia have not been defined previously in a large series of untreated children. We reviewed the ophthalmic manifestations of a series of patients with frontonasal dysplasia who were seen as part of their craniofacial evaluation. All had undergone a complete ophthalmologic examination before any manipulation of either the orbits or the soft tissues of the orbital contents. From 1986 to 1991, 23 patients with frontonasal dysplasia were seen; ophthalmologic abnormalities were found in 20 (87 percent). Abnormalities included significant refractive errors, strabismus, nystagmus, and eyelid ptosis. Three patients had amblyopia, a treatable cause of visual loss, from strabismus or anisometropia. Ten eyes in seven patients (30 percent) had severe structural anomalies, such as optic nerve hypoplasia, optic nerve colobomas, microphthalmia, cataract, corneal dermoid, or inflammatory retinopathy, that resulted in an acuity of 20/100 or worse. The high incidence of ocular abnormalities indicates that early assessment by an ophthalmologist should be part of the initial evaluation of patients with frontonasal dysplasia to detect treatable visual or ocular problems. PMID:8278482

  18. Gender Disparities in Ocular Inflammatory Disorders*

    PubMed Central

    Sen, Hatice Nida; Davis, Janet; Ucar, Didar; Fox, Austin; Chan, Chi Chao; Goldstein, Debra A.

    2014-01-01

    Ocular inflammatory disorders disproportionately affect women, and the majority of affected women are of childbearing age. The role of sex or reproductive hormones has been proposed in many other inflammatory or autoimmune disorders, and findings from non-ocular autoimmune diseases suggest a complex interaction between sex hormones, genetic factors and the immune system. However, despite the age and sex bias, factors that influence this disparity are complicated and unclear. This review aims to evaluate the gender disparities in prevalence, incidence and severity of the most common infectious and non-infectious ocular inflammatory disorders. PMID:24987987

  19. [Ocular manifestations in Behçet's disease].

    PubMed

    Zeghidi, H; Saadoun, D; Bodaghi, B

    2014-02-01

    Uveitis is the most common ocular symptom in Behçet's disease. It is considered as a diagnostic criterion of the disease. Anterior uveitis is always non granulomatous, and sometimes associated with hypopion. Posterior involvement may include vitritis, retinal infiltrates, sheathing of retinal veins, occlusive vasculitis, and macular edema. Behçet's disease is chronic, and characterized by a spontaneously relapsing and remitting course. Male patients with younger age at onset and worse visual acuity at presentation, have higher risk of visual loss over time. The main goals in the management of patients with Behçet's disease-associated uveitis are rapid suppression of intraocular inflammation, preservation of vision, prevention of recurrences, and achievement of remission sustained after discontinuation of treatment. New therapeutic strategies such as interferon alpha and TNF alpha blockers have dramatically improved the visual prognosis of patients with intraocular inflammation related to this chronic and potentially blinding condition. PMID:24290834

  20. Residual deformations in ocular tissues.

    PubMed

    Wang, Ruoya; Raykin, Julia; Gleason, Rudolph L; Ethier, C Ross

    2015-04-01

    Residual deformations strongly influence the local biomechanical environment in a number of connective tissues. The sclera is known to be biomechanically important in healthy and diseased eyes, such as in glaucoma. Here, we study the residual deformations of the sclera, as well as the adjacent choroid and retina. Using freshly harvested porcine eyes, we developed two approaches of quantifying residual deformations in the spherically shaped tissues of interest. The first consisted of punching discs from the posterior wall of the eye and quantifying the changes in the area and eccentricity of these samples. The second consisted of cutting a ring from the equatorial sclera and making stress-relieving cuts in it. Measurements of curvature were made before and after the stress-relieving cuts. Using the first approach, we observed a 42% areal contraction of the choroid, but only modest contractions of the sclera and retina. The observed contractions were asymmetric. In the second approach, we observed an opening of the scleral rings (approx. 10% decrease in curvature). We conclude that residual bending deformations are present in the sclera, which we speculate may be due to radially heterogeneous growth and remodelling of the tissue during normal development. Further, residual areal deformations present in the choroid may be due to the network of elastic fibres in this tissue and residual deformations in the constituent vascular bed. Future studies of ocular biomechanics should attempt to include effects of these residual deformations into mechanical models in order to gain a better understanding of the biomechanics of the ocular wall. PMID:25740853

  1. Ocular toxicity from pesticide exposure: A recent review

    Microsoft Academic Search

    Kushik Jaga; Chandrabhan Dharmani

    2006-01-01

    Toxic effects on eyes result from exposure to pesticides via inhalation, ingestion, dermal contact and ocular exposure. Exposure\\u000a of unprotected eyes to pesticides results in the absorption in ocular tissue and potential ocular toxicity. Recent literature\\u000a on the risks of ocular toxicity from pesticide exposure is limited.\\u000a \\u000a Ocular toxicity from pesticide exposure, including the dose-response relationship, has been studied in

  2. Options for management of intra ocular tumors

    PubMed Central

    Lingam, Gopal

    2015-01-01

    The management of intra ocular tumors has undergone a sea change from the era of enucleation or external beam radiation. With the advent of new chemotherapy protocols, globe and vision salvage have become possible in a majority of cases of retinoblastoma. This article is an overview of the various modalities available for the management of intra ocular tumors and their indications. Chemotherapy has been covered elsewhere in this series of articles on ocular oncology. Photocoagulation and cryopexy are easily administered modalities of treatment for small tumors and totally within the ophthalmologist's domain. Slightly larger tumors are treatable with brachytherapy. The susceptibility of the tumors to chemotherapy and radiation decide the choice of treatment and the dosage. Management of intra ocular tumors very often needs a multidisciplinary approach including ophthalmologist, oncologist, radiation physicist, and radiotherapist. PMID:25971164

  3. Ocular Complications of Inflammatory Bowel Disease

    PubMed Central

    Mady, Rana; Grover, Will; Butrus, Salim

    2015-01-01

    Though inflammatory bowel disease (IBD) has a specific predilection for the intestinal tract, it is a systemic inflammatory disorder affecting multiple organs, including the eye. Ocular complications directly related to IBD are categorized as primary and secondary. Primary complications are usually temporally associated with IBD exacerbations and tend to resolve with systemic treatment of the intestinal inflammation. These include keratopathy, episcleritis, and scleritis. Secondary complications arise from primary complications. Examples include cataract formation due to treatment with corticosteroids, scleromalacia due to scleritis, and dry eye due to hypovitaminosis A following gut resection. Some ocular manifestations of IBD can lead to significant visual morbidity and temporally associated complications can also be a herald of disease control. Furthermore, ocular manifestations of IBD can occasionally manifest before the usual intestinal manifestations, leading to an earlier diagnosis. Thus, it is important to understand the clinical presentation of possible ocular manifestations in order to initiate appropriate treatment and to help prevent significant visual morbidity. PMID:25879056

  4. Microsurgical anatomy of the ocular motor nerves

    Microsoft Academic Search

    Yi ZhangHao; Hao Liu; En-Zhong Liu; You-Zhi Lin; Shi-Guang Zhao; Guo-Hua Jing

    2010-01-01

    This study was designed to provide anatomic data to help surgeons avoid damage to the ocular motor nerves during intraorbital\\u000a operations. The microsurgical anatomy of the ocular motor nerves was studied in 50 adult cadaveric heads (100 orbits). Dissections\\u000a were performed with a microscope. The nerves were exposed and the neural and muscular relationships of each portion of the\\u000a nerve

  5. Ocular findings in arteriohepatic dysplasia (Alagille's syndrome).

    PubMed

    Romanchuk, K G; Judisch, G F; LaBrecque, D R

    1981-04-01

    The ocular findings in a father and two offspring with arteriohepatic dysplasia are reported in this paper. All three people had bilateral posterior embryotoxon, Axenfeld's anomaly and a pigmentary retinopathy. Other ocular findings were exotropia, an ectopic pupil, band keratopathy, choroidal folds, anomalous optic discs and infantile myopia. Persons with arteriohepatic dysplasia typically present with prolonged neonatal jaundice. Cognizance of the associated eye findings helps distinguish this syndrome from other types of familial intrahepatic cholestasis. PMID:6796244

  6. Antibiotic resistance in ocular bacterial pathogens.

    PubMed

    Sharma, S

    2011-01-01

    Bacterial infections of the eye are common and ophthalmologists are spoilt for choice with a variety of antibiotics available in the market. Antibiotics can be administered in the eye by a number of routes; topical, subconjunctival, subtenon and intraocular. Apart from a gamut of eye drops available, ophthalmologists also have the option of preparing fortified eye drops from parenteral formulations, thereby, achieving high concentrations; often much above the minimum inhibitory concentration (MIC), of antibiotics in ocular tissues during therapy. Antibiotic resistance among ocular pathogens is increasing in parallel with the increase seen over the years in bacteria associated with systemic infections. Although it is believed that the rise in resistant ocular bacterial isolates is linked to the rise in resistant systemic pathogens, recent evidence has correlated the emergence of resistant bacteria in the eye to prior topical antibiotic therapy. One would like to believe that either of these contributes to the emergence of resistance to antibiotics among ocular pathogens. Until recently, ocular pathogens resistant to fluoroquinolones have been minimal but the pattern is currently alarming. The new 8-fluoroquinolone on the scene-besifloxacin, is developed exclusively for ophthalmic use and it is hoped that it will escape the selective pressure for resistance because of lack of systemic use. In addition to development of new antibacterial agents, the strategies to halt or control further development of resistant ocular pathogens should always include judicious use of antibiotics in the treatment of human, animal or plant diseases. PMID:21860100

  7. Ocular microtremor laser speckle metrology

    NASA Astrophysics Data System (ADS)

    Al-Kalbani, M.; Mihaylova, E.; Collins, N.; Toal, V.; Coakley, D.; Boyle, G.

    2009-02-01

    Ocular Microtremor (OMT) is a continual, high frequency physiological tremor of the eye present in all subjects even when the eye is apparently at rest. OMT causes a peak to peak displacement of around 150nm-2500nm with a broadband frequency spectrum between 30Hz to 120Hz; with a peak at about 83Hz. OMT carries useful clinical information on depth of consciousness and on some neurological disorders. Nearly all quantitative clinical investigations have been based on OMT measurements using an eye contacting piezoelectric probe which has low clinical acceptability. Laser speckle metrology is a candidate for a high resolution, non-contacting, compact, portable OMT measurement technique. However, tear flow and biospeckle might be expected to interfere with the displacement information carried by the speckle. The paper investigates the properties of the scattered speckle of laser light (? = 632.8nm) from the eye sclera to assess the feasibility of using speckle techniques to measure OMT such as the speckle correlation. The investigation is carried using a high speed CMOS video camera adequate to capture the high frequency of the tremor. The investigation is supported by studies using an eye movement simulator (a bovine sclera driven by piezoelectric bimorphs). The speckle contrast and the frame to frame spatiotemporal variations are analyzed to determine if the OMT characteristics are detectable within speckle changes induced by the biospeckle or other movements.

  8. Immunopathogenesis of ocular Behçet's disease.

    PubMed

    Park, Un Chul; Kim, Tae Wan; Yu, Hyeong Gon

    2014-01-01

    Behçet's disease (BD) is a chronic recurrent systemic inflammatory disorder of unknown etiology characterized by oral and genital ulcerations, skin lesions, and uveitis. The ocular involvement of BD, or Behçet's uveitis (BU), is characterized by panuveitis or posterior uveitis with occlusive retinal vasculitis and tends to be more recurrent and sight threatening than other endogenous autoimmune uveitides, despite aggressive immunosuppression. Although pathogenesis of BD is unclear, researches have revealed that immunological aberrations may be the cornerstone of BD development. General hypothesis of BD pathogenesis is that inflammatory response is initiated by infectious agents or autoantigens in patients with predisposing genetic factors and perpetuated by both innate and acquired immunity. In addition, a network of immune mediators plays a substantial role in the inflammatory cascade. Recently, we found that the immunopathogenesis of BU is distinct from other autoimmune uveitides regarding intraocular effector cell profiles, maturation markers of dendritic cells, and the cytokine/chemokine environment. In addition, accumulating evidence indicates the involvement of Th17 cells in BD and BU. Recent studies on genetics and biologics therapies in refractory BU also support the immunological association with the pathogenesis of BU. In this review, we provide an overview of novel findings regarding the immunopathogenesis of BU. PMID:25061613

  9. Sighting versus sensory ocular dominance

    PubMed Central

    Pointer, Jonathan S.

    2012-01-01

    Purpose An indication of the laterality of ocular dominance (OD) informs the clinical decision making process when considering certain ophthalmic refractive and surgical interventions. Can predictive reliance be assured regardless of OD technique or is the indication of a dominant eye method-dependent? Methods Two alternative OD test formats were administered to a group of 72 emmetropic healthy young adult subjects: the ‘hole-in-card’ test for sighting dominance and the ‘+1.50D blur’ test for sensory dominance. Both techniques were chosen as being likely familiar to the majority of ophthalmic clinicians; to promote and expedite application during the examination routine neither test required specialist training nor equipment. Results Right eye dominance was indicated in 71% of cases by the sighting test but in only 54% of subjects using the sensory test. The laterality of OD indicated for the individual subject by each technique was in agreement on only 50% of occasions. Conclusions Reasons are considered for the poor intra-individual agreement between OD tests, along with an item of procedural advice for the clinician.

  10. Impacts of Nanomedicines in Ocular Pharmacotherapy

    PubMed Central

    Nakhlband, Ailar; Barar, Jaleh

    2011-01-01

    Introduction The integrity of the cells/tissues in anterior and/or posterior segments of the eye plays a crucial role in biofunctions of the vision. To maintain ocular homeostasis, selective restrictiveness of the ophthalmic membranes and barriers control must act on shuttling of biomolecules. Thus, not all attempts to apply de novo nanotechnology approaches for ocular pharmacotherapy have met with the same successes as those cited here in this review, and sometimes these novel technologies tools provoke a great deal of challenges and hurdles mainly because of functional presence of these barriers. Methods Recent published articles related to applications of ocular nanomedicines were reviewed and highlighted in this review article. Results It seems the emergence of nanomedicines have arisen great hopes for ophthalmic pharmacotherapy, in which nanostructured medicines are expected to be able to cross the restrictive barriers of the eye. Although such fast inauguration of ocular nanomedicines will literally convey new challenges in the regulatory and translational processes, it will also grant a prolific platform from which many exciting, and yet unimagined, applications of biomedical nanotechnology will emerge for pharmacotherapy of the eye. Conclusion This review provides recent advancements on ocular nanomedicines. PMID:23678403

  11. Ocular Biometry in Angle Closure

    PubMed Central

    Razeghinejad, Mohammad Reza; Banifatemi, Mohammad

    2013-01-01

    Purpose To compare ocular biometric parameters in primary angle closure suspects (PACS), primary angle closure glaucoma (PACG) and acute primary angle closure (APAC). Methods This cross-sectional study was performed on 113 patients including 33 cases of PACS, 45 patients with PACG and 35 subjects with APAC. Central corneal thickness (CCT), axial length (AL), anterior chamber depth (ACD) and lens thickness (LT) were measured with an ultrasonic biometer. Lens-axial length factor (LAF), relative lens position, corrected ACD (CACD) and corrected lens position were calculated. The parameters were measured bilaterally but only data from the right eyes were compared. In the APAC group, biometric parameters were also compared between affected and unaffected fellow eyes. Logistic regression analysis was performed to identify risk factors. Results No statistically significant difference was observed in biometric parameters between PACS and PACG eyes, or between affected and fellow eyes in the APAC group (P>0.05 for all comparisons). However, eyes with APAC had thicker cornea (P=0.001), thicker lens (P<0.0001), shallower ACD (P=0.009), shallower CACD (P=0.003) and larger LAF (P<0.0001). Based on ROC curve analysis, lower ACD, and larger LT, LAF and CCT values were associated with APAC. In the APAC group, LAF (P<0.0001) and CCT (P=0.001) were significant risk factors. Conclusion This study revealed no significant difference in biometric characteristics in eyes with PACS and PACG. However, larger LAF and CCT were predictive of APAC. PMID:23825708

  12. Ocular effects of cosmetic products and procedures.

    PubMed

    Coroneo, Minas T; Rosenberg, Marni L; Cheung, Leanne M

    2006-04-01

    Cosmetic products and procedures can produce adverse effects on the ocular surface, ranging from mild discomfort to vision-threatening conditions. Complications of skin and eye products can be related to allergy or toxicity, often attributable to perfumes. Complications of blepharoplasty may be associated with overcorrection, scarring, or uneven contour of the lid margins, conditions that can cause significant ocular surface disease until they are corrected. Ocular surface effects of botulinum toxin injection include dry eye syndromes and also epiphora. More serious complications occur (rarely) and are dose- and location-related. Adverse effects of micropigmentation procedures involve pathological processes or, simply, poor cosmetic results. In certain youth cultures, special-effect contact lenses and even decorative conjunctival implants have gained popularity, presenting a wide variety of dangers, often attributable to poor education about care and hygiene. PMID:16681080

  13. Neuroretinitis in ocular bartonellosis: a case series.

    PubMed

    Raihan, Abdul-Rahim; Zunaina, Embong; Wan-Hazabbah, Wan-Hitam; Adil, Hussein; Lakana-Kumar, Thavaratnam

    2014-01-01

    We report a case series of neuroretinitis in ocular bartonellosis and describe the serologic verification for Bartonella henselae. This is a retrospective interventional case series of four patients who presented in the ophthalmology clinic of Hospital Universiti Sains Malaysia from June 2012 to March 2013. All four patients had a history of contact with cats and had fever prior to ocular symptoms. Each patient presented with neuroretinitis characterized by optic disc swelling with macular star. Serology analysis showed strongly positive for B. henselae in all of the patients. All patients were treated with oral azithromycin (except case 4, who was treated with oral doxycycline), and two patients (case 1 and case 3) had poor vision at initial presentation that warranted the use of oral prednisolone. All patients showed a good visual outcome except case 3. Vision-threatening ocular manifestation of cat scratch disease can be improved with systemic antibiotics and steroids. PMID:25120352

  14. Developments in Ocular Genetics: 2013 Annual Review

    PubMed Central

    Aboobakar, Inas F.; Allingham, R. Rand

    2014-01-01

    Purpose To highlight major advancements in ocular genetics from the year 2013. Design Literature review. Methods A literature search was conducted on PubMed to identify articles pertaining to genetic influences on human eye diseases. This review focuses on manuscripts published in print or online in the English language between January 1, 2013 and December 31, 2013. A total of 120 papers from 2013 were included in this review. Results Significant progress has been made in our understanding of the genetic basis of a broad group of ocular disorders, including glaucoma, age-related macular degeneration, cataract, diabetic retinopathy, keratoconus, Fuchs’ endothelial dystrophy, and refractive error. Conclusions The latest next-generation sequencing technologies have become extremely effective tools for identifying gene mutations associated with ocular disease. These technological advancements have also paved the way for utilization of genetic information in clinical practice, including disease diagnosis, prediction of treatment response and molecular interventions guided by gene-based knowledge. PMID:25097799

  15. Vascular basophilia in ocular and orbital tumors.

    PubMed

    Stowe, G C; Zakov, Z N; Albert, D M; Smith, T R; Sang, D N; Craft, J L

    1979-10-01

    The occurrence of vascular basophilia in ocular tumors has been a selective histologic feature of retinoblastomas. We recently observed a metastatic oat-cell carcinoma to the choroid which also demonstrated such a vascular hematoxyphilia. Histologic review of a variety of ocular and orbital metastatic carcinomas failed to yield a similar basophilic pattern. Examination of 100 consecutive retinoblastomas for vascular basophilia revealed an incidence of 6.0%. Similar material was not seen in any of 125 melanomas, including 10 with areas of necrosis. Histochemical studies showed the basophilic material to be DNA, and electron microscopy revealed the nuclear debris of pyknotic tumor cells to be continuous with identical material surrounding the adjacent blood vessels. The pathogenesis of vascular deposition of DNA in these two ocular tumors remains unclear. This finding most likely represents a form of tumor activity requiring comparatively healthy blood vessels to adequately precipitate liberated nucleic acids being filtered from the necrotic and degenerating tumor tissue. PMID:225286

  16. A case of posterior scleritis: differential diagnosis of ocular pain

    Microsoft Academic Search

    Ferdinando Maggioni; Silvia Ruffatti; Federica Viaro; Federico Mainardi; Carlo Lisotto; Giorgio Zanchin

    2007-01-01

    \\u000a Abstract\\u000a   Posterior scleritis is a rare cause of ocular pain, due to scleral inflammation, presenting with periocular pain, pain on\\u000a movement and decreased vision. Although anterior scleritis may be associated with this condition, ocular signs may be absent.\\u000a We report a case of posterior scleritis, presenting with right-sided ocular and periocular pain, exacerbated by ocular movements,\\u000a irradiating to the ipsilateral

  17. Ocular manifestations of systemic inflammatory diseases.

    PubMed

    Mohsenin, Amir; Huang, John J

    2012-10-01

    Inflammation of the eye is often times seen in association with systemic inflammatory diseases. Understanding the various forms of ocular involvement in these conditions is important as untreated ophthalmic involvement can lead to severe vision loss. In addition to providing a basic framework for diagnosis and treatment, this review will highlight the ocular manifestations of the following systemic inflammatory conditions: rheumatoid arthritis, systemic lupus erythematosus, Wegener's granulomatosis, Sjögren's syndrome, polyarteritisnodosa, primary antiphospholipid syndrome, Behçet's syndrome, Kawasaki disease, Cogan's syndrome and relapsing polychondritis. PMID:23155672

  18. Ocular motor abnormalities in neurodegenerative disorders.

    PubMed

    Antoniades, C A; Kennard, C

    2015-02-01

    Eye movements are a source of valuable information to both clinicians and scientists as abnormalities of them frequently act as clues to the localization of a disease process. Classically, they are divided into two main types: those that hold the gaze, keeping images steady on the retina (vestibulo-ocular and optokinetic reflexes) and those that shift gaze and redirect the line of sight to a new object of interest (saccades, vergence, and smooth pursuit). Here we will review some of the major ocular motor abnormalities present in neurodegenerative disorders. PMID:25412716

  19. Damage control surgery in ocular traumatology

    Microsoft Academic Search

    Ferenc Kuhn; Zlatko Slezakb

    2004-01-01

    There seems to be no decrease in the incidence of serious eye injuries. Although recent developments in technology now allow salvage of eyes that would have been lost only a few years ago, certain rules must be followed to achieve optimal outcome. Damage control surgery in ocular traumatology means that the ophthalmologist understands that eye injuries must be treated only

  20. Controlled release polymeric ocular delivery of acyclovir.

    PubMed

    Deshpande, Praful Balavant; Dandagi, Panchaxari; Udupa, Nayanabhirama; Gopal, Shavi V; Jain, Samata S; Vasanth, Surenalli G

    2010-01-01

    The aim of the present study was to formulate and evaluate controlled release polymeric ocular delivery of acyclovir. Reservoir-type ocular inserts were fabricated by sandwiching hydroxypropyl methylcellulose (HPMC) matrix film containing acyclovir between two rate controlling membranes of cellulose acetate phthalate (CAP). The solubility and dissolution rate of poorly soluble acyclovir was enhanced by preparing binary systems with beta-cyclodextrin and then incorporated into HPMC matrix. Nine formulations (AB-1 to AB-9) with varying ratio of HPMC (drug matrix) and CAP (rate controlling membrane) were developed and sterilized by gamma radiation. The formulations were subjected to various physico-chemical evaluations. The in vitro release profile of all the formulations showed a steady, controlled drug release up to 20 h with non-Fickian diffusion behavior. A high correlation coefficient found between in vitro/in vivo release rate studies. Formation of acyclovir complex was confirmed by differential scanning calorimetry. In addition, dissolution rate studies revealed improved solubility of acyclovir when complexed with beta-cyclodextrin. Stability studies showed that the ocular inserts could be stored safely at study storage conditions. In conclusion, the present study demonstrated controlled release formulation of acyclovir inserts for ocular delivery using biodegradable polymers. PMID:19772377

  1. Immunotherapy of bovine ocular squamous cell carcinomas

    Microsoft Academic Search

    PB Spradbrow; BE Wilson; D Hoffmann; WR Kelly; J Francis

    1977-01-01

    Squamous cell carcinomas were collected from the eyes of cattle and saline phenol extracts of the tumours were prepared. The aqueous phase of the extract was used in studies on the immunotherapy of ocular squamous cell carcinomas in cattle. After a single intramuscular injection of the extract, regression and sometimes complete disappearance of eye tumours were observed in 39 of

  2. OCULAR VERGENCE RESPONSE OVER ANAGLYPHIC STEREOSCOPIC VIDEOS

    E-print Network

    Duchowski, Andrew T.

    OCULAR VERGENCE RESPONSE OVER ANAGLYPHIC STEREOSCOPIC VIDEOS A Thesis Presented to the Graduate. Donald H. House Dr. Roy P. Pargas #12;ii 0.1 Abstract The effect of anaglyphic stereographic stimuli induced by anaglyphic stere- ographic display versus standard monoscopic display. Two visualization tools

  3. Ocular biometric characteristics during the menstrual cycle

    PubMed Central

    Çakmak, Harun; Taspinar, Ayten; Ozbagcivan, Mehmet; Kocatürk, Tolga

    2015-01-01

    Purpose To determine the ocular biometric characteristics during the menstrual cycle using the optical low-coherence reflectometry (OLCR) biometry. Methods Twenty-two healthy women between the ages of 19 and 36 years with regular menstrual cycles were enrolled in this prospective study. Subjects with irregular menstrual cycles, those taking contraceptive pills, those with a history of ocular surgery or trauma, and women unable to cooperate with the ocular biometry device were excluded from this study. A complete ophthalmic examination was performed between 8.30 and 10.30 am for all participants. Also, central corneal thickness, axial length, anterior chamber depth, lens thickness, and keratometric measurements were made at the same time using the OLCR device. Measurements were taken at the beginning of the cycle (1–3 days), at ovulation (12–16 days), and at the end of the cycle (26–32 days). Results The mean age of the participants was 22.86±4.22 (range: 18–36) years. The difference in central corneal thickness, axial length, anterior chamber depth, lens thickness, and keratometry values were not statistically significant during the menstrual cycle. Conclusion The ocular biometric parameters did not significantly vary during the menstrual cycle according to the OLCR biometry. PMID:26170610

  4. Evolution of the vestibulo-ocular system

    NASA Technical Reports Server (NTRS)

    Fritzsch, B.

    1998-01-01

    The evolutionary and developmental changes in the eye muscle innervation, the inner ear, and the vestibulo-ocular reflex are examined. Three eye muscle patterns, based on the innervation by distinct ocular motoneurons populations, can be identified: a lamprey, an elasmobranch, and a bony fish/tetrapod pattern. Four distinct patterns of variation in the vestibular system are described: a hagfish pattern, a lamprey pattern, an elasmobranch pattern, and a bony fish/tetrapod pattern. Developmental data suggest an influence of the hindbrain on ear pattern formation, thus potentially allowing a concomitant change of eye muscle innervation and ear variation. The connections between the ear and the vestibular nuclei and between the vestibular nuclei and ocular motoneurons are reviewed, and the role of neurotrophins for pattern specification is discussed. Three patterns are recognized in central projections: a hagfish pattern, a lamprey pattern, and a pattern for jawed vertebrates. Second-order connections show both similarities and differences between distantly related species such as lampreys and mammals. For example, elasmobranchs lack an internuclear system, which is at best poorly developed in lampreys. It is suggested that the vestibulo-ocular system shows only a limited degree of variation because of the pronounced functional constraints imposed on it.

  5. Heritability of refractive value and ocular biometrics.

    PubMed

    Paget, Sandrine; Vitezica, Zulma G; Malecaze, François; Calvas, Patrick

    2008-02-01

    The aim of this work was to analyse genetic influences on ocular refractive value and axial length using the hypothesis of a polygenic control. The genealogical records of 55 families were used in the analyses. The cohort included 723 individuals and clinical data were collected for 445 individuals with a mean age of 37.86 years. Ocular refraction was determined by standard autorefractometry. Axial length was evaluated by scan ultrasonography. Gender, age and ethnic origin were included as covariates in the statistical analyses. Using variance component analysis via a Markov Chain Monte Carlo (MCMC) method, we estimated the heritability of refractive value and axial length in the pedigree. We then performed a segregation analysis, using Loki, a (MCMC) linkage analysis program for multilocus inheritance models, examining different inheritance models with polygenic components. Polygenic control was modelled under an additive infinitesimal model (which assumes infinite loci with small effects, with additive actions) and under a finite locus model (i.e. several causal loci). The estimates of heritability were 0.20 (95% confidence interval (CI) 0.04-0.36) for refractive value and 0.20 (95% CI 0.03-0.43) for axial length. Segregation analyses suggested that ocular refraction and axial length are under a polygenic control. A finite number of genes were identified with or without a polygenic, infinitesimal component. Ocular refraction is mildly-moderately heritable in the studied population. PMID:18160066

  6. Ocular Drug Delivery; Impact of in vitro Cell Culture Models

    PubMed Central

    Barar, Jaleh; Asadi, Masoud; Mortazavi-Tabatabaei, Seyed Abdolreza; Omidi, Yadollah

    2009-01-01

    Normal vision depends on the optimal function of ocular barriers and intact membranes that selectively regulate the environment of ocular tissues. Novel pharmacotherapeutic modalities have aimed to overcome such biological barriers which impede efficient ocular drug delivery. To determine the impact of ocular barriers on research related to ophthalmic drug delivery and targeting, herein we provide a review of the literature on isolated primary or immortalized cell culture models which can be used for evaluation of ocular barriers. In vitro cell cultures are valuable tools which serve investigations on ocular barriers such as corneal and conjunctival epithelium, retinal pigment epithelium and retinal capillary endothelium, and can provide platforms for further investigations. Ocular barrier-based cell culture systems can be simply set up and used for drug delivery and targeting purposes as well as for pathological and toxicological research. PMID:23198080

  7. Ocular toxicity of authentic lunar dust

    PubMed Central

    2012-01-01

    Background Dust exposure is a well-known occupational hazard for terrestrial workers and astronauts alike and will continue to be a concern as humankind pursues exploration and habitation of objects beyond Earth. Humankind’s limited exploration experience with the Apollo Program indicates that exposure to dust will be unavoidable. Therefore, NASA must assess potential toxicity and recommend appropriate mitigation measures to ensure that explorers are adequately protected. Visual acuity is critical during exploration activities and operations aboard spacecraft. Therefore, the present research was performed to ascertain the ocular toxicity of authentic lunar dust. Methods Small (mean particle diameter?=?2.9?±?1.0 ?m), reactive lunar dust particles were produced by grinding bulk dust under ultrapure nitrogen conditions. Chemical reactivity and cytotoxicity testing were performed using the commercially available EpiOcularTM assay. Subsequent in vivo Draize testing utilized a larger size fraction of unground lunar dust that is more relevant to ocular exposures (particles <120 ?m; median particle diameter?=?50.9?±?19.8 ?m). Results In vitro testing indicated minimal irritancy potential based on the time required to reduce cell viability by 50% (ET50). Follow-up testing using the Draize standard protocol confirmed that the lunar dust was minimally irritating. Minor irritation of the upper eyelids was noted at the 1-hour observation point, but these effects resolved within 24 hours. In addition, no corneal scratching was observed using fluorescein stain. Conclusions Low-titanium mare lunar dust is minimally irritating to the eyes and is considered a nuisance dust for ocular exposure. No special precautions are recommended to protect against ocular exposures, but fully shielded goggles may be used if dust becomes a nuisance. PMID:22817808

  8. Vascular function and ocular involvement in sarcoidosis.

    PubMed

    Siasos, Gerasimos; Paraskevopoulos, Theodoros; Gialafos, Elias; Rapti, Aggeliki; Oikonomou, Evangelos; Zaromitidou, Marina; Mourouzis, Konstantinos; Siasou, Georgia; Gouliopoulos, Nikolaos; Tsalamandris, Sotiris; Vlasis, Konstantinos; Stefanadis, Christodoulos; Papavassiliou, Athanasios G; Tousoulis, Dimitris

    2015-07-01

    Ocular involvement occurs in sarcoidosis (Sar) patients mainly in the form of uveitis. This study was designed to determine if uveitis in Sar patients is associated with vascular impairment. We enrolled 82 Sar patients and 77, age and sex matched, control subjects (Cl). Sar patients were divided into those with ocular sarcoidosis (OS) and those without ocular sarcoidosis (WOS). Endothelial function was evaluated by flow-mediated dilation (FMD). Pulse wave velocity (PWV) was measured as an index of aortic stiffness and augmentation index (AIx) as a measure of arterial wave reflections. Although there was no significant difference in sex, age and mean arterial pressure, patients with OS compared to WOS patients and Cl subjects had impaired FMD (p<0.001), increased AIx (p=0.02) and increased PWV (p=0.001). Interestingly, impaired FMD in Sar patients was independently, from possible covariates (age, sex, smoking habits, arterial hypertension, dyslipidemia), associated with increased odds of ocular involvement (odds ratio=1.69, p=0.001). More precisely ROC curve analysis revealed that FMD had a significant diagnostic ability for the detection of OS (AUC=0.77, p<0.001) with a sensitivity of 79% and a specificity of 68% for an FMD value below 6.00%. To conclude in the present study we have shown that ocular involvement in Sar patients is associated with impaired endothelial function and increased arterial stiffness. These results strengthen the vascular theory which considers uveitis a consequence of vascular dysfunction in Sar patients and reveals a possible clinical importance of the use of endothelial function tests. PMID:25937082

  9. Outcome of unexpected adnexal neoplasia discovered during risk reduction salpingo-oophorectomy in women with germ-line BRCA1 or BRCA2 mutations

    PubMed Central

    Conner, James R.; Meserve, Emily; Pizer, Ellen; Garber, Judy; Roh, Michael; Urban, Nicole; Drescher, Charles; Quade, Bradley J.; Muto, Michael; Howitt, Brooke E.; Pearlman, Mark D.; Berkowitz, Ross S.; Horowitz, Neil; Crum, Christopher P.; Feltmate, Colleen

    2014-01-01

    Purpose This study computed the risk of clinically silent adnexal neoplasia in women with germ-line BRCA1 or BRCA2 mutations (BRCAm+) and determined recurrence risk. Methods We analyzed risk reduction salpingo-oophorectomies (RRSOs) from 349 BRCAm+ women processed by the SEE-FIM protocol and addressed recurrence rates for 29 neoplasms from three institutions. Results Nineteen neoplasms (5.4%) were identified at one institution, 9.2% of BRCA1 and 3.4% of BRCA2 mutation-positive women. Fourteen had a high-grade tubal intraepithelial neoplasm (HGTIN, 74%). Mean age (54.4) was higher than the BRCAm+ cohort without neoplasia (47.8) and frequency increased with age (p<0.001). Twenty-nine BRCA m+ patients with neoplasia from three institutions were followed for a median of 5 years (1–8 yrs.). One of 11 with HGTIN alone (9%) recurred at 4 years, in contrast to 3 of 18 with invasion or involvement of other sites (16.7%). All but two, are currently alive. Among the 29 patients in the three institution cohort, mean ages for HGTIN and advanced disease were 49.2 and 57.7 (p = 0.027). Conclusions Adnexal neoplasia is present in 5–6% of RRSOs, is more common in women with BRCA1 mutations, and recurs in 9% of women with HGTIN alone. The lag in time from diagnosis of the HGTIN to pelvic recurrence (4 years) and differences in mean age between HGTIN and advanced disease (8.5 years) suggest an interval of several years from the onset of HGTIN until pelvic cancer develops. However, some neoplasms occur in the absence of HGTIN. PMID:24333842

  10. Ocular Surface as Barrier of Innate Immunity

    PubMed Central

    Bolaños-Jiménez, Rodrigo; Navas, Alejandro; López-Lizárraga, Erika Paulina; de Ribot, Francesc March; Peña, Alexandra; Graue-Hernández, Enrique O; Garfias, Yonathan

    2015-01-01

    Sight is one of the most important senses that human beings possess. The ocular system is a complex structure equipped with mechanisms that prevent or limit damage caused by physical, chemical, infectious and environmental factors. These mechanisms include a series of anatomical, cellular and humoral factors that have been a matter of study. The cornea is not only the most powerful and important lens of the optical system, but also, it has been involved in many other physiological and pathological processes apart from its refractive nature; the morphological and histological properties of the cornea have been thoroughly studied for the last fifty years; drawing attention in its molecular characteristics of immune response. This paper will review the anatomical and physiological aspects of the cornea, conjunctiva and lacrimal apparatus, as well as the innate immunity at the ocular surface.

  11. Ocular Toxicity Testing of Lunar Dust

    NASA Technical Reports Server (NTRS)

    Meyers, Valerie E.

    2010-01-01

    This slide presentation reviews the use of ocular testing to determine the toxicity of lunar dust. The OECD recommendations are reviewed. With these recommendations in mind the test methodology was to use EpiOcular, tissues derived from normal human epidermal keratinocytes, the cells of which have been differentiated on cell culture inserts to form a multi-layered structure, which closely parallels the corneal epithelium and to dose the tissue with 100 mg dust from various sources. The in-vitro study provides evidence that lunar dust is not severely corrosive or irritating, however, in vitro tests have limitations, and in vivo tests provides a more complete scenario, and information, it is recommended that in vivo tests be performed.

  12. Ocular screening tests of elementary school children

    NASA Technical Reports Server (NTRS)

    Richardson, J.

    1983-01-01

    This report presents an analysis of 507 abnormal retinal reflex images taken of Huntsville kindergarten and first grade students. The retinal reflex images were obtained by using an MSFC-developed Generated Retinal Reflex Image System (GRRIS) photorefractor. The system uses a 35 mm camera with a telephoto lens with an electronic flash attachment. Slide images of the eyes were examined for abnormalities. Of a total of 1835 students screened for ocular abnormalities, 507 were found to have abnormal retinal reflexes. The types of ocular abnormalities detected were hyperopia, myopia, astigmatism, esotropia, exotropia, strabismus, and lens obstuctions. The report shows that the use of the photorefractor screening system is an effective low-cost means of screening school children for abnormalities.

  13. Factors in the pathogenesis of ocular onchocerciasis

    PubMed Central

    Kirk, R.

    1957-01-01

    This article briefly reviews the history and distribution of Onchocerca volvulus, and the disease for which it is responsible. The importance is stressed of ophthalmic examination, as opposed to clinical inspection, in determining the incidence of onchocerciasis in a region, such as the Sudan, where eye diseases are common. A description of the ocular manifestations of the infection is given, and their etiology is discussed. PMID:13472405

  14. Speckle interferometric system to measure ocular microtremor

    Microsoft Academic Search

    James P. Ryle; Mohammed Al-Kalbani; Niamh Collins; Unnikrishnan Gopinathan; Gerard Boyle; Davis Coakley; John T. Sheridan

    2008-01-01

    Ocular microtremor (OMT) is a biological high frequency (up to 150Hz) low amplitude (25-2500nm peak to peak) involuntary motion of the human eye. Clinical OMT investigations to date have used eye-contacting mechanical piezoelectric probes or piezoelectric strain gauges. Before contact can be made, the eye must first be anaesthetized. In some cases, this eyelid spasms occur making it impossible to

  15. Advances in Biodegradable Ocular Drug Delivery Systems

    Microsoft Academic Search

    Susan S. Lee; Patrick Hughes; Aron D. Ross; Michael R. Robinson

    \\u000a The limitations of existing medical therapies for ocular disorders include low drug bioavailability, nonspecificity, side\\u000a effects, and poor treatment adherence to therapy. These limitations may be overcome through the use of sustained-release intraocular\\u000a drug delivery systems. Critical to the development of such systems has been the introduction of biocompatible polymers (biodegradable\\u000a and nonbiodegradable) that allow for drug release kinetics to

  16. Digital ocular fundus imaging: a review.

    PubMed

    Bernardes, Rui; Serranho, Pedro; Lobo, Conceição

    2011-01-01

    Ocular fundus imaging plays a key role in monitoring the health status of the human eye. Currently, a large number of imaging modalities allow the assessment and/or quantification of ocular changes from a healthy status. This review focuses on the main digital fundus imaging modality, color fundus photography, with a brief overview of complementary techniques, such as fluorescein angiography. While focusing on two-dimensional color fundus photography, the authors address the evolution from nondigital to digital imaging and its impact on diagnosis. They also compare several studies performed along the transitional path of this technology. Retinal image processing and analysis, automated disease detection and identification of the stage of diabetic retinopathy (DR) are addressed as well. The authors emphasize the problems of image segmentation, focusing on the major landmark structures of the ocular fundus: the vascular network, optic disk and the fovea. Several proposed approaches for the automatic detection of signs of disease onset and progression, such as microaneurysms, are surveyed. A thorough comparison is conducted among different studies with regard to the number of eyes/subjects, imaging modality, fundus camera used, field of view and image resolution to identify the large variation in characteristics from one study to another. Similarly, the main features of the proposed classifications and algorithms for the automatic detection of DR are compared, thereby addressing computer-aided diagnosis and computer-aided detection for use in screening programs. PMID:21952522

  17. Nanoparticles in the ocular drug delivery

    PubMed Central

    Zhou, Hong-Yan; Hao, Ji-Long; Wang, Shuang; Zheng, Yu; Zhang, Wen-Song

    2013-01-01

    Ocular drug transport barriers pose a challenge for drug delivery comprising the ocular surface epithelium, the tear film and internal barriers of the blood-aqueous and blood-retina barriers. Ocular drug delivery efficiency depends on the barriers and the clearance from the choroidal, conjunctival vessels and lymphatic. Traditional drug administration reduces the clinical efficacy especially for poor water soluble molecules and for the posterior segment of the eye. Nanoparticles (NPs) have been designed to overcome the barriers, increase the drug penetration at the target site and prolong the drug levels by few internals of drug administrations in lower doses without any toxicity compared to the conventional eye drops. With the aid of high specificity and multifunctionality, DNA NPs can be resulted in higher transfection efficiency for gene therapy. NPs could target at cornea, retina and choroid by surficial applications and intravitreal injection. This review is concerned with recent findings and applications of NPs drug delivery systems for the treatment of different eye diseases. PMID:23826539

  18. [The ocular fundus findings in dengue fever].

    PubMed

    Wen, K H; Sheu, M M; Chung, C B; Wang, H Z; Chen, C W

    1989-01-01

    From September to December of 1988, 24 cases of clinical diagnosed dengue fever accompanied by visual disturbances were studied. A detailed history and a detailed ocular examination including visual acuity, slit lamp examination, fundus examination through dilated pupil and fluorescein angiography were conducted. In some cases, Amsler grid, visual field, visual evoked potential and color vision test were also evaluated. The chief complaints of these 24 patients were blurred vision, central scotoma, floaters, photophobia and halo vision. The intervals between onset of fever and awareness of blurred vision were 2 to 15 days with an average of 7.26 days. The ocular fundus changes included macular hemorrhage, retinal hemorrhage, maculopathy, Roth's spot, diffuse retinal edema, peripapillary hemorrhage vitreous cells and blurring optic disc. The fluorescein angiographic findings included poor choroidal flushing, delayed disc filling, disc extravasation, block fluorescence, capillary obliteration, non filling of macular network, capillary leakage and window defect. Seventeen cases (30 eyes) were followed-up for 2 weeks to 3 months. Visual recovery was good in most of the cases. However, 2 cases (4 eyes) showed poor visual outcome. In this series studied, the principle ocular fundus change caused by dengue fever was macular hemorrhage. This may be due to the capillary changes near the macular area. But in some of the cases, the direct viral invasion and/or indirect changes of the optic nerve, the retinal pigment epithelium or photoreceptors should be considered. PMID:2733064

  19. [Arguments for prophylactic therapy of ocular hypertension].

    PubMed

    Wahl, J

    2011-11-01

    Increased intraocular pressure is currently the only manipulable risk factor for glaucoma. In ocular hypertension the intraocular pressure is increased but the optic nerve head and visual field are thought to show no damage. Classification into glaucoma by means of the optic nerve head is often possible only over a period of time because there is a large overlap between the already pathological and still normal findings. In the Ocular Hypertension Treatment Study (OHTS) the effectiveness of prophylactic treatment was demonstrated. In the OHTS and the European Glaucoma Prevention Study (EGPS) risk factors have been identified, such as increased intraocular pressure, size of the excavation of the optic nerve head, decreased central corneal thickness, increased pattern standard deviation in the visual field and age. Before treatment of ocular hypertension is initiated these risk factors and the patient's personal situation should be considered. The higher the intraocular pressure, the smaller the central corneal thickness and the larger the excavation of the optic nerve and the younger the patient, the earlier treatment should be started. PMID:22037837

  20. [Therapy for Ocular Graft-vs-Host Disease].

    PubMed

    Steven, P; Sauerbier, L; Siebelmann, S; Gehlsen, U; Tahmaz, V; Wittig, S; Scheid, C; Cursiefen, C

    2015-05-01

    Therapy for ocular graft-vs-host disease (ocular GvHD) is challenging for ophthalmologists as progress of the disease often occurs rapidly and is unforeseeable. Primary goal is the preservation or restoration of visual acuity, however, studies on ocular GvHD that have investigated therapeutic concepts are limited. In contrast, most therapeutic recommendations from consensus conferences derive from studies on dry eye diseases other than ocular GvHD. This review demonstrates the available therapies in the following categories: local, systemic, surgical and prophylactic. Primary targets are anti-inflammation, anti-fibrosis and lubrification of the ocular surface. In conclusion, studies strictly on ocular GvHD are needed to enable better evidence-based therapeutic decision-making in the future. PMID:25989035

  1. New animal model for human ocular toxocariasis: ophthalmoscopic observation

    Microsoft Academic Search

    Tomoko Hara Takayanagi; Nobuaki Akao; Ryoko Suzuki; Misato Tomoda; Setsuko Tsukidate; Koichiro Fujita

    1999-01-01

    BACKGROUND\\/AIMSAlthough human ocular toxocariasis causes severe vision defect, little is known about its aetiology, diagnosis, and treatment. To develop a new animal model for human ocular toxocariasis, ophthalmological findings of fundi in Mongolian gerbils, Meriones unguiculatus, and BALB\\/c mice were investigated following infection withToxocara canis.METHODSUsing an ophthalmoscope, which was specifically developed to observe the fundi of small animals, ocular changes

  2. Management of ocular complications of Vogt-Koyanagi-Harada syndrome

    Microsoft Academic Search

    Irfan Perente; Canan Asli Utine; Hanefi Cakir; Vedat Kaya; Ilknur Tugal Tutkun; Omer Faruk Yilmaz

    2009-01-01

    Background Vogt-Koyanagi-Harada syndrome (VKH) is a multisystem disorder, characterized by the T-cell-mediated autoimmune process directed\\u000a against melanocytic antigens in the ocular, nervous, auditory and integumentary systems. The ocular hallmarks of the disease\\u000a involve severe bilateral panuveitis associated with exudative retinal detachment. Case report We report a pediatric case of probable VKH Syndrome with isolated ocular findings, in which bilateral vitritis,

  3. Acute ocular myositis occurring under etanercept for rheumatoid arthritis.

    PubMed

    Couderc, Marion; Mathieu, Sylvain; Tournadre, Anne; Dubost, Jean-Jacques; Soubrier, Martin

    2014-10-01

    Ocular myositis is a rare disorder characterized by inflammation of single or multiple extra-ocular eye muscles presenting with painful diplopia and/or ophthalmoplegia. The etiology remains obscure and it is rarely associated with rheumatoid arthritis. We here reported the case of a 61-year-old woman treated by TNF-? blockade, namely etanercept, for rheumatoid arthritis for ten years who developed an acute ocular myositis. The patient improved after etanercept was stopped and initiation of high doses of corticosteroids. To our knowledge, this is the second report of ocular myositis occurring under TNF-? blockade treatment for rheumatoid arthritis. PMID:24746476

  4. Ocular effects following the volcanic eruptions of Mount St Helens.

    PubMed

    Fraunfelder, F T; Kalina, R E; Buist, A S; Bernstein, R S; Johnson, D S

    1983-03-01

    Three hundred thirty-two ophthalmologists examined 1,523 patients with immediate ocular complaints following the 1980 eruptions of Mount St Helens. Loggers working up to 18 months in environments with high concentrations of volcanic ash were compared with a control group of loggers without volcanic ash contact. Although the ash particles acted as ocular foreign bodies, the small particles were apparently well tolerated for the most part, except for acute irritation. Patients with contact lenses or sicca syndrome had the most frequent ocular complaints. To date, no long-term ocular effects have been noted secondary to volcanic ash exposure. PMID:6830486

  5. Ocular shell structures in some Cretaceous trachyleberid Ostracoda

    USGS Publications Warehouse

    Kontrovitz, M.; Puckett, T.M.

    1998-01-01

    This is the first study of internal ocular shell structures of Cretaceous ostracodes. Internal molds from eight species of four genera from Santonian, Campanian, and Maastrichtian strata revealed a stalked ocular sinus constricted along its length and distally inflated. The latter part has anterior and posterior lobes and a subcentral concavity. These Cretaceous trachyleberids have ocular shell structures similar to Cenozoic taxa and it is presumed they functioned similarly. However, each taxon has a diagnostic ocular sinus and an inner surface of the eye tubercle that distinguishes each from all other forms examined.

  6. Ocular manifestations of the potentially lethal rheumatologic and vasculitic disorders.

    PubMed

    Foster, C Stephen

    2013-06-01

    Vision threatening ocular inflammation may occur in patients with any of the acquired connective tissue disorders and vasculitic diseases. Additionally, the ocular inflammation may be the presenting manifestation of the disease, which leads the patient to seek medical care. Other manifestations of the potentially lethal disease may be subtle or absent, presenting the thoughtful ophthalmologist with the opportunity to make life saving discoveries. Necrotizing scleritis, peripheral ulcerative keratitis, and retinal vasculitis are the ocular findings which should prompt the ophthalmologist to initiate very aggressive measures aimed at discovering any evidence of extra-ocular abnormalities, laboratory or otherwise. Appropriate therapy will be sight saving and may be life saving. PMID:23688612

  7. Evaluating the risk of ovarian cancer before surgery using the ADNEX model to differentiate between benign, borderline, early and advanced stage invasive, and secondary metastatic tumours: prospective multicentre diagnostic study

    PubMed Central

    Van Hoorde, Kirsten; Valentin, Lil; Testa, Antonia C; Fischerova, Daniela; Van Holsbeke, Caroline; Savelli, Luca; Franchi, Dorella; Epstein, Elisabeth; Kaijser, Jeroen; Van Belle, Vanya; Czekierdowski, Artur; Guerriero, Stefano; Fruscio, Robert; Lanzani, Chiara; Scala, Felice; Bourne, Tom; Timmerman, Dirk

    2014-01-01

    Objectives To develop a risk prediction model to preoperatively discriminate between benign, borderline, stage I invasive, stage II-IV invasive, and secondary metastatic ovarian tumours. Design Observational diagnostic study using prospectively collected clinical and ultrasound data. Setting 24 ultrasound centres in 10 countries. Participants Women with an ovarian (including para-ovarian and tubal) mass and who underwent a standardised ultrasound examination before surgery. The model was developed on 3506 patients recruited between 1999 and 2007, temporally validated on 2403 patients recruited between 2009 and 2012, and then updated on all 5909 patients. Main outcome measures Histological classification and surgical staging of the mass. Results The Assessment of Different NEoplasias in the adneXa (ADNEX) model contains three clinical and six ultrasound predictors: age, serum CA-125 level, type of centre (oncology centres v other hospitals), maximum diameter of lesion, proportion of solid tissue, more than 10 cyst locules, number of papillary projections, acoustic shadows, and ascites. The area under the receiver operating characteristic curve (AUC) for the classic discrimination between benign and malignant tumours was 0.94 (0.93 to 0.95) on temporal validation. The AUC was 0.85 for benign versus borderline, 0.92 for benign versus stage I cancer, 0.99 for benign versus stage II-IV cancer, and 0.95 for benign versus secondary metastatic. AUCs between malignant subtypes varied between 0.71 and 0.95, with an AUC of 0.75 for borderline versus stage I cancer and 0.82 for stage II-IV versus secondary metastatic. Calibration curves showed that the estimated risks were accurate. Conclusions The ADNEX model discriminates well between benign and malignant tumours and offers fair to excellent discrimination between four types of ovarian malignancy. The use of ADNEX has the potential to improve triage and management decisions and so reduce morbidity and mortality associated with adnexal pathology. PMID:25320247

  8. Silk film biomaterials for ocular surface repair

    NASA Astrophysics Data System (ADS)

    Lawrence, Brian David

    Current biomaterial approaches for repairing the cornea's ocular surface upon injury are partially effective due to inherent material limitations. As a result there is a need to expand the biomaterial options available for use in the eye, which in turn will help to expand new clinical innovations and technology development. The studies illustrated here are a collection of work to further characterize silk film biomaterials for use on the ocular surface. Silk films were produced from regenerated fibroin protein solution derived from the Bombyx mori silkworm cocoon. Methods of silk film processing and production were developed to produce consistent biomaterials for in vitro and in vivo evaluation. A wide range of experiments was undertaken that spanned from in vitro silk film material characterization to in vivo evaluation. It was found that a variety of silk film properties could be controlled through a water-annealing process. Silk films were then generated that could be use in vitro to produce stratified corneal epithelial cell sheets comparable to tissue grown on the clinical standard substrate of amniotic membrane. This understanding was translated to produce a silk film design that enhanced corneal healing in vivo on a rabbit injury model. Further work produced silk films with varying surface topographies that were used as a simplified analog to the corneal basement membrane surface in vitro. These studies demonstrated that silk film surface topography is capable of directing corneal epithelial cell attachment, growth, and migration response. Most notably epithelial tissue development was controllably directed by the presence of the silk surface topography through increasing cell sheet migration efficiency at the individual cellular level. Taken together, the presented findings represent a comprehensive characterization of silk film biomaterials for use in ocular surface reconstruction, and indicate their utility as a potential material choice in the development of innovative procedures and technologies for corneal repair.

  9. Amniotic membrane transplantation for ocular surface reconstruction

    PubMed Central

    Azuara-Blanco, A.; Pillai, C; Dua, H.

    1999-01-01

    AIMS—To evaluate the efficacy of amniotic membrane transplantation (AMT) for ocular surface reconstruction.?METHODS—10 consecutive patients who underwent AMT were included. The indications were: group A, cases with persistent epithelial defect after corneal abscess (n=1), radiation (n=1), or chemical burn (n=3); group B, cases with epithelial defect and severe stromal thinning and impending or recent perforation, due to chemical burn (two patients, three eyes) or corneal abscess (n=2); group C, to promote corneal epithelium healing and prevent scarring after symblepharon surgery with extensive corneo-conjunctival adhesion (n=1). Under sterile conditions amniotic membrane was prepared from a fresh placenta of a seronegative pregnant woman and stored at ?70°C. This technique involved the use of amniotic membrane to cover the entire cornea and perilimbal area in groups A and B, and the epithelial defect only in group C.?RESULTS—The cornea healed satisfactorily in four of five patients in group A, but the epithelial defect recurred in one of these patients. After AMT three patients underwent limbal transplantation and one penetrating keratoplasty and cataract extraction. In group B amniotic membrane transplantation was not helpful, and all cases underwent an urgent tectonic corneal graft. Surgery successfully released the symblepharon, promoted epithelialisation and prevented adhesions in the case of group C.?CONCLUSION—AMT was effective to promote corneal healing in patients with persistent epithelial defect, and appeared to be helpful after surgery to release corneo-conjunctival adhesion. Most cases required further surgery for visual and ocular surface rehabilitation. Amniotic membrane used as a patch was not effective to prevent tectonic corneal graft in cases with severe stromal thinning and impending or recent perforation.?? Keywords: amniotic membrane; cornea; ocular surface; epithelial defect PMID:10434859

  10. Ocular Dominance and Visual Function Testing

    PubMed Central

    Lopes-Ferreira, D.; Neves, H.; Queiros, A.; Faria-Ribeiro, M.; Peixoto-de-Matos, S. C.; González-Méijome, J. M.

    2013-01-01

    Purpose. To show the distribution of ocular dominance as measured with sensory and eye sighting methods and its potential relationship with high and low contrast LogMAR visual acuity in presbyopic subjects. Method. Forty-four presbyopes (48.5 ± 3.5 years) participated in this study. Ocular dominance was determined by eye sighting (hole-in-card) and sensorial (+1.50?D lens induced blur) methods. According to the dominance detected with each method (RE: right eye or LE: left eye), patients were classified in dominance type 1 (RE/RE), type 2 (RE/LE), type 3 (LE/RE) and type 4 (LE/LE). Results. Baseline refractive error (MSE) was RE:?0.36 ± 1.67?D and LE:?0.35 ± 1.85?D (P = 0.930). RE was the dominant eye in 61.4% and 70.5% of times as obtained from sensorial and sighting methods, respectively. Most frequent dominance was of type 1 (52.3%), in this case the RE showed statistically significant better distance low contrast LogMAR VA (0.04 LogMAR units) compared to the LE (P < 0.05). Conclusions. The dominance was more frequent in RE in this sample. The eye sighting and sensorial methods to define ocular dominance agreed in more than half of cases. Amount of MSE was not significantly different between dominant and non-dominant eye. But in case of right dominance, the RE presented better distance low contrast VA compared to the LE. PMID:24319677

  11. Ocular Phenotype of Fbn2-Null Mice

    PubMed Central

    Shi, Yanrong; Tu, Yidong; Mecham, Robert P.; Bassnett, Steven

    2013-01-01

    Purpose. Fibrillin-2 (Fbn2) is the dominant fibrillin isoform expressed during development of the mouse eye. To test its role in morphogenesis, we examined the ocular phenotype of Fbn2?/? mice. Methods. Ocular morphology was assessed by confocal microscopy using antibodies against microfibril components. Results. Fbn2?/? mice had a high incidence of anterior segment dysgenesis. The iris was the most commonly affected tissue. Complete iridal coloboma was present in 37% of eyes. Dyscoria, corectopia and pseudopolycoria were also common (43% combined incidence). In wild-type (WT) mice, fibrillin-2-rich microfibrils are prominent in the pupillary membrane (PM) during development. In Fbn2-null mice, the absence of Fbn2 was partially compensated for by increased expression of fibrillin-1, although the resulting PM microfibrils were disorganized, compared with WTs. In colobomatous adult Fbn2?/? eyes, the PM failed to regress normally, especially beneath the notched region of the iris. Segments of the ciliary body were hypoplastic, and zonular fibers, although relatively plentiful, were unevenly distributed around the lens equator. In regions where the zonular fibers were particularly disturbed, the synchronous differentiation of the underlying lens fiber cells was affected. Conclusions. Fbn2 has an indispensable role in ocular morphogenesis in mice. The high incidence of iris coloboma in Fbn2-null animals implies a previously unsuspected role in optic fissure closure. The observation that fiber cell differentiation was disturbed in Fbn2?/? mice raises the possibility that the attachment of zonular fibers to the lens surface may help specify the equatorial margin of the lens epithelium. PMID:24130178

  12. Determination of serum CRP, VEGF, Leptin, CK-MB, CA-15-3 and IL-6 levels for malignancy prediction in adnexal masses

    PubMed Central

    ?en, Serhat; Kuru, O?uzhan; Akbay?r, Özgür; O?uz, Hilal; Yasasever, Vildan; Berkman, Sinan

    2011-01-01

    Objective Investigation of serum markers which could be used in the malignancy prediction of adnexal masses. Material and Methods Vascular endothelial growth factor (VEGF), interleukin 6 (IL-6), leptin, C-reactive protein (CRP), creatine-kinase-MB (CK-MB) and cancer antigen 15-3 (CA 15-3) levels were determined prospectively in serum samples that were obtained from patients who underwent surgery for an adnexal mass and who were referred to Istanbul University, Faculty of Medicine, Department of Obstetrics and Gynecology, between 2009 and 2011, and then were compared with the serum samples of completely healthy outpatient patients as a control group. Based onto the ovarian cancer status, cases were divided into four groups: 13 patients were included in the early-stage malignant group, 12 patients were included in the advanced-stage malignant group, 25 in the benign group and 19 in the healthy control group. Patients with only epithelial ovarian cancer were included into the cancer group. Ethics Commitee approval was obtained for this study. The budget was supported by the Istanbul University Scientific Research Projects Unit. Results Results related with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and odds ratio (OR), respectively, and the following values were calculated: 48%, 95%, 92%, 59% and +OR 9.6 ?OR 0.5 for CA; 15-3; 52%, 75%, 72%, 55%, +OR 2.08 ?OR 0.64 for leptin; 72%, 70%, 75%, 66% 2.4-0.5 for IL-6; 24%, 80%, 60%, 45%, 1.2-0.92 for VEGF; 68%, 30%, 55%, 43%, 0.97–1.06 for CRP; and 8%, 70%, 25%, 38%, 026–1.31 for CK-MB. Conclusion CA 15-3, IL-6, Leptin, VEGF and CRP were effective in the prediction of benign and malignant masses; however they may be more suitable in selected cases as they have a limited use because of their inadequate potential regarding sensitivity and specificity. PMID:24591997

  13. A Rare Case of Ocular Myositis

    PubMed Central

    ALBU, CARMEN VALERIA; C?T?LIN, B.; ZAHARIA, CORNELIA

    2014-01-01

    We report the case of a 43 year old man who presented recurrent left abducens palsy. His medical history included arterial hypertension, ischemic cardiomiopathy, dyslipidemia, rhinitis, maxillary sinusitis. Physical examination revealed a overweight patient, horizontal gaze diplopia, left nerve VI paresis, mild left retro-orbital pain. The orbital MRI also didn’t offer new information: mild external edema on the left eye, with normal tendon aspect, no thickening or enhancement of the muscle belly and also normal aspect of the bony orbit. Recurrent palsy of EOMs can be caused in rare cases by ocular myositis. PMID:24791211

  14. Fabrication of a Custom Ocular Prosthesis

    PubMed Central

    Sethi, Tania; Kheur, Mohit; Haylock, Colin; Harianawala, Husain

    2014-01-01

    Defects of the eye may follow removal of a part of or the entire orbit. This results in the patient becoming visually, esthetically and psychologically handicapped. Restoring the defect with a silicone- or acrylic-based prosthesis not only restores esthetics but also gives back the lost confidence to the patient. This is a case report of a patient with a ‘pthisical eye’ and details the steps in fabrication of an ocular prosthesis. Particular attention has been given to the laboratory process in this technique to minimize the residual monomer content in the artificial eye. PMID:25100916

  15. Ocular globe luxation under general anesthesia.

    PubMed

    Clendenen, Steven R; Kostick, David A

    2008-11-01

    We present a case of ocular globe luxation after general anesthesia. Upon completion of the surgery, the upper eyelid was retracted to examine for conjunctival edema, which resulted in globe luxation. The posterior aspect of the globe was visualized and a small tethering white structure ("check ligament") was observed. The upper lid was retracted, and the globe easily repositioned into the orbit. Ophthalmic sequelae would not be anticipated if the episode of globe luxation is brief. Anesthesiologists should be aware of the risk factors associated with globe luxation and know how to appropriately treat this complication. PMID:18931223

  16. Penetrating ocular trauma from trampoline spring.

    PubMed

    Spokes, David; Siddiqui, Salina; Vize, Colin

    2010-02-01

    The case is presented of a 12-year old boy who sustained severe penetrating ocular trauma while playing on a domestic trampoline. A main spring broke under tension and the hook had struck the eye at high velocity and penetrated the sclera. Primary repair was undertaken but on review it became apparent the eye could not be salvaged. Evisceration was carried out and an orbital implant was placed. Post-operative cosmesis is acceptable. This type of injury has not been reported before. Adult supervision of children on trampolines is recommended to minimise the chance of serious injury. PMID:20302409

  17. Review: Epigenetic mechanisms in ocular disease

    PubMed Central

    He, Shikun; Li, Xiaohua; Chan, Nymph

    2013-01-01

    Epigenetics has become an increasingly important area of biomedical research. Increasing evidence shows that epigenetic alterations influence common pathologic responses including inflammation, ischemia, neoplasia, aging, and neurodegeneration. Importantly, epigenetic mechanisms may have a pathogenic role in many complex eye diseases such as corneal dystrophy, cataract, glaucoma, diabetic retinopathy, ocular neoplasia, uveitis, and age-related macular degeneration. The emerging emphasis on epigenetic mechanisms in studies of eye disease may provide new insights into the pathogenesis of complex eye diseases and aid in the development of novel treatments for these diseases.? PMID:23559860

  18. Penetrating ocular trauma associated with blank cartridge

    PubMed Central

    2014-01-01

    Background Blank cartridge guns are generally regarded as being harmless and relative safe. However recent published articles demonstrated that the gas pressure from the exploding propellant of blank cartridge is powerful enough to penetrate the thoracic wall, abdominal muscle, small intestine and the skull. And there has been a limited number of case reports of ocular trauma associated with blank cartridge injury. In addition, no report on case with split extraocular muscle injury with traumatic cataract and penetrating corneoscleral wound associated with blank cartridge has been previously documented. This report describes the case of patient who sustained penetrating ocular injury with extraocular muscle injury by a close-distance blank cartridge that required surgical intervention. Case presentation A 20-year-old man sustained a penetrating globe injury in the right eye while cleaning a blank cartridge pistol. His uncorrected visual acuity at presentation was hand motion and he had a flame burn of his right upper and lower lid with multiple missile wounds. On slit-lamp examination, there was a 12-mm laceration of conjunctiva along the 9 o'clock position with two pinhole-like penetrating injuries of cornea and sclera. There was also a 3-mm corneal laceration between 9 o'clock and 12 o'clock and the exposed lateral rectus muscle was split. Severe Descemet's membrane folding with stromal edema was observed, and numerous yellow, powder-like foreign bodies were impacted in the cornea. Layered anterior chamber bleeding with traumatic cataract was also noted. Transverse view of ultrasonography showed hyperechoic foreign bodies with mild reduplication echoes and shadowing. However, a computed tomographic scan using thin section did not reveal a radiopaque foreign body within the right globe. Conclusion To our best knowledge, this is the first case report of split extraocular muscle injury with traumatic cataract and penetrating ocular injury caused by blank cartridge injury. Intraocular foreign bodies undetectable by CT were identified by B-scan ultrasonography in our patient. This case highlights the importance of additional ultrasonography when evaluating severe ocular trauma. And ophthalmologists should consider the possibility of penetrating injury caused by blank ammunition. PMID:24589340

  19. Temporal Dynamics of Ocular Position Dependence of the Initial Human Vestibulo-ocular Reflex

    PubMed Central

    Crane, Benjamin T.; Tian, Junru; Demer, Joseph L.

    2007-01-01

    Purpose While an ideal vestibulo-ocular reflex (VOR) generates ocular rotations compensatory for head motion, during visually guided movements, Listing’s Law (LL) constrains the eye to rotational axes lying in Listing’s Plane (LP). The present study was conducted to explore the recent proposal that the VOR’s rotational axis is not collinear with the head’s, but rather follows a time-dependent strategy intermediate between LL and an ideal VOR. Methods Binocular LPs were defined during visual fixation in eight normal humans. The VOR was evoked by a highly repeatable transient whole-body yaw rotation in darkness at a peak acceleration of 2800 deg/s2. Immediately before rotation, subjects regarded targets 15 or 500 cm distant located at eye level, 20° up, or 20° down. Eye and head responses were compared with LL predictions in the position and velocity domains. Results LP orientation varied both among subjects and between individual subject’s eyes, and rotated temporally with convergence by 5 ± 5° (±SEM). In the position domain, the eye compensated for head displacement even when the head rotated out of LP. Even within the first 20 ms from onset of head rotation, the ocular velocity axis tilted relative to the head axis by 30% ± 8% of vertical gaze position. Saccades increased this tilt. Regardless of vertical gaze position, the ocular rotation axis tilted backward 4° farther in abduction than in adduction. There was also a binocular vertical eye velocity transient and lateral tilt of the ocular axis. Conclusions These disconjugate, short-latency axis perturbations appear intrinsic to the VOR and may have neural or mechanical origins. PMID:16565376

  20. “Johnny Poppers”: a cause of serious ocular injury

    Microsoft Academic Search

    Kerr MacAndie; Peter Kyle

    1998-01-01

    AIMS\\/BACKGROUNDThe causes of blunt ocular trauma are many and diverse. We present two cases of ocular injury caused by an unusual form of weapon called a “Johnny Popper”. There follows a theoretical and experimental evaluation of the velocity of the projectiles fired by this device.METHODSA Johnny Popper was constructed under expert guidance. The elastic properties of the device were measured

  1. Determination of infrared radiation levels for acute ocular cataractogenesis

    Microsoft Academic Search

    Donald G. Pitts; Anthony P. Cullen

    1981-01-01

    One hundred pigmented rabbit eyes and ten primate eyes were exposed to infrared (IR) radiation in the 715 to 1,400 nm wavelength range and to the full spectrum output from a 5,000 W Xenon high-pressure source. The ocular exposures were evaluated independently with a slitlamp by two researchers and classified for ocular damage.

  2. Benefit of higher closedloop bandwidths in ocular adaptive optics

    E-print Network

    Dainty, Chris

    Benefit of higher closed­loop bandwidths in ocular adaptive optics Luis Diaz-Santana, Cristiano, Ireland Abstract: We present an ocular adaptive optics system with a wavefront sampling rate of 240 Hz frequency content around 30 Hz. © 2003 Optical Society of America OCIS codes: (010.1080) Adaptive optics

  3. Microemulsion: New Insights into the Ocular Drug Delivery

    PubMed Central

    Hegde, Rahul Rama; Verma, Anurag; Ghosh, Amitava

    2013-01-01

    Delivery of drugs into eyes using conventional drug delivery systems, such as solutions, is a considerable challenge to the treatment of ocular diseases. Drug loss from the ocular surface by lachrymal fluid secretion, lachrymal fluid-eye barriers, and blood-ocular barriers are main obstacles. A number of ophthalmic drug delivery carriers have been made to improve the bioavailability and to prolong the residence time of drugs applied topically onto the eye. The potential use of microemulsions as an ocular drug delivery carrier offers several favorable pharmaceutical and biopharmaceutical properties such as their excellent thermodynamic stability, phase transition to liquid-crystal state, very low surface tension, and small droplet size, which may result in improved ocular drug retention, extended duration of action, high ocular absorption, and permeation of loaded drugs. Further, both lipophilic and hydrophilic characteristics are present in microemulsions, so that the loaded drugs can diffuse passively as well get significantly partitioned in the variable lipophilic-hydrophilic corneal barrier. This review will provide an insight into previous studies on microemulsions for ocular delivery of drugs using various nonionic surfactants, cosurfactants, and associated irritation potential on the ocular surface. The reported in vivo experiments have shown a delayed effect of drug incorporated in microemulsion and an increase in the corneal permeation of the drug. PMID:23936681

  4. Dominant frequency content of ocular microtremor from normal subjects

    Microsoft Academic Search

    Ciaran Bolger; Stana Bojanic; Noirin F. Sheahan; Davis Coakley; James F. Malone

    1999-01-01

    Ocular microtremor (OMT) is a high frequency tremor of the eyes present during fixation and probably related to brainstem activity (Coakley, D. (1983). Minute eye movement and brain stem function. CRC Press, FL.). Published observations on the frequency of OMT have varied widely. Ocular microtremor was recorded in 105 normal healthy subjects using the Piezoelectric strain gauge technique. The dominant

  5. Ocular problem in Ebola virus infection: A short review.

    PubMed

    Wiwanitkit, Somsri; Wiwanitkit, Viroj

    2015-01-01

    In 2014, the outbreak of Ebola virus infection occured in Africa and became the global concern. The infection is an acute febrile illness and the patient can have several clinical manifestations including the hemorrhage. The ocular manifestation of Ebola infection is interesting. In this brief review, the authors summarize on the ocular manifestation in Ebola virus infection. PMID:26155084

  6. Ocular problem in Ebola virus infection: A short review

    PubMed Central

    Wiwanitkit, Somsri; Wiwanitkit, Viroj

    2015-01-01

    In 2014, the outbreak of Ebola virus infection occured in Africa and became the global concern. The infection is an acute febrile illness and the patient can have several clinical manifestations including the hemorrhage. The ocular manifestation of Ebola infection is interesting. In this brief review, the authors summarize on the ocular manifestation in Ebola virus infection.

  7. Presentation of pinealoblastoma with ocular dipping and deafness.

    PubMed

    Toshniwal, P; Yadava, R; Goldbarg, H

    1986-06-01

    Ocular dipping and deafness as presenting manifestations in a patient with pinealoblastoma are highly unusual. Presence of a discrete lesion allows us to postulate a mechanism to explain ocular dipping in light of the present understanding of vertical eye movement control. A mechanism for deafness, probably a false localizing sign of raised intracranial pressure, is proposed also. PMID:2942571

  8. Ocular air-gun injury: 19 cases

    PubMed Central

    Shuttleworth, G N; Galloway, P H

    2001-01-01

    There have been many calls for preventive action against injuries caused by air-guns. Eye injuries are particularly serious, and we conducted a retrospective study to review their characteristics. Ophthalmic consultants in the south-west region of England and South Wales were asked to recollect any injuries that had resulted from air weapons. Information was recorded on the nature and circumstances of the injury, subsequent management, and long-term effects. 19 cases of ocular injury were identified, sustained at mean age 19.7 years, all in the past decade. 15 of the victims were male. At least 12 shootings were accidental but 2 were deliberate. The injury was self-inflicted in 5 cases, and in 6 the assailant was known to the victim. 9 sustained ruptured globes and 8 had severe contusions. Ultimately 4 individuals required enucleation and 2 evisceration. At last review, visual acuity was no perception of light in 10 (53%) and ‘counting fingers’ or worse in 16. Victims spent an average of nearly 10 days as an inpatient. The characteristics of the incidents that lead to ocular air-weapon injuries are unchanged. Reform of the firearms laws is probably the best way to prevention. PMID:11461983

  9. Vascular endothelial growth factor and ocular neovascularization.

    PubMed Central

    Miller, J. W.

    1997-01-01

    Okamoto et al have developed an extremely useful and interesting model of retinal and subretinal neovascularization. Using molecular techniques, they have developed a transgenic model driven by overexpression of VEGF, a growth factor demonstrated to play an important role in neovascularization in many ocular diseases. They have been able to demonstrate that VEGF overexpression is sufficient to cause intraretinal and subretinal neovascularization. The mouse model is relatively cheap and reliable, does not require any exogenous agent, and has many characteristics of clinical intraocular neovascularization. The new vessels develop in the outer retina and subretinal space and have a characteristic histological appearance. They leak fluorescein on angiography, demonstrating their similarity to human disease and allowing identification and grading of neovascularization in vivo. The model can be used to investigate molecular mechanisms of VEGF-dependent neovascularization, with applications beyond ocular eye disease. The model can also be used to study anti-angiogenic agents that have the potential to treat common blinding diseases such as age-related macular degeneration. Okamoto et al have made a substantial contribution to the angiogenesis field with this work, and one looks forward to future investigations. PMID:9212726

  10. [Pathology of dermatoglyphics in ocular diseases].

    PubMed

    Tarc?, A

    2000-01-01

    The paper studies dermatoglyphics, viewed from a pathological perspective, on a group of 200 blind subjects or suffering from other grave congenital ocular affections, many of them hereditary, living in the province of Moldavia, from which 400 finger prints and palms have been collected. The observation to be made in that the advanced degree of sight's affection, up to the total loss, is correlated with an ample and strong pathological charge of the digital and palmar dermatoglyphic image of the subjects affected, suggestively expressed at the sample's level by a higher incidence of the distortions with serious medical implications, quite close to that recorded at deaf-mutes, mental handicapped people, in the grave congenital cardio-vascular affections, or at parents with malformed children from Moldavia. From the multitude of dermatoglyphic distortions put into evidence, the author considers that it is only one that might be specific to the serious congenital grave ocular affections, that is a certain disposal of the epidermal ridges, as a dense or very dense network at the level of the Th/I, in a ratio of 80% with women and 38% with men. The very high frequency of this distortion for females subjects might assume that the gene responsible for such a pathological configuration is placed on chromosome X. PMID:12089910

  11. Interleukin-6 blockade in ocular inflammatory diseases

    PubMed Central

    Mesquida, M; Leszczynska, A; Llorenç, V; Adán, A

    2014-01-01

    Interleukin-6 (IL-6) is a key cytokine featuring redundancy and pleiotropic activity. It plays a central role in host defence against environmental stress such as infection and injury. Dysregulated, persistent interleukin (IL)-6 production has been implicated in the development of various autoimmune, chronic inflammatory diseases and even cancers. Significant elevation of IL-6 has been found in ocular fluids derived from refractory/chronic uveitis patients. In experimental autoimmune uveitis models with IL-6 knock-out mice, IL-6 has shown to be essential for inducing inflammation. IL-6 blockade can suppress acute T helper type 17 (Th17) responses via its differentiation and, importantly, can ameliorate chronic inflammation. Tocilizumab, a recombinant humanized anti-IL-6 receptor antibody, has been shown to be effective in several autoimmune diseases, including uveitis. Herein, we discuss the basic biology of IL-6 and its role in development of autoimmune conditions, focusing particularly on non-infectious uveitis. It also provides an overview of efficacy and safety of tocilizumab therapy for ocular inflammatory diseases. PMID:24528300

  12. Numerical Modeling of Ocular Dysfunction in Space

    NASA Technical Reports Server (NTRS)

    Nelson, Emily S.; Mulugeta, Lealem; Vera, J.; Myers, J. G.; Raykin, J.; Feola, A. J.; Gleason, R.; Samuels, B.; Ethier, C. R.

    2014-01-01

    Upon introduction to microgravity, the near-loss of hydrostatic pressure causes a marked cephalic (headward) shift of fluid in an astronaut's body. The fluid shift, along with other factors of spaceflight, induces a cascade of interdependent physiological responses which occur at varying time scales. Long-duration missions carry an increased risk for the development of the Visual Impairment and Intracranial Pressure (VIIP) syndrome, a spectrum of ophthalmic changes including posterior globe flattening, choroidal folds, distension of the optic nerve sheath, kinking of the optic nerve and potentially permanent degradation of visual function. In the cases of VIIP found to date, the initial onset of symptoms occurred after several weeks to several months of spaceflight, by which time the gross bodily fluid distribution is well established. We are developing a suite of numerical models to simulate the effects of fluid shift on the cardiovascular, central nervous and ocular systems. These models calculate the modified mean volumes, flow rates and pressures that are characteristic of the altered quasi-homeostatic state in microgravity, including intracranial and intraocular pressures. The results of the lumped models provide initial and boundary data to a 3D finite element biomechanics simulation of the globe, optic nerve head and retrobulbar subarachnoid space. The integrated set of models will be used to investigate the evolution of the biomechanical stress state in the ocular tissues due to long-term exposure to microgravity.

  13. Lipid Nanoparticles for Ocular Gene Delivery

    PubMed Central

    Wang, Yuhong; Rajala, Ammaji; Rajala, Raju V. S.

    2015-01-01

    Lipids contain hydrocarbons and are the building blocks of cells. Lipids can naturally form themselves into nano-films and nano-structures, micelles, reverse micelles, and liposomes. Micelles or reverse micelles are monolayer structures, whereas liposomes are bilayer structures. Liposomes have been recognized as carriers for drug delivery. Solid lipid nanoparticles and lipoplex (liposome-polycation-DNA complex), also called lipid nanoparticles, are currently used to deliver drugs and genes to ocular tissues. A solid lipid nanoparticle (SLN) is typically spherical, and possesses a solid lipid core matrix that can solubilize lipophilic molecules. The lipid nanoparticle, called the liposome protamine/DNA lipoplex (LPD), is electrostatically assembled from cationic liposomes and an anionic protamine-DNA complex. The LPD nanoparticles contain a highly condensed DNA core surrounded by lipid bilayers. SLNs are extensively used to deliver drugs to the cornea. LPD nanoparticles are used to target the retina. Age-related macular degeneration, retinitis pigmentosa, and diabetic retinopathy are the most common retinal diseases in humans. There have also been promising results achieved recently with LPD nanoparticles to deliver functional genes and micro RNA to treat retinal diseases. Here, we review recent advances in ocular drug and gene delivery employing lipid nanoparticles. PMID:26062170

  14. Lipid Nanoparticles for Ocular Gene Delivery.

    PubMed

    Wang, Yuhong; Rajala, Ammaji; Rajala, Raju V S

    2015-01-01

    Lipids contain hydrocarbons and are the building blocks of cells. Lipids can naturally form themselves into nano-films and nano-structures, micelles, reverse micelles, and liposomes. Micelles or reverse micelles are monolayer structures, whereas liposomes are bilayer structures. Liposomes have been recognized as carriers for drug delivery. Solid lipid nanoparticles and lipoplex (liposome-polycation-DNA complex), also called lipid nanoparticles, are currently used to deliver drugs and genes to ocular tissues. A solid lipid nanoparticle (SLN) is typically spherical, and possesses a solid lipid core matrix that can solubilize lipophilic molecules. The lipid nanoparticle, called the liposome protamine/DNA lipoplex (LPD), is electrostatically assembled from cationic liposomes and an anionic protamine-DNA complex. The LPD nanoparticles contain a highly condensed DNA core surrounded by lipid bilayers. SLNs are extensively used to deliver drugs to the cornea. LPD nanoparticles are used to target the retina. Age-related macular degeneration, retinitis pigmentosa, and diabetic retinopathy are the most common retinal diseases in humans. There have also been promising results achieved recently with LPD nanoparticles to deliver functional genes and micro RNA to treat retinal diseases. Here, we review recent advances in ocular drug and gene delivery employing lipid nanoparticles. PMID:26062170

  15. Nanoliposomal minocycline for ocular drug delivery

    PubMed Central

    Kaiser, James M.; Imai, Hisanori; Haakenson, Jeremy K.; Brucklacher, Robert M.; Fox, Todd E.; Shanmugavelandy, Sriram S.; Unrath, Kellee A.; Pedersen, Michelle M.; Dai, Pingqi; Freeman, Willard M.; Bronson, Sarah K.; Gardner, Thomas W.; Kester, Mark

    2012-01-01

    Nanoliposomal technology is a promising drug delivery system that could be employed to improve the pharmacokinetic properties of clearance and distribution in ocular drug delivery to the retina. We developed a nanoscale version of an anionic, cholesterol-fusing liposome that can encapsulate therapeutic levels of minocycline capable of drug delivery. We demonstrate that size extrusion followed by size-exclusion chromatography can form a stable 80-nm liposome that encapsulates minocycline at a concentration of 450 ± 30 ?M, which is 2% to 3% of loading material. More importantly, these nontoxic nanoliposomes can then deliver 40% of encapsulated minocycline to the retina after a subconjunctival injection in the STZ model of diabetes. Efficacy of therapeutic drug delivery was assessed via transcriptomic and proteomic biomarker panels. For both the free minocycline and encapsulated minocycline treatments, proinflammatory markers of diabetes were downregulated at both the messenger RNA and protein levels, validating the utility of biomarker panels for the assessment of ocular drug delivery vehicles. PMID:22465498

  16. Transmission of ocular media in labrid fishes.

    PubMed

    Siebeck, U E; Marshall, N J

    2000-09-29

    Wrasses (Labridae) are the second largest family of fishes on the Great Barrier Reef (after the Gobiidae) and, in terms of morphology and lifestyle, one of the most diverse. They occupy all zones of the reef from the very shallow reef flats to deep slopes, feeding on a variety of fauna. Many wrasses also have elaborately patterned bodies and reflect a range of colours from ultraviolet (UV) to far red. As a first step to investigating the visual system of these fishes we measured the transmission properties of the ocular media of 36 species from the Great Barrier Reef, Australia, and Hawaii, California and the Florida Keys, USA. Transmission measurements were made of whole eyes with a window cut into the back, and also of isolated lenses and corneas. Based on the transmission properties of the corneas the species could be split into two distinct groups within which the exact wavelength of the cut-off was variable. One group had visibly yellow corneas, while the corneas of the other group appeared clear to human observers. Five species had ocular media that transmitted wavelengths below 400 nm, making a perception of UV wavelengths for those species possible. Possible functional roles for the different filter types are discussed. PMID:11079410

  17. A clinicopathologic and molecular biologic study of patients presenting with few adnexal tumors (two to four) from the morphological spectrum of Brooke-Spiegler syndrome.

    PubMed

    Kacerovska, Denisa; Vanecek, Tomas; Spagnolo, Dominic V; Bisceglia, Michele; Zelger, Bernhard; Michal, Michal; Kazakov, Dmitry V

    2013-02-01

    We report 11 individuals, each presenting with few (2-4) adnexal neoplasms histologically confirmed as belonging to the spectrum of lesions typical for Brooke-Spiegler syndrome (BSS) and/or multiple familial trichoepitheliomas. These include spiradenoma, cylindroma, spiradenocylindroma, and trichoblastoma variants. Our objective was to clarify whether this is merely a sporadic, albeit unusual, occurrence of multiple neoplasms in these patients or whether they are related to BSS and its phenotypic variant, multiple familial trichoepithelioma. Six patients presented with 2 neoplasms, 4 had 3 lesions and the last had 4 lesions. In none was there any family history of similar lesions. The 28 neoplasms consisted of 7 spiradenomas, 6 cylindromas, 5 spiradenocylindromas, and 11 trichoblastomas (6 trichoepitheliomas and 5 with mixed patterns). In 1 patient only with 2 spiradenomas, both tumors harbored identical CYLD sequence alterations (c.1112C>A/S371X) in the CYLD gene and both showed loss of heterozygosity on chromosome 16q. The remaining cases yielded neither germ line nor somatic alterations in CYLD. It is concluded that the presentation with few (2-4) cylindromas, spiradenomas, spiradenocylindromas, and trichoepitheliomas is a sporadic occurrence, and that these patients do not have any relationship to BSS. PMID:22588548

  18. TNF-Related Apoptosis Inducing Ligand in Ocular Cancers and Ocular Diabetic Complications

    PubMed Central

    Perri, Paolo; Zauli, Giorgio; Gonelli, Arianna; Milani, Daniela; Celeghini, Claudio; Lamberti, Giuseppe; Secchiero, Paola

    2015-01-01

    TNF-related apoptosis inducing ligand (TRAIL) is an intensively studied cytokine, in particular for its anticancer activity. The discovery that conjunctival sac fluid contains extremely high levels of soluble TRAIL as compared to other body fluids suggested important implications in the context of the immunological surveillance of the eye, in particular of the anterior surface. In this review, we discuss the potential physiopathologic and therapeutic role of the TRAIL/TRAIL receptor system in a variety of ocular cancers. Moreover, since an increasing amount of data has indicated the important biological activities of the TRAIL/TRAIL receptor systems also in a completely different pathologic context such as diabetes mellitus, in the second part of this review we summarize the currently available data on the involvement of TRAIL in the ocular complications of diabetes mellitus as modulator of the inflammatory and angiogenic response in the eye. PMID:25834817

  19. Ocular Hemodynamics and Glaucoma: The Role of Mathematical Modeling

    PubMed Central

    Harris, Alon; Guidoboni, Giovanna; Arciero, Julia C.; Amireskandari, Annahita; Tobe, Leslie A.; Siesky, Brent A.

    2013-01-01

    Purpose Many studies suggest that alterations in ocular hemodynamics can significantly impact the development, progression, and incidence of glaucoma. This article discusses the role of mathematical modeling in studying the relationship between ocular hemodynamics and glaucoma pathophysiology. Methods Recent literature on glaucoma, ocular blood flow, autoregulation, the optic nerve head, and the use of mathematical modeling in ocular circulation was reviewed to summarize the current approaches used to investigate the relationship between vascular impairment and glaucoma progression. Results Mathematical models describing the mechanical, hemodynamic, and regulatory aspects of the ocular circulation have been developed. Preliminary modeling work shows the potential of mathematical models to elucidate the mechanisms that contribute most significantly to glaucoma progression. Conclusion Mathematical modeling is a useful tool when used synergistically with clinical and laboratory data in the study of ocular blood flow and glaucoma. The development of models to investigate the relationship between ocular hemodynamic alterations and glaucoma progression will provide a unique and useful method for studying the pathophysiology of glaucoma. PMID:23413108

  20. ELECTRICAL SIGNALING IN CONTROL OF OCULAR CELL BEHAVIORS

    PubMed Central

    Zhao, Min; Chalmers, Laura; Cao, Lin; Viera, Ana C.; Mannis, Mark; Reid, Brian

    2011-01-01

    Epithelia of the cornea, lens and retina contain a vast array of ion channels and pumps. Together they produce a polarized flow of ions in and out of cells, as well as across the epithelia. These naturally occurring ion fluxes are essential to the hydration and metabolism of the ocular tissues, especially for the avascular cornea and lens. The directional transport of ions generates electric fields and currents in those tissues. Applied electric fields affect migration, division and proliferation of ocular cells which are important in homeostasis and healing of the ocular tissues. Abnormalities in any of those aspects may underlie many ocular diseases, for example chronic corneal ulcers, posterior capsule opacity after cataract surgery, and retinopathies. Electric field-inducing cellular responses, termed electrical signaling here, therefore may be an unexpected yet powerful mechanism in regulating ocular cell behavior. Both endogenous electric fields and applied electric fields could be exploited to regulate ocular cells. We aim to briefly describe the physiology of the naturally occurring electrical activities in the corneal, lens, and retinal epithelia, to provide experimental evidence of the effects of electric fields on ocular cell behaviors, and to suggest possible clinical implications. PMID:22020127

  1. Effect of different antiglaucomatous drugs on ocular perfusion pressures.

    PubMed

    Pillunat, L; Stodtmeister, R

    1988-01-01

    In an attempt to elucidate whether antiglaucomatous drugs, especially beta-blockers, affect systemic and/or ocular blood flow, we measured ocular perfusion pressures (PP), systemic blood pressure (BP) and heart rate in 50 healthy subjects before and after topical instillation of the following eye drops: timolol 0.5% (n = 10), betaxolol 0.5% (n = 10), carteolol 2% (n = 10), pilocarpine 2% (n = 10) and acetazolamide 750 mg per os (n = 10). The ocular perfusion pressures were measured by OODG as described by Ulrich. By means of this method--retinal and ciliary perfusion pressure can be recorded separately and simultaneously. Our results indicated that, in spite of a statistically significant decrease in IOP in all 5 groups, there was no change in retinal or ciliary perfusion pressure, heart rate or blood pressure in any of the groups except the carteolol subjects. The ocular perfusion pressures should be increased with reduction of the IOP when the systemic parameters remain unchanged. This was not the case in our experiments and therefore it can be suggested that a relative reduction in ocular perfusion pressure occurs with all agents and, in this respect, timolol and betaxolol did not affect ocular perfusion pressure more than pilocarpine and acetazolamide. Carteolol, however, produced a slight decrease (alpha less than 0.02) in ocular perfusion pressure, in spite of lowering of the IOP. PMID:2904474

  2. Mine blast injuries: ocular and social aspects

    PubMed Central

    Muzaffar, W.; Khan, M. D.; Akbar, M; Khan, M. D.; Malik, A. M.; Durrani, O.

    2000-01-01

    BACKGROUND/AIMS—Landmines have long been used in conventional warfare. These are antipersonnel mines which continue to injure people long after a ceasefire without differentiating between friend or foe, soldier or civilian, women or children. This study focuses on Afghan non-combatants engaged in mine clearing operations in Afghanistan in the aftermath of the Russo-Afghan war. The patterns and types of injuries seen are described and experiences in their management, ways, and means to prevent them, and recommendations for the rehabilitation of the affected individuals are given.?METHODS—It is a retrospective and analytical study of 84 patients aged 19-56 years who sustained mine blast injuries during mine clearing operations in Afghanistan from November 1992 to January 1996. The study was carried out at a military hospital with tertiary care facilities. The patients were divided into three groups on the basis of their injuries. Group 1 required only general surgical attention, group 2 sustained only ocular injuries, while group 3 had combined ocular and general injuries. Patients in groups 2 and 3 were treated in two phases. The first phase aimed at immediate restoration of the anatomy, while restoration of function wherever possible was done in subsequent surgical procedures in the second phase.?RESULTS—It was observed that 51 out of 84 patients (60.7%) had sustained ocular trauma of a variable degree as a result of the blasts. The mean age of the victims was 29 years and they were all male. A total of 91 eyes of 51 patients (89.2%) had been damaged. Bilaterality of damage was seen in 40 (78.4%) patients. Most, 34 (37.3%), eyes became totally blind (NPL). Only a few escaped with injury mild enough not to impair vision. Foreign bodies, small and multiple, were found in the majority of eyes; most, however, were found in the anterior segment, and posterior segment injuries were proportionally less.?CONCLUSIONS—The prevalence of blindness caused by mine blast injuries is quite high. The resulting psychosocial trauma to the patients and their families is tremendous and has not been adequately highlighted. These injuries are a great drain on the country's resources. Enforcement of preventive measures and the use of protective gear and sophisticated equipment by the mine clearing personnel would prove to be far more economical in terms of human life as well as medical and economic resources. There is also need for greater attention towards the establishment of support groups and rehabilitation programmes for these individuals.?? PMID:10837390

  3. Age-Dependent Ocular Dominance Plasticity in Adult Mice

    PubMed Central

    Lehmann, Konrad; Löwel, Siegrid

    2008-01-01

    Background Short monocular deprivation (4 days) induces a shift in the ocular dominance of binocular neurons in the juvenile mouse visual cortex but is ineffective in adults. Recently, it has been shown that an ocular dominance shift can still be elicited in young adults (around 90 days of age) by longer periods of deprivation (7 days). Whether the same is true also for fully mature animals is not yet known. Methodology/Principal Findings We therefore studied the effects of different periods of monocular deprivation (4, 7, 14 days) on ocular dominance in C57Bl/6 mice of different ages (25 days, 90–100 days, 109–158 days, 208–230 days) using optical imaging of intrinsic signals. In addition, we used a virtual optomotor system to monitor visual acuity of the open eye in the same animals during deprivation. We observed that ocular dominance plasticity after 7 days of monocular deprivation was pronounced in young adult mice (90–100 days) but significantly weaker already in the next age group (109–158 days). In animals older than 208 days, ocular dominance plasticity was absent even after 14 days of monocular deprivation. Visual acuity of the open eye increased in all age groups, but this interocular plasticity also declined with age, although to a much lesser degree than the optically detected ocular dominance shift. Conclusions/Significance These data indicate that there is an age-dependence of both ocular dominance plasticity and the enhancement of vision after monocular deprivation in mice: ocular dominance plasticity in binocular visual cortex is most pronounced in young animals, reduced but present in adolescence and absent in fully mature animals older than 110 days of age. Mice are thus not basically different in ocular dominance plasticity from cats and monkeys which is an absolutely essential prerequisite for their use as valid model systems of human visual disorders. PMID:18769674

  4. Laser applications and system considerations in ocular imaging

    PubMed Central

    Elsner, Ann E.; Muller, Matthew S.

    2009-01-01

    We review laser applications for primarily in vivo ocular imaging techniques, describing their constraints based on biological tissue properties, safety, and the performance of the imaging system. We discuss the need for cost effective sources with practical wavelength tuning capabilities for spectral studies. Techniques to probe the pathological changes of layers beneath the highly scattering retina and diagnose the onset of various eye diseases are described. The recent development of several optical coherence tomography based systems for functional ocular imaging is reviewed, as well as linear and nonlinear ocular imaging techniques performed with ultrafast lasers, emphasizing recent source developments and methods to enhance imaging contrast. PMID:21052482

  5. Panretinal photocoagulation for radiation-induced ocular ischemia

    SciTech Connect

    Augsburger, J.J.; Roth, S.E.; Magargal, L.E.; Shields, J.A.

    1987-08-01

    We present preliminary findings on the effectiveness of panretinal photocoagulation in preventing neovascular glaucoma in eyes with radiation-induced ocular ischemia. Our study group consisted of 20 patients who developed radiation-induced ocular ischemia following cobalt-60 plaque radiotherapy for a choroidal or ciliary body melanoma. Eleven of the 20 patients were treated by panretinal photocoagulation shortly after the diagnosis of ocular ischemia, but nine patients were left untreated. In this non-randomized study, the rate of development of neovascular glaucoma was significantly lower (p = 0.024) for the 11 photocoagulated patients than for the nine who were left untreated.

  6. Diffuse infiltrating retinoblastoma coexisting with ocular toxoplasmosis.

    PubMed

    Ghassemi, Fariba; Ghadimi, Hadi; Amoli, Fahimeh Asadi; Esfahani, Mohammad Riazi; Tavakoli, Vida; Fariba, Ghassemi

    2014-02-01

    A 4-year-old boy presented with unilateral endophthalmitis and echography revealed an abscess in the vitreous cavity. A pars plana vitrectomy with intravitreal antibiotic injections was performed with a presumed diagnosis of endophthalmitis; however, the patient returned after 10 days with fibrin reaction in the anterior chamber, iris nodules and cataract. The vitreous sample from the vitrectomy showed Toxoplasma gondii parasite, so he was treated with intravitreal clindamycin and lensectomy. The postoperative fundus examination revealed multifocal white patches with calcified deposits and cytology proved the diagnosis of retinoblastoma. Enucleation was performed in addition to systemic chemotherapy. To our knowledge, this is the first reported case of the coexistence of retinoblastoma and ocular toxoplasmosis. PMID:23504282

  7. Nanotechnology Approaches for Ocular Drug Delivery

    PubMed Central

    Xu, Qingguo; Kambhampati, Siva P.; Kannan, Rangaramanujam M.

    2013-01-01

    Blindness is a major health concern worldwide that has a powerful impact on afflicted individuals and their families, and is associated with enormous socio-economical consequences. The Middle East is heavily impacted by blindness, and the problem there is augmented by an increasing incidence of diabetes in the population. An appropriate drug/gene delivery system that can sustain and deliver therapeutics to the target tissues and cells is a key need for ocular therapies. The application of nanotechnology in medicine is undergoing rapid progress, and the recent developments in nanomedicine-based therapeutic approaches may bring significant benefits to address the leading causes of blindness associated with cataract, glaucoma, diabetic retinopathy and retinal degeneration. In this brief review, we highlight some promising nanomedicine-based therapeutic approaches for drug and gene delivery to the anterior and posterior segments. PMID:23580849

  8. Ocular torsional movements in normal humans.

    PubMed

    Kushner, B J; Kraft, S

    1983-06-01

    We conducted three studies of compensatory ocular torsional movements in normal human subjects, using changes in the axis of astigmatism, afterimages, and direct observation with cinematography. Measurements of changes in the axis of astigmatism and the subjects' subjective perception of afterimages with a superimposed Maddox rod showed a partial compensatory intorsion on head tilt to the ipsilateral side and extorsion on head tilt to the contralateral side. Cinematography demonstrated that the eye lags behind the head in a slow rolling movement as the head is tilted. Periodic rotary movements in the direction of the head tilt partially correct the lag and result in a partial compensatory torsion. A fourth experiment excluded false torsion as an artifact in these studies. PMID:6859183

  9. Updates in the treatment of ocular allergies.

    PubMed

    Kari, Osmo; Saari, K Matti

    2010-01-01

    Allergic diseases have greatly increased in industrialized countries. About 30% of people suffer from allergic symptoms and 40%-80% of them have symptoms in the eyes. Atopic conjunctivitis can be divided into seasonal allergic conjunctivitis (SAC) and perennial allergic conjunctivitis (PAC). The treatment of SAC is simple; antihistamines, anti-inflammatory agents, or chromoglycate. In severe cases of SAC, subcutaneous or sublingual immunotherapy is helpful. PAC needs longer therapy, often year round, with mast cell stabilizers, antihistamines, and sometimes local steroids. Atopic keratoconjunctivitis is a more severe disease showing chronic blepharitis often connected with severe keratitis. It needs, in many cases, continuous treatment of the lid eczema and keratoconjunctivitis. Blepharitis is treated with tacrolimus or pimecrolimus ointment. Conjunctivitis additionally needs corticosteroids and, if needed, cyclosporine A (CsA) drops are administered for longer periods. Basic conjunctival treatment is with mast cell-stabilizing agents and in addition, antihistamines are administered. Vernal keratoconjunctivitis is another chronic and serious allergic disease that mainly affects children and young people. It is a long-lasting disease which commonly subsides in puberty. It demands intensive therapy often for many years to avoid serious complicating corneal ulcers. Treatment is mast cell-stabilizing drops and additionally antihistamines. In relapses, corticosteroids are needed. When the use of corticosteroids is continuous, CsA drops should be used, and in relapses, corticosteroids should be used additionally. Nonallergic eosinophilic conjunctivitis (NAEC) is a less known, but rather common, ocular disease. It affects mostly middle-aged and older women. The eye symptoms of NAEC are largely similar to those seen in chronic allergic conjunctivitis. Basic therapy is mast cell-stabilizing drops. Eosinophilic inflammation needs additional corticosteroids. In severe cases, CsA drops are recommended. Antihistamines should be avoided. It is important to recognize the different forms of allergic ocular diseases and to start the treatment early and intensively enough to avoid chronicity of the disease and accompanying tissue destruction. PMID:21437049

  10. Risk factors for ocular toxoplasmosis in Brazil.

    PubMed

    Ferreira, A I C; De Mattos, C C Brandão; Frederico, F B; Meira, C S; Almeida, G C; Nakashima, F; Bernardo, C R; Pereira-Chioccola, V L; De Mattos, L C

    2014-01-01

    The aim of this study was to investigate risk factors for ocular toxoplasmosis (OT) in patients who received medical attention at a public health service. Three hundred and forty-nine consecutive patients, treated in the Outpatient Eye Clinic of Hospital de Base, São José do Rio Preto, São Paulo state, Brazil, were enrolled in this study. After an eye examination, enzyme-linked immunosorbent assay (ELISA) was used to determine anti-Toxoplasma gondii antibodies. The results showed that 25.5% of the patients were seronegative and 74.5% were seropositive for IgG anti-T. gondii antibodies; of these 27.3% had OT and 72.7% had other ocular diseases (OOD). The presence of cats or dogs [odds ratio (OR) 2.22, 95% confidence interval (CI) 1.24-3.98, P = 0.009] and consumption of raw or undercooked meat (OR 1.77, 95% CI 1.05-2.98, P = 0.03) were associated with infection but not with the development of OT. Age (OT 48.2 ± 21.2 years vs. OOD: 69.5 ± 14.7 years, P < 0.0001) and the low level of schooling/literacy (OT vs. OOD: OR 0.414, 95% CI 0.2231-0.7692, P = 0.007) were associated with OT. The presence of dogs and cats as well as eating raw/undercooked meat increases the risk of infection, but is not associated with the development of OT. PMID:23507508

  11. Novel ocular antihypertensive compounds in clinical trials

    PubMed Central

    Chen, June; Runyan, Stephen A; Robinson, Michael R

    2011-01-01

    Introduction: Glaucoma is a multifactorial disease characterized by progressive optic nerve injury and visual field defects. Elevated intraocular pressure (IOP) is the most widely recognized risk factor for the onset and progression of open-angle glaucoma, and IOP-lowering medications comprise the primary treatment strategy. IOP elevation in glaucoma is associated with diminished or obstructed aqueous humor outflow. Pharmacotherapy reduces IOP by suppressing aqueous inflow and/or increasing aqueous outflow. Purpose: This review focuses on novel non-FDA approved ocular antihypertensive compounds being investigated for IOP reduction in ocular hypertensive and glaucoma patients in active clinical trials within approximately the past 2 years. Methods: The mode of IOP reduction, pharmacology, efficacy, and safety of these new agents were assessed. Relevant drug efficacy and safety trials were identified from searches of various scientific literature databases and clinical trial registries. Compounds with no specified drug class, insufficient background information, reformulations, and fixed-combinations of marketed drugs were not considered. Results: The investigational agents identified comprise those that act on the same targets of established drug classes approved by the FDA (ie, prostaglandin analogs and ?-adrenergic blockers) as well as agents belonging to novel drug classes with unique mechanisms of action. Novel targets and compounds evaluated in clinical trials include an actin polymerization inhibitor (ie, latrunculin), Rho-associated protein kinase inhibitors, adenosine receptor analogs, an angiotensin II type 1 receptor antagonist, cannabinoid receptor agonists, and a serotonin receptor antagonist. Conclusion: The clinical value of novel compounds for the treatment of glaucoma will depend ultimately on demonstrating favorable efficacy and benefit-to-risk ratios relative to currently approved prostaglandin analogs and ?-blockers and/or having complementary modes of action. PMID:21629573

  12. "Johnny Poppers": a cause of serious ocular injury

    PubMed Central

    MacAndie, K.; Kyle, P.

    1998-01-01

    AIMS/BACKGROUND—The causes of blunt ocular trauma are many and diverse. We present two cases of ocular injury caused by an unusual form of weapon called a "Johnny Popper". There follows a theoretical and experimental evaluation of the velocity of the projectiles fired by this device.?METHODS—A Johnny Popper was constructed under expert guidance. The elastic properties of the device were measured and this allowed calculation of a theoretical exit velocity of the projectiles fired. The weapon was subsequently fired under test conditions which permitted the exit velocity of the projectiles fired to be measured directly.?RESULTS—The theoretical velocity of the projectiles was calculated as 80 ms-1 and the experimentally measured velocity was 57 ms-1.?CONCLUSIONS—Johnny Poppers are a previously undescribed and unique form of home made weapon. They are intended for playful mischief, but have the potential to cause serious ocular trauma.?? Keywords: ocular trauma; projectiles PMID:9924377

  13. Sebaceous Carcinoma of the Ocular Region: A Review

    Microsoft Academic Search

    Jerry A. Shields; Hakan Demirci; Brian P. Marr; Ralph C. Eagle; Carol L. Shields

    2005-01-01

    Sebaceous carcinoma of the ocular region is a malignant neoplasm that is being recognized more frequently and managed by innovative techniques of local resection, cryotherapy, topical chemotherapy, and radiotherapy, resulting in improved visual and systemic prognosis.

  14. Intra-bleb hematoma and hyphema following digital ocular compression

    PubMed Central

    Bhargava, Sagar; Choudhari, Nikhil S.; Vijaya, Lingam

    2014-01-01

    We report successful outcome of a huge post- trabeculectomy intra-bleb hematoma and hyphema that occurred following digital ocular compression. The patient was a 64-year-old lady suffering from bilateral primary angle closure glaucoma and cataract. She was on anti-platelet therapy. She underwent single-site phacoemulsification, intra-ocular lens implantation and trabeculectomy with mitomycin C in the right eye. The trabeculectomy was under-filtering. She was asked to perform digital ocular compression thrice daily. On 15th post-operative day, she presented with a huge intra-bleb hematoma and hyphema. The hematoma did not respond to conservative measures and was drained to prevent bleb failure. We recommend caution in the consideration of digital ocular compression in patients on prophylactic anti-coagulation. PMID:24799798

  15. Intra-bleb hematoma and hyphema following digital ocular compression.

    PubMed

    Bhargava, Sagar; Choudhari, Nikhil S; Vijaya, Lingam

    2014-01-01

    We report successful outcome of a huge post- trabeculectomy intra-bleb hematoma and hyphema that occurred following digital ocular compression. The patient was a 64-year-old lady suffering from bilateral primary angle closure glaucoma and cataract. She was on anti-platelet therapy. She underwent single-site phacoemulsification, intra-ocular lens implantation and trabeculectomy with mitomycin C in the right eye. The trabeculectomy was under-filtering. She was asked to perform digital ocular compression thrice daily. On 15(th) post-operative day, she presented with a huge intra-bleb hematoma and hyphema. The hematoma did not respond to conservative measures and was drained to prevent bleb failure. We recommend caution in the consideration of digital ocular compression in patients on prophylactic anti-coagulation. PMID:24799798

  16. Ocular muscular dystrophy. A cause of curare sensitivity.

    PubMed

    Robertson, J A

    1984-03-01

    A case is described of a child with ocular muscular dystrophy, who demonstrated the extreme sensitivity to non-depolarising muscle relaxants, with lack of reversal by anticholinesterases, characteristic of this condition. PMID:6703294

  17. Progressive hemifacial atrophy with ciliary body atrophy and ocular hypotony.

    PubMed

    Kini, T Ashwini; Prakash, V S; Puthalath, Suresh; Bhandari, P L

    2015-01-01

    Progressive hemifacial atrophy (PHA) is a disease of unknown etiology affecting one-half of the face. Ocular involvement is uncommon. Atrophy of iris is rare, with only a few cases of partial atrophy being reported in the literature. We report a case of total atrophy of iris and ciliary body with associated ocular hypotony in a 16-year-old girl with PHA. We believe this is the first reported case of complete atrophy of iris and ciliary body in PHA. Ocular hypotony in PHA was thought to be due to intra-ocular inflammation. However in our case it appears to be secondary to severe atrophy of the ciliary body. PMID:25686066

  18. Progressive hemifacial atrophy with ciliary body atrophy and ocular hypotony

    PubMed Central

    Kini, T Ashwini; Prakash, V S; Puthalath, Suresh; Bhandari, P L

    2015-01-01

    Progressive hemifacial atrophy (PHA) is a disease of unknown etiology affecting one-half of the face. Ocular involvement is uncommon. Atrophy of iris is rare, with only a few cases of partial atrophy being reported in the literature. We report a case of total atrophy of iris and ciliary body with associated ocular hypotony in a 16-year-old girl with PHA. We believe this is the first reported case of complete atrophy of iris and ciliary body in PHA. Ocular hypotony in PHA was thought to be due to intra-ocular inflammation. However in our case it appears to be secondary to severe atrophy of the ciliary body. PMID:25686066

  19. Anatomical origins of ocular dominance in mouse primary visual cortex

    E-print Network

    Coleman, Jason E.

    Ocular dominance (OD) plasticity is a classic paradigm for studying the effect of experience and deprivation on cortical development, and is manifested as shifts in the relative strength of binocular inputs to primary ...

  20. Ocular tear film bubble formation after breath-hold diving.

    PubMed

    Sheard, P W

    2008-01-01

    Bubbles in the ocular tear film have been observed following both dry-chamber, simulated compressed air dives and in-water, recreational compressed air dives. The current paper reports on the formation of tear film bubbles in a breath-hold diver following repeated, extended breath-hold excursions to a maximum depth of -28.5 m. It is believed that this is the first time that ocular tear film bubbles have been reported in breath-hold divers. PMID:18500071

  1. High-resolution dual-modality photoacoustic ocular imaging.

    PubMed

    Wu, Ning; Ye, Shuoqi; Ren, Qiushi; Li, Changhui

    2014-04-15

    We have developed a prototype ocular imaging system that integrates optical-resolution photoacoustic microscopy and high-frequency ultrasound imaging. The system can perform high-resolution ocular imaging from the anterior region down to the fundus. It has successfully imaged murine eyes in vivo, including iris, lens, retina, and retinal pigment epithelium. Our results demonstrate that this system shows strong potential for the diagnosis of ophthalmic diseases. PMID:24979016

  2. Surgical treatment of vertical ocular motility disorders of supranuclear origin.

    PubMed

    Brodsky, Michael C

    2011-01-01

    Vertical ocular motility disorders of supranuclear origin can be congenital or acquired later in life. They produce complex forms of strabismus that require specialized surgical management to restore ocular alignment, eliminate torticollis, treat diplopia, and restore normal lid position. For each condition, surgical management must be individualized to address multiple impediments to fusion. This article outlines the surgical management of three common types of supranuclear vertical strabismus. PMID:22069848

  3. Ocular vestibular evoked myogenic potentials in superior canal dehiscence

    Microsoft Academic Search

    S M Rosengren; S T Aw; G M Halmagyi; N P McAngus Todd; J G Colebatch

    2008-01-01

    Objective:Patients with superior canal dehiscence (SCD) have large sound-evoked vestibular reflexes with pathologically low threshold. We wished to determine whether a recently discovered measure of the vestibulo-ocular reflex—the ocular vestibular evoked myogenic potential (OVEMP)—produced similar high-amplitude, low-threshold responses in SCD, and could differentiate patients with SCD from normal control patients.Methods:Nine patients with CT-confirmed SCD and 10 normal controls were stimulated

  4. Apoptosis of Ocular Surface Cells in Experimentally Induced Dry Eye

    Microsoft Academic Search

    Steven Yeh; Xiu Jun Song; William Farley; De-Quan Li; Michael E. Stern; Stephen C. Pflugfelder

    2003-01-01

    PURPOSE. To evaluate to effect of experimental dry eye on ocular surface apoptosis. METHODS. Aqueous tear production and clearance were inhib- ited by systemic administration of scopolamine and exposure to an air draft for 12 days in 4- to 6-week-old 129SvEv\\/CD-1 mixed white mice. Eyes and ocular adnexa were excised, cryosectioned, and evaluated for apoptosis by terminal deoxy- nucleotidyl transferase-mediated

  5. Ocular neovascularisation and excessive vascular permeability.

    PubMed

    Campochiaro, Peter A

    2004-09-01

    Diseases complicated by vascular leakage and/or neovascularisation in the eye are responsible for the vast majority of visual morbidity and blindness in developed countries. The molecular signals that control vascular permeability and neovascularisation in the eye are being defined. Members of the vascular endothelial growth factor (VEGF) family are key stimulators that interact with two tyrosine kinase receptors, VEGF receptor (VEGFR)1 and 2; binding to two other receptors that lack tyrosine kinase activity, the neuropilins, is also important. Signalling through the VEGF pathway is modulated by the Tie2 receptor and its binding partners, the angiopoietins. Each of the participants in these two signalling pathways provides a potential target for intervention. Several proteins with antiangiogenic activity balance the stimulators and the outcome is determined by the net balance. Endostatin suppresses vascular permeability as well as ocular neovascularisation, suggesting that vascular leakage may also be regulated by counteracting proteins. Gene transfer provides a useful way to influence these balances. Clinical trials are underway to test whether these mechanisms can be translated into new therapies. PMID:15335307

  6. Inertial processing of vestibulo-ocular signals

    NASA Technical Reports Server (NTRS)

    Hess, B. J.; Angelaki, D. E.

    1999-01-01

    New evidence for a central resolution of gravito-inertial signals has been recently obtained by analyzing the properties of the vestibulo-ocular reflex (VOR) in response to combined lateral translations and roll tilts of the head. It is found that the VOR generates robust compensatory horizontal eye movements independent of whether or not the interaural translatory acceleration component is canceled out by a gravitational acceleration component due to simultaneous roll-tilt. This response property of the VOR depends on functional semicircular canals, suggesting that the brain uses both otolith and semicircular canal signals to estimate head motion relative to inertial space. Vestibular information about dynamic head attitude relative to gravity is the basis for computing head (and body) angular velocity relative to inertial space. Available evidence suggests that the inertial vestibular system controls both head attitude and velocity with respect to a gravity-centered reference frame. The basic computational principles underlying the inertial processing of otolith and semicircular canal afferent signals are outlined.

  7. MicroRNAs Regulate Ocular Neovascularization

    PubMed Central

    Shen, JiKui; Yang, Xiaoru; Xie, Bing; Chen, Yangjian; Swaim, Mara; Hackett, Sean F.; Campochiaro, Peter A.

    2011-01-01

    In this study, we used ischemia-induced retinal neovascularization (NV) as a model to investigate the possible role of microRNAs in a clinically important disease process. Microarray analysis demonstrated seven microRNAs, miR-106a, -146, -181, -199a, -214, -424, and -451, that were substantially increased and three, miR-31, -150, and -184, that were substantially decreased in ischemic retina. Potential targets for the upregulated microRNAs were not identified, but bioinformatic analysis suggested target genes for the downregulated microRNAs that were confirmed by a luciferase reporter assay. Real time RT-PCR confirmed substantial levels of miR-31, -150, and -184 in normal retina that were significantly reduced in ischemic retina. Interestingly, constitutive levels of miR-31 and -184 are high in cornea and lens, two avascular tissues. Intraocular injection of pre-miR-31, -150, or -184 significantly reduced ischemia-induced retinal NV, and injection of pre-miR-31 or -150 also significantly reduced choroidal NV. These data suggest that alteration of microRNA levels contributes to two types of ocular NV and suggest that injection or enhanced expression of microRNAs is a potential therapeutic strategy. PMID:18500251

  8. Speckle interferometric system to measure ocular microtremor

    NASA Astrophysics Data System (ADS)

    Ryle, James P.; Al-Kalbani, Mohammed; Collins, Niamh; Gopinathan, Unnikrishnan; Boyle, Gerard; Coakley, Davis; Sheridan, John T.

    2008-04-01

    Ocular microtremor (OMT) is a biological high frequency (up to 150Hz) low amplitude (25-2500nm peak to peak) involuntary motion of the human eye. Clinical OMT investigations to date have used eye-contacting mechanical piezoelectric probes or piezoelectric strain gauges. Before contact can be made, the eye must first be anaesthetized. In some cases, this eyelid spasms occur making it impossible to measure OMT. Using the contact probe method, the eye motion is mechanically loaded. Results from clinical studies with this method to date have given electrical signal amplitudes from the probe proportional to the displacement, but not the exact displacement information. Recent studies suggest a number of clinical applications for OMT, these include monitoring the depth of anesthesia of a patient in surgery, prediction of outcome in coma, diagnosis of brain stem death. In addition to this, in patients with neurological disorders such as Multiple Sclerosis and Parkinson's disease, abnormal OMT frequency content is present. In this paper, we design a compact non-contact phase modulating optical fiber speckle interferometer to measure eye motions. We simulate OMT motion using a calibrated piezoelectric vibration simulator and compare results produced using a contact method with those using our optical non-contact method.

  9. Prospective Observational Study of Ocular Health in ISS Crews - The Ocular Health Study

    NASA Technical Reports Server (NTRS)

    Otto, C.; Barr, Y.; Platts, S.; Ploutz-Snyder, R.; Sargsyan, A.; Alexander, D.; Riascos, R.; Gibson, C.; Patel, N.

    2015-01-01

    INTRODUCTION: The Visual Impairment Intracranial Pressure (VIIP) syndrome is currently NASA's number one human space flight risk. The syndrome, which is related to microgravity exposure, manifests with changes in visual acuity (hyperopic shifts, scotomas), changes in eye structure (optic disc edema, choroidal folds, cotton wool spots, globe flattening, and dilated optic nerve sheaths), and in some cases with documented increased intracranial pressure (ICP) postflight. While the eye appears to be the main affected end organ of this syndrome, the ocular effects are thought to be related to underlying changes in the vascular system and the central nervous system. The leading hypotheses for the development of VIIP involve microgravity-induced head-ward fluid shifts along with a loss of gravity-assisted drainage of venous blood from the brain, leading to cephalic congestion, decreased CSF resorption and increased ICP. Since 70% of ISS crewmembers have manifested clinical signs or symptoms of the VIIP syndrome, it is assumed that the majority have some degree of ICP elevation in-flight compared to the ground. Prolonged elevations of ICP can cause long-term reduced visual acuity and loss of peripheral visual fields, and have been reported to cause mild cognitive impairment in the analog terrestrial population of Idiopathic Intracranial Hypertension (IIH). These potentially irreversible health consequences underscore the importance of identifying the factors that lead to this syndrome and mitigating them. METHODS: The Ocular Health study expands on the required in-flight medical testing required of long-duration crewmembers assigned to an International Space Station (ISS) mission, to include 13 sessions over a three-year period. Pre- and postflight evaluations include functional eye exams (visual testing), structural eye exams (fundoscopy, ocular ultrasound, optical coherence tomography, optical biometry and biomicroscopy), intraocular pressure (IOP, tonometry), cardiovascular compliance (via ultrasound with concurrent ECG and blood pressure), noninvasive intracranial pressure (via pulsatility index, measured by transcranial Doppler), and Magnetic Resonance Imaging (MRI) to assess brain anatomy. In-flight evaluations include visual testing, optical coherence tomography, fundoscopy, tonometry, cardiovascular compliance and transcranial Doppler. RESULTS: Preflight, in-flight and postflight data will be presented for five Ocular Health subjects. These data will include: visual acuity, refraction, fundoscopy, OCT, ocular ultrasound, vascular compliance, TCD, IOP and MRI. One-year postflight data will be presented for two of these subjects. Data indicates that vascular compliance, retro-orbital pressure and IOP affect retinal nerve fiber layer swelling. DISCUSSION: This prospective study aims to understand the etiology of the VIIP syndrome, establish preflight baseline characteristics, define the temporal sequence for the appearance of signs and symptoms, characterize the nature of in-flight changes, document the postflight time course for recovery to baseline, and determine the impact of prolonged changes on crew health. Data from this study will improve the understanding of VIIP incidence, signs, symptoms, susceptibilities, timeline for development and recovery, and aid in guiding the development of countermeasures and targeted treatments for preventing the VIIP syndrome and its complications.

  10. Ocular toxoplasmosis II: clinical features, pathology and management

    PubMed Central

    Butler, Nicholas J; Furtado, João M; Winthrop, Kevin L; Smith, Justine R

    2014-01-01

    The term, ocular toxoplasmosis, refers to eye disease related to infection with the parasite, Toxoplasma gondii. Recurrent posterior uveitis is the typical form of this disease, characterized by unilateral, necrotizing retinitis with secondary choroiditis, occurring adjacent to a pigmented retinochoroidal scar and associated with retinal vasculitis and vitritis. Multiple atypical presentations are also described, and severe inflammation is observed in immunocompromised patients. Histopathological correlations demonstrate focal coagulative retinal necrosis, and early in the course of the disease, this inflammation is based in the inner retina. For typical ocular toxoplasmosis, a diagnosis is easily made on clinical examination. In atypical cases, ocular fluid testing to detect parasite DNA by polymerase chain reaction or to determine intraocular production of specific antibody may be extremely helpful for establishing aetiology. Given the high seroprevalence of toxoplasmosis in most communities, serological testing for T. gondii antibodies is generally not useful. Despite a lack of published evidence for effectiveness of current therapies, most ophthalmologists elect to treat patients with ocular toxoplasmosis that reduces or threatens to impact vision. Classic therapy consists of oral pyrimethamine and sulfadiazine, plus systemic corticosteroid. Substantial toxicity of this drug combination has spurred interest in alternative antimicrobials, as well as local forms of drug delivery. At this time, however, no therapeutic approach is curative of ocular toxoplasmosis. PMID:22712598

  11. Effect of bilastine upon the ocular symptoms of allergic rhinoconjunctivitis.

    PubMed

    Bartra, J; Mullol, J; Montoro, J; Jáuregui, I; del Cuvillos, A; Dávila, I; Ferrer, M; Sastre, J; Valero, A

    2011-01-01

    Ocular symptoms often accompany allergic rhinitis and can be as or even more bothersome for the patient than the actual nasal symptoms. Ocular manifestations of allergic rhinoconjunctivitis may result from both direct allergen-mediated mast cell stimulation on the surface of the eye and naso-ocular reflexes--histamine being one of the mediators of symptoms onset. An H1 antihistamine would be the first line treatment for allergic conjunctivitis. Since allergic conjunctivitis is always (or almost always) accompanied by nasal symptoms, a second-generation H1 antihistamine administered via oral route is the drug of choice for jointly managing both the nasal and the ocular symptoms--minimizing the impact of the effects inherent to first-generation H, antihistamine, including particularly drowsiness. Bilastine is a new H1 antihistamine with an excellent safety profile, developed for the treatment of allergic rhinoconjunctivitis and urticaria, with potency similar to that of cetirizine and desloratadine, and superior to that of fexofenadine. This new drug has been shown to be effective in controlling the ocular symptoms of allergic rhinoconjunctivitis. PMID:22185047

  12. Liposomes and nanotechnology in drug development: focus on ocular targets

    PubMed Central

    Honda, Miki; Asai, Tomohiro; Oku, Naoto; Araki, Yoshihiko; Tanaka, Minoru; Ebihara, Nobuyuki

    2013-01-01

    Poor drug delivery to lesions in patients’ eyes is a major obstacle to the treatment of ocular diseases. The accessibility of these areas to drugs is highly restricted by the presence of barriers, including the corneal barrier, aqueous barrier, and the inner and outer blood–retinal barriers. In particular, the posterior segment is difficult to reach for drugs because of its structural peculiarities. This review discusses various barriers to drug delivery and provides comprehensive information for designing nanoparticle-mediated drug delivery systems for the treatment of ocular diseases. Nanoparticles can be designed to improve penetration, controlled release, and drug targeting. As highlighted in this review, the therapeutic efficacy of drugs in ocular diseases has been reported to be enhanced by the use of nanoparticles such as liposomes, micro/nanospheres, microemulsions, and dendrimers. Our recent data show that intravitreal injection of targeted liposomes encapsulating an angiogenesis inhibitor caused significantly greater suppression of choroidal neovascularization than did the injection of free drug. Recent progress in ocular drug delivery systems research has provided new insights into drug development, and the use of nanoparticles for drug delivery is thus a promising approach for advanced therapy of ocular diseases. PMID:23439842

  13. Ocular effects of organophosphates: a historical perspective of Saku disease.

    PubMed

    Dementi, B

    1994-01-01

    Many publications, primarily of work performed in Japan, report findings in human populations of an increased incidence of myopia and of a more advanced visual disease syndrome (Saku disease), which reportedly correlated with increasing use of organophosphate pesticides in agriculture. Follow-up studies in animals performed in Japan using such agents as ethylthiometon, fenthion and fenitrothion demonstrate adverse effects of organophosphates on the visual system. The several ocular effects in question are dose dependent, ranging in severity from lenticular and electro-retinographic changes to the seemingly more serious histophysiological changes in such tissues as the ciliary body and retina. An important question arising from this work is that of the role of cholinesterase inhibition in the etiology of the effects. Studies currently in progress on particular organophosphates being conducted at EPA's research facility and by certain registrants of pesticides, which are in various stages of completion, appear to be substantiating much that has been reported in Japan. While animal studies clearly show that some organophosphates elicit ocular toxicity, there are many knowledge gaps with regard to effects in humans and the ocular toxicity in general, e.g. time and dose dependency, cholinesterase inhibition vs ocular effects and effects of routes of exposure. Consequently, the office is unable at this time to incorporate hazard assessment data with exposure assessment data or to perform risk assessments on organophosphates based on the ocular toxicity potential of this class of chemicals. PMID:8027507

  14. Onchocerciasis in Ecuador: ocular findings in Onchocerca volvulus infected individuals.

    PubMed

    Cooper, P J; Proaño, R; Beltran, C; Anselmi, M; Guderian, R H

    1995-02-01

    Little is known of the epidemiology and clinical picture of ocular onchocerciasis in South America. A survey of onchocercal eye disease was performed in the hyperendemic area of a rain forest focus of onchocerciasis in Esmeraldas Province in Ecuador. A total of 785 skin snip positive individuals from black and Chachi Amerindian communities were examined. The blindness rate attributable to onchocerciasis was 0.4%, and 8.2% were visually impaired. Onchocercal ocular lesions were seen in a high proportion of the study group: 33.6% had punctate keratitis, microfilariae in the anterior chamber and cornea were seen in 28.9% and 33.5% respectively, iridocyclitis was seen in 1.5%, optic atrophy in 5.1%, and chorioretinopathy in 28.0%. Sclerosing keratitis was not seen. The prevalence of all ocular lesions increased with age. Punctate keratitis was strongly associated with microfilarial counts in the cornea and chorioretinopathy was correlated with infection intensities in the cornea and anterior chamber. Chachi Amerindians had higher anterior chamber microfilarial counts and a greater prevalence of punctate keratitis than blacks though blacks had a greater prevalence of iridocyclitis and optic nerve disease. The pattern of ocular disease resembled rain forest onchocerciasis in west Africa with few severe ocular lesions in the anterior segment and all blinding lesions attributable to posterior segment disease. PMID:7696237

  15. Neuro-ocular cutaneous syndrome: a case report.

    PubMed

    Onesti, M G; Trignano, E; Fino, P; Scuderi, N

    2009-08-01

    Neuro-ocular cutaneous syndrome is a rare and little-known illness. It affects the ocular apparatus, the nervous system and the skin. The disease causes pathologies such as phacomatosis, which is a generic term used to describe small cutaneous neoformations, as well as other ectodermal organ malformations (ocular apparatus and central nervous system). The symptoms of this disease are ocular, neurological and dermatological and can include: corneal opacity, papillary coloboma, optical atrophy, epibulbar dermoids, corectopia, palpebral coloboma, frontoparietal alopecia, epilepsy, psychomotor delay, pedunculated skin growths, a yellowing of the frontal area, milled papules, milled patches of skin, cutaneous spotting, familial angioma and hemiplegia. Due to the complexity of this disease, it is imperative that specialists (including ophthalmologists, neurologists, dermatologists, plastic surgeons, pediatricians and genetics) examine a great number of families affected by this rare pathology in a precise, accurate and ongoing manner. The clinical case of a 15 year-old patient (who was diagnosed at 10 months old) affected by the neuro-ocular cutaneous syndrome will be discussed below. PMID:19755953

  16. The Great Imitator: Ocular Syphilis Presenting as Posterior Uveitis

    PubMed Central

    Kuo, Alan; Ziaee, Saba M.; Hosseini, Hamid; Voleti, Vinod; Schwartz, Steven D.; Kim, Nam U.; Ge, Phillip S.

    2015-01-01

    Patient: Female, 34 Final Diagnosis: Ocular syphilis Symptoms: Painful unilateral vision loss Medication: Benzylpenicillin Clinical Procedure: Lumbar puncture Specialty: Infectious Diseases • Ophthalmology Objective: Rare disease Background: Syphilis is often known as the “Great Imitator”. The differential diagnosis of posterior uveitis is broad with ocular syphilis being particularly challenging to diagnose as it presents similarly to other ocular conditions such as acute retinal necrosis. Case Report: A 34-year-old woman with multiple sexual partners over the past few years presented with painful and progressively worsening unilateral vision loss for 2 weeks. Several months prior, she had reported non-specific symptoms of headache and diffuse skin rash. Despite treatment with oral acyclovir for 3 weeks, her vision progressively declined, and she was referred to the university ophthalmology clinic for further evaluation. On examination, there was concern for acute retinal necrosis and she was empirically treated with parenteral acyclovir while awaiting further infectious disease study results. Workup ultimately revealed ocular syphilis, and neurosyphilis was additionally confirmed with cerebrospinal fluid studies. Treatment with intravenous penicillin was promptly initiated with complete visual recovery. Conclusions: Ocular syphilis varies widely in presentation and should be considered in all patients with posterior uveitis, especially with a history of headache and skin rashes. However, given that acute retinal necrosis is a more common cause of posterior uveitis and can rapidly result in permanent vision loss, it should be empirically treated whenever it is suspected while simultaneous workup is conducted to evaluate for alternative diagnoses. PMID:26151369

  17. Ocular manifestations in children and adolescents with Lyme arthritis

    PubMed Central

    Huppertz, H.; Munchmeier, D.; Lieb, W.

    1999-01-01

    BACKGROUND—Lyme arthritis is the most frequent late manifestation of Lyme borreliosis and has been associated with ocular inflammation.?METHODS—A group of 153 children and adolescents with arthritis, 84 of whom had Lyme arthritis and 69 other causes of arthritis, were followed prospectively for 22-73 (median 44) months in the course of a national study.?RESULTS—Three of 84 patients with Lyme arthritis had ocular inflammation (4%), including keratitis, anterior uveitis, and uveitis intermedia. All three had symptoms of decreased visual acuity. Whereas anterior uveitis disappeared without sequelae, a corneal scar and a permanent loss of visual acuity in the patients with keratitis and intermediate uveitis remained. Systematic examination of all patients revealed no further ocular involvement. Of 69 patients with other causes of arthritis who were followed in parallel as a control group, four of 15 patients with early onset pauciarticular juvenile rheumatoid arthritis had chronic anterior uveitis and two of 12 patients with juvenile spondyloarthropathy had acute anterior uveitis.?CONCLUSIONS—Ocular involvement with keratitis, anterior uveitis, and intermediate uveitis may occur in children and adolescents with Lyme arthritis. Visual loss appears to be symptomatic, making regular ocular screening of such patients unnecessary.?? PMID:10502576

  18. Current concepts of mechanical and neural factors in ocular motility

    PubMed Central

    Demer, Joseph L.

    2007-01-01

    Purpose of review The oculomotor periphery was classically regarded as a simple mechanism executing complex behaviors specified explicitly by neural commands. A competing view has emerged that many important aspects of ocular motility are properties of the extraocular muscles and their associated connective tissue pulleys. This review considers current concepts regarding aspects of ocular motility that are mechanically determined versus those that are specified explicitly as innervation. Recent findings While it was established several years ago that the rectus extraocular muscles have connective tissue pulleys, recent functional imaging and histology has suggested that the rectus pulley array constitutes an inner mechanism, analogous to a gimbal, that is rotated torsionally around the orbital axis by an outer mechanism driven by the oblique extraocular muscles. This arrangement may account mechanically for several commutative aspects of ocular motor control, including Listing’s Law, yet permits implementation of non-commutative motility. Recent human behavioral studies, as well as neurophysiology in monkeys, are consistent with implementation of Listing’s Law in the oculomotor periphery, rather than centrally. Summary Varied evidence now strongly supports the conclusion that Listing’s Law and other important ocular kinematics are mechanically determined. This finding implies more limited possibilities for neural adaptation to some ocular motor pathologies, but indicates possibilities for surgical treatments. PMID:16415671

  19. Ocular disease in American crocodiles (Crocodylus acutus) in Costa Rica.

    PubMed

    Rainwater, Thomas R; Millichamp, Nicholas J; Barrantes, Luz Denia Barrantes; Barr, Brady R; Montero, Juan R Bolaños; Platt, Steven G; Abel, Mike T; Cobb, George P; Anderson, Todd A

    2011-04-01

    Beginning in early 2006, an ocular disease of unknown etiology was routinely observed in American crocodiles (Crocodylus acutus) inhabiting the highly polluted Tarcoles River in west-central Costa Rica. We examined the nature and incidence of ocular disease in Tarcoles crocodiles and assessed the possible association between the disease and accumulation of chemical pollutants in diseased individuals. During 12-15 September and 12-13 December 2007, crocodiles were captured and examined for ocular disease and sampled to determine environmental contaminant accumulation. Three of 11 (27.3%) crocodiles captured (all males) exhibited unilateral ocular disease, primarily characterized by corneal opacity and scarring, anterior synechia, and phthisis bulbi. Multiple pollutants were detected in crocodile caudal scutes (organochlorine pesticides [OCPs] and metals), crocodile blood (OCPs), and sediments (OCPs and metals) from the Tarcoles, but no associations were found between contaminant accumulation and the incidence of eye disease. On the basis of the limited number of diseased animals examined and the potential exposure of crocodiles to pathogens and other pollutants not targeted in this study, we cannot rule out infection or chemical toxicosis as causes of the eye lesions. However, circumstantial evidence suggests that the observed ocular disease is likely the result of injury-induced trauma (and possibly secondary infection) inflicted during aggressive encounters (e.g., territorial combat) among large adult crocodiles living at relatively high densities. PMID:21441195

  20. Candidate Genes in Ocular Dominance Plasticity

    PubMed Central

    Rietman, M. Liset; Sommeijer, J.-P.; Levelt, Christiaan N.; Heimel, J. Alexander

    2012-01-01

    Many studies have been devoted to the identification of genes involved in experience-dependent plasticity in the visual cortex. To discover new candidate genes, we have reexamined data from one such study on ocular dominance (OD) plasticity in recombinant inbred BXD mouse strains. We have correlated the level of plasticity with the gene expression data in the neocortex that have become available for these same strains. We propose that genes with a high correlation are likely to play a role in OD plasticity. We have tested this hypothesis for genes whose inactivation is known to affect OD plasticity. The expression levels of these genes indeed correlated with OD plasticity if their levels showed strong differences between the BXD strains. To narrow down our candidate list of correlated genes, we have selected only those genes that were previously found to be regulated by visual experience and associated with pathways implicated in OD plasticity. This resulted in a list of 32 candidate genes. The list contained unproven, but not unexpected candidates such as the genes for IGF-1, NCAM1, NOGO-A, the gamma2 subunit of the GABA(A) receptor, acetylcholine esterase, and the catalytic subunit of cAMP-dependent protein kinase A. This demonstrates the viability of our approach. More interestingly, the following novel candidate genes were identified: Akap7, Akt1, Camk2d, Cckbr, Cd44, Crim1, Ctdsp2, Dnajc5, Gnai1, Itpka, Mapk8, Nbea, Nfatc3, Nlk, Npy5r, Phf21a, Phip, Ppm1l, Ppp1r1b, Rbbp4, Slc1a3, Slit2, Socs2, Spock3, St8sia1, Zfp207. Whether all these novel candidates indeed function in OD plasticity remains to be established, but possible roles of some of them are discussed in the article. PMID:22347157

  1. Genetics Home Reference: Short stature, hyperextensibility, hernia, ocular depression, Rieger anomaly, and teething ...

    MedlinePLUS

    ... OMIM Genetic disorder catalog Conditions > Short stature, hyperextensibility, hernia, ocular depression, Rieger anomaly, and teething delay (often ... 2013 What is SHORT syndrome? Short stature, hyperextensibility, hernia, ocular depression, Rieger anomaly, and teething delay, commonly ...

  2. Prosthetic Rehabilitation of Ocular Defect resulting from Pediatric Retinoblastoma

    PubMed Central

    Janya, Suma; Gubrellay, Priyanka; Khanna, Shally

    2014-01-01

    ABSTRACT% Ocular defects result from tumor, congenital anomaly and external injury not only lead to serious impairment of function and esthetics but also make the patient psychologically disabled. Prosthetic rehabilitation attempts to restore these disfgurements may improve esthetic, level of function, general psychologic improvement and quality of life. This clinical report details an attempt to rehabilitate a pediatric patient who has undergone orbital enucleation resulting from retinoblastoma with the aid of custom ocular prosthesis using commercially available prefabricated eye shell. How to cite this article: Janya S, Gubrellay P, Purwar A, Khanna S. Prosthetic Rehabilitation of Ocular Defect resulting from Pediatric Retinoblastoma. Int J Clin Pediatr Dent 2014; 7(3):209-212. PMID:25709304

  3. Surgical correction of ptosis in ocular fibrosis syndrome.

    PubMed Central

    Liu, C; Ohri, R; Frongia, G; Collin, R

    1994-01-01

    The surgical management of ptosis is reported in seven patients suffering from the ocular fibrosis syndrome. Satisfactory results were obtained with bilateral Crawford type brow suspension with autologous fascia lata in six patients and bilateral Fox type brow suspension with stored fascia lata in a young child. As patients with ocular fibrosis syndrome usually exhibit little or no Bell's phenomenon, corneal exposure can become a problem after brow suspension. It was recommended that the lids are left just closed on the operating table at the end of the operation. None of the patients required a subsequent procedure to lower an overcorrection of the ptosis. The routine prescription of ocular lubricants for 2 months after ptosis correction is advocated. Urgent brow suspension in young children using non-autologous materials should only be considered if there is a risk of amblyopia. Images PMID:8199112

  4. Ocular manifestations in the Hutchinson-Gilford progeria syndrome

    PubMed Central

    Chandravanshi, Shivcharan L; Rawat, Ashok Kumar; Dwivedi, Prem Chand; Choudhary, Pankaj

    2011-01-01

    The Hutchinson-Gilford progeria (HGP) syndrome is an extremely rare genetic condition characterized by an appearance of accelerated aging in children. The word progeria is derived from the Greek word progeros meaning ‘prematurely old’. It is caused by de novo dominant mutation in the LMNA gene (gene map locus 1q21.2) and characterized by growth retardation and accelerated degenerative changes of the skin, musculoskeletal and cardiovascular systems. The most common ocular manifestations are prominent eyes, loss of eyebrows and eyelashes, and lagophthalmos. In the present case some additional ocular features such as horizontal narrowing of palpebral fissure, superior sulcus deformity, upper lid retraction, upper lid lag in down gaze, poor pupillary dilatation, were noted. In this case report, a 15-year-old Indian boy with some additional ocular manifestations of the HGP syndrome is described. PMID:22011502

  5. Serum levels of dehydroepiandrosterone sulfate (DHEAS) in ocular toxoplasmosis.

    PubMed

    de-la-Torre, Alejandra; Ríos-Cadavid, Angela Cristina; Cardozo-García, Carlos Mario; Padilla, Leonardo; Gómez-Marín, Jorge Enrique

    2012-02-01

    There are no previous study about ocular toxoplasmosis and serum levels of dehydroepiandrosterone sulphated hormone (DHEAS). We use the chemoluminiscence automatized Immulite assay to determine the levels of DHEAS. Four groups were studied: (1) Individuals with chronic asymptomatic infection with a positive test for IgG anti-Toxoplasma and without ocular lesions (n = 16); (2) Chronic asymptomatic patients with retinal scars of retinochoroiditis by Toxoplasma (n = 19); (3) Acute symptomatic patients with active retinochoroiditis by Toxoplasma (n = 26); (4) Individuals with negative assays for IgG anti-Toxoplasma (n = 21). Comparison of DHEAS levels between groups were adjusted by age and sex and non-parametric Kruskall Wallis statistical tests were applied. No significant differences in serum levels of DHEAS were found between groups when age and sex were controlled. DHEAS levels were not significantly different in active ocular toxoplasmosis related to non active or non infected persons. PMID:22153766

  6. Ocular torsional movements in humans with normal and abnormal ocular motility: Part II--Subjective observations.

    PubMed

    Kushner, B J

    1986-01-01

    A technique is described by which subjects, using a Maddox rod, can subjectively appreciate the dynamic torsional movements that occur at the end of forced head tilt. The subjective responses of a large series of subjects with normal ocular motility confirm my previous observations that at the end of ipsilateral head tilt the eye is undergoing an extorsional movement and at the end of contralateral head tilt, an intorsional movement. Observations made in patients with oblique dysfunction confirm that the extorsional movements are largely produced by the inferior oblique and the intorsional movements by the superior oblique. This is consistent with the classic observation that a partial compensatory intorsion occurs after ipsilateral tilt, and extorsion after contralateral tilt, however, it suggests that this compensatory torsion occurs by a different mechanism than is classically taught. Patients with dissociated vertical divergence appear to have an abnormal response of the oblique muscles to change in head tilt. PMID:3950843

  7. Diagnostic value of nystagmus: spontaneous and induced ocular oscillations

    PubMed Central

    Serra, A; Leigh, R

    2002-01-01

    Research over the past 20 years has provided a clearer understanding of the pathogenesis of most forms of nystagmus and other ocular oscillations. To the clinician, these advances translate into greater accuracy of nystagmus as a diagnostic sign. However, to capitalise on these advances, it is important to systematically examine eye movements and interpret the findings with reference to pathophysiology. In this review we describe a scheme for examining the patient with nystagmus and interpreting common ocular oscillations; some examples are provided as video clips. PMID:12438459

  8. Ocular tilt reaction due to a cerebellar hemorrhage.

    PubMed

    Tsuda, Hiromasa; Tanaka, Kozue

    2014-01-01

    A 78-year-old man with essential hypertension abruptly developed complete ocular tilt reaction (OTR) which consisted of concomitant skew deviation with left hypertropia, extorsion of the right eye and intorsion of the left, and rightward head tilt. Cranial computed tomography demonstrated a localized cerebellar hemorrhage involving the left nodulus. The patient became asymptomatic within two weeks. This is a first reported case of complete OTR due to a cerebellar hemorrhage. Concomitant skew deviation is a common symptom of cerebellar lesions. Moreover, unilateral damage to the utricular pathway due to involvement of the left nodulus might cause rightward conjugate ocular torsion and rightward head tilt. PMID:25274240

  9. Ocular surface changes in glaucoma patients related to topical medications.

    PubMed

    Kova?evi?, Suzana; ?anovi?, Samir; Pavi?i?, Ana Didovi?; Kolega, Marija Škara; Baši?, Jadranka Katuši?

    2015-03-01

    Topical glaucoma therapy is a long termed, usually lifelong. Antiglaucomatous drugs have toxic effects on ocular surface, due to preservative toxicitiy or the drug itself. Adding a lubricant eyedrops to antiglaucomatous therapy, especially if considering the preservative used, can have protective effect. The purpose of this study was to evaluate the stabilty of precorneal tear film in glaucoma patient prior and after administration of lubricant eye drops with different tipe of preservatives. The study showed the protective role of ocular surface lubrication especially when using drugs with less harmful preservatives. PMID:26040067

  10. Treating ocular surface disease: new agents in development

    PubMed Central

    Fahmy, Ahmad M; Hardten, David R

    2011-01-01

    This paper reviews recent advances and investigation in the treatment of ocular surface pathology. There is significant investment in this area, paralleling the growing demand for more effective alternatives to current treatments. Clinicians are becoming more aware of surface pathology, yet the ability to treat the most common forms of ocular pathology are still limited to the few medications approved by the US Food and Drug Administration. Medicines and devices currently under investigation are very promising. It is absolutely critical to understand the emerging options and think of their role in the treatment paradigm. PMID:21573093

  11. Glycerogelatin-based ocular inserts of aceclofenac: physicochemical, drug release studies and efficacy against prostaglandin E?-induced ocular inflammation.

    PubMed

    Mathurm, Manish; Gilhotra, Ritu Mehra

    2011-01-01

    An attempt has been made in the present study to formulate soluble ocular inserts of aceclofenac to facilitate the bioavailability of the drug into the eye, as no eye drop solution could be formulated. Glycero-gelatin ocular inserts/films were prepared and physicochemical parameters and drug release profiles of glycerol-gelatin films of aceclofenac were compared with surface cross-linked films of similar compositions. Ocular irritation of the developed formulation was also checked by HET-CAM test and efficacy of the developed formulation against prostaglandin-induced ocular inflammation in rabbit eye was determined. The non-cross-linked films showed poor mechanical, physicochemical properties, and very little potential of sustaining drug release, however cross-linking the films enhanced tensile strength by 70%, but elasticity decreased by 95%. The cross-linked ocular inserts showed less swelling than non-cross-linked. Formulation AF8 (20% gelatin and 70% glycerin, treated by cross-linker for 1?h) demonstrated the longest drug release for 24?h. As per the kinetic models all films showed a constant drug release with Higuchi diffusion mechanism. Formulation was found to be practically non-irritant. The optimized formulation was tested and compared with eye drops of aceclofenac for anti-inflammatory activity in rabbits against PGE?-induced inflammation. In vivo studies with developed formulation indicated a significant inhibition of PGE?-induced PMN migration as compared to eye drops. In conclusion, ocular inserts of aceclofenac was found promising as it achieved sustained drug release and better pharmacodynamic activity. PMID:20718601

  12. Heterogeneity and Persistence Length in Human Ocular Mucins

    Microsoft Academic Search

    A. N. Round; M. Berry; T. J. McMaster; S. Stoll; D. Gowers; A. P. Corfield; M. J. Miles

    2002-01-01

    Atomic force microscopy (AFM) has been used to investigate the heterogeneity and flexibility of human ocular mucins and their subunits. We have paid particular attention, in terms of theory and experiment, to the problem of inducing the polymers to assume equilibrium conformations at a surface. Mucins deposited from a buffer containing Ni2+ ions adopt extended conformations on mica akin to

  13. OCULAR HYPERTELORISM (GREIG'S SYNDROME) ASSOCIATED WITH SPRENGEL'S DEFORMITY

    Microsoft Academic Search

    THEODORE E. KEATS

    CASE I. W.M., a 12 year old white boy, has been confined to a state training school since the age ofbecause of mental retardation. His facies was unusual in that he had striking ocular hypertelorism and depression of the root of the nose and maxilla. His head was abnormally small and a bone defect was palpable in the midline of

  14. The Great Imitator: Ocular Syphilis Presenting as Posterior Uveitis.

    PubMed

    Kuo, Alan; Ziaee, Saba M; Hosseini, Hamid; Voleti, Vinod; Schwartz, Steven D; Kim, Nam U; Ge, Phillip S

    2015-01-01

    BACKGROUND Syphilis is often known as the "Great Imitator". The differential diagnosis of posterior uveitis is broad with ocular syphilis being particularly challenging to diagnose as it presents similarly to other ocular conditions such as acute retinal necrosis. CASE REPORT A 34-year-old woman with multiple sexual partners over the past few years presented with painful and progressively worsening unilateral vision loss for 2 weeks. Several months prior, she had reported non-specific symptoms of headache and diffuse skin rash. Despite treatment with oral acyclovir for 3 weeks, her vision progressively declined, and she was referred to the university ophthalmology clinic for further evaluation. On examination, there was concern for acute retinal necrosis and she was empirically treated with parenteral acyclovir while awaiting further infectious disease study results. Workup ultimately revealed ocular syphilis, and neurosyphilis was additionally confirmed with cerebrospinal fluid studies. Treatment with intravenous penicillin was promptly initiated with complete visual recovery. CONCLUSIONS Ocular syphilis varies widely in presentation and should be considered in all patients with posterior uveitis, especially with a history of headache and skin rashes. However, given that acute retinal necrosis is a more common cause of posterior uveitis and can rapidly result in permanent vision loss, it should be empirically treated whenever it is suspected while simultaneous workup is conducted to evaluate for alternative diagnoses. PMID:26151369

  15. The role of chemokines and their receptors in ocular disease

    Microsoft Academic Search

    Graham R Wallace; S John Curnow; Kaska Wloka; Mike Salmon; Philip I Murray

    2004-01-01

    The migration and infiltration of cells into the eye whether blood-borne leucocytes, endothelial or epithelial cells occurs in many ocular diseases. Dysregulation of this process is apparent in chronic inflammation, corneal graft rejection, allergic eye disease and other sight-threatening conditions. Under normal and inflammatory conditions, chemokines and their receptors are important contributors to cell migration. To date, 47 chemokines and

  16. Drug-Induced Ocular Hypertension and Angle-Closure Glaucoma.

    PubMed

    Badhu, Badri P; Bhattarai, Balkrishna; Sangraula, Himal P

    2013-01-01

    The objective of this study was to review the available literature on the drugs causing ocular hypertension and glaucoma. Electronic literature search was carried out using the Web sites www.pubmed.gov and www.google.com published through the year 2011. The search words were "drug induced ocular hypertension" and "drug induced glaucoma" used in combination. The articles published or translated into English were studied. Quite a significant number of drugs commonly prescribed by various physicians of different specialties can induce ocular hypertension or glaucoma. A brief account of various drugs that can induce ocular hypertension has been given in this article. Those drugs are parasympatholytics; steroids; anticholinergics, adrenergics, and antidepressants; cholinomimetics; antineoplastic agents; antipsychotic and antiparkinsonism agents; H1 and H2 receptor blockers; botulinum toxin, cardiac agents, and anticoagulants; silicone oil; sulfa drugs; and anesthetic agents. Rational use of these drugs and knowledge of their potential adverse effects can help prevent the devastating complications resulting in loss of vision and compromised quality of life. PMID:26108110

  17. Comparative analysis of deformable mirrors for ocular adaptive optics

    E-print Network

    Dainty, Chris

    Comparative analysis of deformable mirrors for ocular adaptive optics Eugenie Dalimier and Chris OCIS codes: (010.1080) Adaptive optics; (230.3990) Microstructures devices; (330.4460) Ophthalmic, "Supernormal vision and high-resolution retinal imaging through adaptive optics," J. Opt. Soc. Am. A 14, 2884

  18. Successfully improving ocular drug delivery using the cationic nanoemulsion, novasorb.

    PubMed

    Lallemand, Frederic; Daull, Philippe; Benita, Simon; Buggage, Ronald; Garrigue, Jean-Sebastien

    2012-01-01

    Topical ophthalmic delivery of active ingredients can be achieved using cationic nanoemulsions. In the last decade, Novagali Pharma has successfully developed and marketed Novasorb, an advanced pharmaceutical technology for the treatment of ophthalmic diseases. This paper describes the main steps in the development of cationic nanoemulsions from formulation to evaluation in clinical trials. A major challenge of the formulation work was the selection of a cationic agent with an acceptable safety profile that would ensure a sufficient ocular surface retention time. Then, toxicity and pharmacokinetic studies were performed showing that the cationic emulsions were safe and well tolerated. Even in the absence of an active ingredient, cationic emulsions were observed in preclinical studies to have an inherent benefit on the ocular surface. Moreover, clinical trials demonstrated the efficacy and safety of cationic emulsions loaded with cyclosporine A in patients with dry eye disease. Ongoing studies evaluating latanoprost emulsion in patients with ocular surface disease and glaucoma suggest that the beneficial effects on reducing ocular surface damage may also extend to this patient population. The culmination of these efforts has been the marketing of Cationorm, a preservative-free cationic emulsion indicated for the symptomatic treatment of dry eye. PMID:22506123

  19. Consensus statement on the immunohistochemical detection of ocular lymphatic vessels.

    PubMed

    Schroedl, Falk; Kaser-Eichberger, Alexandra; Schlereth, Simona L; Bock, Felix; Regenfuss, Birgit; Reitsamer, Herbert A; Lutty, Gerard A; Maruyama, Kazuichi; Chen, Lu; Lütjen-Drecoll, Elke; Dana, Reza; Kerjaschki, Dontscho; Alitalo, Kari; De Stefano, Maria Egle; Junghans, Barbara M; Heindl, Ludwig M; Cursiefen, Claus

    2014-10-01

    There is currently considerable controversy about existence and classification of "lymphatic vessels" in the eye. Some of the confusion is certainly caused by inappropriate use (or nonuse) of the correct immunohistochemical markers. Many experts in the field expressed the need for a consensus statement, and, in this perspective, authors offer arguments and solutions to reliably continue with immunohistochemical ocular lymphatic research. PMID:25315233

  20. Ocular injuries among industrial welders in Port Harcourt, Nigeria

    PubMed Central

    Fiebai, B; Awoyesuku, EA

    2011-01-01

    Background The purpose of this study was to determine the prevalence and pattern of ocular injuries among industrial welders and rate the use of protective eyewear at work among industrial welders in Port Harcourt. Information from this study will provide a database for effective policy formation on prevention of occupational eye injuries in Port Harcourt Rivers State. Methods A cross-sectional survey of ocular injuries and use of protective eyewear among industrial welders in the Port Harcourt local government area of Rivers State, Nigeria, was carried out over a three-month period. Five hundred welders were selected by simple random sampling. Information was obtained using an interviewer-administered questionnaire. All welders were examined in their workshops. Results Flying metal chips were the chief source of ocular injury, as reported by 199 (68.15%) of those who gave a history of work-related eye injury, while arc rays accounted for the remaining 93 (31.85%). There was a high level of awareness of the risk of sustaining an eye injury from welding (n = 490, 98%), but only 46 (15.3%) of the welders were using protective eyewear at the time of injury. Conclusion To minimize ocular injury and promote eye health amongst industrial welders, safety intervention programs, such as awareness campaigns, setting up of targeted programs by the relevant government agencies, and encouragement of locally produced eye protectors is recommended. The involvement of occupational medical practitioners is also strongly recommended. PMID:21966197

  1. Treatment of ocular cicatricial pemphigoid with tacrolimus (FK 506)

    Microsoft Academic Search

    Erik Letko; Razzaque A. Ahmed; Stephen C. Foster

    2001-01-01

    Purpose: To evaluate the efficacy of tacrolimus (FK 506) therapy in patients with ocular cicatricial pemphigoid (OCP). Methods: In a cohort study, six patients with OCP, in whom the disease was not controlled by conventional immunosuppressive agents administered in high doses for an appropriate period of time, were treated with FK 506. The FK 506 was administered orally at the

  2. The Development of Ocular Dominance Columns: Mechanisms and Models

    E-print Network

    Stryker, Michael

    to the left, from which emerge the optic nerves. At the optic chiasm the fibers from the nasal side of e prediction of the size of ocular dominance colmnns from potential experimental measurements. This analysis illuminates the relative importance of the properties of the cortex and its inputs in detennining this size

  3. Prosthetic Rehabilitation of a Pediatric Patient with an Ocular Defect

    PubMed Central

    Mallikarjuna, Rachappa M; Anand, Bina M; Shashibhusan, Mayur Anand KK; Reddy, VV Subba

    2013-01-01

    ABSTRACT The eye is a vital organ for vision and an important component of facial expression. Loss of an eye has a crippling effect physically and psychologically. Especially, in case of a child where it affects the parent too and the approach toward these special children needs to be very special indeed. The construction of an ocular prosthesis for a child is the same as for an adult. A growing child will require periodic enlargement of the prosthesis in order to accompany the expansion of the anophthalmic cavity and it is the only way to esthetically rebuild the anophthalmic socket. Although implant eye prosthesis has superior outcome, due to economic factors it may not be advisable in all patients. Therefore, an acrylic custom-made ocular prosthesis replacement as soon as possible is a good alternative to promote physical and psychological healing for the patient and to improve social acceptance. A case of a custom fabricated ocular acrylic prosthesis using the advantages of digital photography is presented here, which had acceptable fit, retention and improved esthetics with a certain degree of motility in coordination with the contralateral normal eye. How to cite this article: Nalawade TM, Mallikarjuna RM, Anand BM, Anand M, Shashibhusan KK, Subba Reddy VV. Prosthetic Rehabilitation of a Pediatric Patient with an Ocular Defect. Int J Clin Pediatr Dent 2013;6(1):62-65. PMID:25206192

  4. Prosthetic rehabilitation of a pediatric patient with an ocular defect.

    PubMed

    Nalawade, Triveni Mohan; Mallikarjuna, Rachappa M; Anand, Bina M; Shashibhusan, Mayur Anand Kk; Reddy, Vv Subba

    2013-01-01

    The eye is a vital organ for vision and an important component of facial expression. Loss of an eye has a crippling effect physically and psychologically. Especially, in case of a child where it affects the parent too and the approach toward these special children needs to be very special indeed. The construction of an ocular prosthesis for a child is the same as for an adult. A growing child will require periodic enlargement of the prosthesis in order to accompany the expansion of the anophthalmic cavity and it is the only way to esthetically rebuild the anophthalmic socket. Although implant eye prosthesis has superior outcome, due to economic factors it may not be advisable in all patients. Therefore, an acrylic custom-made ocular prosthesis replacement as soon as possible is a good alternative to promote physical and psychological healing for the patient and to improve social acceptance. A case of a custom fabricated ocular acrylic prosthesis using the advantages of digital photography is presented here, which had acceptable fit, retention and improved esthetics with a certain degree of motility in coordination with the contralateral normal eye. How to cite this article: Nalawade TM, Mallikarjuna RM, Anand BM, Anand M, Shashibhusan KK, Subba Reddy VV. Prosthetic Rehabilitation of a Pediatric Patient with an Ocular Defect. Int J Clin Pediatr Dent 2013;6(1):62-65. PMID:25206192

  5. Ocular Surface Changes Induced by Topical Antiglaucoma Monotherapy

    Microsoft Academic Search

    Barbara Cvenkel; Alojz Ihan

    2002-01-01

    Purpose: To investigate the expression of inflammatory markers HLA-DR in impression cytology specimens from patients receiving topical antiglaucoma monotherapy. Methods: Impression cytology specimens were obtained from patients taking no topical medication (n = 13) and from primary open-angle glaucoma or ocular hypertensive patients taking one topical medication for at least 3 months (latanoprost n = 14; betaxolol n = 12;

  6. Lyin’ Eyes: Ocular-motor Measures of Reading Reveal Deception

    PubMed Central

    Cook, Anne E.; Hacker, Douglas J.; Webb, Andrea K.; Osher, Dahvyn; Kristjansson, Sean; Woltz, Dan J.; Kircher, John C.

    2013-01-01

    Our goal was to evaluate an alternative to current methods for detecting deception in security screening contexts. We evaluated a new cognitive-based test of deception that measured participants’ ocular-motor responses (pupil responses and reading behaviors) while they read and responded to statements on a computerized questionnaire. In Experiment 1, participants from a university community were randomly assigned to either a “guilty” group that committed one of two mock crimes or an “innocent” group that only learned about the crime. Participants then reported for testing, where they completed the computer-administered questionnaire that addressed their possible involvement in the crimes. Experiment 2 also manipulated participants’ incentive to pass the test and difficulty of statements on the test. In both experiments, guilty participants had increased pupil responses to statements answered deceptively; however, they spent less time fixating on, reading, and re-reading those statements than statements answered truthfully. These ocular-motor measures were optimally weighted in a discrimination function that correctly classified 85% of participants as either guilty or innocent. Findings from Experiment 2 indicated that group discrimination was improved with greater incentives to pass the test and the use of statements with simple syntax. The present findings suggest that two cognitive processes are involved in deception -- vigilance and strategy -- and that these processes are reflected in different ocular-motor measures. The ocular-motor test reported here represents a new approach to detecting deception that may fill an important need in security screening contexts. PMID:22545928

  7. Upper Eyelid Ptosis Surgery Using a Preparatory Ocular Prosthesis

    Microsoft Academic Search

    Ilse Mombaerts; Erica Groet

    2009-01-01

    Purpose: When an ocular prosthesis is unable to correct upper eyelid ptosis, surgery is performed with the existing prosthesis, which may be difficult and unsatisfactory. We used an alternative approach, in which the prosthesis was modified as a preparation to surgery. Methods: This retrospective, noncomparative, interventional case series included 26 anophthalmic and 3 microphthalmic patients with unilateral, moderate to severe

  8. Screening athletes with Down syndrome for ocular disease

    Microsoft Academic Search

    Walter Gutstein; Stephen H. Sinclair; Rachel V. North; N. Bekiroglu

    2010-01-01

    BackgroundPersons with Down syndrome are well known to have a high prevalence of vision and eye health problems, many of which are undetected or untreated primarily because of infrequent ocular examinations. Public screening programs, directed toward the pediatric population, have become more popular and commonly use letter or symbol charts. This study compares 2 vision screening methods, the Lea Symbol

  9. Photoacoustic ocular imaging Adam de la Zerda,1,2

    E-print Network

    Khuri-Yakub, Butrus T. "Pierre"

    in imaging the deeper lay- ers of the eye including the retina, choroid, and optic nerve. Using safe laser detection and improved man- agement of neovascular ocular diseases, including wet age-related macular effectively visualize deep structures such as the choroid. Furthermore, such imaging de- vices provide mostly

  10. Systane® lubricant eye drops in the management of ocular dryness

    PubMed Central

    Benelli, Umberto

    2011-01-01

    The understanding of dry eye disease has advanced recently through increasing recognition that the etiology of the condition involves both tear evaporation and insufficient tear production, and that tear film instability and inflammation play roles in the various stages of the disease. Of significance, it has been recognized that lipid layer thickness correlates with tear film stability. The management of dry eye involves various strategies and therapeutic approaches that address one or more etiopathological components of the disease. The purpose of this review is to outline the characteristics and clinical utility of the Systane® ocular lubricants that contain hydroxypropyl-guar and one or both of the demulcents, ie, polyethylene glycol 400 and propylene glycol. Clinically, these products are safe and are indicated for the temporary relief of burning and irritation due to dryness of the eye. In particular, this review describes the formulations, mechanisms of action, and clinical utility of the newest additions to this topical ocular lubricant family, Systane Ultra® and Systane Balance®. Both of these ocular products are formulated with an intelligent delivery system and both provide symptomatic relief to patients with dry eye. However, Systane Balance is a novel formulation that contains both polymer and lipid components designed to protect the ocular surface and replenish tear film lipids simultaneously, a factor that is of particular relevance to patients who have dry eye associated with meibomian gland dysfunction. PMID:21750611

  11. The additive intraocular pressure-lowering effect of latanoprost in combined therapy with other ocular hypotensive agents

    Microsoft Academic Search

    Philip F. J. Hoyng; Alexander Rulo; Erik Greve; Peter Watson; Albert Alm

    1997-01-01

    Latanoprost, a prostaglandin F2? analogue prodrug, has been shown to be an effective ocular hypotensive agent when used alone on ocular hypertensive or open angle glaucoma patients. In various studies, the ocular hypotensive effects oflatanoprost have also been evaluated when used in addition to, or in combination with, other ocular hypotensive agents. Latanoprost produces an additional reduction of intraocular pressure

  12. Hydroxyapatite ocular implant and non-integrated implants in eviscerated patients

    PubMed Central

    Gradinaru, S; Popescu, V; Leasu, C; Pricopie, S; Yasin, S; Ciuluvica, R; Ungureanu, E

    2015-01-01

    Introduction: This study compares the outcomes and complications of hydroxyapatite ocular implant and non-integrated ocular implants following evisceration. Materials and Methods: This is a retrospective study of 90 patients who underwent evisceration for different ocular affections, in the Ophthalmology Department of the University Emergency Hospital Bucharest, between January 2009 and December 2013. The outcomes measured were conjunctival dehiscence, socket infection, implant exposure and extrusion rate. Results: Forty-three patients had the hydroxyapatite implant (coralline–Integrated Ocular Implants, USA or synthetic–FCI, France) and forty-seven received non-integrated ocular implants (24 acrylic and 23 silicone). Five cases of socket infection, thirteen cases of extrusion and two cases of conjunctival dehiscence were encountered. Conclusions: There was a higher rate of conjunctival dehiscence with hydroxyapatite ocular implant, but implant extrusion and socket infection were found in non-integrated ocular implants. PMID:25914747

  13. Non-cytomegalovirus ocular opportunistic infections in patients with AIDS

    PubMed Central

    Gangaputra, Sapna; Drye, Lea; Vaidya, Vijay; Thorne, Jennifer E.; Jabs, Douglas A; Lyon, Alice T.

    2014-01-01

    Purpose To report the incidence and clinical outcomes of non-cytomegalovirus (non-CMV) ocular opportunistic infections in patients with AIDS in the era of highly active antiretroviral therapy (HAART). Design Multicenter, prospective, observational study of patients with AIDS Methods Medical history, ophthalmologic examination, and laboratory tests were performed at enrollment and every 6 months subsequently. Once an ocular opportunistic infection was diagnosed, patients were seen every 3 months for outcomes. Results At enrollment, 37 non-CMV ocular opportunistic infections were diagnosed: 16 patients, herpetic retinitis; 11 patients, toxoplasmic retinitis; and 10 patients, choroiditis. During the follow-up period, the estimated incidences (and 95% confidence intervals [CI]) of these were: herpetic retinitis, 0.007/100 person-years (PY) (95% CI 0.0004, 0.039); toxoplasmic retinitis, 0.007/100 PY (95% CI 0.004, 0.039); and choroiditis 0.014/100 PY (95% CI 0.0025, 0.050). The mortality rates appeared higher among those patients with newly diagnosed or incident herpetic retinitis and choroiditis (rates=21.7 deaths/100 PY [P=0.02] and 12.8 deaths/100 PY [P=0.04]) respectively, than that for patients with AIDS without an ocular opportunistic infection (4.1 deaths/100 PY); Toxoplasmic retinitis did not appear to be associated with greater mortality (6.4/100 PY, P=0.47). Eyes with newly-diagnosed herpetic retinitis appeared to have a poor visual prognosis with high rates of visual impairment (37.9/100 PY) and blindness (17.5/100 PY), whereas those outcomes in eyes with choroiditis appeared to be lower (2.3/100 PY and 0/100 PY, respectively). Conclusions Although uncommon, non-CMV ocular opportunistic infections may be associated with high rates of visual loss and/or mortality. PMID:23068916

  14. A New Look at Theory of Mind in Children with Ocular and Ocular-Plus Congenital Blindness

    ERIC Educational Resources Information Center

    Begeer, Sander; Dik, Marjolein; voor de Wind, Marieke J.; Asbrock, Doreen; Brambring, Michael; Kef, Sabina

    2014-01-01

    Introduction: Delays in theory of mind (ToM) of children who are congenitally blind have often been attributed to the absence of visual and social experiences. However, these delays could also be partly due to neural factors. In some children, the blindness itself has neural causes (ocular-plus blindness). Children whose blindness has an…

  15. Adaptations and deficits in the vestibulo-ocular reflex after peripheral ocular motor palsies.

    PubMed

    Sharpe, James A; Tweed, Douglas; Wong, Agnes M F

    2003-10-01

    Palsy of a nerve might be expected to lower vestibulo-ocular reflex (VOR) responses in its fields of motion, but effects of peripheral neuromuscular disease were unknown. We recorded the VOR during sinusoidal head rotations in yaw, pitch, and roll at 0.5-2 Hz and static torsional gain in 43 patients with unilateral nerve palsies. Sixth nerve palsy (n = 21) reduced both abduction and adduction VOR gains in darkness. In light, horizontal visually enhanced VOR (VVOR) gains were normal in moderate and mild palsy. In severe palsy, horizontal VVOR gains remained low in the paretic eye when it was fixating, whereas gains in the nonparetic eye became higher than normal. Third nerve palsy (n = 10) decreased VOR and VVOR gains during abduction, adduction, elevation, depression, extorsion, and intorsion. Fourth nerve palsy (n = 13) reduced VOR gains of the paretic eye during intorsion, extorsion, elevation, depression, abduction, and adduction, but in light vertical and horizontal VVOR gains were normal. In the nonparetic eye, all gains were normal. Reduced VOR gains in the direction of paretic muscles and also in the direction of their antagonists, together with normal gains in the nonparetic eye, indicate a selective adjustment to the antagonists of paretic muscles. Increase of VVOR gains to normal in the paretic eye, when used for fixation, without conjugate increase in gains in the occluded nonparetic eye, provides further evidence of selective adaptation for the paretic eye. Motions of the eyes after nerve palsies indicate monocular VOR adaptation in three dimensions. PMID:14662452

  16. Ocular torsional movements in humans with normal and abnormal ocular motility--Part I: Objective measurements.

    PubMed

    Kushner, B J; Kraft, S E; Vrabec, M

    1984-01-01

    Using a corneal marker and cinematography, we analyzed ocular torsional movements during forced head tilt in three patients with superior oblique palsy before and after ipsilateral inferior oblique recession and compared them to those of normal subjects. As the head is tilted in normal subjects, the eye lags behind the head in a slow rolling movement. Periodic rapid wheel-like movements occur in the direction of head tilt which do not completely allow the eye to catch up with the head. This results in a partial compensatory intorsion on ipsilateral head tilt and extorsion on contralateral head tilt. In patients with superior oblique palsy, the rapid extorsional movement on ipsilateral head tilt is greater and faster than in the normal, but becomes slower after inferior oblique recession, indicating it comes from the overacting inferior oblique. The rapid intorsional movement seen during contralateral head tilt is absent in patients with superior oblique palsy, but appears in a diminished form after inferior oblique recession. PMID:6502406

  17. Tear function and ocular surface after muller muscle- conjunctival resection

    PubMed Central

    U?urba?, Suat Hayri; Alpay, Atilla; Bahad?r, Burak; U?urba?, S?lay Cantürk

    2014-01-01

    Muller muscle-conjunctival resection (MCR) is a surgical technique to correct mild and moderate ptosis. In this study, tear function tests and ocular surface are evaluated in patients who underwent unilateral surgery. Sixteen patients with normal preoperative tear function who underwent unilateral MCR were evaluated prospectively. The fellow eyes of the patients were taken as the control group. A dry eye assessment questionnaire, Schirmer testing, tear film break-up time, fluorescein stain, Rose-Bengal stain, and conjunctival impression cytology were used to assess the tear film functions and ocular surface changes in the operated and non-operated eyes. There was no statistically significant difference in the tear function tests and goblet cell densities between the operated and non-operated eyes. The results indicate that an MCR procedure has no apparent effect on tear function tests and goblet cell density in patients with normal preoperative tear function. PMID:24088631

  18. Ranibizumab for the treatment of degenerative ocular conditions.

    PubMed

    Triantafylla, Magdalini; Massa, Horace F; Dardabounis, Doukas; Gatzioufas, Zisis; Kozobolis, Vassilios; Ioannakis, Konstantinos; Perente, Irfan; Panos, Georgios D

    2014-01-01

    Degenerative ocular conditions, such as age-related macular degeneration, diabetic retinopathy, retinal vein occlusions, and myopic degeneration, have become a major public health problem and a leading cause of blindness in developed countries. Anti-vascular endothelial growth factor (VEGF) drugs seem to be an effective and safe treatment for these conditions. Ranibizumab, a humanized monoclonal antibody antigen-binding fragment, which inhibits all biologically active isoforms of VEGF-A, is still the gold standard treatment for the majority of these pathological entities. In this review, we present the results of the most important clinical trials concerning the efficacy and safety of ranibizumab for the treatment of degenerative ocular conditions. PMID:25028531

  19. Ocular toxoplasmosis: a very rare presentation in an immunocompetent patient.

    PubMed

    Matias, Margarida; Gomes, Antonia; Marques, Tiago; Fonseca, Ana Claudia

    2014-01-01

    A 28-year-old man presented with a 2-week history of red eye, photophobia, pain and decreased visual acuity of the right eye. The ophthalmological examination revealed hypertensive non-granulomatous panuveitis, retinal vasculitis with focus of retinochoroiditis with pigmented central area suggestive of ocular toxoplasmosis in the active phase. He started treatment with azithromycin, pyrimethamine, topical steroids and measures for control of intraocular pressure. Serology for Toxoplasma gondii was positive and for HIV, negative. For headache and vomiting, he was hospitalised in order to exclude cerebral toxoplasma. The cerebral CT scan, MRI and lumbar puncture were negative and treatment was changed to pyrimethamine, sulfadiazine and prednisolone. For persistence of vomiting he started clindamycin with clinical and ophthalmological improvement. The patient is currently under prophylaxis with co-trimoxazol for 1 year, and maintains clinical improvement. This case illustrates the rarity of presentation of ocular toxoplasmosis, without cerebral in an immunocompetent patient. PMID:25270156

  20. Ocular tolerance of absorption enhancers in ophthalmic preparations.

    PubMed

    Furrer, Pascal; Mayer, Joachim Michael; Plazonnet, Bernard; Gurny, Robert

    2002-01-01

    The use of absorption promoters is a way to improve the bioavailability and therapeutic response of topically applied ophthalmic drugs. The ocular tolerance of 9 potential absorption promoters was investigated as well as the influence of the enhancers' concentration on the ocular tolerance. The substances tested were instillated repetitively (4 times per day, during 3 days, and once just before examination) as aqueous solutions onto rabbit corneas. Fluorescein dyeing enabled us to specifically mark corneal damage that was observed by confocal microscopy. The degree of corneal injury was assessed with an image-processing system that calculated the total fluorescent areas. Confocal microscopy results showed the relatively good tolerance of permeation enhancers like dimethyl sulfoxide (DMSO), decamethonium, edetate, glycocholate, and cholate in contrast to the poorly tolerated saponin and fusidate. Increasing the promoters' concentration led generally to an increase in corneal lesions. PMID:12049486

  1. Ocular ischemic syndrome and ischemic optic neuropathy in Takayasu arteritis.

    PubMed

    Malik, Tayyaba Gul; Khalil, Muhammad; Ijaz, Asad Ullah; Bhatti, Muhammad Moeen

    2015-04-01

    Ocular Ischemic Syndrome (OIS) is a disorder, which consists of constellation of signs and symptoms secondary to chronic ocular hypoperfusion. We report a case of 35 years old Pakistani female who presented to us with gradual fall of vision in both eyes. On examination, she had bilateral OIS and ischemic optic neuropathy. The patient had past history of transient ischemic attack and facial palsy almost 20 years back. We referred her to physician for the diagnosis of Takayasu arteritis associated with relapsing polychondritis. She was given 60 mg of dexamethasone per day as initial treatment. At her last follow-up after approximately 3 months, she was quite comfortable systemically and her general condition was improved. Unfortunately, her vision did not improve. These two autoimmune diseases are rarely reported together in the same patient in Pakistan. Whether this association is rare or is underdiagnosed still remains to be answered. PMID:25933464

  2. [Diagnosis and treatment of ocular viral infections in AIDS patients].

    PubMed

    Guex-Crosier, Y

    1998-11-01

    Ocular complication of AIDS are seen in about 75% of patients. Viral infections are predominant and can involve either external segment in the eye (Herpes type 8 in Kaposi sarcoma, molluscum contagiosum, Herpes simplex and zoster), or the posterior segment of the eye (CMV retinitis). The introduction of a Highly Active Antiretroviral Therapy (HAART) which associates two reverse transcriptase inhibitors and one antiprotease has changed the evolution of AIDS. The decrease of onset of CMV retinitis in AIDS patient is one of the best exemple. For the first time it was possible to stop the maintenance therapy against CMV retinitis in patients that have a sufficient increase in CD4+ cells and they did not present any relapse of CMV retinitis. But an increase of ocular inflammation can be observed with the onset of HAART such as uveitis or cystoid macular edema. PMID:9865123

  3. Optical radiation safety considerations for ocular glucose monitoring.

    PubMed

    Ediger, M N; Landry, R J; Sliney, D H

    1999-01-01

    The potential for noninvasive detection of blood glucose is an area of intense academic and commercial research and a subject of keen interest in the diabetic and healthcare communities. A number of techniques are under investigation that attempt to infer blood glucose levels from measurements of optical signals. Frequently, these techniques are based on laser sources that may, under certain circumstances, be capable of inducing ocular injury. This article provides an overview of ocular damage mechanisms and the international standards for laser exposure limits that have been developed. The application of relevant standards to specific implementations of lasers in optical glucose sensing is presented. In addition, the concept of risk versus benefit for consideration of new medical devices is also discussed. PMID:11475268

  4. Image analysis of ocular fundus for retinopathy characterization

    SciTech Connect

    Ushizima, Daniela; Cuadros, Jorge

    2010-02-05

    Automated analysis of ocular fundus images is a common procedure in countries as England, including both nonemergency examination and retinal screening of patients with diabetes mellitus. This involves digital image capture and transmission of the images to a digital reading center for evaluation and treatment referral. In collaboration with the Optometry Department, University of California, Berkeley, we have tested computer vision algorithms to segment vessels and lesions in ground-truth data (DRIVE database) and hundreds of images of non-macular centric and nonuniform illumination views of the eye fundus from EyePACS program. Methods under investigation involve mathematical morphology (Figure 1) for image enhancement and pattern matching. Recently, we have focused in more efficient techniques to model the ocular fundus vasculature (Figure 2), using deformable contours. Preliminary results show accurate segmentation of vessels and high level of true-positive microaneurysms.

  5. An Imaging Review of Intra-ocular Calcifications.

    PubMed

    Kachewar, Sushil G; Kulkarni, Devidas S

    2014-01-01

    Intra-ocular calcifications can occur due to a variety of reasons. In cataract, the lovely lens gets calcified and the bright beautiful world becomes dark and dreadful. Cataract comes in various forms like; congenital, traumatic and senile. Asteroid Hyalosis (AH) occurs because of the accumulation of calcium soaps in vitreous of the eyes. Although it is asymptomatic and unilateral, it is seen more often in diabetic patients. Tumours of eye like retinoblastoma and optic nerve meningioma too are known to show calcifications. This review has focussed on imaging appearances of intra-ocular calcifications, a small process in a small organ that nevertheless has a wide impact on the entire organs. PMID:24596775

  6. Stereotactic radiotherapy for ocular melanoma: initial experience using closed eyes for ocular target immobilization.

    PubMed

    Miralbell, Raymond; Caro, Monica; Weber, Damien C; Elizalde, Javier; Perez-Ochoa, Agata; Villà, Salvador; IgnacioToscas, José; Martinez, Pedro; Linero, Dolors; Nouet, Philippe; Escudé, Lluís

    2007-10-01

    To assess the reliability and target positioning reproducibility with eyes closed in uveal melanoma patients treated with a micromultileaf-based linear accelerator dedicated for stereotactic radiotherapy. Five consecutive patients treated with curative radiotherapy for uveal melanoma were monitored for positioning reproducibility with resimulation CT scans performed every two days while on treatment (23 resimulation CTs available). All patients underwent MRIs of the orbits before simulation to help to define the target and organs at risk (e.g., lenses, optic nerves, ciliary bodies, and lacrimal glands) in the simulation CT (MRI-to-CT bone registration). Patients were simulated, resimulated, and treated with eyes closed. Patient #1 was treated with 5 daily fractions while patients #2 to #5, were treated with 10 daily fractions. We chose the lens of the tumor-bearing eye as the structure to be controlled, assuming that correct repositioning of the lens should be a valid surrogate for correctness of target repositioning. Displacements (mean and standard deviations, SD) of the lens in the three axes were measured for each patient. Systematic and standard errors were calculated. Planning target volume (PTV) margins were estimated according to McKenzie et al. [Phys Med Biol 45, 3331-3342 (2000)]. For both AP-PA and left-right shifts calculated SD were always below 1 mm, except for patient #4, who was treated with a non-customized bolus that pushed the globe backwards in a random fashion. In ideal set-up conditions PTV margins around the target were estimated to be 3 mm. Asking patients to close their eyes is a simple and reliable immobilization procedure when treating ocular tumors with stereotactic radiotherapy. Margins of 3 mm around the target may be necessary to safely treat these tumors under ideal set-up conditions. PMID:17877429

  7. Fabry disease: a survey of visual and ocular symptoms

    PubMed Central

    Davey, Pinakin Gunvant

    2014-01-01

    Purpose To evaluate a visual symptoms survey on patients with a known diagnosis of Fabry disease, and to compare the scores to those from a group of healthy subjects. Materials and methods An ocular symptom survey instrument was used to evaluate the symptoms of general ocular problems like itching, tearing, dryness, burning sensation, sensation of foreign body, difficulty in scotopic and photopic vision, and asthenopic symptoms. The survey instrument was administered to 95 participants (75 patients with Fabry disease and 20 healthy controls; median age: 32.5 years [standard deviation: 19.1 years] and 42.6 years [standard deviation: 14.7 years], respectively). A Mann–Whitney test was performed to evaluate the difference between the Fabry group and the healthy controls for each symptom survey severity score. A P-value <0.05 was considered significant. Results Of the survey instrument items, it was found that compared to the control group, the mean severity score of the Fabry disease group was significant for “dryness” of the eyes (P=0.02), “blurry/dim vision” (P=0.02), “hard to see in dark places” (P=0.01), and “halos around light” (P=0.01). The Fabry group also had a mean severity score for “soreness/tiredness” that was significantly higher than that of the control group (P=0.009). Conclusion The patients with Fabry disease may be suffering from ocular and visual symptoms related to manifestations of the disease. Further quantitative testing is needed to investigate the ocular and visual symptoms. PMID:25170250

  8. Children's Ocular Components and Age, Gender, and Ethnicity

    PubMed Central

    Twelker, J. Daniel; Mitchell, G. Lynn; Messer, Dawn H.; Bhakta, Rita; Jones, Lisa A.; Mutti, Donald O.; Cotter, Susan A.; Kleinstein, Robert N.; Manny, Ruth E.; Zadnik, Karla

    2010-01-01

    Purpose This cross-sectional report includes ocular component data as a function of age, gender, and ethnicity from the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study. Methods The ocular components of 4881 school-aged children were examined using cycloplegic autorefraction (refractive error), keratometry (corneal curvature), ultrasonography (axial dimensions), and videophakometry (lens curvature). Results The average age (± SD) was 8.8 ± 2.3 years, and 2458 were girls (50.4%). Sixteen percent were African American, 14.8% were Asian, 22.9% were Hispanic, 11.6% were Native American, and 34.9% were White. More myopic/less hyperopic refractive error was associated with greater age, especially in Asians, less in Whites and African Americans. Corneal power varied slightly with age, with girls showing a greater mean corneal power. Native-American children had greater corneal toricity with a markedly flatter horizontal corneal power. Anterior chambers were deeper with age, and boys had deeper anterior chambers. Native-American children had the shallowest anterior chambers and Whites the deepest. Girls had higher Gullstrand and calculated lens powers than boys. Boys had longer vitreous chambers and axial lengths, and both were deeper with age. Native Americans had the longest vitreous chambers and Whites the shortest. Conclusions Most ocular components showed little clinically meaningful variation by ethnicity. The shallower anterior chambers and deeper vitreous chambers of Native-American children appeared to be offset by flatter corneas. The relatively deeper anterior chamber and shallower vitreous chambers of White children appeared to be offset by steeper corneas. Asian children had more myopic spherical equivalent refractive errors, but for a given refractive error the ocular parameters of Asian children were moderate in value compared to those of other ethnic groups. Asian children may develop longer, myopic eyes more often than other ethnic groups, but the eyes of Asian emmetropes do not appear to be innately longer. PMID:19650241

  9. Pain in ischaemic ocular motor cranial nerve palsies

    Microsoft Academic Search

    S C Wilker; J C Rucker; N J Newman; V Biousse; R L Tomsak

    2009-01-01

    Aim:Pain is a common feature of microvascular ischaemic ocular motor cranial nerve palsies (MP). The natural history of pain in this condition has not been studied. The purpose of this report is to define the spectrum of pain in isolated MP, with special reference to diabetic versus non-diabetic patients.Design and methods:Retrospective and prospective chart review was performed on 87 patients

  10. Ocular Photodynamic Therapy – Standard Applications and New Indications (Part 1)

    Microsoft Academic Search

    Stefan Mennel; Irene Barbazetto; Carsten H. Meyer; Silvia Peter; Michael Stur

    2007-01-01

    Ocular photodynamic therapy (PDT) was introduced as a novel treatment for neovascular forms of age-related macular degeneration and choroidal neovascularization (CNV) secondary to pathologic myopia in the mid\\/end 1990s. The current treatment recommendations are based on the results of two large, prospective, multicenter, randomized clinical trials (Treatment of Age-Related Macular Degeneration with Photodynamic Therapy and Verteporfin in Photodynamic Therapy Studies)

  11. The removal of ocular artefacts from the electroencephalogram: a review

    Microsoft Academic Search

    B. W. Jervis; E. C. Ifeachor; E. M. Allen

    1988-01-01

    The causes of ocular artefacts (OAs) in the human electroencephalogram (EEG) are explained and methods for their removal and\\u000a their effectiveness are discussed. Recommendations for the best procedures to adopt are given together with suggestions for\\u000a future research. Analogue subtraction techniques are found to be inferior to time domain techniques based on parameter estimation\\u000a using the method of least squares

  12. Ocular features in Alport syndrome: pathogenesis and clinical significance.

    PubMed

    Savige, Judy; Sheth, Shivanand; Leys, Anita; Nicholson, Anjali; Mack, Heather G; Colville, Deb

    2015-04-01

    Alport syndrome is an inherited disease characterized by progressive renal failure, hearing loss, and ocular abnormalities. Mutations in the COL4A5 (X-linked), or COL4A3 and COL4A4 (autosomal recessive) genes result in absence of the collagen IV ?3?4?5 network from the basement membranes of the cornea, lens capsule, and retina and are associated with corneal opacities, anterior lenticonus, fleck retinopathy, and temporal retinal thinning. Typically, these features do not affect vision or, in the case of lenticonus, are correctable. In contrast, the rarer ophthalmic complications of posterior polymorphous corneal dystrophy, giant macular hole, and maculopathy all produce visual loss. Many of the ocular features of Alport syndrome are common, easily recognizable, and thus, helpful diagnostically, and in identifying the likelihood of early-onset renal failure. Lenticonus and central fleck retinopathy strongly suggest the diagnosis of Alport syndrome and are associated with renal failure before the age of 30 years, in males with X-linked disease. Sometimes, ophthalmic features suggest the mode of inheritance. A peripheral retinopathy in the mother of a male with hematuria suggests X-linked inheritance, and central retinopathy or lenticonus in a female means that recessive disease is likely. Ocular examination, retinal photography, and optical coherence tomography are widely available, safe, fast, inexpensive, and acceptable to patients. Ocular examination is particularly helpful in the diagnosis of Alport syndrome when genetic testing is not readily available or the results are inconclusive. It also detects complications, such as macular hole, for which new treatments are emerging. PMID:25649157

  13. Ocular lesions in the blue rubber bleb naevus syndrome.

    PubMed Central

    Crompton, J L; Taylor, D

    1981-01-01

    Investigations of a neonate presenting with multiple pleomorphic vascular skin lesions enabled a clinical and histological diagnosis of blue rubber bleb naevus syndrome to be made. This child had lesions in the conjunctiva, iris, and retina, associated with local haemorrhages at the time of birth. All the lesions regressed spontaneously, and a conservative approach to management of the ocular lesions in this syndrome is therefore suggested. Images PMID:7459316

  14. Ocular Manifestations of Late-Onset Behçet Disease

    Microsoft Academic Search

    Mehmet Citirik; Nilufer Berker; Murat Serkan Songur; Seyhan Sonar Ozkan; Orhan Zilelioglu

    2011-01-01

    Purpose: To describe the demographic characteristics and ocular manifestations of patients with late-onset Behçet disease (BD). Patients and Methods: The patients for this retrospective study were selected using the data obtained from the medical records of 16 patients with late-onset BD between January 2000 and May 2008. Results: Twelve (75%) of the cases were male and 4 (25%) were female.

  15. Ocular Biometry in Acute and Chronic Angle-Closure Glaucoma

    Microsoft Academic Search

    Yu-Wen Lan; Jui-Wen Hsieh; Por-Tying Hung

    2007-01-01

    Aim: To evaluate the biometric difference between eyes with acute angle-closure (AAC) attack, their uninvolved fellow eyes and eyes with chronic angle-closure glaucoma (CACG). Methods: Patients with prior laser iridotomy on both eyes for unilateral AAC attack or CACG were recruited. We compared ocular biometric parameters by A-scan ultrasonography of the acutely affected eyes with those of the uninvolved fellow

  16. Local interleukin-2 therapy in bovine ocular squamous cell carcinoma

    Microsoft Academic Search

    V. P. M. G. Rutten; W. R. Klein; W. A. C. De Jong; W. Misdorp; W. Den Otter; P. A. Steerenberg; W. H. De Jong; E. J. Ruitenberg

    1989-01-01

    Summary Five cows bearing bovine ocular squamous cell carcinoma (BOSCC) were treated with low doses of recombinant human interleukin-2 (rhIL-2). A dose of 2500 U rhIL-2 was injected intralesionally and another 2500 U were injected into the subparotid regional lymph node once a day during a period of 5 consecutive days. This cycle of 5 days was repeated after an

  17. Ocular blood flow changes after dynamic exercise in humans

    Microsoft Academic Search

    T Okuno; T Sugiyama; M Kohyama; S Kojima; H Oku; T Ikeda

    2006-01-01

    PurposeTo investigate control mechanisms for ocular blood flow changes after dynamic exercise using two different methods.MethodsChanges over time in the tissue blood flow in the retina and choroid-retina of healthy volunteers were determined after dynamic exercise (Master's double two-step test), using scanning laser Doppler flowmetry (SLDF) and laser speckle flowgraphy (LSFG). Changes in intraocular pressure (IOP), blood pressure, plasma CO2

  18. Long acting betaxolol ocular inserts based on polymer composite.

    PubMed

    Gevariya, Hitesh B; Patel, Jayvadan K

    2013-08-01

    Poor bioavailability and therapeutic response of conventional therapy due to many pre-corneal constraints necessitate the development of novel controlled and sustained ocular drug delivery to become a standard one in modern pharmaceutical era. This investigation aimed to study the drug release kinetics of betaxolol hydrochloride from a hydrophobic matrix system of PMMA cast with incorporating different proportions of polyethylene oxide (PEO) and evaluate its ability to improve ocular bioavailability and duration of action for the drug. Matrix type ocular inserts were prepared by the film casting technique and characterized in vitro by drug release studies using a flow through apparatus that simulated the eye conditions. All the formulations were subjected to physicochemical evaluation. Rabbit model with steroid induced glaucoma was used to establish in vivo efficacy of inserts. Polymer composition and concentration significantly affected the drug release based on change in diffusional path length and formation of gelaneous pores by polymer erosion. Formulations released the drug by non-fickian diffusion including anomalous transport (0.51). It was also observed that increasing the proportion of PEO in to PMMA does not affect the blend miscibility. IVIVC suggested no significant difference (P< 0.001) between in vitro and in vivo release of drug from inserts. In vivo IOP lowering activity was better for optimized insert F8 (for 24 h) as compared to eye drops (10 h). This ocular insert could be a promising once-a-day sustained release formulation for treating glaucoma. PMID:23909665

  19. Penetrating ocular injury with a fetal scalp monitoring spiral electrode

    Microsoft Academic Search

    Michael J Miyashiro; Helen A Mintz-Hittner

    1999-01-01

    PURPOSE:To report a penetrating ocular injury resulting from inadvertent placement of a fetal scalp monitoring spiral electrode into the right eye of a preterm male with a face presentation.METHODS:Case report and review of the literature.RESULTS:A spiral electrode was screwed clockwise into the right eye, tearing the inferior retina and creating two inferior iridotomies. Severe myopic astigmatism resulted from gradual lens

  20. Risk Factors for Fluoroquinolone Resistance in Ocular Cultures

    PubMed Central

    Lee, Junsung

    2015-01-01

    Purpose To identify the risk factors associated with fluoroquinolone resistance in patients undergoing cataract surgery. Methods A total of 1,125 patients (1,125 eyes) who underwent cataract surgery at Veterans Health Service Medical Center from May 2011 to July 2012 were enrolled in this study. Conjunctival cultures were obtained from the patients on the day of surgery before instillation of any ophthalmic solutions. The medical records of patients with positive coagulase negative staphylococcus (CNS) and Staphylococcus aureus (S. aureus) cultures were reviewed to determine factors associated with fluoroquinolone resistance. Results Of 734 CNS and S. aureus cultures, 175 (23.8%) were resistant to ciprofloxacin, levofloxacin, gatifloxacin, or moxifloxacin. Use of fluoroquinolone within 3 months and within 1 year before surgery, topical antibiotic use other than fluoroquinolone, systemic antibiotic use, recent hospitalization, ocular surgery, intravitreal injection and use of eyedrops containing benzalkonium chloride were significantly more frequent in resistant isolates than in susceptible isolates. In multivariable logistic regression analysis, ocular surgery (odds ratio [OR], 8.457), recent hospitalization (OR, 6.646) and use of fluoroquinolone within 3 months before surgery (OR, 4.918) were significant predictors of fluoroquinolone resistance, along with intravitreal injection (OR, 2.976), systemic antibiotic use (OR, 2.665), use of eyedrops containing benzalkonium chloride (OR, 2.323), use of fluoroquinolone within 1 year before surgery (OR, 1.943) and topical antibiotic use other than fluoroquinolone (OR, 1.673). Conclusions Recent topical fluoroquinolone use, hospitalization and ocular surgery were significantly associated with fluoroquinolone resistance in CNS and S. aureus isolates from ocular culture. PMID:25646055

  1. Ocular motility findings in chronic progressive external ophthalmoplegia

    Microsoft Academic Search

    C Richardson; T Smith; A Schaefer; D Turnbull; P Griffiths

    2005-01-01

    AimsTo characterise the ocular motility features of chronic progressive external ophthalmoplegia by quantitative and semiquantitative means.To assess the prevalence of diplopia and the binocular adaptations to nonaligned visual axes.MethodWe studied 25 patients with chronic progressive external ophthalmoplegia. In each case muscle biopsies were consistent with mitochondrial myopathy. All patients underwent cover test in the primary position, assessment of binocular status,

  2. Effect of aluminum consumption on the vestibulo-ocular reflex

    Microsoft Academic Search

    O. Mameli; M. A. Caria; P. Melis; P. Zambenedetti; M. Ramila; P. Zatta

    2006-01-01

    The effects of chronic exposure (90 days) to Aluminum chloride (AlCl3) were analyzed in 3, 10 and 24 month old male rats (n=270) by investigating the function of the VOR (vestibulo-ocular reflex) in correlation with Aluminum (Al) concentrations\\u000a in blood and brain. The VOR was chosen and tested in basal conditions (pre-exposure measures) and during the continuous administration\\u000a of three

  3. Ocular and Systemic Pharmacokinetics Of Latanoprost in Humans

    Microsoft Academic Search

    Birgitta Sjöquist; Johan Stjernschantz

    2002-01-01

    The ocular pharmacokinetics of latanoprost (13,14-dihydro-17-phenyl-18, 19,20-trinor-PGF2?-isopropyl ester; Xalatan [Pharmacia-Upjohn, Peapack, NJ]) was studied in patients undergoing cataract surgery using radio-immunoassay, and the systemic pharmacokinetics of latanoprost was studied in healthy human volunteers with 3H-latanoprost as well as radioimmunoassay. After topical application, latanoprost was rapidly hydrolysed in the cornea and blood. The maximum concentration of the active drug, latanoprost acid,

  4. PERFORMANCE OF NONLINEAR VISUAL UNITS IN OCULAR HYPERTENSION AND GLAUCOMA

    Microsoft Academic Search

    T. MADDESS; G. H. H ENRY

    1992-01-01

    Summary-l. Two psychophysical tests to assess retinal function in ocular hypertension and glaucoma are described. The basis for these tests is the frequency-doubled percept seen with rapid temporal modulation of the contrast of very low spatial frequencies. 2. The results of the second set of experiments show correlation (P < 0.01) with optic disc cupping. Without the inclusion of information

  5. Piceatannol Suppresses endotoxin-induced ocular inflammation in Rats

    PubMed Central

    Kalariya, Nilesh M.; Shoeb, Mohammad; Reddy, Aramati B. M.; Sawhney, Rahul; Ramana, Kota V.

    2013-01-01

    Anti-inflammatory effect of piceatannol, a naturally occurring polyphenol and a potent free radical scavenger, on ocular inflammation is not known. We examined the anti-inflammatory role of piceatannol in ocular inflammatory response due to endotoxin-induced uveitis (EIU) in rats. EIU was induced in Lewis rats by subcutaneous injection of lipopolysaccharide (LPS; 150 ug/rat). Piceatannol (30 mg/kg body wt, i.p) was injected either 2 h prior to or 1 h post LPS induction. A significant increase in the number of infiltrating cells, total protein, and various cytokines and chemokines in AqH were observed in the EIU rat eyes as compared to control groups. However, pre- or post- treatment of piceatannol significantly blocked the LPS-induced changes. Further, piceatannol also suppressed the expression of Cox-2, iNOS and activation of NF-?B in the ciliary bodies as well as retina. Further, piceatannol also inhibited the expression of Cox-2, iNOS, and phosphorylation of NF-?B in primary human non-pigmented ciliary epithelial cells (HNPECs) treated with LPS. Similarly, piceatannol also diminished LPS-induced level of NO and PGE2 in HNPECs. Thus our results demonstrate an anti-inflammatory role of piceatannol in suppressing ocular inflammation induced by endotoxin in rats. PMID:23892029

  6. Role of ocular pigment epithelial cells in immune privilege.

    PubMed

    Sugita, Sunao

    2009-01-01

    The ocular microenvironment is both immunosuppressive and anti-inflammatory in nature. Pigment epithelial (PE) cells isolated from the eye possess the ability to suppress the T cell receptor-dependent activation of T cells and the induction of regulatory T cells in vitro. This property is dependent on the cells' capacity to produce cell-surface and soluble inhibitory molecules, for example CD86 (B7-2), transforming growth factor (TGF)-beta, thrombospondin-1, programmed cell death 1 ligand 1 (PD-L1/B7-H1), and cytotoxic T lymphocyte-associated antigen 2alpha. Cultured ocular PE cells from the iris, ciliary body, and retina can individually suppress T-cell activation via mechanisms that partially overlap. Moreover, PE-derived regulatory T cells acquire functions that play a role in establishing immune regulation in the eye. Multiple strategies are employed within the eye to control immune-mediated inflammation. This phenomenon is known as immune privilege and is instrumental in helping to prevent extensive damage to bystander cells that would otherwise lead to blindness. This review focuses on the immunosuppressive property and role of ocular PE cells in immune privileged sites. PMID:19568919

  7. Diagnostics and new developments in the treatment of ocular allergies.

    PubMed

    Kari, Osmo; Saari, K Matti

    2012-06-01

    About 30% of people suffer from allergic symptoms, and 40% to 80% of them have eye symptoms. Atopic conjunctivitis is divided into seasonal allergic conjunctivitis and perennial allergic conjunctivitis. The treatment of seasonal allergic conjunctivitis is simple: antihistamines, anti-inflammatory agents, or cromoglycate. Perennial allergic conjunctivitis needs longer therapy with mast cell stabilizers and sometimes local steroids. Atopic keratoconjunctivitis requires long-term treatment of the lid eczema and keratoconjunctivitis. Vernal keratoconjunctivitis mainly affects children and young people. It commonly calms down after puberty. It demands intensive therapy, often for many years, to avoid serious complicating corneal ulcers. Giant papillary conjunctivitis is a foreign body reaction in contact lens users or patients with sutures following ocular surgery. Nonallergic eosinophilic conjunctivitis affects mostly middle-aged and older women with eosinophilic conjunctivitis and dry eye. Contact allergic blepharoconjunctivitis is often caused by cosmetics and eye medication. Work-related ocular allergies should be considered as a cause of resistant ocular symptoms in workplaces. PMID:22382607

  8. Characterization of Ocular Tissues Using Microindentation and Hertzian Viscoelastic Models

    PubMed Central

    Yoo, Lawrence; Reed, Jason; Shin, Andrew; Kung, Jennifer; Gimzewski, James K.; Poukens, Vadims; Goldberg, Robert A.; Mancini, Ronald; Taban, Mehryar; Moy, Ronald

    2011-01-01

    Purpose. The authors applied a novel microindentation technique to characterize biomechanical properties of small ocular and orbital tissue specimens using the Hertzian viscoelastic formulation, which defines material viscoelasticity in terms of the contact pressure required to maintain deformation by a harder body. Methods. They used a hard spherical indenter having 100 nm displacement and 100 ?g force precision to impose small deformations on fresh bovine sclera, iris, crystalline lens, kidney fat, orbital pulley tissue, and orbital fatty tissue; normal human orbital fat, eyelid fat, and dermal fat; and orbital fat associated with thyroid eye disease. For each tissue, stress relaxation testing was performed using a range of ramp displacements. Results for single displacements were used to build quantitative Hertzian models that were, in turn, compared with behavior for other displacements. Findings in orbital tissues were correlated with quantitative histology. Results. Viscoelastic properties of small specimens of orbital and ocular tissues were reliably characterized over a wide range of rates and displacements by microindentation using the Hertzian formulation. Bovine and human orbital fatty tissues exhibited highly similar elastic and viscous behaviors, but all other orbital tissues exhibited a wide range of biomechanical properties. Stiffness of fatty tissues tissue depended strongly on the connective tissue content. Conclusions. Relaxation testing by microindentation is a powerful method for characterization of time-dependent behaviors of a wide range of ocular and orbital tissues using small specimens, and provides data suitable to define finite element models of a wide range of tissue interactions. PMID:21310907

  9. Ocular Surface Alterations and Topical Antiglaucomatous Therapy: A Review

    PubMed Central

    Actis, Alessandro G; Rolle, Teresa

    2014-01-01

    Ocular Surface Disease (OSD) is prevalent among medically treated patients with glaucoma. This is basically related to three key-points: OSD and glaucoma are both prevalent in elderly and are common comorbidities in the same patient; the role of the active ingredient of the medical antiglaucomatous therapy; the role of the preservative agent of this medical therapy. Considering the actual state of literature we can state that the active glaucoma agent have a role in OSD, but the main cause seems to be the preservative agent, in particular referring to benzalkonium chloride, BAK. In the clinical evaluation of dry eye patients there is no actually established gold standard. Since the ocular surface injury not only causes dry eye, red eye, eye itching, photophobia and other discomforts, but also increases the risk of failure of glaucoma surgery in patients, it becomes fundamental a complete and good clinical evaluation of OSD (considering Schirmer’s test, tear breakup time, corneal and conjunctival staining) together with a good evaluation of patients’ quality of life (with validated questionnaires). Development of complex preparations, preservative-free and/or novel preservative preparations for glaucoma therapy could provide a promising approach in the prevention of ocular surface injuries. PMID:25317218

  10. Nonionic Surfactant Vesicles in Ocular Delivery: Innovative Approaches and Perspectives

    PubMed Central

    Sahoo, Ranjan Ku.; Biswas, Nikhil; Guha, Arijit; Sahoo, Nityananda

    2014-01-01

    With the recent advancement in the field of ocular therapy, drug delivery approaches have been elevated to a new concept in terms of nonionic surfactant vesicles (NSVs), that is, the ability to deliver the therapeutic agent to a patient in a staggered profile. However the major drawbacks of the conventional drug delivery system like lacking of permeability through ocular barrier and poor bioavailability of water soluble drugs have been overcome by the emergence of NSVs. The drug loaded NSVs (DNSVs) can be fabricated by simple and cost-effective techniques with improved physical stability and enhance bioavailability without blurring the vision. The increasing research interest surrounding this delivery system has widened the areas of pharmaceutics in particular with many more subdisciplines expected to coexist in the near future. This review gives a comprehensive emphasis on NSVs considerations, formulation approaches, physicochemical properties, fabrication techniques, and therapeutic significances of NSVs in the field of ocular delivery and also addresses the future development of modified NSVs. PMID:24995280

  11. [Adverse ocular drug reactions of systemic antimicrobial agents].

    PubMed

    Huber, M; Stahlmann, R

    2012-01-01

    Antimicrobial therapy can cause adverse ocular drug reactions. They are most often noticed by changes of the eyes' anterior segments or by pain and visual disturbances. It is important that physicians but also patients are watchful for the symptoms and know about their potential dangerous consequences because the chance for reversibility may depend on their early detection. During therapy with voriconazol about one third of patients complain of visual disturbances soon after the first doses but symptoms generally resolve after a short period of time without sequelae. Telithromycin may impair accommodation due to its anticholinergic activity. Neuropathies of the optic nerve may be caused by ethambutol, isoniazid, streptomycin, and linezolid. The first symptoms, such as disturbances in colour vision, typically occur with a latency of several weeks after start of therapy. This adverse effect may result in serious long term impairment of visual function. Toxic effects on the mitochondria in retinal ganglion cells are discussed as underlying mechanisms. Rifabutin and cidofovir may cause intraocular inflammatory reactions. In addition cidofovir may induce a pronounced reduction of the ocular pressure. Adverse drug reactions are often dose dependent and therefore influenced by impaired kidney or liver function, pharmacogenetics, or by drug-drug interactions. Potential serious drug induced ocular side effects require close cooperation with an ophthalmologist for evaluation of the individual risk benefit ratio, if possible, even before beginning of antimicrobial therapy. PMID:22241448

  12. Current Treatment of Vestibular, Ocular Motor Disorders and Nystagmus

    PubMed Central

    Brandt, Thomas

    2009-01-01

    Vertigo and dizziness are among the most common complaints with a lifetime prevalence of about 30%. The various forms of vestibular disorders can be treated with pharmacological therapy, physical therapy, psychotherapeutic measures or, rarely, surgery. In this review, the current pharmacological treatment options for peripheral and central vestibular, cerebellar and ocular motor disorders will be described. They are as follows for peripheral vestibular disorders. In vestibular neuritis recovery of the peripheral vestibular function can be improved by treatment with oral corticosteroids. In Menière's disease a recent study showed long-term high-dose treatment with betahistine has a significant effect on the frequency of the attacks. The use of aminopyridines introduced a new therapeutic principle in the treatment of downbeat and upbeat nystagmus and episodic ataxia type 2 (EA 2). These potassium channel blockers presumably increase the activity and excitability of cerebellar Purkinje cells, thereby augmenting the inhibitory influence of these cells on vestibular and cerebellar nuclei. A few studies showed that baclofen improves periodic alternating nystagmus, and gabapentin and memantine, pendular nystagmus. However, many other eye movement disorders such as ocular flutter opsoclonus, central positioning, or see-saw nystagmus are still difficult to treat. Although progress has been made in the treatment of vestibular neuritis, downbeat and upbeat nystagmus, as well as EA 2, state-of-the-art trials must still be performed on many vestibular and ocular motor disorders, namely Menière's disease, bilateral vestibular failure, vestibular paroxysmia, vestibular migraine, and many forms of central eye movement disorders. PMID:21179531

  13. The Correlation between Angle Kappa and Ocular Biometry in Koreans

    PubMed Central

    Choi, Se Rang

    2013-01-01

    Purpose To investigate normative angle kappa data and to examine whether correlations exist between angle kappa and ocular biometric measurements (e.g., refractive error, axial length) and demographic features in Koreans. Methods Data from 436 eyes (213 males and 223 females) were analyzed in this study. The angle kappa was measured using Orbscan II. We used ocular biometric measurements, including refractive spherical equivalent, interpupillary distance and axial length, to investigate the correlations between angle kappa and ocular biometry. The IOL Master ver. 5.02 was used to obtain axial length. Results The mean patient age was 57.5 ± 12.0 years in males and 59.4 ± 12.4 years in females (p = 0.11). Angle kappa averaged 4.70 ± 2.70 degrees in men and 4.89 ± 2.14 degrees in women (p = 0.48). Axial length and spherical equivalent were correlated with angle kappa (r = -0.342 and r = 0.197, respectively). The correlation between axial length and spherical equivalent had a negative correlation (r = -0.540, p < 0.001). Conclusions Angle kappa increased with spherical equivalent and age. Thus, careful manipulation should be considered in older and hyperopic patients when planning refractive or strabismus surgery. PMID:24311927

  14. Ocular complications in robotic-assisted prostatectomy: a review of pathophysiology and prevention.

    PubMed

    Kan, K M; Brown, S E; Gainsburg, D M

    2015-05-01

    Ocular complications reported after robotic-assisted laparoscopic radical prostatectomy (RALP) include corneal abrasion and ischemic optic neuropathy. While corneal abrasions often resolve without permanent sequelae, scarring or infection can occasionally lead to vision loss and other adverse outcomes. The rare complication of ischemic optic neuropathy leads to permanent vision loss and is a devastating outcome of non-ocular surgery. Given the unique patient positioning of steep Trendelenburg during these operations, ocular complications may be more likely to occur secondary to physiologic changes that occur within the eye itself. A review of the pathophysiology and incidence of ocular complications specific to robotic-assisted laparoscopic prostatectomy as well as the potential preventative measures in the current literature is presented to further inform and guide perioperative patient care. In addition we address other potential ocular complications and the impact of patient's ocular history on choice of RALP as a surgical treatment modality. PMID:24994499

  15. Follicular T cells and tissue IgG3 or IgG4 expressing plasma cells in a case of IgG4-related systemic disease with interstitial nephritis

    E-print Network

    ). This protean disorder covers an increasing variety of lesions including the so-called "autoimmune pancreatitis of Diet in Renal Disease (MDRD) Study equation), normal levels of bilirubin, lipase, CRP, and lactate

  16. Ocular colobomata, cardiac defect, and other anomalies: a study of seven cases including two sibs.

    PubMed Central

    Ho, C K; Kaufman, R L; Podos, S M

    1975-01-01

    An association of ocular colobomata and congenital heart disease was observed in seven patients. Two of these were maternal half sisters whose mother also had ocular colobomata. All the patients had normal karyotypes. There was a high incidence of other associated abnormalities involving the central nervous, skeletal, and urogenital systems. Discovery of an ocular coloboma should alert the clinician to search for other abnormalities. PMID:1177280

  17. Influenza Virus Respiratory Infection and Transmission Following Ocular Inoculation in Ferrets

    PubMed Central

    Belser, Jessica A.; Gustin, Kortney M.; Maines, Taronna R.; Pantin-Jackwood, Mary J.; Katz, Jacqueline M.; Tumpey, Terrence M.

    2012-01-01

    While influenza viruses are a common respiratory pathogen, sporadic reports of conjunctivitis following human infection demonstrates the ability of this virus to cause disease outside of the respiratory tract. The ocular surface represents both a potential site of virus replication and a portal of entry for establishment of a respiratory infection. However, the properties which govern ocular tropism of influenza viruses, the mechanisms of virus spread from ocular to respiratory tissue, and the potential differences in respiratory disease initiated from different exposure routes are poorly understood. Here, we established a ferret model of ocular inoculation to explore the development of virus pathogenicity and transmissibility following influenza virus exposure by the ocular route. We found that multiple subtypes of human and avian influenza viruses mounted a productive virus infection in the upper respiratory tract of ferrets following ocular inoculation, and were additionally detected in ocular tissue during the acute phase of infection. H5N1 viruses maintained their ability for systemic spread and lethal infection following inoculation by the ocular route. Replication-independent deposition of virus inoculum from ocular to respiratory tissue was limited to the nares and upper trachea, unlike traditional intranasal inoculation which results in virus deposition in both upper and lower respiratory tract tissues. Despite high titers of replicating transmissible seasonal viruses in the upper respiratory tract of ferrets inoculated by the ocular route, virus transmissibility to naïve contacts by respiratory droplets was reduced following ocular inoculation. These data improve our understanding of the mechanisms of virus spread following ocular exposure and highlight differences in the establishment of respiratory disease and virus transmissibility following use of different inoculation volumes and routes. PMID:22396651

  18. Ocular manifestations of graft-versus-host disease: 10 years’ experience

    PubMed Central

    Lin, Xihui; Cavanagh, Harrison Dwight

    2015-01-01

    Purpose To evaluate the ocular presentation, treatment, and clinical course of graft-versus-host disease (GVHD). Design Retrospective case series. Participants Two hundred and forty-nine patients with systemic GVHD were included in the study. Methods Ocular and systemic data were collected from 2003 to 2013. Main outcome measures Mortality, visual acuity, and response of ocular symptoms. Results Sixty-four patients had ocular manifestations (25.7%). At presentation, the mean age was 44.5 years and mean latency was 16.4 months. The most common presentations were keratoconjunctivitis sicca, cataract, blepharitis, ocular hypertension, and filamentary keratitis. Visual acuity at presentation was 20/49; at the worst point in the disease was 20/115; and at most recent visit was 20/63. When topical anti-inflammatory drops were used in addition to tears, 54.3% of patients’ ocular symptoms stabilized. When autologous serum was used in addition, 80% stabilized. The overall 10-year mortality of GVHD was 29.7%. For those with ocular involvement, it was 21.9%. Conclusion Systemic GVHD has a high mortality rate, but ocular involvement does not suggest a worse prognosis. The main ocular presentations were keratoconjunctivitis sicca, cataracts, and ocular hypertension. Dry eyes in this population were very severe with overall worsening in visual acuity. However, with a step-wise approach involving topical anti-inflammatory medications and autologous serum tears, ocular symptoms do improve. It is important to monitor these patients closely, as they are prone to serious ocular complications such as corneal perforation and endophthalmitis.

  19. Ocular Surface Discomfort and Demodex: Effect of Tea Tree Oil Eyelid Scrub in Demodex Blepharitis

    PubMed Central

    Koo, Hyun; Kim, Tae Hyung; Kim, Kyoung Woo; Wee, Sung Wook; Chun, Yeoun Sook

    2012-01-01

    The purpose of this study was to evaluate the relation between ocular discomfort and ocular Demodex infestation, and therapeutic effects of tea tree oil (TTO) in Demodex blepharitis patients. Three hundred and thirty-five patients with ocular discomfort were evaluated for ocular Demodex infestation and subjective symptoms with ocular surface discomfort index (OSDI) score. Among them, Demodex-infested patients were randomized to receive either eyelid scrubbing with TTO (TTO group,106 patients) or without TTO (Control group, 54 patients) for 1 month. Demodex were found in 84% of patients with ocular discomfort. The number of Demodex was significantly correlated with age (P = 0.04) and OSDI score (P = 0.024). After eyelid scrub treatment, Demodex count was reduced from 4.0 ± 2.5 to 3.2 ± 2.3 in the TTO group (P = 0.004) and from 4.3 ± 2.7 to 4.2 ± 2.5 in the control group (P = 0.27). Also, OSDI score was reduced from 34.5 ± 10.7 to 24.1 ± 11.9 in the TTO group (P = 0.001) and from 35.3 ± 11.6 to 27.5 ± 12.8 in the control group (P = 0.04). In conclusion, Demodex number showed a significant positive correlation with age and subjective ocular discomfort. The tea tree oil eyelid scrub treatment is effective for eliminating ocular Demodex and improving subjective ocular symptoms. PMID:23255861

  20. In Vivo Studies Demonstrating Feasibility and Biocompatibilitya of a MEMS Ocular Drug Delivery System

    E-print Network

    Meng, Ellis

    these limitations with a polymer-based MEMS (microelectromechanical systems) intraocular drug delivery deviceIn Vivo Studies Demonstrating Feasibility and Biocompatibilitya of a MEMS Ocular Drug Delivery

  1. Endogenous ocular nocardiosis: an interventional case report with a review of the literature.

    PubMed

    Eschle-Meniconi, Margherita E; Guex-Crosier, Yan; Wolfensberger, Thomas J

    2011-01-01

    We present an illustrative case of endogenous ocular Nocardia (EON) infection in a man with Hodgkin disease treated by chemotherapy who underwent aggressive vitreoretinal surgery for diagnosis and treatment of a subretinal abscess. Visual acuity recovered from hand movements to 20/25. We review the 38 reported cases of EON published between 1967 and 2007, describe the clinical presentation from a systemic and ocular point of view, examine which ocular procedures were successful in identifying the bacterium, and analyze ocular morbidity and the factors affecting successful treatment. PMID:21813147

  2. Prosthetic Rehabilitation of a Patient with Ocular Defect using Semi-customized Prosthesis: A Case Report

    PubMed Central

    Putanikar, Nagaraj Y.; Patil, Anandkumar G.; Shetty, Pavithra K.; Nagaral, Suresh; Mithaiwala, Hatimali I.

    2015-01-01

    Severe physical and psychological distress occurs due to disfigurement caused by loss of eye. Ocular prosthesis is the only mode of rehabilitation for the missing eye. There are different materials and techniques used for the fabrication of the same. Resin proved to be the better among the available materials. Either using the stock eye or using customized ocular prosthesis has their own advantages and disadvantages. Through our clinical report, we have fabricated a semi-customized ocular prosthesis with stock iris and customized sclera. This prosthesis had the advantages of both stock and custom ocular prosthesis providing functionally and esthetically satisfactory result. PMID:25954078

  3. Effects of ocular surface strontium-90 beta radiotherapy in dogs latently infected with canine herpesvirus-1.

    PubMed

    Nicklin, Amanda M; McEntee, Margaret C; Ledbetter, Eric C

    2014-12-01

    Latent canine herpesvirus-1 (CHV-1) infections are common in domestic dogs, but stimuli causing viral reactivation and recrudescent disease are poorly understood. Immunosuppressive pharmaceuticals are currently the only experimentally established triggers for recurrent ocular CHV-1 infection in dogs; however, ocular CHV-1 shedding has been reported clinically following strontium-90 beta radiotherapy of the ocular surface and it has been speculated that radiotherapy can directly induce viral reactivation. Strontium-90 is used as a beta radiation source for the treatment of a variety of neoplastic and immune-mediated canine ocular surface diseases. In the present study, the effects of ocular surface strontium-90 beta radiotherapy in dogs latently infected with CHV-1 were evaluated. Ten mature dogs with experimentally induced latent CHV-1 infections were randomly divided into two groups: one group received a single fraction 50 Gy radiation dose in one application from a strontium-90 ophthalmic applicator and the second group received sham radiotherapy. Dogs were then monitored for 45 days for recurrent ocular CHV-1 infection using clinical and virological outcome measures. Clinical ophthalmic examinations, ocular sample CHV-1 PCR assays, and serum CHV-1 virus neutralizing antibody assays were performed at specified intervals. No abnormalities suggestive of recurrent CHV-1 ocular disease were observed on clinical examination in any dog during the study. Ocular viral shedding was not detected and CHV-1 virus neutralizing titers remained stable in all dogs. A single fraction 50 Gy radiation dose administered to the ocular surface by strontium-90 beta radiotherapy did not result in detectable recurrent ocular CHV-1 infection in mature dogs with experimentally induced latent infection. PMID:25465181

  4. Ocular Pharmacokinetic Modeling Using Corneal Absorption and Desorption Rates from in Vitro Permeation Experiments with Cultured Corneal Epithelial Cells

    Microsoft Academic Search

    Veli-Pekka Ranta; Mirka Laavola; Elisa Toropainen; Kati-Sisko Vellonen; Anu Talvitie; Arto Urtti

    2003-01-01

    Purpose. To determine corneal absorption and desorption rate constants in a corneal epithelial cell culture model and to apply them to predict ocular pharmacokinetics after topical ocular drug application.

  5. Testing ocular irritancy in vitro with the silicon microphysiometer.

    PubMed

    Bruner, L H; Miller, K R; Owicki, J C; Parce, J W; Muir, V C

    1991-01-01

    The silicon microphysiometer, an instrument based on the light-addressable potentiometric sensor, was evaluated as an in vitro alternative for assessing ocular irritancy potential. It indirectly and non-invasively measures cell metabolism by determining the rate of acid metabolite production from cells, in this case human epidermal keratinocytes, placed inside the microphysiometer chamber. The 17 materials used for the evaluation included bar soaps, a liquid hand soap, shampoos, dishwashing liquids, laundry detergents, a fabric softener and several single chemicals. All materials tested were in liquid form. The in vivo irritancy potential of the materials was obtained from historical data using the rabbit low-volume eye test. There was a positive correlation between the in vivo irritancy potential of the test materials and the concentration of test material that decreased the acidification rate of cells by 50% (MRD(50); r = 0.86, P < 0.0001). Preliminary studies suggest other endpoints obtainable from the system may also provide useful information for making ocular safety assessments. Because the method is non-invasive, it is possible to determine whether cells recover from a treatment with the test material. The metabolic rate of the cells also increases at sub-inhibitory concentrations of some of the test materials. Because of the good correlation between the in vivo and in vitro data, the ease with which test materials can be applied to the system, and the multiple endpoints available from the system, it holds great potential as a useful in vitro alternative for ocular safety testing. PMID:20732027

  6. Identification of the vestibulo-ocular reflex dynamics.

    PubMed

    Ranjbaran, Mina; Galiana, Henrietta L

    2014-08-01

    The vestibulo-ocular reflex (VOR) plays an important role in our daily activities by enabling us to fixate on objects during head movements. Modeling and identification of the VOR improves our insight into the system behavior and helps in diagnosing various disorders. However, the switching nature of eye movements, including the VOR, makes the dynamic analysis challenging. In this work we are using integration of subspace and prediction error methods to analyze VOR dynamics. The performance of the method is evaluated using simulation studies and experimental data. PMID:25570250

  7. Mucinous adenocarcinoma of the rectum with breast and ocular metastases.

    PubMed

    Hisham, Raja B; Thuaibah, Hashim; Gul, Yunus A

    2006-04-01

    We present the case of a 32-year-old woman who, 10 months after abdominoperineal resection and total mesorectal excision for a locally advanced mucinous adenocarcinoma of the rectum, presented with local recurrence and metastases to the breast, spine, the left eye and orbit. Following surgery, due to the patient's personal reasons, adjuvant chemoradiation was not given. The patient died 2 months later, with disseminated cancer. To the best of our knowledge, breast as well as ocular metastasis in a patient with mucinous adenocarcinoma of the rectum has never been reported and, therefore, needs to be documented. PMID:16644510

  8. Development of gene and stem cell therapy for ocular neurodegeneration

    PubMed Central

    Zhang, Jing-Xue; Wang, Ning-Li; Lu, Qing-Jun

    2015-01-01

    Retinal degenerative diseases pose a serious threat to eye health, but there is currently no effective treatment available. Recent years have witnessed rapid development of several cutting-edge technologies, such as gene therapy, stem cell therapy, and tissue engineering. Due to the special features of ocular structure, some of these technologies have been translated into ophthalmological clinic practice with fruitful achievements, setting a good example for other fields. This paper reviews the development of the gene and stem cell therapies in ophthalmology. PMID:26086019

  9. Cogan's syndrome: an audiovestibular, ocular, and systemic autoimmune disease.

    PubMed

    Mazlumzadeh, Mehrdad; Matteson, Eric L

    2007-11-01

    Cogan's syndrome is an immune-mediated systemic disorder characterized by ocular and audiovestibular inflammation. Although interstitial keratitis in the absence of an infectious cause is the classic form of eye involvement, other nonspecific inflammatory eye diseases can also occur, often making prompt diagnosis of the underlying disease challenging. The audiovestibular disease is difficult to treat and can lead to profound hearing loss. A poor outcome, especially complete hearing loss, can sometimes be prevented through a timely recognition and initiation of glucocorticoid therapy at the onset of the disease. PMID:18037121

  10. A system for functional imaging of the ocular fundus

    NASA Astrophysics Data System (ADS)

    Bonaiuti, Matteo; Rovati, Luigi; Riva, Charles E.

    2007-02-01

    Neurovascular coupling in the optic nerve is the physiological mechanism that adjusts the blood perfusion in the microcirculation of the optic nerve to support the neural activity induced by vision. The resulting variations in blood flow and thus in neural tissue oxygenation induce changes in the optical properties of the tissues. These variations can be detected optically as reflectivity changes in the neural tissues, i.e. the retina and optic nerve disk. To achieve a better understanding of the mechanisms underlying the neurovascular coupling, our study is aimed at the evaluation of reflectance changes of the optic nerve induced by visual stimulation. For this purpose, an ocular fundus reflectometer has been developed.

  11. Two-point fluorophotometer for the human ocular fundus.

    PubMed

    Riva, C; Ben-Sira, I

    1975-11-01

    A new technique for making on-line recordings of fluorescein dilution curves from two locations in the human retina has been devised. A modified Zeiss fundus camera with two optical fibers mounted in a scanning ocular collects the light emitted by fluorescein dye from two spots in the fundus. Two fiber-optic cables transmit the collected light to a photomultiplier. The detector output current is transmitted to a two-channel pulse sorter. The output signals from the pulse sorter are amplified and displayed on a two-channel recorder. Since this technique utilizes only small amounts of fluorescein, multiple measurements in the same subject are possible. PMID:20155087

  12. Severe penetrating ocular injury from ninja stars in two children.

    PubMed

    Jeng, B H; Steinemann, T L; Henry, P; Brodsky, M C

    2001-01-01

    The authors describe two cases of penetrating ocular trauma in children resulting from ninja stars. In the first case, despite a scleral laceration, loss of iris tissue, and a vitreous hemorrhage, the child had a good result with a final best corrected visual acuity of 20/20. Unfortunately, the child in the second case did not fare as well. In this case, the child suffered a large corneal laceration and traumatic cataract. He ultimately required a penetrating keratoplasty, and he is currently being treated for amblyopia, strabismus, and elevated intraocular pressures. His best corrected visual acuity is 20/70. PMID:11475403

  13. Ocular blood flow measurements in healthy human myopic eyes

    Microsoft Academic Search

    Alexandra Benavente-Pérez; Sarah L. Hosking; Nicola S. Logan; David C. Broadway

    2010-01-01

    Background  To evaluate the haemodynamic features of young healthy myopes and emmetropes, in order to ascertain the perfusion profile\\u000a of human myopia and its relationship with axial length prior to reaching a degenerative state.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The retrobulbar, microretinal and pulsatile ocular blood flow (POBF) of one eye of each of twenty-two high myopes (N?=?22, mean spherical equivalent (MSE) ??5.00D), low myopes (N?=?22,

  14. Ocular and cervical VEMPs: A study of 74 patients suffering from peripheral vestibular disorders

    Microsoft Academic Search

    Elodie Chiarovano; Franck Zamith; Pierre-Paul Vidal; Catherine de Waele

    2011-01-01

    ObjectiveThis study compared the results of ocular and cervical vestibular evoked myogenic potentials (VEMPs) tests for healthy subjects with those for patients suffering from vestibular diseases to try to determine the clinical usefulness of combined ocular and cervical STB VEMP testing.

  15. The Overall Pattern of Ocular Dominance Bands in Cat Visual Cortex

    Microsoft Academic Search

    Patricia A. Anderson; Jaime Olavarria; Richard C. Van Sluyters

    1988-01-01

    This study describes the overall arrangement of geniculo- cortical input representing the system of cortical ocular dom- inance bands in layer IV of striate cortex in the adult cat. The pattern of ocular dominance bands was revealed by transneuronal transport of the intraocularly injected tracer wheat germ agglutinin conjugated to horseradish peroxidase (WGA-HRP). Our data indicate that this procedure does

  16. Mitomycin C, with or without surgery, for the treatment of ocular squamous cell carcinoma in horses

    Microsoft Academic Search

    F. Malalana; D. Knottenbelt; S. McKane

    2010-01-01

    Ocular lesions in horses, confirmed as squamous cell carcinoma, were treated topically with mitomycin C. Fourteen horses with confirmed ocular squamous cell carcinoma, three of which were affected bilaterally, were included in the study. Eight of the affected eyes were treated topically with mitomycin C alone; in the other nine eyes, the tumours were surgically removed and topical treatment with

  17. Effect of ultraviolet radiation on melanogenesis in four different types of cultured bovine ocular pigmented cells

    Microsoft Academic Search

    Monika Sahm; Karin Ute Loeffler; Peter Seifert; Manfred Spitznas

    2001-01-01

    Background: Ultraviolet radiation is thought to play a causative role in various ocular diseases such as macular degeneration, cataract, and possibly melanomas. Since most of the energy is absorbed by pigmented cells, the aim of this study was to examine and compare the reactions of different ocular melanocytic cells to ultraviolet light in vitro. Materials and methods: Bovine iris melanocytes,

  18. Comparative assessment of distribution of blackcurrant anthocyanins in rabbit and rat ocular tissues

    Microsoft Academic Search

    Hitoshi Matsumoto; Yuko Nakamura; Hiroyuki Iida; Kyoko Ito; Hiroshi Ohguro

    2006-01-01

    Anthocyanins (ACs) are phenolic compounds that are distributed widely in fruits and vegetables. Although consumption of these compounds has been shown to improve visual function, the distribution of ACs in ocular tissue has not been examined in detail. The aim of this study was therefore to evaluate the ocular distribution of blackcurrant anthocyanins (BCAs) in rats and rabbits after oral,

  19. The effect of topical beta-adrenoceptor blocking agents on pulsatile ocular blood flow

    Microsoft Academic Search

    C D Morsman; M E Bosem; M Lusky; R N Weinreb

    1995-01-01

    Thirty-three ocular hypertensive patients (21 with primary open angle glaucoma and 12 glaucoma suspects) were randomly assigned to receive either timolol, levobunolol or betaxolol in one eye. Pulsatile ocular blood flow (POBF) was measured before treatment (baseline) and 2 hours after drop administration. After 1 week of regular twice-daily dosage, POBF was measured again both immediately before and 2 hours

  20. Regression of Ocular Neovascularization in Response to Increased Expression of Pigment Epithelium-Derived Factor

    Microsoft Academic Search

    Keisuke Mori; Peter Gehlbach; Akira Ando; Duncan McVey; Lisa Wei; Peter A. Campochiaro

    PURPOSE. Several pharmacologic treatments have been shown to reduce ocular neovascularization when administered before the onset of angiogenic stimuli, but none have been shown to cause regression of already established ocular neovasculariza- tion. In this study, the authors tested the effect of adenoviral vectored pigment epithelium-derived factor (PEDF) gene trans- fer on established neovascularization in transgenic mice with expression of

  1. Color Doppler imaging in ocular hypertension and open-angle glaucoma

    Microsoft Academic Search

    Cengiz Akarsu; M. YaseminKaradeniz Bilgili

    2004-01-01

    Purpose To quantify the retrobulbar hemodynamics of patients with ocular hypertension and open-angle glaucoma and to compare it with that of normal subjects. Methods Nineteen eyes of 19 ocular hypertensive patients, 19 eyes of 19 open-angle glaucoma patients and 19 eyes of 19 normal subjects were recruited from our clinic and underwent color Doppler imaging evaluation of the ophthalmic, posterior

  2. Visual Behaviors and Adaptations Associated with Cortical and Ocular Impairment in Children.

    ERIC Educational Resources Information Center

    Jan, J. E.; Groenveld, M.

    1993-01-01

    This article shows the usefulness of understanding visual behaviors in the diagnosis of various types of visual impairments that are due to ocular and cortical disorders. Behaviors discussed include nystagmus, ocular motor dyspraxia, head position, close viewing, field loss adaptations, mannerisms, photophobia, and abnormal color perception. (JDD)

  3. Premorbid childhood ocular alignment abnormalities and adult schizophrenia-spectrum disorder

    Microsoft Academic Search

    Jason Schiffman; Justin A. Maeda; Kentaro Hayashi; Niels Michelsen; Holger J. Sorensen; Morton Ekstrom; Kylie A. Abe; Edward P. Chronicle; Sarnoff A. Mednick

    2006-01-01

    This study examined the relation between childhood ocular alignment deficits and adult psychiatric outcomes among children at high-risk for schizophrenia and controls. A sample of 265 Danish children was administered a standardized eye exam assessing strabismus and related ocular alignment deficits. All children whose mothers or fathers had a psychiatric diagnosis of schizophrenia comprised the first group (N=90). Children who

  4. Photogrammetry of the optic disc in glaucoma and ocular hypertension with simultaneous stereo photography

    Microsoft Academic Search

    Chris A. Johnson; John L. Keltner; Marijane A. Krohn; Gerald L. Portney

    Stereophotogrammetric evaluations of the optic cup were performed for normal, ocular hy- pertensive, and glaucomatous eyes. Average volume, area, and depth measurements were progressively larger from normal to ocular hypertensive to glaucomatous eyes, although the distributions of individual values exhibited considerable overlap among the three groups. Similar results were obtained for volume, area, and depth asymmetry between each pair of

  5. The Ocular Surface and Tear Film and Their Dysfunction in Dry Eye Disease

    Microsoft Academic Search

    Maurizio Rolando; Manfred Zierhut

    2001-01-01

    The ocular surface, tear film, lacrimal glands, and eyelids act as a functional unit to preserve the quality of the refractive surface of the eye and to resist injury and protect the eye against changing bodily and environmental conditions. Events that disturb the homeostasis of this functional unit can result in a vicious cycle of ocular surface disease. The tear

  6. [Non-Invasive Diagnosis of Ocular Graft-versus-Host Disease].

    PubMed

    Siebelmann, S; Jing, B; Cursiefen, C; Steven, P

    2015-05-01

    Ocular graft-vs-host disease (GvHD) is a major complication following allogenic blood stem cell transplantation (aBSCT) leading to a disturbance of the ocular surface integrity with a broad range of severity. Leading symptom is a pronounced autoinflammatory reaction in particular at the ocular surface with typical features of dry eye disease. Potential complications include visual loss, pain and damage to the ocular structures with, e.?g. corneal ulcerations. Diagnosis and treatment of ocular GvHD are a challenge for attending ophthalmologists and require intensive interdisciplinary patient care in particular with haemato-oncologists. First and follow-up examinations consist of several diagnostic steps that include quantitative and qualitative analysis of tearfilm, visual acuity, ocular surface and retinal integrity, cataract development and subjective symptoms. Available tests are mostly evaluated for usage in dry eye diagnosis but are, however, mostly unspecific for diagnosing ocular GvHD reliably. Only combinations of several clinical tests together with the experience of specialised ophthalmologists may lead to the certain diagnosis and treatment decisions at state. This review illustrates the available established and innovative non-invasive diagnostic tests and evaluates their potential use for diagnosing ocular GvHD. PMID:25989034

  7. Ocular complications associated with systemic medications used in allergy/immunology practice.

    PubMed

    Gurbaxani, Avinash; Fraser, Clare L; Skalicky, Simon E; McCluskey, Peter

    2013-06-01

    The repertoire of treatment options available to allergists and immunologists is ever increasing and with this comes the increased potential for these treatments to cause adverse ocular side effects. Corticosteroids remain the first line of treatment for most immunological disorders and physicians should be alerted to their extensive ocular morbidity profile. Patients requiring longer-term therapy may often receive immune modulators or newer biologic agents. While effective, these medications may have additional ocular side effects; as newer agents are more frequently used, some of these may not be previously documented. A number of patients will seek alternative or herbal remedies for these long-term conditions, often unknown to the treating physician; these too can cause harmful ocular morbidity. We review the latest information about the potential ocular side effects that may be encountered in treating patients with medications used in allergic and immunological disorders. PMID:23288506

  8. [The organization of emergency actions for ocular burns in conditions of military unit (of the ship)].

    PubMed

    Bo?ko, É V; Chernysh, V F

    2014-06-01

    Prehospital services for ocular burns are delivered by servicemen as self or mutual management and also by paramedic. Every case of ocular burn should be considered as severe one. The patient, shortly after the first aid, should be transported to the medical company or medical unit. Under conditions of medical unit military doctor has to organize an ophthalmological working space (ophthalmological comer) with the necessary equipment. Eye irrigation has to be made for chemical ocular burns. Military doctor should consider any previous irrigation as insufficient. For severe ocular burns during evacuation to the hospital it is necessary to perform a simple blepharorrhaphy or (if the condition of lids allows) to make a hermetic seal with aid of aid-band. Doctor's obligations should also include prophylaxis of ocular burns. PMID:25286571

  9. Sequence analysis of tyrosinase gene in ocular and oculocutaneous albinism patients: introducing three novel mutations

    PubMed Central

    Khordadpoor-Deilamani, Faravareh; Karimipoor, Morteza; Javadi, Gholamreza

    2015-01-01

    Purpose Albinism is a heterogeneous genetic disorder of melanin synthesis that results in hypopigmented eyes (in patients with ocular albinism) or hair, skin, and eyes (in individuals with oculocutaneous albinism). It is associated with decreased visual acuity, nystagmus, strabismus, and photophobia. The tyrosinase gene is known to be involved in both oculocutaneous albinism and autosomal recessive ocular albinism. In this study, we aimed to screen the mutations in the TYR gene in the nonsyndromic OCA and autosomal recessive ocular albinism patients from Iran. Methods The tyrosinase gene was examined in 23 unrelated patients with autosomal recessive ocular albinism or nonsyndromic OCA using DNA sequencing and bioinformatics analysis. Results TYR gene mutations were identi?ed in 14 (app. 60%) albinism patients. Conclusions We found 10 mutations, 3 of which were novel. No mutation was found in our ocular albinism patients, but one of them was heterozygous for the p.R402Q polymorphism.

  10. Confocal light microscopy of the living in-situ ocular lens: two- and three-dimensional imaging

    Microsoft Academic Search

    Barry R. Masters

    1991-01-01

    The ocular lens is an import variable refractive element in the eye; its transparency is vital for vision. Conventional ophthalmic imaging devices, such as MRI, ultrasound, and optical instruments are unable to image the ocular lens at submicron resolution. Confocal light microscopy can image the in situ ocular lens and produce high contrast images of the semi-transparent structures. The transverse

  11. Ocular and extra-ocular features of patients with Leber congenital amaurosis and mutations in CEP290

    PubMed Central

    den Hollander, Anneke I.; Lopez, Irma; Pott, Jan-Willem R.; de Faber, Jan Tjeerd H.N.; Cremers, Frans P.M.; Koenekoop, Robert K.; van den Born, L. Ingeborgh

    2012-01-01

    Purpose This study investigated the centrosomal protein, 290-KD (CEP290) associated genotype and ocular and extra-ocular phenotype in 18 patients with Leber congenital amaurosis (LCA). Methods Eighteen patients with LCA from 14 families with mutations in the CEP290 gene were identified with sequencing or with heteroduplex analysis. Ophthalmic examinations were performed on all patients. Scans of the central nervous system were reassessed in three patients and obtained in two. Renal function was evaluated in all patients. Ultrasonography of the kidneys was performed in six patients. Results Eight patients (from five families) carried the c.2991+1655A>G mutation homozygously. Nine solitary patients carried this variant combined with a nonsense, frameshift, or splice site mutation on the second allele. One new nonsense mutation was identified: c.1078C>T. Fourteen patients (from 12 families) had been completely blind from birth or had light perception. The best-recorded visual acuity was 20/200. Peripheral fundus changes appeared to be progressive with a relatively preserved posterior pole. Novel ophthalmic features for the CEP290 phenotype were Coats-like exudative vasculopathy in two patients, a small chorioretinal coloboma in one patient, and well defined, small, atrophic spots at the level of the retinal pigment epithelium causing a dot-like appearance in five patients. Some CEP290 patients exhibited systemic abnormalities. We found abnormal proprioception in two patients and mild mental retardation in one. One patient was infertile due to immobile spermatozoa. No renal abnormalities were detected. Conclusions CEP290-associated LCA has a severe, progressive, and clinically identifiable phenotype. Distinct extra-ocular findings were noted, which may be attributed to ciliary dysfunction. PMID:22355252

  12. Ocular lesions associated with systemic hypertension in dogs: 65 cases (2005–2007)

    PubMed Central

    LeBlanc, Nicole L.; Stepien, Rebecca L.; Bentley, Ellison

    2014-01-01

    Objective To characterize ocular findings in hypertensive dogs, determine prevalence of hypertension in dogs with ocular disease suggestive of hypertension, and examine possible relationships between degree of hypertension and ocular disease. Design Retrospective case series. Animals 65 dogs initially referred for blood pressure measurement (n = 22), ophthalmic examination (25), or both (18). Procedures Medical records were reviewed to identify dogs examined at the teaching hospital that underwent a complete ophthalmic examination and blood pressure measurement within a 24-hour period between January 1, 2005, and December 31, 2007. Signalment, history, blood pressure measurements, ophthalmic examination findings, and any vasoactive drug treatments were recorded. Ocular lesions considered likely to be associated with systemic hypertension included retinal hemorrhage, retinal detachment, hyphema, tortuous vessels, and subretinal edema. Results Of the 65 dogs, 42 were hypertensive (systolic blood pressure ? 160 mm Hg) and 23 were normotensive. Sixty-two percent (26/42) of hypertensive dogs had ? 1 type of ocular lesion identified. Retinal hemorrhage was the most common ocular lesion in hypertensive dogs (17/42 [40%]). The presence of ? 1 type of ocular lesion had moderate sensitivity and specificity of 62% and 61%, respectively, for identification of hypertension. Fifteen of the 25 (60%) dogs referred for blood pressure measurement after initial ophthalmic examination were found to be hypertensive. Conclusions and Clinical Relevance Ocular lesions are common in dogs with systemic hypertension. Dogs with hypertension or diseases associated with hypertension should be monitored carefully for evidence of ocular target organ damage, and hypertension should be systematically ruled out in dogs with characteristic ocular lesions. PMID:21453181

  13. Characteristics and visual outcomes of patients hospitalized for ocular trauma in central China: 2006–2011

    PubMed Central

    Qi, Ying; Zhang, Feng-Yan; Peng, Guang-Hua; Zhu, Yu; Wan, Guang-Ming; Wang, Wen-Zhan; Ma, Jing; Ren, Shi-Jie

    2015-01-01

    AIM To complete the data of ocular trauma in central China, as a well-known tertiary referral center for ocular trauma, we documented the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in this region. METHODS A retrospective study of patients hospitalized for ocular trauma in central China from 2006 to 2011 was performed. RESULTS This study included 5964 eyes of 5799 patients. The average age was 35.5±21.8y with a male-to-female ratio of 2.8:1. The most common age was 45-59y age group. Most patients were farmers and workers (51.9%). The most common injuries were firework related (24.5%), road traffic related (24.2%), and work related (15.0%). Among the most common causative agents were firecrackers (24.5%), followed by metal/knife/scissors (21.4%). Most injuries occurred in January (14.2%), February (27.0%), and August (10.0%). There were 8.5% patients with ocular injuries combined with other injuries. The incidence of open ocular injuries (4585 eyes, 76.9%) was higher than closed ocular injuries (939 eyes, 15.7%). The incidences of chemical and thermal ocular injuries were 1.2% and 0.6%. Ocular trauma score (OTS) predicted final visual acuity at non light perception (NLP), 20/200-20/50 and 20/40 with a sensitivity of 100%, and light perception (LP)/hand motion (HM) and 1/200-19/200 with a specificity of 100%. CONCLUSIONS This study provides recent epidemiological data of patients hospitalized for ocular trauma in central China. Some factors influencing the visual outcome include time interval between injury and visit to the clinic, wound location, open or closed globe injury, initial visual acuity, and OTS. PMID:25709927

  14. Heterozygous Mutations of OTX2 Cause Severe Ocular Malformations

    PubMed Central

    Ragge, Nicola K.; Brown, Alison G.; Poloschek, Charlotte M.; Lorenz, Birgit; Henderson, R. Alex; Clarke, Michael P.; Russell-Eggitt, Isabelle; Fielder, Alistair; Gerrelli, Dianne; Martinez-Barbera, Juan Pedro; Ruddle, Piers; Hurst, Jane; Collin, J. Richard O.; Salt, Alison; Cooper, Simon T.; Thompson, Pamela J.; Sisodiya, Sanjay M.; Williamson, Kathleen A.; FitzPatrick, David R.; Heyningen, Veronica van; Hanson, Isabel M.

    2005-01-01

    Major malformations of the human eye, including microphthalmia and anophthalmia, are examples of phenotypes that recur in families yet often show no clear Mendelian inheritance pattern. Defining loci by mapping is therefore rarely feasible. Using a candidate-gene approach, we have identified heterozygous coding-region changes in the homeobox gene OTX2 in eight families with ocular malformations. The expression pattern of OTX2 in human embryos is consistent with the eye phenotypes observed in the patients, which range from bilateral anophthalmia to retinal defects resembling Leber congenital amaurosis and pigmentary retinopathy. Magnetic resonance imaging scans revealed defects of the optic nerve, optic chiasm, and, in some cases, brain. In two families, the mutations appear to have occurred de novo in severely affected offspring, and, in two other families, the mutations have been inherited from a gonosomal mosaic parent. Data from these four families support a simple model in which OTX2 heterozygous loss-of-function mutations cause ocular malformations. Four additional families display complex inheritance patterns, suggesting that OTX2 mutations alone may not lead to consistent phenotypes. The high incidence of mosaicism and the reduced penetrance have implications for genetic counseling. PMID:15846561

  15. Cationic Polyene Phospholipids as DNA Carriers for Ocular Gene Therapy

    PubMed Central

    Machado, Susana; Calado, Sofia; Bitoque, Diogo; Oliveira, Ana Vanessa; Øpstad, Christer L.; Zeeshan, Muhammad; Sliwka, Hans-Richard; Partali, Vassilia; Pungente, Michael D.; Silva, Gabriela A.

    2014-01-01

    Recent success in the treatment of congenital blindness demonstrates the potential of ocular gene therapy as a therapeutic approach. The eye is a good target due to its small size, minimal diffusion of therapeutic agent to the systemic circulation, and low immune and inflammatory responses. Currently, most approaches are based on viral vectors, but efforts continue towards the synthesis and evaluation of new nonviral carriers to improve nucleic acid delivery. Our objective is to evaluate the efficiency of novel cationic retinoic and carotenoic glycol phospholipids, designated C20-18, C20-20, and C30-20, to deliver DNA to human retinal pigmented epithelium (RPE) cells. Liposomes were produced by solvent evaporation of ethanolic mixtures of the polyene compounds and coformulated with 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE) or cholesterol (Chol). Addition of DNA to the liposomes formed lipoplexes, which were characterized for binding, size, biocompatibility, and transgene efficiency. Lipoplex formulations of suitable size and biocompatibility were assayed for DNA delivery, both qualitatively and quantitatively, using RPE cells and a GFP-encoding plasmid. The retinoic lipoplex formulation with DOPE revealed a transfection efficiency comparable to the known lipid references 3?-[N-(N?,N?-dimethylaminoethane)-carbamoyl]-cholesterol (DC-Chol) and 1,2-dioleoyl-sn-glycero-3-ethylphosphocholine (EPC) and GeneJuice. The results demonstrate that cationic polyene phospholipids have potential as DNA carriers for ocular gene therapy. PMID:25147812

  16. Ocular motor behavior in macaques with surgical exotropia.

    PubMed

    Economides, John R; Adams, Daniel L; Jocson, Cristina M; Horton, Jonathan C

    2007-12-01

    To provide an animal model of human exotropia, a free tenotomy of the medial recti was performed in two infant macaques. When the animals were old enough to record eye movements with video eye trackers, we measured their ductions, ocular alignment, comitance, smooth pursuit, fixation preference, and gaze stability. Partial recovery of adduction occurred in each monkey from spontaneous re-attachment of the medial rectus muscle to the eye. However, each animal was left with a relatively comitant, large angle exotropia. The magnitude of the exotropia was not affected by covering one eye. There was no dissociated vertical deviation or any significant "A" or "V" pattern to the horizontal misalignment. Smooth pursuit was more accurate when tracking nasally compared with temporally in both animals. Compensatory catch-up saccades in the tracking eye were always accompanied by conjugate movements in the deviated eye. Despite tenotomy of the medial recti, the velocity of adducting saccades was normal. Both monkeys alternated fixation, preferring to use the left eye for targets on the left side and the right eye for targets on the right. Each animal was capable of switching fixation while making accurate saccades. One of the monkeys developed a vertical pendular nystagmus, which was most prominent in the deviated eye. Macaques with ocular misalignment from medial rectus tenotomy exhibit features that are present in humans with alternating exotropia. These animals will be valuable for probing the cortical mechanisms that underlie visual suppression in strabismus. PMID:17928552

  17. Estimation of the surface tension of ocular cornea

    NASA Astrophysics Data System (ADS)

    Zhang, Xueyong; Ma, Jianguo; Lu, Rongsheng; Xia, Ruixue

    2008-12-01

    Considering the potential clinical importance, the surface tension of ocular cornea under the action of normal physiological intraocular pressure is estimated, and a novel technique and a simple mechanical model for determining the tension are also presented in this paper. An instrument embodying mainly a CCD camera, an optical staff gauge and a manometer was developed primarily to measure both the surface point displacement and intraocular pressure of the cornea. A simple theoretical model was used to characterize the tensions of the ocular corneas under the action of the intraocular pressure. Due to the difficulty in obtaining the human cornea, laboratory experiments were carried out on porcine cornea specimens. The thickness of the specimens was accurately measured by optical coherence tomography. The matrix and collagen properties within the corneal tissue were manifested in the experiment. Experimental results on porcine corneas showed that the present technique is applicable to estimate the surface tension. In the normal physiological intraocular pressure range, both meridian and circumference tensions of the porcine corneas along the radial coordinate distribute are not uniform.

  18. Cultured human ocular surface epithelium on therapeutic contact lenses

    PubMed Central

    Girolamo, Nick Di; Chui, Jeanie; Wakefield, Denis; Coroneo, Minas T

    2007-01-01

    Background This study was initiated after observation of some intriguing epithelial growth properties of contact lenses used as a bandage for patients after pterygium surgery. Aim To determine the efficacy of culturing human ocular surface epithelial cells on therapeutic contact lenses in autologous serum with a view of using this system to transfer epithelial cells to patients with persistent corneal or limbal defects. Methods Excess graft tissue resected from patients undergoing pterygium surgery (n?=?3) consisting of limbal epithelium was placed on siloxane–hydrogel contact lenses (lotrafilcon A and balafilcon A). Limbal explants were cultured in media with 10% autologous serum. Morphology, proliferative capacity and cytokeratin profile were determined by phase contrast, light and electron microscopy, and immunohistochemical analysis. Results Lotrafilcon A contact lenses sustained proliferation and migration from limbal tissue. Cells became confluent after 10–14?days and consisted of 2–3 layers with a corneal phenotype (CK3+/CK12+/CK19?) and a propensity to proliferate (p63+). Electron microscopy showed microvilli on the apical surface with adhesive projections, indicating that these cells were stable and likely to survive for a long term. Growth was not observed from limbal explants cultured on balafilcon A contact lenses. Conclusion A method for culturing human ocular surface epithelium on contact lenses that may facilitate expansion and transfer of autologous limbal epithelial cells while avoiding the risks associated with transplanting allogeneic tissue has been developed. This technique may be potentially useful for the treatment of patients with limbal stem cell deficiency. PMID:16987897

  19. How can bioactive glasses be useful in ocular surgery?

    PubMed

    Baino, Francesco

    2015-03-01

    In the last few decades, the introduction of bioactive glasses (BGs), a special class of bioceramics that are able to bond to living tissues stimulating new tissue growth, has improved both treatment procedures via reconstructive surgery and the quality of life of rehabilitated patients in orthopedics and dentistry. While BGs have been extensively investigated for applications in these two surgical fields, there has been relatively little research on their use in other medical areas. Glass has been used for centuries to produce external refractive lenses and the intraocular implantation of small glass disks to correct visual deficiencies has been documented since the mid 1700s. Moreover, some evidences reported in the recent literature seem to demonstrate that the success of three specific types of ophthalmic devices, that is, synthetic grafts for eye orbit bone repair, orbital implants replacing the whole ocular globe and keratoprostheses (artificial cornea), could significantly benefit by the use of BG. A prospective view as well as a state-of-the-art review on this topic are currently lacking in the literature. The present article aims to give a comprehensive picture of the BG-based implants that have been developed in the context of ocular surgery; the strengths and shortcomings of the existing devices are outlined in order to provide useful stimuli for future research. Promising research directions are also proposed, emphasizing the added values that BGs could carry in ophthalmology in the light of recent findings in tissue engineering and regenerative medicine. PMID:24909562

  20. Ocular aberrations after wavefront optimized LASIK for myopia

    PubMed Central

    Padmanabhan, Prema; Basuthkar, Subam S; Joseph, Roy

    2010-01-01

    Purpose: To study the change in ocular aberrations after wavefront optimized (WFO) laser in situ keratomileusis (LASIK) for correction of myopia and to analyze causative factors that may influence them. Materials and Methods: This was a prospective case series. WFO LASIK was performed for the correction of myopia, using the hansatome (Bausch and Lomb) microkeratome to create the flap and the Allegretto laser (Wavelight Technologie) to perform the ablation. The Allegretto wave analyser (Tscherning-type) measured the ocular aberrations prior to LASIK , one month and six months postoperatively. Results: The mean age of the 59 patients included in the study was 25±5.64 years and the mean spherical equivalent of the 117 eyes that underwent LASIK was ?5.33±1.22 preoperatively and ?0.21±0.38 postoperatively. Hundred and two eyes of 117 (87%) achieved uncorrected visual acuity (UCVA) of 20/20 or better after WFO LASIK and 104 of 117 eyes (89%) were within ±0.5D of the attempted refractive correction. There was a 1.96-fold increase in total root-mean-square of higher order aberrations. Induced changes in seven of the 22 higher order Zernike terms showed a significant linear correlation with the refractive correction attempted. Larger ablation zones induced less spherical aberration. Conclusion: In spite of an excellent visual outcome, WFO LASIK induces significant higher order aberrations. Large ablation zones reduce the induction of spherical aberration. PMID:20534921

  1. A lymphatic defect causes ocular hypertension and glaucoma in mice.

    PubMed

    Thomson, Benjamin R; Heinen, Stefan; Jeansson, Marie; Ghosh, Asish K; Fatima, Anees; Sung, Hoon-Ki; Onay, Tuncer; Chen, Hui; Yamaguchi, Shinji; Economides, Aris N; Flenniken, Ann; Gale, Nicholas W; Hong, Young-Kwon; Fawzi, Amani; Liu, Xiaorong; Kume, Tsutomu; Quaggin, Susan E

    2014-10-01

    Glaucoma is a leading cause of blindness, afflicting more than 60 million people worldwide. Increased intraocular pressure (IOP) due to impaired aqueous humor drainage is a major risk factor for the development of glaucoma. Here, we demonstrated that genetic disruption of the angiopoietin/TIE2 (ANGPT/TIE2) signaling pathway results in high IOP, buphthalmos, and classic features of glaucoma, including retinal ganglion degeneration and vision loss. Eyes from mice with induced deletion of Angpt1 and Angpt2 (A1A2Flox(WB) mice) lacked drainage pathways in the corneal limbus, including Schlemm's canal and lymphatic capillaries, which share expression of the PROX1, VEGFR3, and FOXC family of transcription factors. VEGFR3 and FOXCs have been linked to lymphatic disorders in patients, and FOXC1 has been linked to glaucoma. In contrast to blood endothelium, in which ANGPT2 is an antagonist of ANGPT1, we have shown that both ligands cooperate to regulate TIE2 in the lymphatic network of the eye. While A1A2Flox(WB) mice developed high IOP and glaucoma, expression of ANGPT1 or ANGPT2 alone was sufficient for ocular drainage. Furthermore, we demonstrated that loss of FOXC2 from lymphatics results in TIE2 downregulation, suggesting a mechanism for ocular defects in patients with FOXC mutations. These data reveal a pathogenetic and molecular basis for glaucoma and demonstrate the importance of angiopoietin ligand cooperation in the lymphatic endothelium. PMID:25202984

  2. A lymphatic defect causes ocular hypertension and glaucoma in mice

    PubMed Central

    Thomson, Benjamin R.; Heinen, Stefan; Jeansson, Marie; Ghosh, Asish K.; Fatima, Anees; Sung, Hoon-Ki; Onay, Tuncer; Chen, Hui; Yamaguchi, Shinji; Economides, Aris N.; Flenniken, Ann; Gale, Nicholas W.; Hong, Young-Kwon; Fawzi, Amani; Liu, Xiaorong; Kume, Tsutomu; Quaggin, Susan E.

    2014-01-01

    Glaucoma is a leading cause of blindness, afflicting more than 60 million people worldwide. Increased intraocular pressure (IOP) due to impaired aqueous humor drainage is a major risk factor for the development of glaucoma. Here, we demonstrated that genetic disruption of the angiopoietin/TIE2 (ANGPT/TIE2) signaling pathway results in high IOP, buphthalmos, and classic features of glaucoma, including retinal ganglion degeneration and vision loss. Eyes from mice with induced deletion of Angpt1 and Angpt2 (A1A2FloxWB mice) lacked drainage pathways in the corneal limbus, including Schlemm’s canal and lymphatic capillaries, which share expression of the PROX1, VEGFR3, and FOXC family of transcription factors. VEGFR3 and FOXCs have been linked to lymphatic disorders in patients, and FOXC1 has been linked to glaucoma. In contrast to blood endothelium, in which ANGPT2 is an antagonist of ANGPT1, we have shown that both ligands cooperate to regulate TIE2 in the lymphatic network of the eye. While A1A2FloxWB mice developed high IOP and glaucoma, expression of ANGPT1 or ANGPT2 alone was sufficient for ocular drainage. Furthermore, we demonstrated that loss of FOXC2 from lymphatics results in TIE2 downregulation, suggesting a mechanism for ocular defects in patients with FOXC mutations. These data reveal a pathogenetic and molecular basis for glaucoma and demonstrate the importance of angiopoietin ligand cooperation in the lymphatic endothelium. PMID:25202984

  3. Ocular findings in the Hermansky-Pudlak syndrome.

    PubMed Central

    Izquierdo, N J; Townsend, W; Hussels, I E

    1995-01-01

    BACKGROUND: The Hermansky-Pudlak syndrome (HPS) is defined by the autosomal recessively inherited triad of tyrosinase-positive oculocutaneous albinism, bleeding diathesis and accumulation of ceroid in tissues. Late complications include: interstitial pulmonary fibrosis; inflammatory bowel disease; and renal failure. PATIENTS AND METHODS: We undertook a non-concurrent prospective study of 55 Puerto Rican patients with HPS (age range 1 to 54 yrs; mean = 19.7 yrs). These patients had a comprehensive ocular examination and a systemic evaluation for HPS. RESULTS: Visual acuities ranged from 20/50 to 5/200. All patients had nystagmus. Forty-three patients had strabismus; esotropia was found in 24 patients; exotropia in 18 patients; and one patient had hypertropia. Posterior embryotoxon occurred in 15 patients and Axenfeld anomaly in 4 patients. Iris pigmentation varied from minimal to almost completely normal. Three patients had cataract formation. The retina was typically albinotic with macular hypoplasia. All patients had cutaneous albinism, bleeding diathesis and various systemic manifestations as part of HPS. CONCLUSION: Ocular findings in HPS include reduced visual acuity; congenital nystagmus, strabismus and cataract. Diagnosis of the syndrome ought to be made preoperatively to help minimize the potential complications associated with bleeding diathesis at the time of extraocular muscle and intraocular surgery in patients with HPS. PMID:8719678

  4. Ocular poloxamer-based ciprofloxacin hydrochloride in situ forming gels.

    PubMed

    Mansour, Mai; Mansour, Samar; Mortada, Nahed D; Abd Elhady, Seham S

    2008-07-01

    The purpose of this study was to develop poloxamer-based in situ gelling formulations of ciprofloxacin hydrochloride (HCl) aiming at prolonging corneal contact time, controlling drug release, enhancing ocular bioavailability, and increasing patient compliance. The in situ forming gels were prepared using different concentrations of poloxamer 407 (P407) and poloxamer 188 (P188). Mucoadhesives such as hydroxypropylmethyl cellulose (HPMC) or hydroxyethyl cellulose (HEC) were added to the formulations to enhance the gel bioadhesion properties. The prepared formulations were evaluated for their in vitro drug release, sol-gel transition temperature, rheological behavior, and mucoadhesion force. The in vivo antimicrobial efficacy of selected ciprofloxacin HCl in situ gelling formulations was studied on infected rabbit's eyes and compared with that of the marketed conventional eye drops. The gelation temperature of the prepared formulations ranged from 28.00 to 34.03 degrees C. Increasing the concentrations of P407, HPMC, and HEC increased the viscosity and mucoadhesion force of the preparations and decreased the in vitro drug release. Ciprofloxacin HCl in situ forming gel formulae composed of P407/P188/HPMC (18/13/1.5%, wt/wt), and P407/P188/HEC (18/13/0.5%, wt/wt) showed optimum release and mucoadhesion properties and improved ocular bioavailability as evidenced by an enhanced therapeutic response compared with the marketed conventional eye drops. PMID:18612913

  5. Alkali-related ocular burns: a case series and review.

    PubMed

    Bunker, Daniel J L; George, Robert J; Kleinschmidt, Andrew; Kumar, Rohit J; Maitz, Peter

    2014-01-01

    Alkali burns are known to possess high pathological potential because of their inherent ability to lyse cell membranes and penetrate intraocular structures with devastating results. The authors aimed to evaluate the most common cause of this presentation, the current treatment approaches to injury, and eventual outcome as related to severity. The authors performed a retrospective review of all patients who sustained chemical-related ocular injuries seen at the Concord Hospital Burns Unit, Australia between January 2005 and March 2012. Management was based on cooperation between ophthalmic staff and the burns unit, with emphasis on early aggressive intervention and rigorous follow-up. The records of 39 patients who presented with chemical-related injury were assessed, 12 of whom had confirmed alkali burns involving the cornea. The most commonly implicated agent was sodium hydroxide, usually in the context of otherwise trivial domestic accidents. Acute medical management included copious irrigation and the use of analgesics, cycloplegics, and topical antibiotics. In half the cases, steroid drops and oral vitamin C were also used. Ten of the 12 patients (83%) had return to premorbid visual acuity. Complications included cicatrical ectropion (n = 1), pseudoexfoliative syndrome (n = 1), and symblepharon (n = 1). Surgical correction was needed in the one patient with cicatrical ectropion. This case series shows that appropriate acute management minimizes the potentially devastating sequelae of ocular alkali burns. Emphasis should be placed on prevention of domestic and workplace injuries when using alkaline products. PMID:23877138

  6. Nanoparticles laden in situ gelling system for ocular drug targeting

    PubMed Central

    Kumar, Divya; Jain, Nidhi; Gulati, Neha; Nagaich, Upendra

    2013-01-01

    Designing an ophthalmic drug delivery system is one of the most difficult challenges for the researchers. The anatomy and physiology of eye create barriers like blinking which leads to the poor retention time and penetration of drug moiety. Some conventional ocular drug delivery systems show shortcomings such as enhanced pre-corneal elimination, high variability in efficiency, and blurred vision. To overcome these problems, several novel drug delivery systems such as liposomes, nanoparticles, hydrogels, and in situ gels have been developed. In situ-forming hydrogels are liquid upon instillation and undergo phase transition in the ocular cul-de-sac to form viscoelastic gel and this provides a response to environmental changes. In the past few years, an impressive number of novel temperature, pH, and ion-induced in situ-forming systems have been reported for sustain ophthalmic drug delivery. Each system has its own advantages and drawbacks. Thus, a combination of two drug delivery systems, i.e., nanoparticles and in situ gel, has been developed which is known as nanoparticle laden in situ gel. This review describes every aspects of this novel formulation, which present the readers an exhaustive detail and might contribute to research and development. PMID:23662277

  7. How Ocular Surface Disease Impacts the Glaucoma Treatment Outcome

    PubMed Central

    Kaštelan, Snježana; Tomi?, Martina; Metež Soldo, Kata; Salopek-Rabati?, Jasminka

    2013-01-01

    The treatment goals for glaucoma are lowering the intraocular pressure and preservation of vision. Topical hypotensive drops are the standard form of therapy which is often associated with some symptoms of toxicity, ocular inflammation, allergy, or ocular surface disease (OSD). OSD is a common comorbidity in glaucoma patients, and its prevalence with glaucoma increases with age. Use of topical treatment could additionally increase symptoms of OSD mostly due to preservatives added to multidose medication bottles used to reduce the risk of microbial contamination. This toxicity has been particularly associated with BAK, the most commonly used preservative which damages conjunctival and corneal epithelial cells and significantly aggravates OSD symptoms. OSD adversely affects patients' quality of life causing discomfort and problems with vision which in turn may result in noncompliance, lack of adherence, and eventually visual impairment. In the management of glaucoma patients OSD symptoms should not be overlooked. If they are present, topical glaucoma treatment should be adapted by decreasing the amount of drops instilled daily, using BAK-free or preservative-free medication and lubricants if necessary. Awareness of the presence and importance of OSD will in turn improve patients' adherence and compliance and thus ultimately the preservation of long-term vision. PMID:24224176

  8. Glycan structures of ocular surface mucins in man, rabbit and dog display species differences.

    PubMed

    Royle, Louise; Matthews, Elizabeth; Corfield, Anthony; Berry, Monica; Rudd, Pauline M; Dwek, Raymond A; Carrington, Stephen D

    2008-11-01

    The composition of the mucus gel of the tear film reflects the competing needs for transparency, stability, hydration, and protection of the ocular surface. Mucins form the macromolecular scaffolding of this hydrated gel, and glycans decorating these glycoproteins represent a rich source of binding ligands that may both modulate microbial binding and regulate the physicochemical characteristics of the gel. This study compares the structure of O-linked glycans derived from the ocular mucins of three species, to determine whether the ocular surface microenvironment dictates the need for a common pattern of O-linked carbohydrate structures. Ocular mucus aspirates were collected from healthy humans, rabbits and dogs. Mucins were purified using standard protocols. O-glycans were released by hydrazinoloysis and subsequently analysed by a combination of HPLC, exoglycosidase digestions and LC-MS/MS. A total of 12 different O-glycans were identified. In human ocular mucin, the majority were negatively charged and terminated in sialic acid, whilst those from rabbit or dog were mainly neutral and terminated in alpha 1-2 fucose and/or alpha 1-3 N-acetylgalactosamine. The glycans were short: the most common structures being tetra-, tri- or disaccharides. Less elaborate glycan structures are encountered at the ocular surface than at many other mucosal surfaces. Species-specific glycan expression is a feature of ocular surface mucins, and has implications for their defensive properties where different microbial and environmental challenges are encountered. PMID:18465222

  9. Meibography and meibomian gland measurements in ocular graft-versus-host disease.

    PubMed

    Engel, L A; Wittig, S; Bock, F; Sauerbier, L; Scheid, C; Holtick, U; Chemnitz, J-M; Hallek, M; Cursiefen, C; Steven, P

    2015-07-01

    Meibomian gland loss in ocular GvHD was described as a mechanism contributing to dry eye and severe damage to the ocular surface. Infrared images of upper eyelid meibomian glands from 86 ocular GvHD patients, from 10 patients after allogeneic stem cell transplantation (aSCT) without ocular GvHD, from 32 patients prior to aSCT and from 30 healthy controls were analyzed retrospectively and evaluated using two grading schemes. The upper meibomian gland area (uMGA) was calculated and set in relation to the total tarsal area of the lid. Results demonstrate that meibomian gland loss is significantly increased in patients with ocular GvHD as well as in patients prior to aSCT in comparison with controls (P between 0.05 and <0.001). Patients after aSCT without ocular GvHD had no significant difference in uMGA in comparison with controls. This study suggests that meibomian gland loss in GvHD patients is likely to be a multifactorial process that also occurs prior to aSCT, possibly due to underlying diseases and/or secondary to chemotherapy or irradiation. In addition, the question has to be addressed whether meibomian gland loss could serve as a predictor for the development of ocular GvHD. Overall, infrared meibography should be included in routine examination of patients undergoing aSCT and during follow-up. PMID:25893453

  10. Ocular Surface Displacement with and without Contact Lenses during Non-Contact Tonometry

    PubMed Central

    Rimayanti, Ulfah; Kiuchi, Yoshiaki; Uemura, Shohei; Takenaka, Joji; Mochizuki, Hideki; Kaneko, Makoto

    2014-01-01

    Purpose To evaluate the displacement of the central ocular surface during non-contact tonometry with and without soft contact lenses and determine the factors associated with the displacement of the central ocular surface and intraocular pressure (IOP) reading changes caused by wearing soft contact lenses (CLs). Methods One eye each in 21 subjects was studied. The cornea was photographed using a high-speed camera at 5,000 frames/sec during non-contact tonometry without contact lenses (NCL), with -5.0 diopters (D), -0.5 D and +5.0 D CL. The displacement of the ocular surface and the factors affecting displacement at the IOP reading and maximum displacement time were investigated. Results The IOP readings while wearing +5 D CL were significantly higher than those obtained while wearing -5 D CL. The ocular surface displacement between +5 D CL and other groups were significantly different. A significant positive correlation was found between the ocular surface displacement of subjects at the IOP reading time and the IOP obtained with the non-contact tonometer. A significant negative correlation was found between the ocular surface curvature and the IOP obtained using the non-contact tonometer. The radius of curvature of the ocular surface affected the displacement during the IOP reading and maximum displacement time. Conclusions Our results indicate that soft contact lens use changes the ocular surface behavior and IOP readings during non-contact tonometry. The radius of curvature of the eye affects the ocular surface displacement and IOP readings in this situation. PMID:24781212

  11. Increased Ocular Pulse Amplitude Associated with Unilateral Dysgenesis of the Orbital Roof

    PubMed Central

    Vira, Ami Shah; Mahmoud, Ashraf M.; Roberts, Cynthia J.; Katz, Steven E.

    2015-01-01

    Introduction Two patients (one with neurofibromatosis type 1) presented with unilateral ocular pulsation. Methods A CT scan of the orbits revealed extensive dysgenesis of the orbital roof with herniation of the frontal lobe into the orbit in both cases. PASCAL dynamic contour tonometry was performed. Results The ipsilateral ocular pulse amplitude (OPA) was greater than the contralateral side, and the ocular pulse waveform morphology more closely approximated the known intracranial waveform in these patients. Conclusions We hypothesize that the greater OPA was due to stronger transmission of the intracranial pressure waveform amplitude and morphology in the absence of the orbital roof.

  12. Radiological correlate of ocular flutter in a case with paraneoplastic encephalitis.

    PubMed

    Newey, Christopher R; Sarwal, Aarti; Wu, Guiyun

    2013-04-01

    We present an interesting [18F]fluoro-2-deoxyglucose positron emission tomography (FDG-PET) imaging finding in a patient with ocular flutter and cerebellar ataxia as part of anti-Ma 1/2 antibody-mediated paraneoplastic syndrome associated with a testicular seminoma. He had a typical anterior mesial temporal hyperintensity on magnetic resonance imaging (MRI) without gadolinium enhancement. In addition, his FDG-PET images showed increased deep cerebellar and inferior rectus and superior oblique ocular muscles FDG uptake. This case is the first to visualize in vivo the possible underlying neuropathological mechanism of ocular flutter associated with cerebellar nuclei on functional imaging. PMID:22175797

  13. Torsional augmentation for the treatment of lateropulsion and torticollis in partial ocular tilt reaction

    PubMed Central

    Brodsky, Michael C.; Holmes, Jonathan M.

    2012-01-01

    Purpose We describe a new surgical treatment for lateropulsion and torticollis arising from an ocular tilt reaction. Methods Visual sensory parameters and postural abnormalities were retrospectively reviewed in a patient with a partial ocular tilt reaction who was treated with horizontal transposition of the vertical rectus muscles to surgically augment preexisting binocular torsion. Results Torsional augmentation eliminated the sensation of lateropulsion and produced almost complete resolution of her torticollis and associated body tilt. Conclusions Binocular torsional augmentation can be used to reduce both lateropulsion and torticollis in the setting of an ocular tilt reaction. PMID:22525169

  14. Ocular manifestations of syphilis: recent cases over a 2.5-year period

    Microsoft Academic Search

    Cindy Puech; Stéphane Gennai; Patricia Pavese; Isabelle Pelloux; Max Maurin; Jean-Paul Romanet; Christophe Chiquet

    2010-01-01

    Background  The ocular manifestations of syphilis are protean and can affect every structure of the eye. There has been a recent increase\\u000a of syphilis infection in Europe. We report recent cases of ocular syphilis infection in a tertiary center.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  During a 2.5-year period (2005–2007) we collected the medical records of eight male patients with ocular syphilis. The diagnosis\\u000a was based on

  15. Role of Peroxisome Proliferator-Activated Receptor ? in Ocular Diseases

    PubMed Central

    Zhang, Su; Gu, Hongwei; Hu, Nan

    2015-01-01

    Peroxisome proliferator-activated receptor ? (PPAR ?), a member of the nuclear receptor superfamily, is a ligand-activated transcription factor that plays an important role in the control of a variety of physiological processes. The last decade has witnessed an increasing interest for the role played by the agonists of PPAR ? in antiangiogenesis, antifibrosis, anti-inflammation effects and in controlling oxidative stress response in various organs. As the pathologic mechanisms of major blinding diseases, such as age-related macular degeneration (AMD), diabetic retinopathy (DR), keratitis, and optic neuropathy, often involve neoangiogenesis and inflammation- and oxidative stress-mediated cell death, evidences are accumulating on the potential benefits of PPAR ? to improve or prevent these vision threatening eye diseases. In this paper we describe what is known about the role of PPAR ? in the ocular pathophysiological processes and PPAR ? agonists as novel adjuvants in the treatment of eye diseases. PMID:26146566

  16. Spatial Transformation of the Vestibulo-Ocular Reflex during Spaceflight

    NASA Technical Reports Server (NTRS)

    Clement, Gilles; Wood, Scott J.; Reschke, Millard F.

    1996-01-01

    It was hypothesized that the absence of the gravitational reference cues may be responsible for adaptive changes in the vestibulo-ocular reflex (VOR). These changes result in the alteration of the direction of the compensatory slow phase (SP) eye movements in microgravity. In order to test this hypothesis, the direction of the VOR SP relative to head motion was investigated in three astronauts during and after an eight-day orbital flight by passive sinusoidal pitch or yaw angular motion at two frequencies. The results of the inflight and postflight testing are considered. The observed deviation between VOR SP and head motion suggests that spatial transformation in the VOR occurred during adaptation to microgravity. It is considered that, although this spatial transformation might be due to a sensory bias, it may reflect central changes in the reference system used for spatial orientation in microgravity.

  17. Ocular myiasis caused by Chrysomya bezziana - a case report.

    PubMed

    Nene, Amit S; Mishra, Anoop; Dhand, Purnima

    2015-01-01

    Ophthalmomyiasis can have variable presentation depending on the type of fly, structures involved, and level of penetration. A 42-year-old female presented with extensive myiasis of the right eye. A lesion of 3×2 cm was noted at the medial canthus and was infested with maggots. The larvae were removed meticulously and the wound debrided. The larva isolated was that of Chrysomya bezziana (Old World screwworm). Computed tomography (CT) scan was normal. The wound was dressed regularly and healed by secondary intention. Ocular myiasis is a rare disease that can lead to life threatening consequences, such as intracranial extension. Prompt management with debridement and radical antibiotic therapy is essential. PMID:25784787

  18. Ocular myiasis caused by Chrysomya bezziana – a case report

    PubMed Central

    Nene, Amit S; Mishra, Anoop; Dhand, Purnima

    2015-01-01

    Ophthalmomyiasis can have variable presentation depending on the type of fly, structures involved, and level of penetration. A 42-year-old female presented with extensive myiasis of the right eye. A lesion of 3×2 cm was noted at the medial canthus and was infested with maggots. The larvae were removed meticulously and the wound debrided. The larva isolated was that of Chrysomya bezziana (Old World screwworm). Computed tomography (CT) scan was normal. The wound was dressed regularly and healed by secondary intention. Ocular myiasis is a rare disease that can lead to life threatening consequences, such as intracranial extension. Prompt management with debridement and radical antibiotic therapy is essential. PMID:25784787

  19. An ocular view of the IGF-IGFBP system

    PubMed Central

    Nguyen, Dung V.; Calzi, Sergio Li; Shaw, Lynn C.; Kielczewski, Jennifer L.; Korah, Hannah E.; Grant, Maria B.

    2013-01-01

    IGFs and their binding proteins have been shown to exhibit both protective and deleterious effects in ocular disease. Recent studies have characterized the expression patterns of different IGFBPs in retinal layers and within the vitreous. IGFBP-3 has roles in vascular protection stimulating proliferation, migration, and differentiation of vascular progenitor cells to sites of injury. IGFBP-3 increases pericyte ensheathment and shows anti-inflammatory effects by reducing microglia activation in diabetes. IGFBP-5 has recently been linked to mediating fibrosis in proliferative vitreoretinopathy but also reduces neovascularization. Thus, the regulatory balance between IGF and IGFBPs can have profound impact on target tissues. This review discusses recent findings of IGF and IGFBP expression in the eye with relevance to different retinopathies. PMID:23578754

  20. Ocular coloboma: a reassessment in the age of molecular neuroscience

    PubMed Central

    Gregory-Evans, C; Williams, M; Halford, S; Gregory-Evans, K

    2004-01-01

    Congenital colobomata of the eye are important causes of childhood visual impairment and blindness. Ocular coloboma can be seen in isolation and in an impressive number of multisystem syndromes, where the eye phenotype is often seen in association with severe neurological or craniofacial anomalies or other systemic developmental defects. Several studies have shown that, in addition to inheritance, environmental influences may be causative factors. Through work to identify genes underlying inherited coloboma, significant inroads are being made into understanding the molecular events controlling closure of the optic fissure. In general, severity of disease can be linked to the temporal expression of the gene, but this is modified by factors such as tissue specificity of gene expression and genetic redundancy. PMID:15591273

  1. Advances in Corticosteroid Therapy for Ocular Inflammation: Loteprednol Etabonate

    PubMed Central

    Comstock, Timothy L.; DeCory, Heleen H.

    2012-01-01

    Topical corticosteroids are effective in reducing anterior segment inflammation but are associated with adverse drug reactions (ADRs) including elevation of intraocular pressure (IOP) and cataract formation. Retrometabolic drug design has advanced the development of new corticosteroids with improved therapeutic indices. Engineered from prednisolone, loteprednol etabonate (LE) has a 17?-chloromethyl ester, in lieu of a ketone group, and a 17?-etabonate group. LE is highly lipophilic and binds with high affinity to the glucocorticoid receptor; any unbound LE is metabolized to inactive metabolites. LE has been studied in several anterior segment inflammatory conditions (giant papillary conjunctivitis, allergic conjunctivitis, anterior uveitis, and keratoconjunctivitis sicca), and in postoperative ocular inflammation and pain. Combined with tobramycin, it is effective in blepharokeratoconjunctivitis. Elevations in IOP are infrequent with LE, and the absence of a C-20 ketone precludes formation of Schiff base intermediates with lens proteins, a common first step implicated in cataract formation with ketone steroids. PMID:22536546

  2. Portable ocular laser Doppler red blood cell velocimeter

    NASA Astrophysics Data System (ADS)

    Logean, E.; Geiser, M. H.; Petrig, B. L.; Riva, C. E.

    1997-07-01

    A new hand-held bidirectional ocular laser Doppler system for measurement of red blood cell (RBC) velocity in retinal vessels and blood flow in the optic nerve head tissue and in the choriocapillaris is described. Laser power at the cornea is below the maximum permissible level. The instrument is based on the well-established laser Doppler velocimetry/flowmetry techniques. The optical systems for the delivery of the probing laser beam to the eye fundus and bidirectional detection of the light scattered by the RBCs have been implemented in a portable Kowa Genesis fundus camera. In vitro experiments demonstrate the performance of the instrument and in vivo measurements illustrate the feasibility of retinal blood velocity and choriocapillaris blood flow measurements in awake volunteers.

  3. The cerebellar nodulus: perceptual and ocular processing of graviceptive input.

    PubMed

    Tarnutzer, Alexander A; Wichmann, Werner; Straumann, Dominik; Bockisch, Christopher J

    2015-02-01

    Current concepts postulate a decisive role of the cerebellar nodulus in the processing of otolith input. We hypothesized that nodular lesions abolish otolith-perceptual integration, predicting alignment of perceived direction of earth vertical with the z-axis of the head and not with gravity. In an 80-year-old patient with acute heminodular infarction, the subjective visual vertical deviated contralesionally by -21.1° when the patient was upright. After subtracting this offset, perceived vertical closely matched the patient's head orientation when the patient was roll-tilted. Otolith-ocular reflexes remained normal. This is the first report on abolished earth verticality perception in heminodular stroke and underlines the importance of the nodulus in spatial orientation. PMID:25515599

  4. Ocular disorders in children with spastic subtype of cerebral palsy

    PubMed Central

    Ozturk, A.Taylan; Berk, A.Tulin; Yaman, Aylin

    2013-01-01

    AIM To document common ocular abnormalities in children with spastic subtype of cerebral palsy (CP) and to find out whether any correlation exists between their occurance and etiologic factors. METHODS Totally 194 patients with the diagnosis of spastic type CP were enrolled in this retrospective study. Detailed ophthalmic examinations were performed. Demographic data and neuroradiological findings were documented. Kruskal-Wallis, Mann Whitney U, Pearson Chi-square tests and Student's t tests were used in the statistical analysis. RESULTS The mean age was 64.7±44.2 months on the first ophthalmic examination. Prevalences of diplegia (47.4%) and tetraplegia (36.1%) were found to be higher than the frequency of hemiplegia (16.5%) in our study population. Etiologic factor was asphyxia in 60.8% of the patients. Abnormal ocular findings were present in 78.9% of the patients. Statistically significant poor vision was detected in tetraplegia group among all the spastic ubtypes of CP (P=0.000). Anisometropia and significant refractive error were found in 14.4% and 70.1% of the patients, respectively. Thirty-six children (18.6%) had nystagmus and 107 children (55.2%) had strabismus. Lower gestational age and birth weight were statistically higher in patients with esotropia than exotropia (P=0.009 and P=0.024, respectively). Abnormal morphology of the optic disc was present in 152 eyes (39.2%). Severe periventricular leukomalacia (PVL) was found in 48 patients and statistically significant poor vision was detected in the presence of PVL (P=0.000). CONCLUSION Spastic diplegic or tetraplegic CP patients with positive neuroradiological symptoms, younger gestational age and lower birth weight ought to have detailed ophthalmic examinations as early as possible to provide best visual rehabilitation. PMID:23638425

  5. Cortisol Biosynthesis in the Human Ocular Surface Innate Immune Response

    PubMed Central

    Walker, Elizabeth A.; Bujalska, Iwona J.; Alsalem, Jawaher; Williams, Geraint P.; Sreekantam, Sreekanth; Taylor, Angela E.; Tallouzi, Mohammad; Southworth, H. Susan; Murray, Philip I.; Wallace, Graham R.; Rauz, Saaeha

    2014-01-01

    Innate immune responses have a critical role in regulating sight-threatening ocular surface (OcS) inflammation. While glucocorticoids (GCs) are frequently used to limit tissue damage, the role of intracrine GC (cortisol) bioavailability via 11-beta-hydroxysteroid dehydrogenase type 1 (11?-HSD1) in OcS defense, remains unresolved. We found that primary human corneal epithelial cells (PHCEC), fibroblasts (PHKF) and allogeneic macrophages (M1, GM-CSF; M2, M-CSF) were capable of generating cortisol (M1>PHKF>M2>PHCEC) but in corneal cells, this was independent of Toll-like receptor (TLR) activation. While PolyI?C induced maximal cytokine and chemokine production from both PHCEC (IFN?, CCL2, CCL3, and (CCL4), IL6, CXCL10, CCL5, TNF?) and PHKF (CCL2, IL-6, CXCL10, CCL5), only PHKF cytokines were inhibited by GCs. Both Poly I?C and LPS challenged-corneal cells induced M1 chemotaxis (greatest LPS-PHKF (250%), but down-regulated M1 11?-HSD1 activity (30 and 40% respectively). These data were supported by clinical studies demonstrating reduced human tear film cortisol?cortisone ratios (a biomarker of local 11?-HSD1 activity) in pseudomonas keratitis (1?2.9) versus healthy controls (1?1.3; p<0.05). This contrasted with putative TLR3-mediated OcS disease (Stevens-Johnson Syndrome, Mucous membrane pemphigoid) where an increase in cortisol?cortisone ratio was observed (113.8?1; p<0.05). In summary, cortisol biosynthesis in human corneal cells is independent of TLR activation and is likely to afford immunoprotection under physiological conditions. Contribution to ocular mucosal innate responses is dependent on the aetiology of immunological challenge. PMID:24736562

  6. Characteristics of cervico-ocular responses in the chameleon.

    PubMed

    Gioanni, H; Sansonetti, A; Bennis, M

    1997-01-01

    The cervico-ocular reflex (COR) was investigated in the chameleon. Two kinds of responses were observed by oscillating the body (sine-wave stimuli) in the fixed-head animal: a "smooth response" of very low gain (around 0.08) and a saccadic response composed of 1-12 saccades per cycle of stimulation (depending on the stimulation frequency). Both responses were elicited in the compensatory direction (same direction as the stimulation) and exhibited a frequency dependence with low-pass properties. The saccadic response was especially developed and displayed a higher gain (up to 0.4) than the smooth response. In darkness, the saccades were triggered near the zero point (head-body alignment), whereas in the presence of a fixed visual surround they were elicited more regularly throughout the stimulation cycle. The amplitude of saccades was increased in the light. Consequently, the gain and the phase lag of the saccadic response were enhanced by the visual input. No visuo-cervical interaction was observed for the smooth response. Oscillating the body at a constant velocity (seesaw or ramp stimuli) revealed a frequency effect on the number of saccades (during a cycle of stimulation), but not on the gain of the response. Increasing the amplitude of oscillations augmented only very slightly the amplitude of saccades and consequently decreased the gain. Hence, the best working range of the saccadic response corresponds to body or head movements of low amplitude (up to +/- 20 deg) and low frequency (up to 0.25 Hz), and is improved by a visual input. These properties are discussed on a comparative point of view. It is proposed that, in chameleons, the saccadic response could contribute to gaze stabilization and add to the vestibulo-ocular and the optokinetic responses. PMID:9447697

  7. Ocular hypotensive efficacy and safety of once daily carteolol alginate

    PubMed Central

    Demailly, P.; Allaire, C.; Trinquand, C.

    2001-01-01

    BACKGROUND/AIM—Carteolol is a ? adrenoceptor antagonist used topically to reduce intraocular pressure, typically twice daily. In an effort to provide a once daily dosing regimen, carteolol was formulated with 1% alginic acid. The objective of this study was to evaluate the efficacy and safety of carteolol alginate solution in comparison with standard carteolol solution.?METHODS—This was a double masked, parallel group, multicentre study. Patients with ocular hypertension or open angle glaucoma (n=235) were randomly assigned to receive either carteolol alginate four times daily or standard carteolol solution, twice daily. The masking was maintained through the use of a vehicle in the evening for the alginate group. Patients were evaluated at baseline, 15, 60, and 120 days.?RESULTS—At 0900 (presumed trough) on day 60, mean reductions in intraocular pressure (IOP) from baseline were 6.09 (SD 2.97) and 6.09 (3.18) mm Hg for the standard carteolol and alginate, respectively. At 1100 (presumed peak), mean reductions were 6.51 (2.53) and 6.47 (2.76) mm Hg, respectively. Results were similar at other times (day 15 and day 120). The most common side effect was transient stinging on instillation of drops, which did not differ significantly between groups. There were no differences of note in other ocular or systemic signs or symptoms.?CONCLUSION—The new alginate formulation of carteolol 2% given once daily was as effective as standard carteolol 2% given twice daily with no meaningful differences regarding safety.?? PMID:11466245

  8. The effects of lateral head tilt on ocular astigmatic axis

    PubMed Central

    Fesharaki, Hamid; Azizzadeh, Ahmad; Ghoreishi, Seyyed Mohamad; Fasihi, Mohamad; Badiei, Sajjad; Rezaei, Leila

    2014-01-01

    Background: Compensatory ocular counter-torsion (COCT) is supposed to maintain the eyes aligned with the visual environment following head tilt. Because of some recent controversies the functional capacity of this phenomenon was defined according to the extent of induced astigmatic axis error following head tilt. Materials and Methods: Objective autorefractometry was performed on 70 eyes with a regular astigmatism of ?2D at vertical, right head tilt and left head tilt positions of 5°, 10°, 15°, 20° and 25°. Astigmatic axis error was calculated according to the difference between the defined axis at each tilted head position and the defined axis at the vertical head position. A tiltometer was used for this purpose to show the angle of head tilt without disturbing the process of refractometry. Results: The mean astigmatic axis error was 3.2° ± 1.5° and 18.4° ± 4.2° at the head tilt angles of 5° and 25° respectively. The mean percentage of tilt angle compensation by COCT was 36% and 26% at the head tilt angles of 5° and 25° respectively. There was a direct relation between the head tilt angle and the induced astigmatic axis error (ANOVA, P < 0.001, 95% of confidence interval [CI]). Astigmatic axis error values at right head tilt were significantly lower than their corresponding values at left head tilt (ANOVA, P = 0.04 95% CI). Conclusion: Any minimal angle of head tilt may cause erroneous measurement of astigmatic axis and should be avoided during refraction. One cannot rely on the compensatory function of ocular counter-torsion during the refraction. PMID:24592363

  9. Differential Lateral Rectus Compartmental Contraction during Ocular Counter-Rolling

    PubMed Central

    Clark, Robert A.; Demer, Joseph L.

    2012-01-01

    Purpose. The lateral rectus (LR) and medial rectus (MR) extraocular muscles (EOMs) have largely nonoverlapping superior and inferior innervation territories, suggesting functional compartmental specialization. We used magnetic resonance imaging (MRI) in humans to investigate differential compartmental activity in the rectus EOMs during head tilt, which evokes ocular counter-rolling, a torsional vestibulo-ocular reflex (VOR). Methods. MRI in quasi-coronal planes was analyzed during target-controlled central gaze in 90° right and left head tilts in 12 normal adults. Cross sections and posterior partial volumes of the transverse portions of the four rectus EOMs were compared in contiguous image planes 2 mm thick spanning the orbit from origins to globe equator, and used as indicators of contractility. Results. Horizontal rectus EOMs had significantly greater posterior volumes and maximum cross sections in their inferior compartments (P < 10?8). In orbit tilt up (extorted) compared with orbit tilt down (intorted) head tilts, contractile changes in LR maximum cross section (P < 0.0001) and posterior partial volume (P < 0.05) were significantly greater in the inferior but not in the superior compartment. These changes were not explainable by horizontal or vertical eye position changes. A weaker compartmental effect was suggested for MR. The vertical rectus EOMs did not exhibit significant compartmental contractile changes during head tilt. Mechanical modeling suggests that differential LR contraction may contribute to physiological cyclovertical effects. Conclusions. Selective activation of the two LR, and possibly MR, compartments correlates with newly recognized segregation of intramuscular innervation into distinct compartments, and probably contributes to noncommutative torsion during the VOR. PMID:22427572

  10. Ocular Surface Reconstruction With a Tissue-Engineered Nasal Mucosal Epithelial Cell Sheet for the Treatment of Severe Ocular Surface Diseases

    PubMed Central

    Kobayashi, Masakazu; Yasuda, Makoto; Hata, Yuiko; Okura, Shoki; Iwamoto, Miyu; Nagata, Maho; Fullwood, Nigel J.; Koizumi, Noriko; Hisa, Yasuo; Kinoshita, Shigeru

    2015-01-01

    Severe ocular surface diseases (OSDs) with severe dry eye can be devastating and are currently some of the most challenging eye disorders to treat. To investigate the feasibility of using an autologous tissue-engineered cultivated nasal mucosal epithelial cell sheet (CNMES) for ocular surface reconstruction, we developed a novel technique for the culture of nasal mucosal epithelial cells expanded ex vivo from biopsy-derived human nasal mucosal tissues. After the protocol, the CNMESs had 4–5 layers of stratified, well-differentiated cells, and we successfully generated cultured epithelial sheets, including numerous goblet cells. Immunohistochemistry confirmed the presence of keratins 3, 4, and 13; mucins 1, 16, and 5AC; cell junction and basement membrane assembly proteins; and stem/progenitor cell marker p75 in the CNMESs. We then transplanted the CNMESs onto the ocular surfaces of rabbits and confirmed the survival of this tissue, including the goblet cells, up to 2 weeks. The present report describes an attempt to overcome the problems of treating severe OSDs with the most severe dry eye by treating them using tissue-engineered CNMESs to supply functional goblet cells and to stabilize and reconstruct the ocular surface. The present study is a first step toward assessing the use of tissue-engineered goblet-cell transplantation of nonocular surface origin for ocular surface reconstruction. PMID:25411478

  11. Summary of studies on the blue-green autofluorescence and light transmission of the ocular lens

    NASA Astrophysics Data System (ADS)

    Van Best, Jaap A.; Kuppens, Esmeralda V.

    1996-07-01

    This paper reviews previous work done to demonstrate the clinical relevance of the measurement of blue-green autofluorescence and light transmission of the ocular lens. These can be determined quantitatively with fluorophotometry in a few seconds. Autofluorescence and transmission values are determined in healthy volunteers, in patients with insulin-dependent diabetes mellitus, and in patients with untreated glaucoma or untreated ocular hypertension. The lens autofluorescence of healthy volunteers increased linearly and transmission decreased exponentially with age. Each year of diabetes induced an increase of autofluorescence equal to one extra year of age. Untreated glaucoma or ocular hypertension had no significant effect on lens autofluorescence and transmission. Increased autofluorescence and decreased transmission values in comparison with values of a healthy population are proved to be indicative for an increased risk of developing cataract and the clinical usefulness of these measures is demonstrated. Diabetes is a risk factor for developing cataracts while untreated glaucoma or ocular hypertension is not.

  12. In vivo visualization of CaMKII activity in ocular dominance plasticity

    E-print Network

    Kwok, Show Ming

    2009-01-01

    Alterations in sensory experience can persistently modify the responses of cortical neurons. Ocular dominance (OD) plasticity, a process in which alternation of visual input induces a shift in cortical responsiveness, is ...

  13. Surgical and prosthetic considerations to rehabilitate an ocular defect using extraoral implants: a clinical report.

    PubMed

    de Negreiros, Wagner Araujo; Verde, Marcus Aurelio Rabelo Lima; da Silva, Antonio Materson; Pinto, Lecio Pitombeira

    2012-04-01

    This clinical report shows the use of extraoral implants to rehabilitate an ocular defect, focusing the surgical and prosthetic procedures. Using local anesthesia and a surgical template obtained from the diagnostic wax ocular pattern, two cylinder dental implants were strategically placed in the lateral aspect of the right infraorbital region. Four months later, an acrylic framework including two spherical magnets was made using plastic UCLA abutments. After casting laboratory steps, a customized silicon prosthetic appliance was fabricated from the diagnostic wax ocular pattern and attached to the Co-Cr framework, observing its profile and seating aspects. The patient was satisfied with the treatment result, due to the retention, esthetics, and adhesive-free method to anchor his ocular prostheses. PMID:22339798

  14. Relative contribution of feedforward excitatory connections to ocular dominance plasticity in layer 4 of visual cortex

    E-print Network

    Khibnik, Lena A.

    Brief monocular deprivation (MD) shifts ocular dominance (OD) in primary visual cortex by causing depression of responses to the deprived eye. Here we address the extent to which the shift is expressed by a modification ...

  15. The protean ocular involvement in monogenic autoinflammatory diseases: state of the art.

    PubMed

    Bascherini, Vittoria; Granato, Carmela; Lopalco, Giuseppe; Emmi, Giacomo; Vannozzi, Lorenzo; Bacherini, Daniela; Franceschini, Rossella; Iannone, Florenzo; Salerni, Annabella; Molinaro, Francesco; Messina, Mario; Frediani, Bruno; Selmi, Carlo; Rigante, Donato; Cantarini, Luca

    2015-07-01

    Ocular involvement is frequent in the monogenic autoinflammatory disorders and generally occurs as spontaneously recurring inflammatory events at different ocular sites caused by the aberrant release of proinflammatory cytokines, mainly IL-1?. Over the past decade, we witnessed a significant growth of eye abnormalities associated with idiopathic granulomatous disorders, familial Mediterranean fever, tumor necrosis factor receptor-associated periodic syndrome, mevalonate kinase deficiency, and cryopyrin-associated periodic syndrome. The pathogenetic mechanisms of these disorders have shown the evidence of disrupted cytokine signaling, but the explanation for the heterogeneous ocular involvement remains to be elucidated. We herein review the monogenic autoinflammatory disorders affecting the eye, describing their main clinical features with specific regard to the ocular involvement, which can lead to decreased visual acuity and even blindness, if the primary disorder is undetected or left untreated. PMID:25833143

  16. Clinical trials of interference-based extended depth of focus intra ocular lens design

    NASA Astrophysics Data System (ADS)

    Zalevsky, Zeev; Raveh, Ido; Limon, Ofer; ben Yaish, Shai; Lahav Yacouel, Karen; Doron, Ravid; Zlotnik, Alex

    2015-03-01

    In this paper we present the clinical trials performed with intra ocular lens (IOL) design having interference based extended depth of focus. The purpose of such IOL design is to allow cataract patients avoid using glasses after doing their surgery.

  17. System identification of the vestibular ocular reflex via visual and vestibular co-stimulation

    E-print Network

    Tangorra, James Louis, 1967-

    2003-01-01

    The study of eye motions involved in the vestibular ocular reflex (VOR) is a key tool for understanding the performance of the vestibular system and for the diagnosis of dysfunction. Limitations in experimental equipment ...

  18. Ocular adverse effects after facial cosmetic procedures: a review of case reports.

    PubMed

    Ricci, Lucas H; Navajas, Samia V; Carneiro, Paula R; Söderberg, Stephanie A; Ferraz, Caroline A

    2015-06-01

    To review indexed literature concerning adverse ocular effects of the most common aesthetic facial procedures (light-emitting therapy, dermal fillers injection, and botulinum toxin). Literature search using three online databases - PubMed, SciELO, and Capes - selecting case reports, series of cases and reviews, with no language restriction, published in a period of the last twenty years (1995-2015). After reviewing 48 case reports and most recent reviews, the authors found the most common ocular adverse effects of dermal fillers were related to vascular occlusion; light-emitting therapy was associated with pigmented tissue damage leading to anterior uveitis and iris atrophy, and ptosis presented the higher relative risk associated with botulinum toxin. Even though ocular adverse effects are not very frequent, some of them can lead to permanent ocular dysfunction and visual impairment. Professionals involved in cosmetic procedures should be aware of the risks. PMID:25790150

  19. Latanoprost versus timolol gel to prevent ocular hypertension after phacoemulsification and intraocular lens implantation

    Microsoft Academic Search

    Jimmy S. M Lai; John K. H Chua; Alfred T. S Leung; Dennis S. C Lam

    2000-01-01

    PurposeTo evaluate the efficacy of latanoprost and timolol gel in preventing ocular hypertension in the early period after phacoemulsification and posterior chamber intraocular lens (PC IOL) implantation.

  20. Rarely reported ocular complications following surgery to correct chronic suppurative otitis media

    Microsoft Academic Search

    Xiaopan Lu; Yu Zhao; Dan Lu; Ping An; Yongbo Zheng; Xueling Qin; LiHong Wang; Joseph B. Roberson

    The objective of this study was to describe the rarely reported ocular complications following surgery to correct chronic\\u000a suppurative otitis media. A retrospective analysis was made of 2,318 cases of chronic suppurative otitis media treated with\\u000a surgery between January 2004 and December 2009 at West China Hospital, Sichuan University, a medical center in Western China.\\u000a Ninety-two cases of ocular complications

  1. Radioactive gold in the treatment of bovine ocular squamous carcinoma and its precursor lesions 

    E-print Network

    England, Roy Belvin

    1973-01-01

    tissues. These platinum coated seeds are well tolerated by tissue following decay of radioactivity MATERIALS AND METHODS Seven bulls, three displaying bilateral ocular lesions, repre- senting ten cases of clinically diagnosed bovine ocular squamous... carcinoma were selected for use in this study. These animals were obtained from a herd of approximately 400 grade and registered Hereford bulls maintained for breeding by the Texas Department of Corrections, Sugarland, Texas. These bulls were confined...

  2. Speckle interferometric sensor to measure low-amplitude high frequency Ocular Microtremor (OMT)

    Microsoft Academic Search

    James P. Ryle; Mohammed Al-Kalbani; Unnikrishnan Gopinathan; Gerard Boyle; Davis Coakley; John T. Sheridan

    2009-01-01

    Ocular microtremor (OMT) is a physiological high frequency (up to 150Hz) low amplitude (150-2500nm) involuntary tremor of the human eye. It is one of the three fixational ocular motions described by Adler and Fliegelman in 1934 as well as microsaccades and drift. Clinical OMT investigations to date have used eye-contacting piezoelectric probes or piezoelectric strain gauges. Before contact can be

  3. A simple ocular irrigation system for alkaline burns of the eye.

    PubMed

    Terzidou, C; Georgiadis, N

    1997-03-01

    An alkaline burn of the eye constitutes an ocular emergency. Emergency treatment consisting of copious irrigation begins at the site of the accident and alters the outcome of the injury. The authors describe a low-cost, simple, and effective system for continuous irrigation of the ocular surface after a severe alkaline burn of the eye. This system also can be applied by inexperienced personnel during the transport of a patient to an ophthalmologic center. PMID:9076805

  4. Gas-permeable scleral contact lens therapy in ocular surface disease

    Microsoft Academic Search

    Tatiana Romero-Rangel; Panagiota Stavrou; Janis Cotter; Perry Rosenthal; Stefanos Baltatzis; C. Stephen Foster

    2000-01-01

    PURPOSE: To describe the therapeutic benefits of nonfenestrated gas-permeable scleral contact lenses in the management of patients with ocular surface disease.METHODS: The charts of 49 consecutive patients (76 eyes) with ocular surface disease whose management included the use of gas-permeable scleral contact lenses were reviewed. We also developed a questionnaire to assess the impact of lens wear on subjective aspects

  5. Nonpreserved human amniotic membrane transplantation for conjunctival reconstruction after excision of extensive ocular surface neoplasia

    Microsoft Academic Search

    K Gündüz; Ö Ö Uçakhan; A Kanpolat; I Günalp

    2006-01-01

    PurposeTo report our experience on the use of nonpreserved human amniotic membrane transplantation (AMT) in ocular surface reconstruction after excision of extensive ocular surface neoplasia (OSN).DesignProspective noncomparative interventional case series.ParticipantsIn all, 10 eyes of 10 consecutive patients with extensive OSN involving various areas of limbus, conjunctiva, and cornea (conjunctival carcinoma in situ, four eyes; squamous cell carcinoma, three eyes; malignant

  6. Vision-guided ocular growth in a mutant chicken model with diminished visual acuity

    PubMed Central

    Ritchey, Eric R.; Zelinka, Christopher; Tang, Junhua; Liu, Jun; Code, Kimberly A.; Petersen-Jones, Simon; Fischer, Andy J.

    2012-01-01

    Visual experience is known to guide ocular growth. We tested the hypothesis that vision-guided ocular growth is disrupted in a model system with diminished visual acuity. We examine whether ocular elongation is influenced by form-deprivation (FD) and lens-imposed defocus in the Retinopathy, Globe Enlarged (RGE) chicken. Young RGE chicks have poor visual acuity, without significant retinal pathology, resulting from a mutation in guanine nucleotide-binding protein ?3 (GNB3), also known as transducin ?3 or G?3. The mutation in GNB3 destabilizes the protein and causes a loss of G?3 from photoreceptors and ON-bipolar cells. (Ritchey et al. 2010)FD increased ocular elongation in RGE eyes in a manner similar to that seen in wild-type (WT) eyes. By comparison, the excessive ocular elongation that results from hyperopic defocus was increased, whereas myopic defocus failed to significantly decrease ocular elongation in RGE eyes. Brief daily periods of unrestricted vision interrupting FD prevented ocular elongation in RGE chicks in a manner similar to that seen in WT chicks. Glucagonergic amacrine cells differentially expressed the immediate early gene Egr1 in response to growth-guiding stimuli in RGE retinas, but the defocus-dependent up-regulation of Egr1 was lesser in RGE retinas compared to that of WT retinas. We conclude that high visual acuity, and the retinal signaling mediated by G?3, is not required for emmetropization and the excessive ocular elongation caused by FD and hyperopic defocus. However, the loss of acuity and G?3 from RGE retinas causes enhanced responses to hyperopic defocus and diminished responses to myopic defocus. PMID:22824538

  7. Excised Porcine Cornea Integrity Evaluation in an in vitro Model of Iontophoretic Ocular Research

    Microsoft Academic Search

    T. Gratieri; G. M. Gelfuso; J. A. Thomazini; R. F. V. Lopez

    2010-01-01

    Background\\/Aims: It is a challenge to adapt traditional in vitro diffusion experiments to ocular tissue. Thus, the aim of this work was to present experimental evidence on the integrity of the porcine cornea, barrier function and maintenance of electrical properties for 6 h of experiment when the tissue is mounted on an inexpensive and easy-to-use in vitro model for ocular

  8. MILES device: ocular hazard evaluation. Interim report, 1 May-30 September 1979

    SciTech Connect

    Zuclich, J.A.; Tredici, T.J.; Mikesell, G.W. Jr.; Gibbons, W.D.; Schmidt, R.E.

    1980-03-01

    This report describes an attempt to find ocular effects in the primate eye as a result of exposure to a MILES (Multiple Integrated Laser Engagement System) laser transmitter for a M16A1 rifle. The MILES device incorporates a pulsed gallium arsenide laser operating in the near infrared. For the exposure parameters reported, no ocular alterations could be detected with either a fundus camera or a direct ophthalmoscope.

  9. Efficacy of bimatoprost in glaucoma and ocular hypertension unresponsive to latanoprost

    Microsoft Academic Search

    Robert D. Williams

    2002-01-01

    This open-label, monocular, two-phase trial was conducted to determine whether bimatoprost is effective in patients with open-angle\\u000a glaucoma or ocular hypertension not responsive to latanoprost. After a 4-week washout of any ocular hypotensive agents, patients\\u000a with IOP between 22 and 34 mm Hg (n = 51) instilled latanoprost in one eye and were evaluated at weeks 4 and 8 (phase

  10. Topical cyclosporine to control ocular surface disease in patients with chronic glaucoma after long-term usage of topical ocular hypotensive medications.

    PubMed

    Saini, M; Dhiman, R; Dada, T; Tandon, R; Vanathi, M

    2015-06-01

    PurposeTo evaluate changes in ocular surface and central corneal sub-basal nerve fiber layer (SBNFL) after topical cyclosporin therapy in chronic glaucoma patients on long-term topical antiglaucoma therapy.MethodsA prospective comparative study of ocular surface evaluation of chronic glaucoma patients on long-term topical therapy treated concurrently with a topical cyclosporine 0.05% twice daily for 6 months and controls was done. The study parameters evaluated at recruitment and at the 6-month follow-up included details of topical antiglaucoma medications, visual acuity, intraocular pressure, ocular surface evaluation parameters (TBUT, Schirmers I, ocular surface staining scores and ocular surface disease (OSD) index score (OSDI)), central corneal sensation (Cochet Bonnett aesthesiometer), and central confocal microscopy to study the SBNFL density (SBNFLD).ResultsThirty-two eyes of 16 patients with chronic glaucoma and 30 eyes of 15 normal subjects as controls were studied. Mean TBUT, pre/post CsA treatment was 8.67±3.01/12.24±1.83?s (P=0.007). Mean conjunctival/corneal staining scores pre/post CsA treatment were 3.38±1.93/1.50±0.718 (P=0.00) /5.19±1.82/1.81±0.78 (P=0.098), respectively. Mean OSDI pre/post CsA treatment scores were 30.63±14.61/14.76±6.06 (P=0.007). Mean corneal sensations scores pre/post CsA treatment were 4.64±0.46/4.94±0.39 (P=0.002). Central corneal SBNFLD pre and post CsA treatment was 8811.35±2985.29/10335.13±4092.064??m/mm(2) (P=0.0001).ConclusionsSchirmer's test, ocular surface staining scores, OSDI, corneal sensations, and corneal SBNFLD showed a statistically significant improvement following a 6-month concurrent topical CsA therapy. PMID:25857609

  11. Ocular clinical pictures disclosed by PCR molecular diagnosis of Chlamydia trachomatis infection performed following the appropriate sampling modality in ocular ecosystem.

    PubMed

    Gallenga, P E; Del Boccio, M; Lobefalo, L; Rapinese, M; Pennelli, A; Martinotti, S

    2012-01-01

    Four clinical cases regarding the correct diagnosis of early ocular Chlamydia trachomatis (Ct) inflammation, performed by two different modalities on the ocular ecosystem, are discussed. The present study was carried out in parallel using a cotton flock ocular swab and the scraping of upper lid conjunctiva. The ocular samplings were carried out by a first ocular swab from inner canthus and fornix, while the second by a conjunctival scraping from upper the conjunctiva of four patients. In the first case, by ocular swab, all samples resulted negative to Ct-DNA research by PCR, while the cultural analyses showed a growth of saprophytic and opportunist germs in all patients. No growth micetes resulted. On the contrary, in the second case, by conjunctival scraping, three of four samples were positive to Ct-DNA research. No fungal growth was observed, while only the 3rd patient, negative to Ct-DNA research, showed microbial growth. Our study, carried out with two different modalities of sampling on different areas of the same ecosystem, showed different results, demonstrating the importance of sampling accuracy for chlamydial research by molecular analysis in PCR, during the slight phase of inflammation. These initial data indicate that laboratory diagnosis by PCR for precocious Ct infection, not revealed clinically, could represent the first step for a correct diagnostic procedure, eliminating one of the critical points, allowing an accurate, effective and precocious antibiotic therapy. We hypothesize that only by following these correct procedures of sampling during the early phase of chlamydial inflammation, in the future, will it be possible to reduce a pejorative evolution of this worsening disease in people genetically susceptible, building a more efficacious Public Health program of prevention against chronic conjunctivitis and to favour a major prevention of trachoma in endemic areas. PMID:23298500

  12. High resolution fMRI of ocular dominance columns within the visual cortex of human amblyopes.

    PubMed

    Goodyear, Bradley G; Nicolle, David A; Menon, Ravi S

    2002-06-01

    Non-human primate models suggest that amblyopia has a neural basis in the form of a massive reduction in binocular neurons, and in some cases, a shift in ocular dominance of neural activity toward the unaffected eye. To date, the resolution of neuroimaging has been insufficient to investigate the neural basis of ocular dominance in human amblyopia. We used high spatial resolution (0.5 x 0.5 x 3 mm) functional magnetic resonance imaging (fMRI) to obtain maps of ocular dominance within the visual cortex of adult human amblyopes. fMRI maps of ocular dominance were similar in appearance to maps reported in the literature. For each of six adults with early-onset amblyopia, the number of map pixels corresponding to the unaffected eye was greater than the number corresponding to the amblyopic eye. This shift in ocular dominance was not seen for the two adults with later-onset amblyopia, suggesting that a shift in ocular dominance of neural activity occurs only if amblyopia onset is within the critical period of brain development. Our findings demonstrate how fMRI can non-invasively investigate the neural substrates underlying human amblyopia at the cortical column level. PMID:12221492

  13. Antiangiogenic immunotherapy targeting Flk-1, DNA vaccine and adoptive T cell transfer, inhibits ocular neovascularization

    SciTech Connect

    Zhang, Han [Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582 (Japan)] [Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582 (Japan); Sonoda, Koh-Hei, E-mail: sonodak@med.kyushu-u.ac.jp [Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582 (Japan)] [Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582 (Japan); Hijioka, Kuniaki; Qiao, Hong; Oshima, Yuji; Ishibashi, Tatsuro [Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582 (Japan)] [Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582 (Japan)

    2009-04-17

    Ocular neovascularization (NV) is the primary cause of blindness in a wide range of ocular diseases. The exact mechanism underlying the pathogenesis of ocular NV is not yet well understood, and so there is no satisfactory therapy for ocular NV. Here, we describe a strategy targeting Flk-1, a self-antigen overexpressed on proliferating endothelial cells in ocular NV, by antiangiogenic immunotherapy-DNA vaccine and adoptive T cell therapy. An oral DNA vaccine encoding Flk-1 carried by attenuated Salmonella typhimurium markedly suppressed development of laser-induced choroidal NV. We further demonstrated that adoptive transfer of vaccine-induced CD8{sup +} T cells reduced pathological preretinal NV, with a concomitant facilitation of physiological revascularization after oxygen-induced retinal vessel obliteration. However, physiological retinal vascular development was unaffected in neonatal mice transferred with vaccine-induced CD8{sup +} T cells. These findings suggested that antiangiogenic immunotherapy targeting Flk-1 such as vaccination and adoptive immunotherapy may contribute to future therapies for ocular NV.

  14. Effects of fixation and optokinetic stimulation on vestibulo-ocular reflex suppression.

    PubMed Central

    Chambers, B R; Gresty, M A

    1982-01-01

    Suppression of the vestibulo-ocular reflex was assessed in normal subjects and patients with neurological disorders to determine the relative effects on suppression of a single fixation target and an optokinetic field. Subjects were rotated sinusoidally in yaw at varying frequencies of up to 0.5 Hz whilst seated in a Barany chair. A comparison was made between eye movements in darkness, those produced during fixation on a central target mounted to the chair, and eye movements during fixation on the target plus an "earth-fixed" or "chair-fixed" visual background. Presentation of a background produced only minimal effects on the suppression of the vestibulo-ocular reflex in normal subjects. In patients with impairment of fixation suppression, suppression of the vestibulo-ocular reflex was not improved after presentation of either form of optokinetic field. The results demonstrate that central fixation is the predominant requirement for suppression of the vestibulo-ocular reflex. This correlates closely with the ability to pursue. Although the optokinetic reflex generates following eye movements similar to pursuit, it cannot be used to mediate suppression of the vestibulo-ocular reflex in the absence of an intact pursuit system. The findings strengthen the view that the optokinetic reflex evolved to act in synergy with the vestibulo-ocular reflex in generating compensatory eye movements. Images PMID:7175543

  15. Difference in ocular surface temperature by infrared thermography in phakic and pseudophakic patients

    PubMed Central

    Sniegowski, Matthew; Erlanger, Michael; Velez-Montoya, Raul; Olson, Jeffrey L

    2015-01-01

    Purpose To assess the change in ocular surface temperature between healthy phakic and pseudophakic patients. Methods We included patients with no history of ocular disease other than cataract. Patients were divided into three groups: clear lens, cataract, and pseudophakic. All patients had two ocular surface digital thermal scans. An average of five surface points was used as the mean ocular surface temperature. Results were analyzed with a one-way analysis of variance and a Tukey’s least significance difference test. The patients were further divided into phakic and pseudophakic groups. Correlation coefficients between several variables were done in order to assess dependencies. Results Fifty-six eyes (28 cataracts, 12 clear lenses, 16 pseudophakic) were enrolled. The mean ocular surface temperature in the cataract group was 34.14°C±1.51°C; clear lens: 34.43°C±2.27°C; and pseudophakic: 34.97°C±1.57°C. There were no statistical differences among the study groups (P=0.3). There was a nonsignificant negative correlation trend between age and surface temperature in the phakic group. The trend inverted in the pseudophakic group but without statistical significance. Conclusion Although cataract extraction and intraocular lens implantation seem to induce a mild increase in ocular surface temperature, the effect is not clear and not significant. PMID:25834383

  16. Ocular counterrolling induced by centrifugation during orbital space flight

    NASA Technical Reports Server (NTRS)

    Moore, S. T.; Clement, G.; Raphan, T.; Cohen, B.

    2001-01-01

    During the 1998 Neurolab mission (STS-90), four astronauts were exposed to interaural centripetal accelerations (Gy centrifugation) of 0.5 g and 1 g during rotation on a centrifuge, both on Earth and during orbital space flight. Subjects were oriented either left-ear out or right-ear out, facing or back to motion. Binocular eye movements were measured in three dimensions using a video technique. On Earth, tangential centrifugation that produces 1 g of interaural linear acceleration combines with gravity to tilt the gravitoinertial acceleration (GIA) vector 45 degrees in the roll plane relative to the head vertical, generating a summed vector of 1.4 g. Before flight, this elicited mean ocular counterrolling (OCR) of 5.7 degrees. Due to the relative absence of gravity during flight, there was no linear acceleration along the dorsoventral axis of the head. As a result, during in-flight centrifugation, gravitoinertial acceleration was strictly aligned with the centripetal acceleration along the interaural axis. There was a small but significant decrease (mean 10%) in the magnitude of OCR in space (5.1 degrees). The magnitude of OCR during postflight 1 g centrifugation was not significantly different from preflight OCR (5.9 degrees). Findings were similar for 0.5 g centrifugation, but the OCR magnitude was approximately 60% of that induced by centrifugation at 1 g. OCR during pre- and postflight static tilt was not significantly different and was always less than OCR elicited by centrifugation of Earth for an equivalent interaural linear acceleration. In contrast, there was no difference between the OCR generated by in-flight centrifugation and by static tilt on Earth at equivalent interaural linear accelerations. These data support the following conclusions: (1) OCR is generated predominantly in response to interaural linear acceleration; (2) the increased OCR during centrifugation on Earth is a response to the head dorsoventral 1 g linear acceleration component, which was absent in microgravity. The dorsoventral linear acceleration could have activated either the otoliths or body-tilt receptors that responded to the larger GIA magnitude (1.4 g), to generate the increased OCR during centrifugation on Earth. A striking finding was that magnitude of OCR was maintained throughout and after flight. This is in contrast to most previous postflight OCR studies, which have generally registered decreases in OCR. We postulate that intermittent exposure to artificial gravity, in the form of the centripetal acceleration experienced during centrifugation, acted as a countermeasure to deconditioning of this otolith-ocular orienting reflex during the 16-day mission.

  17. Incidence of new coding for dry eye and ocular infection in open-angle glaucoma and ocular hypertension patients treated with prostaglandin analogs: Retrospective analysis of three medical\\/pharmacy claims databases

    Microsoft Academic Search

    Gail F Schwartz; Sameer Kotak; Jack Mardekian; Joel M Fain

    2011-01-01

    Background  To investigate the clinical relevance of two different preservative formulations, we compared 1-year incidence rates of additional\\u000a coding of dry eye, ocular infection, or ocular surface disease (either dry eye or ocular infection) in open-angle glaucoma\\u000a and ocular hypertension patients newly treated with latanoprost with benzalkonium chloride (BAK) or with travoprost-Z with\\u000a SofZia®.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  This was a retrospective study of three

  18. Ocular Vestibular Evoked Myogenic Potential Using Different Test Stimuli

    PubMed Central

    Deepak, Dessai Teja; Bhat, Jayashree S.; Kumar, Kaushlendra

    2013-01-01

    Aim. Ocular Evoked Myogenic Potential (oVEMP) are short latency potentials evoked by higher acoustic stimulation. In this study, we aimed at comparing the click, 500?Hz mixed modulated, and 500?Hz short duration tone burst stimuli using oVEMP. Material. Click, 500?Hz mixed modulated and 500?Hz short duration tone burst stimuli were used for the study. Method. Conventional sampling and conveneint study design were used. Sixty healthy subjects underwent contralateral oVEMP testing maintaining 30 degrees upward gaze. Single channel electrode montage was applied to record oVEMP response. Results. On statistical analysis the three stimuli evoked equal response rates (100%), and when latency of n1 and p1 and peak-peak amplitude were compared, the click evoked showed significantly early latency and lower peak-peak amplitude than the 500?Hz stimuli. Five hundred Hz stimuli did not show significant difference in latency and peak-peak amplitude of n1-p1. Discussion. Thus, 500?Hz stimuli can evoke better latency and peak-peak amplitude. oVEMP has good clinical significance in diagnosing subjects with vestibular dysfunction. To add to the sensitivity of the oVEMP test, 500?Hz stimuli may also be used as it can evoke better oVEMP responses in clinical population with good morphology. PMID:23986874

  19. Toxoplasma Serotype Is Associated With Development of Ocular Toxoplasmosis

    PubMed Central

    Shobab, Leila; Pleyer, Uwe; Johnsen, Joerdis; Metzner, Sylvia; James, Erick R.; Torun, N.; Fay, Michael P.; Liesenfeld, Oliver; Grigg, Michael E.

    2013-01-01

    Background.?Worldwide, ocular toxoplasmosis (OT) is the principal cause of posterior uveitis, a severe, life-altering disease. A Toxoplasma gondii enzyme-linked immunoassay that detects strain-specific antibodies present in serum was used to correlate serotype with disease. Methods.?Toxoplasma serotypes in consecutive serum samples from German uveitis patients with OT were compared with non-OT seropositive patients with noninfectious autoimmune posterior uveitis. OT patients were tested for association of parasite serotype with age, gender, location, clinical onset, size, visual acuity, or number of lesions (mean follow-up, 3.8 years) to determine association with recurrences. Results.?A novel, nonreactive (NR) serotype was detected more frequently in serum samples of OT patients (50/114, 44%) than in non-OT patients (4/56, 7%) (odds ratio, 10.0; 95% confidence interval 3.4–40.8; P < .0001). Non-OT patients were predominantly infected with Type II strains (39/56; 70%), consistent with expected frequencies in Central Europe. Among OT patients, those with NR serotypes experienced more frequent recurrences (P = .037). Polymerase chain reaction detected parasite DNA in 8/60 OT aqueous humor specimens but failed to identify Type II strain alleles. Conclusions.?Toxoplasma NR and Type II serotypes predominate in German OT patients. The NR serotype is associated with OT recurrences, underscoring the value of screening for management of disease. PMID:23878321

  20. The human vestibulo-ocular reflex during linear locomotion

    NASA Technical Reports Server (NTRS)

    Moore, S. T.; Hirasaki, E.; Raphan, T.; Cohen, B.

    2001-01-01

    During locomotion, there is a translation and compensatory rotation of the head in both the vertical and horizontal planes. During moderate to fast walking (100 m/min), vertical head translation occurs at the frequency of stepping (2 Hz) and generates peak linear acceleration of 0.37 g. Lateral head translation occurs at the stride frequency (1 Hz) and generates peak linear acceleration of 0.1 g. Peak head pitch and yaw angular velocities are approximately 17 degrees/s. The frequency and magnitude of these head movements are within the operational range of both the linear and angular vestibulo-ocular reflex (IVOR and aVOR). Vertical eye movements undergo a phase reversal from near to far targets. When viewing a far (>1 m) target, vertical eye velocity is typical of an aVOR response; that is, it is compensatory for head pitch. At close viewing distances (<1 m), vertical eye velocity is in phase with head pitch and is compensatory for vertical head translation, suggesting that the IVOR predominantly generates the eye movement response. Horizontal head movements during locomotion occur at the stride frequency of 1 Hz, where the IVOR gain is low. Horizontal eye movements are compensatory for head yaw at all viewing distances and are likely generated by the aVOR.

  1. Dendrimeric Systems and Their Applications in Ocular Drug Delivery

    PubMed Central

    Yavuz, Burçin; Bozda? Pehlivan, Sibel; Ünlü, Nur?en

    2013-01-01

    Ophthalmic drug delivery is one of the most attractive and challenging research area for pharmaceutical scientists and ophthalmologists. Absorption of an ophthalmic drug in conventional dosage forms is seriously limited by physiological conditions. The use of nonionic or ionic biodegradable polymers in aqueous solutions and colloidal dosage forms such as liposomes, nanoparticles, nanocapsules, microspheres, microcapsules, microemulsions, and dendrimers has been studied to overcome the problems mentioned above. Dendrimers are a new class of polymeric materials. The unique nanostructured architecture of dendrimers has been studied to examine their role in delivery of therapeutics and imaging agents. Dendrimers can enhance drug's water solubility, bioavailability, and biocompatibility and can be applied for different routes of drug administration successfully. Permeability enhancer properties of dendrimers were also reported. The use of dendrimers can also reduce toxicity versus activity and following an appropriate application route they allow the delivery of the drug to the targeted site and provide desired pharmacokinetic parameters. Therefore, dendrimeric drug delivery systems are of interest in ocular drug delivery. In this review, the limitations related to eye's unique structure, the advantages of dendrimers, and the potential applications of dendrimeric systems to ophthalmology including imaging, drug, peptide, and gene delivery will be discussed. PMID:24396306

  2. Large stroke actuators and mirror devices for ocular adaptive optics

    NASA Astrophysics Data System (ADS)

    Wu, Xingtao; Li, Hong; Yao, Li; Ou, Haijiang; Pang, Chaoyang

    2012-03-01

    After laboratory studies have demonstrated that the DM-based adaptive optics ophthalmic instruments are promising for future clinical applications, the next step would be to further enhance the functionality of ocular adaptive optics for research and commercialize it for clinical applications. The first essential requirement is the stroke which should cover most wavefront errors of the eyes in clinical population, for which, we presented here design, modeling, and experimental performance of PMN-PT unimorph actuators suitable for generating large stroke up to 50?m per 1-mm pixel in order to cover wavefront correction for older adults and patients with diseased eyes. Clinical acceptance will also requires DMs to be low cost, have a small form factor, running low power, have satisfactory speed, and be an easy add-on for system integration, thus we further presented an effort of developing a high voltage amplifier (HVA) based application specific integrated circuits (ASIC) for driving the mirror actuators with significantly reduced power and system form factors.

  3. Association between Ocular Pseudoexfoliation and Sensorineural Hearing Loss

    PubMed Central

    Singham, Nandini Vijaya; Zahari, Mimiwati; Prepageran, Narayanan; Subrayan, Visvaraja

    2014-01-01

    Background. Our study aimed to investigate an association between ocular pseudoexfoliation (PXF) and sensorineural hearing loss (SNHL) and to compare them with age and sex matched controls without pseudoexfoliation. Method. This was a case-control study of 123 patients which included 68 cases with PXF (at least one eye) and 55 controls without pseudoexfoliation. Pure-tone audiometry (PTA) was done for these patients at sound frequencies taken as important for speech comprehension, that is, 250 Hertz (Hz), 500?Hz, 1000?Hz, and 2000?Hz. Results. There were 41 patients with pseudoexfoliation syndrome (PXE) and 27 with pseudoexfoliative glaucoma (PXEG). The majority of patients with hearing loss (60%; n = 51) were PXF patients and the remaining 40% (n = 34) were controls. Below average hearing thresholds were significantly higher in the pseudoexfoliation group compared to the control group (P = 0.01; odds ratio (OR), 3.00; 95% confidence interval (CI), 1.25–7.19). However, there was no significant difference in the mean hearing threshold levels between the three groups (PXE, PXEG, and controls) in either ear (ANOVA, right ear: P = 0.46 and left ear P = 0.36). Conclusion. Our study found an association between PXF and SNHL, confirming that PXF can involve organs in the body other than the eye. PMID:24864196

  4. Ocular toxocariasis--United States, 2009-2010.

    PubMed

    2011-06-10

    Ocular toxocariasis (OT) is caused by the zoonotic parasites Toxocara canis and Toxocara cati, roundworms of dogs and cats. Persons become infected with Toxocara when they unintentionally ingest embryonated eggs that have been shed in the feces of infected animals. Although OT is uncommon, it most often affects young children and can cause debilitating ophthalmologic disease, including blindness. Previous studies of OT in the United States have been conducted in single institutions. This report describes the results of a web-based survey distributed to uveitis, retinal, and pediatric ophthalmology specialists nationwide to collect epidemiologic, demographic, and clinical information on patients with OT. A total of 68 patients were newly diagnosed with OT from September 2009 through September 2010. Among the 44 patients for whom demographic information was available, the median patient age was 8.5 years (range: 1-60 years), and 25 patients (57%) lived in the South at the time of diagnosis. Among 30 patients with reported clinical data, the most common symptom was vision loss, reported by 25 (83%) patients; of these, 17 (68%) suffered permanent vision loss. The results of this first national level survey demonstrate that OT transmission continues to occur in the United States, frequently affecting children and causing permanent vision loss in the majority of reported patients. Good hygiene practices, timely disposal of pet feces, and routine deworming of pets are strategies necessary to reduce OT in humans. PMID:21659981

  5. Vergence-dependent adaptation of the vestibulo-ocular reflex

    NASA Technical Reports Server (NTRS)

    Lewis, Richard F.; Clendaniel, Richard A.; Zee, David S.; Shelhamer, M. J. (Principal Investigator)

    2003-01-01

    The gain of the vestibulo-ocular reflex (VOR) normally depends on the distance between the subject and the visual target, but it remains uncertain whether vergence angle can be linked to changes in VOR gain through a process of context-dependent adaptation. In this study, we examined this question with an adaptation paradigm that modified the normal relationship between vergence angle and retinal image motion. Subjects were rotated sinusoidally while they viewed an optokinetic (OKN) stimulus through either diverging or converging prisms. In three subjects the diverging prisms were worn while the OKN stimulus moved out of phase with the head, and the converging prisms were worn when the OKN stimulus moved in-phase with the head. The relationship between the vergence angle and OKN stimulus was reversed in the fourth subject. After 2 h of training, the VOR gain at the two vergence angles changed significantly in all of the subjects, evidenced by the two different VOR gains that could be immediately accessed by switching between the diverged and converged conditions. The results demonstrate that subjects can learn to use vergence angle as the contextual cue that retrieves adaptive changes in the angular VOR.

  6. Correlation between ocular perfusion pressure fluctuation and glaucoma severity.

    PubMed

    de Oliveira, Ana Paula Chaves; Kasahara, Niro

    2015-04-01

    The aim of the study is to assess the correlation between ocular perfusion pressure (OPP) fluctuation and the severity of glaucoma. Forty-three patients with primary open-angle glaucoma (POAG) were enrolled in the study. All subjects had intraocular pressure (IOP) and blood pressure measured at three time points (7:00 a.m., 1:00 p.m. and 7:00 p.m.). OPP was calculated based upon blood pressure and IOP, and OPP fluctuation was calculated as the standard deviation of the three measurements. OPP fluctuation was correlated with a structural measure (cup-to-disk ratio) and two functional measures [mean deviation (MD) and pattern standard deviation (PSD) values from automated perimetry] with the Pearson's correlation coefficient. OPP fluctuation showed statistically significant correlation with both MD (r = -0.35, P = 0.01) and PDS (r = 0.44, P = 0.00). No correlation was found between OPP fluctuation and cup-to-disk ratio (r = 0.10, P = 0.48). POAG patients with higher OPP fluctuation have greater severity of disease as measured by functional parameters. PMID:24643517

  7. Human ocular torsion and perceived roll responses to linear acceleration

    PubMed Central

    Zupan, Lionel H.; Merfeld, Daniel M.

    2006-01-01

    We investigated if human ocular torsion (OT) and perceived roll (PR) are elicited in response to either dynamic interaural linear acceleration or dynamic roll tilt of the gravito-inertial force (GIF). We expanded a previous study [26] that measured only OT across a limited frequency-range (from 0.35 Hz to 1 Hz) by simultaneously measuring OT and PR at three very low (0.01, 0.02 and 0.05 Hz) and one high (1 Hz) frequencies. Three experimental conditions were investigated: (1) Y-Upright with acceleration along the interaural (Y) axis while upright, (2) Y-Supine with acceleration along the Y -axis while supine, and (3) Z-RED with acceleration along the rostro-caudal (Z) axis with right-ear-down (RED). OT was measured by video-oculography, while PR was measured by use of a somatosensory bar. OT and PR were qualitatively different. Large OT responses were measured for Y-Upright and Y-Supine, while large perceived roll responses were observed for Y-Upright and Z-RED. OT for Z-RED was small, and PR for Y-Supine was absent. In conclusion, OT and PR appear governed by qualitatively different neural mechanisms. OT appears mostly influenced by central low-pass filtering of interaural graviceptor cues, while PR appears mostly influenced by roll tilt of the GIF. PMID:16286699

  8. High-frequency ultrasonic arrays for ocular imaging

    NASA Astrophysics Data System (ADS)

    Jaeger, M. D.; Kline-Schoder, R. J.; Douville, G. M.; Gagne, J. R.; Morrison, K. T.; Audette, W. E.; Kynor, D. B.

    2007-03-01

    High-resolution ultrasound imaging of the anterior portion of the eye has been shown to provide important information for sizing of intraocular lens implants, diagnosis of pathological conditions, and creation of detailed maps of corneal topography to guide refractive surgery. Current ultrasound imaging systems rely on mechanical scanning of a single acoustic element over the surface of the eye to create the three-dimensional information needed by clinicians. This mechanical scanning process is time-consuming and subject to errors caused by eye movement during the scanning period. This paper describes development of linear ultrasound imaging arrays intended to increase the speed of image acquisition and reduce problems associated with ocular motion. The arrays consist of a linear arrangement of high-frequency transducer elements designed to operate in the 50 - 75 MHz frequency range. The arrays are produced using single-crystal lithium niobate piezoelectric material, thin film electrodes, and epoxy-based acoustic layers. The array elements have been used to image steel test structures and bovine cornea.

  9. [Bacteriological study of the strains isolated from ocular infections].

    PubMed

    Hajoui, Fatima-Zahra; Daoudi, Naima; Kabbaj, Hakima; Alaoui, Ahmed; Seffar, Myriam

    2012-01-01

    Isolation of bacteria involved in eye infections and their susceptibility pattern to various antibiotics in vitro eye were studied. Different ocular samples were obtained from 354 patients hospitalized in ophthalmology unit. The samples were inoculated directly onto appropriate culture media. Biochemical tests have been performed and microorganisms were identified according to standard procedure. The in vitro susceptibility of pathogens to antibiotics has been studied as recommended by the CA-SFM; 129 bacteria were isolated with a prevalence rate of 36.4%. The conjunctival swabs were predominant in 70.5% (n=91). In conjunctivitis and keratitis, the main causal agent was coagulase-negative staphylococci followed by alpha hemolytic streptococci. Bacteria from contact lenses were represented mostly by Enterobacteriaceae (50%). In uveitis and cellulite, different bacteria were isolated. The pathogens studied were susceptible to most antibiotics tested except Staphylococcus aureus that showed resistance to penicillin G, Pseudomonas sp expressed an average sensitivity to piperacillin and ticarcillin. The alpha hemolytic streptococci showed very low sensitivity to ciprofloxacin. In conclusion many species could be responsible for eye infections. They were sensitive to most antibiotics tested exceptions. PMID:23207815

  10. Dendrimeric systems and their applications in ocular drug delivery.

    PubMed

    Yavuz, Burçin; Pehlivan, Sibel Bozda?; Unlü, Nur?en

    2013-01-01

    Ophthalmic drug delivery is one of the most attractive and challenging research area for pharmaceutical scientists and ophthalmologists. Absorption of an ophthalmic drug in conventional dosage forms is seriously limited by physiological conditions. The use of nonionic or ionic biodegradable polymers in aqueous solutions and colloidal dosage forms such as liposomes, nanoparticles, nanocapsules, microspheres, microcapsules, microemulsions, and dendrimers has been studied to overcome the problems mentioned above. Dendrimers are a new class of polymeric materials. The unique nanostructured architecture of dendrimers has been studied to examine their role in delivery of therapeutics and imaging agents. Dendrimers can enhance drug's water solubility, bioavailability, and biocompatibility and can be applied for different routes of drug administration successfully. Permeability enhancer properties of dendrimers were also reported. The use of dendrimers can also reduce toxicity versus activity and following an appropriate application route they allow the delivery of the drug to the targeted site and provide desired pharmacokinetic parameters. Therefore, dendrimeric drug delivery systems are of interest in ocular drug delivery. In this review, the limitations related to eye's unique structure, the advantages of dendrimers, and the potential applications of dendrimeric systems to ophthalmology including imaging, drug, peptide, and gene delivery will be discussed. PMID:24396306

  11. Sustained delivery of a HIF-1 antagonist for ocular neovascularization.

    PubMed

    Iwase, Takeshi; Fu, Jie; Yoshida, Tsunehiko; Muramatsu, Daisuke; Miki, Akiko; Hashida, Noriyasu; Lu, Lili; Oveson, Brian; Lima e Silva, Raquel; Seidel, Christopher; Yang, Ming; Connelly, Sheila; Shen, Jikui; Han, Bing; Wu, Mingsheng; Semenza, Gregg L; Hanes, Justin; Campochiaro, Peter A

    2013-12-28

    Doxorubicin (DXR) and daunorubicin (DNR) inhibit hypoxia-inducible factor-1 (HIF-1) transcriptional activity by blocking its binding to DNA. Intraocular injections of DXR or DNR suppressed choroidal and retinal neovascularization (NV), but also perturbed retinal function as demonstrated by electroretinograms (ERGs). DXR was conjugated to novel copolymers of branched polyethylene glycol and poly(sebacic acid) (DXR-PSA-PEG3) and formulated into nanoparticles that when placed in aqueous buffer, slowly released small DXR-conjugates. Intraocular injection of DXR-PSA-PEG3 nanoparticles (1 or 10 ?g DXR content) reduced HIF-1-responsive gene products, strongly suppressed choroidal and retinal NV, and did not cause retinal toxicity. In transgenic mice that express VEGF in photoreceptors, intraocular injection of DXR-PSA-PEG3 nanoparticles (10 ?g DXR content) suppressed NV for at least 35 days. Intraocular injection of DXR-PSA-PEG3 nanoparticles (2.7 mg DXR content) in rabbits resulted in sustained DXR-conjugate release with detectable levels in aqueous humor and vitreous for at least 105 days. This study demonstrates a novel HIF-1-inhibitor-polymer conjugate formulated into controlled-release particles that maximizes efficacy and duration of activity, minimizes toxicity, and provides a promising new chemical entity for treatment of ocular NV. PMID:24126220

  12. Direct Differentiation of Adult Ocular Progenitors into Striatal Dopaminergic Neurons

    PubMed Central

    Ahmad, Iqbal; Zhao, Xing; Parameswaran, Sowmya; Destache, Christopher J.; Rodriguez-Sierra, Jorge; Thoreson, Wallace B.; Ahmad, Hiba; Sorrentino, John; Balasubramanian, Sudha

    2015-01-01

    Parkinson’s disease, characterized by motor dysfunction due to the loss of nigrostriatal dopaminergic neurons, is one of the most prevalent age-related neurodegenerative disorders. Given there is no current cure, the stem cell approach has emerged as a viable therapeutic option to replace the dopaminergic neurons that are progressively lost to the disease. The success of the approach is likely to depend upon accessible, renewable, immune compatible, and non-tumorigenic sources of neural progenitors from which stable dopaminergic neurons can be generated efficaciously. Here, we demonstrate that neural progenitors derived from limbus, a regenerative and accessible ocular tissue, represent a safe source of dopaminergic neurons. When the limbus-derived neural progenitors were subjected to a well-established protocol of directed differentiation under the influence of Shh and FGF8, they acquired the biochemical and functional phenotype of dopaminergic neurons that included the ability to synthesize dopamine. Their intrastriatal transplantation in the rat model of hemi-Parkinsonism was associated with a reduction in the amphetamine-induced rotation. No tumor formation was observed 6 weeks post-transplantation. Together, these observations posit limbus-derived neural progenitors as an accessible and safe source of dopaminergic neurons for a potential autologous ex-vivo stem cell approach to Parkinson’s disease. PMID:26019760

  13. Ocular cicatricial pemphigoid antigen: Partial sequence and?biochemical?characterization

    PubMed Central

    Tyagi, Shivraj; Bhol, K.; Natarajan, K.; Livir-Rallatos, C.; Foster, C.?S.; Ahmed, A.?R.

    1996-01-01

    Ocular cicatricial pemphigoid (OCP) is an autoimmune disease that affects mainly conjunctiva and other squamous epithelia. OCP is histologically characterized by a separation of the epithelium from underlying tissues within the basement membrane zone. Immunopathological studies demonstrate the deposition of anti-basement membrane zone autoantibodies in vivo. Purified IgG from sera of patients with active OCP identified a cDNA clone from a human keratinocyte cDNA library that had complete homology with the cytoplasmic domain of ?4-integrin. The sera recognized a 205-kDa protein in human epidermal, human conjunctiva, and tumor cell lysates that was identified as ?4-integrin by its reaction with polyclonal and monoclonal antibodies to human ?4-integrin. Sera from patients with bullous pemphigoid, pemphigus vulgaris, and cicatricial pemphigoid-like diseases did not recognize the 205-kDa protein, indicating the specificity of the binding. These data strongly implicate a role for human ?4-integrin in the pathogenesis of OCP. It should be emphasized that multiple antigens in the basement membrane zone of squamous epithelia may serve as targets for a wide spectrum of autoantibodies observed in vesiculobullous diseases. Molecular definition of these autoantigens will facilitate the classification and characterization of subsets of cicatricial pemphigoid and help distinguishing them from bullous pemphigoid. This study highlights the function and importance of ?4-integrin in maintaining the attachment of epithelial cells to the basement membrane. PMID:8962120

  14. Intermittent diplopia and strabismus caused by ocular neuromyotonia.

    PubMed Central

    Yee, R D; Purvin, V A; Azzarelli, B; Nelson, P B

    1996-01-01

    PURPOSE: Two cases illustrate the symptoms, signs, etiologies, and treatment of ocular neuromyotonia (ONM). METHODS: The histories, neuroradiologic tests, and/or biopsy revealed the etiologies of ONM in both patients. Clinical observations, videotaping, and electronic eye movement recordings documented the eye movements. RESULTS: A 72-year-old man with chronic arachnoiditis following myelography with thorium dioxide (Thorotrast) developed intermittent diplopia and a partial right third nerve palsy. Left gaze induced spasm of the right medial rectus. Right gaze produced right lateral rectus spasm. A 66-year-old woman, who had radiation treatment for a pituitary tumor and acromegaly, had intermittent spasm of the left medial rectus muscle and left esotropia. The episodes occurred spontaneously and were induced by right gaze. A left internuclear ophthalmoplegia was also found. Carbamazepine (Tegretol) abolished the ONM in both patients. CONCLUSIONS: Although ONM is an unusual cause of intermittent diplopia and strabismus, its distinctive clinical features identify it. Injury to the peripheral cranial nerves probably leads to segmental demyelination, axonal hyperexcitability, and a self-perpetuating, reverberating circuit, which causes spasms of the extraocular muscles. Images FIGURE 4 FIGURE 5 FIGURE 6 FIGURE 7 FIGURE 8 PMID:8981697

  15. Diclofenac/biodegradable polymer micelles for ocular applications

    NASA Astrophysics Data System (ADS)

    Li, Xingyi; Zhang, Zhaoliang; Li, Jie; Sun, Shumao; Weng, Yuhua; Chen, Hao

    2012-07-01

    In this paper, methoxypoly(ethylene glycol)-poly(?-caprolactone) (MPEG-PCL) micelle formulations as promising nano-carriers for poorly water soluble drugs were investigated for the delivery of diclofenac to the eye. Diclofenac loaded MPEG-PCL micelles were prepared by a simple solvent-diffusion method and characterized by dynamic light scattering (DLS), atomic force microscopy (AFM), Fourier transform infra-red (FTIR), X-ray diffraction (XRD), differential scanning calorimetery (DSC), etc. With the analysis of XRD and DSC, the diclofenac was present as an amorphous state in the formulation. The in vitro release profile indicated a sustained release manner of diclofenac from the micelles. Meanwhile, in vivo studies on eye irritation were performed with blank MPEG-PCL micelles (200 mg ml-1). The results showed that the developed MPEG-PCL micelles were non-irritants to the eyes of rabbits. In vitro penetration studies across the rabbit cornea demonstrated that the micelle formulations exhibited a 17-fold increase in penetration compared with that of diclofenac phosphate buffered saline (PBS) solution. The in vivo pharmacokinetics profile of the micelle parent drug in the aqueous humor of the rabbit was evaluated and the data showed that the diclofenac loaded MPEG-PCL micelles exhibited a 2-fold increase in AUC0-24 h than that of the diclofenac PBS solution eye drops. These results suggest a great potential of our micelle formulations as a novel ocular drug delivery system to improve the bioavailability of the drugs.

  16. Echography in extreme postoperativne ocular hypotony: case report.

    PubMed

    Henc-Petrinovi?, Ljerka; Petrinovi?-Doresi?, Jelena; Kuzmanovi?-Elabjer, Biljana

    2012-12-01

    A case is presented of excessive optic disk edema upon evacuation of the silicon oil instilled after vitrectomy. Retinal detachment in the right myopic eye of a 45-year-old female patient was the indication for vitrectomy with instillation of silicon oil. Consecutive cataract formation, shallow anterior chamber and corneal edema with slight ocular hypertonus lasting for two months were the reasons to perform phacoemulsification with posterior chamber lens implantation and silicon oil evacuation. Shallow anterior chamber and corneal edema persisted, accompanied by excessive hypotony. Echography revealed a highly echogenic massive lesion protruding from the posterior pole into the vitreal space without initial double spike, casting a shadow upon distal structures. The retrobulbar part of the optic nerve was not visible. Echographic presentation of the massive lesion was not corresponding to choroidal detachment and the diagnosis of excessive papilledema was established. Another procedure with refilling of the eye with silicon oil to restore the hypotony was performed. Regression of the papilledema was gradual, intraocular pressure normalized, and control echography showed flat optic nerve head. PMID:23431739

  17. Effect of 2-(6-cyano-1-hexyn-1-yl)adenosine on ocular blood flow in rabbits

    Microsoft Academic Search

    Takashi Konno; Takehiro Uchibori; Akihiko Nagai; Kentaro Kogi; Norimichi Nakahata

    2007-01-01

    Previously, we reported that a relatively selective adenosine A2A receptor agonist 2-(6-cyano-1-hexyn-1-yl)adenosine (2-CN-Ado) elicited ocular hypotension in rabbits (Journal of Pharmacological Sciences 2005;97:501–509). In the present study, we investigated the effect of 2-CN-Ado on ocular blood flow in rabbit eyes. An intravitreal injection of 2-CN-Ado increased ocular blood flow, measured by a non-contact laser flowmeter. 2-CN-Ado-induced increase in ocular blood

  18. Ocular Graft Versus Host Disease Following Allogeneic Stem Cell Transplantation: A Review of Current Knowledge and Recommendations

    PubMed Central

    Nassiri, Nariman; Eslani, Medi; Panahi, Nekoo; Mehravaran, Shiva; Ziaei, Alireza; Djalilian, Ali R.

    2013-01-01

    Graft versus host disease (GVHD) is a common complication of allogeneic stem cell transplantation (allo-SCT). Ocular GVHD develops in approximately 40-60% of patients following allo-SCT and its most common clinical manifestations include keratoconjunctivitis sicca and cicatricial conjunctivitis. Ocular GVHD may lead to severe ocular surface disease, which can significantly diminish quality of life and restrict daily activities. It is thus important to monitor the condition closely since with timely diagnosis, irreversible damage can be avoided. The current review will focus on updated information regarding ocular GVHD. PMID:24653823

  19. Abnormal Ocular Enhancement in Sturge-Weber Syndrome: Correlation of Ocular MR and CT Findings with Clinical and Intracranial Imaging Findings

    Microsoft Academic Search

    Paul D. Griffiths; Mitra B. Boodram; Susan Blaser; Filiberto Altomare; J. Raymond Buncic; Alex V. Levin; Venita Jay; Derek Armstrong; Derek Harwood-Nash

    PURPOSE: To estimate the prevalence of abnormal ocular enhancement in children with Sturge- Weber syndrome as detected with MR imaging and CT and to correlate this with the clinical, fundoscopic, and intracranial imaging findings. METHODS: Fifteen children, 4 years old or younger, with Sturge-Weber syndrome were examined with enhanced CT and MR imaging. Eleven children had unilateral intracranial involvement and

  20. Ocular Signs Correlate Well with Disease Severity and Genotype in Fabry Disease

    PubMed Central

    Pitz, Susanne; Kalkum, Gisela; Arash, Laila; Karabul, Nesrin; Sodi, Andrea; Larroque, Sylvain; Beck, Michael; Gal, Andreas

    2015-01-01

    Ocular signs in Fabry disease have generally been regarded to be primarily of diagnostic value. We explored whether ocular findings, alone or in particular in combination with the ?-galactosidase A gene mutation, have predictive value for disease severity. Data from the Fabry Outcome Survey (FOS), a large, global database sponsored by Shire, were selected for adult patients who had undergone ophthalmological examination. Three ocular signs were assessed: cornea verticillata, tortuous conjunctival and/or retinal vessels, and cataract. Fabry disease severity was measured using FOS Mainz Severity Score Index and modifications thereof. Ophthalmological data were available for 1203 (699 female, 504 male) adult patients with eye findings characteristic of Fabry disease in 55.1%. Cornea verticillata had a similar distribution in women (51.1%) and men (50.8%), whereas tortuous vessels and Fabry cataract were somewhat more frequent in men than in women. Patients with cornea verticillata, selected as the principal ocular sign for this study, had more severe disease (median score, 20.0) versus those without ocular signs (11.0; P<0.001). This finding could be confirmed by applying age adjusted severity scores. Moreover, the prevalence of cornea verticillata was significantly higher in patients with null (male, 76.9%; female, 64.5%) and missense (male, 79.2%; female, 67.4%) mutations versus mild missense (male, 17.1%; female, 23.1%) and the p.N215S (male, 15.0%; female, 15.6%) mutations (P<0.01). Our analyses show a correlation between the prevalence of ocular changes in Fabry disease and disease severity. Consequently, information on ocular findings and ?-galactosidase A gene mutation may help assess the risk for more severe Fabry disease. These observed findings are of notable clinical importance, as Fabry disease is characterized by high clinical course variability and only weak genotype-phenotype correlation at the individual patient level. Further confirmatory studies are needed. PMID:25781336