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1

[IgG4-related sclerosing disease].  

PubMed

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

Kazantsev, I A; Lishchuk, S V

2011-01-01

2

Ocular adnexal lymphoma--comparison of MALT lymphoma with other histological types  

PubMed Central

AIMS—To correlate histological features of ocular adnexal lymphoma using the revised European American lymphoma classification (REAL), with stage of disease at presentation, treatment modalities, and patient outcome. MALT lymphoma defines an extranodal marginal zone B cell lymphoma as outlined in the REAL classification. Comparison groups of patients included those with primary ocular adnexal MALT lymphoma versus primary ocular adnexal lymphomas of other types, MALT lymphoma versus non-MALT lymphomas (primary and secondary), and primary ocular adnexal lymphoma (MALT lymphomas and other types) versus secondary ocular adnexal lymphomas.?METHODS—A retrospective review of the National Ophthalmic Pathology Laboratory records identified 20 cases of ocular adnexal lymphoma over a 10 year period which were reclassified using appropriate immunohistochemical stains. Patients' medical records were examined for data including stage of the disease at presentation, mode of treatment, and patient outcome.?RESULTS—Among the 20 cases identified 14 had primary ocular adnexal lymphomas. 10 of the primary lymphomas had histological features of MALT lymphoma. One case was a primary ocular adnexal T cell lymphoma, one a follicular centre, follicular B cell lymphoma, and two were large cell B cell lymphomas. Six cases had systemic disease, four large B cell, one follicular centre, follicular B cell, and one mantle cell. A significantly higher proportion of patients with MALT lymphomas had early disease (p = 0.005), initially required local treatment (p = 0.005) and were alive at last follow up (p = 0.001) than those without. Two patients with MALT lymphoma had recurrence of lymphoma which responded to further treatment.?CONCLUSIONS—Patients with primary ocular adnexal MALT lymphomas present with localised disease requiring local treatment and have a better outcome compared with patients with other types. As a small percentage of these tumours recur, patients should be followed up indefinitely.?? PMID:10340987

Cahill, M.; Barnes, C.; Moriarty, P.; Daly, P.; Kennedy, S.

1999-01-01

3

Ocular adnexal non-Hodgkin’s lymphoma: a review of epidemiology and risk factors  

PubMed Central

Ocular adnexal non-Hodgkin’s lymphoma (NHL), the most common form of ophthalmic NHL, has a unique incidence pattern showing a steady and rapid increase in the past few decades, nearly equal rates among both genders, and predominance among Asians/Pacific Islanders. No major cause for ocular adnexal NHL has been identified, although infectious agents, immune disorders and genetic/epigenetic factors have all been implicated in its etiology. Identifying putative risk factors and biologic mechanisms leading to carcinogenesis in ocular adnexal NHL may enable implementation of effective preventive and/or therapeutic approaches for this malignancy. This article summarizes current knowledge on epidemiology of ocular adnexal NHL and the role of various potential risk factors in its etiology. PMID:23976898

Moslehi, Roxana; Schymura, Maria J; Nayak, Seema; Coles, F Bruce

2013-01-01

4

IgG4-Related Disease in a Urachal Tumor.  

PubMed

IgG4-related disease is a newly recognized fibroinflammatory disorder that has the ability to affect nearly every organ system. It is characterized by tumefactive lesions and fibrosis and closely mimics neoplasms. Only one case of IgG4-related bladder mass has been reported in the literature, but there are no reports of IgG4-related disease in a urachal mass. Herein, we report a 26-year-old male who initially presented with symptoms of recurrent UTI. Work-up revealed a 6?cm urachal tumor, a 1.4?cm pulmonary lesion, and mediastinal lymphadenopathy; all metabolically active on PET scan and suspicious for urachal adenocarcinoma. Lung lesion fine needle aspiration and TURBT pathology revealed inflammation but no evidence of malignancy. The patient underwent a partial cystectomy and umbilectomy with pathology demonstrating dense plasmacytic cells, a high rate of immunohistochemistry staining positive for IgG4 plasma cells, a storiform pattern of fibrosis, and an obliterative phlebitis. Furthermore, the patient had an elevated serum IgG4 level of 227?mg/dL (range 2.4-121?mg/dL). IgG4-related disease is a newly recognized fibroinflammatory disorder that can mimic neoplastic processes and a high index of suspicion and accurate tissue pathology is necessary for an accurate diagnosis. PMID:25202466

Dum, Travis W; Zhang, Da; Lee, Eugene K

2014-01-01

5

Rituximab and chlorambucil as first-line treatment for low-grade ocular adnexal lymphomas  

Microsoft Academic Search

Ocular adnexal lymphomas (OALs) are typically low-grade lymphomas and are largely represented by marginal-zone lymphomas (EMZL).\\u000a Radiotherapy is the treatment of choice but is frequently associated to local complications. We investigated the association\\u000a of chlorambucil and rituximab as first-line treatment for primary OALs. Nine consecutive, newly diagnosed OALs patients (eight\\u000a with a EMZL, one with a follicular lymphoma) with a

Luigi Rigacci; Luca Nassi; Marco Puccioni; Silvia Mappa; Ennio Polito; Serena Dal Pozzo; Renato Alterini; Valentina Carrai; Benedetta Puccini; Alberto Bosi

2007-01-01

6

Diagnosis of IgG4-related tubulointerstitial nephritis.  

PubMed

IgG4-related systemic disease is an autoimmune disease that was first recognized in the pancreas but also affects other organs. This disease may manifest as tubulointerstitial nephritis (IgG4-TIN), but its clinicopathologic features in the kidney are not well described. Of the 35 patients with IgG4-TIN whose renal tissue specimens we examined, 27 (77%) had acute or progressive chronic renal failure, 29 (83%) had involvement of other organ systems, and 18 of 23 (78%) had radiographic abnormalities. Elevated total IgG or IgG4 serum levels were present in 79%. All pathologic specimens featured plasma cell-rich TIN, with most showing diffuse, expansile interstitial fibrosis. Immune complexes along the tubular basement membranes were present in 25 of 30 (83%). All specimens had a moderate to marked increase in IgG4+ plasma cells by immunohistochemistry. We used a control group of 175 pathologic specimens with plasma cell-rich interstitial infiltrates that can mimic IgG4-TIN to examine the diagnostic utility of IgG4 immunostaining. Excluding pauci-immune necrotizing and crescentic glomerulonephritis, IgG4 immunohistochemistry had a sensitivity of 100% (95% CI 90-100%) and a specificity of 92% (95% CI 86-95%) for IgG4-TIN. Of the 19 patients with renal failure for whom treatment and follow-up data were available, 17 (89%) responded to prednisone. In summary, because no single test definitively diagnoses IgG4-related systemic disease, we rely on a combination of histologic, immunophenotypic, clinical, radiographic, and laboratory features. When the disease manifests in the kidney, our data support diagnostic criteria that can distinguish IgG4-TIN from other types of TIN. PMID:21719792

Raissian, Yassaman; Nasr, Samih H; Larsen, Christopher P; Colvin, Robert B; Smyrk, Thomas C; Takahashi, Naoki; Bhalodia, Ami; Sohani, Aliyah R; Zhang, Lizhi; Chari, Suresh; Sethi, Sanjeev; Fidler, Mary E; Cornell, Lynn D

2011-07-01

7

Diagnosis of IgG4-Related Tubulointerstitial Nephritis  

PubMed Central

IgG4-related systemic disease is an autoimmune disease that was first recognized in the pancreas but also affects other organs. This disease may manifest as tubulointerstitial nephritis (IgG4-TIN), but its clinicopathologic features in the kidney are not well described. Of the 35 patients with IgG4-TIN whose renal tissue specimens we examined, 27 (77%) had acute or progressive chronic renal failure, 29 (83%) had involvement of other organ systems, and 18 of 23 (78%) had radiographic abnormalities. Elevated total IgG or IgG4 serum levels were present in 79%. All pathologic specimens featured plasma cell–rich TIN, with most showing diffuse, expansile interstitial fibrosis. Immune complexes along the tubular basement membranes were present in 25 of 30 (83%). All specimens had a moderate to marked increase in IgG4+ plasma cells by immunohistochemistry. We used a control group of 175 pathologic specimens with plasma cell–rich interstitial infiltrates that can mimic IgG4-TIN to examine the diagnostic utility of IgG4 immunostaining. Excluding pauci-immune necrotizing and crescentic glomerulonephritis, IgG4 immunohistochemistry had a sensitivity of 100% (95% CI 90–100%) and a specificity of 92% (95% CI 86–95%) for IgG4-TIN. Of the 19 patients with renal failure for whom treatment and follow-up data were available, 17 (89%) responded to prednisone. In summary, because no single test definitively diagnoses IgG4-related systemic disease, we rely on a combination of histologic, immunophenotypic, clinical, radiographic, and laboratory features. When the disease manifests in the kidney, our data support diagnostic criteria that can distinguish IgG4-TIN from other types of TIN. PMID:21719792

Raissian, Yassaman; Nasr, Samih H.; Larsen, Christopher P.; Colvin, Robert B.; Smyrk, Thomas C.; Takahashi, Naoki; Bhalodia, Ami; Sohani, Aliyah R.; Zhang, Lizhi; Chari, Suresh; Sethi, Sanjeev; Fidler, Mary E.

2011-01-01

8

Molecular and Genomic Aberrations in Chlamydophila psittaci Negative Ocular Adnexal Marginal Zone Lymphomas  

PubMed Central

The etiology and pathogenesis of ocular adnexal extranodal marginal zone lymphoma (OAEMZL) are still unknown and the association with Chlamydophila psittaci (C. psittaci) has been shown in only some geographic regions. Herein we comprehensively examined the frequency of chromosomal translocations as well as CARD11, MYD88 (L265P) and A20 mutations /deletions in 45 C. psittaci negative OAEMZLs. t(14;18)(q32;q21) IGH-MALT1 and t(11;18)(q21;q21) API2-MALT1 were not detected in any of the analyzed tumors while 3 tumors harbored IGH translocations to an unidentified partner. CARD11 mutations were not found in all the analyzed tumors while MYD88 L265P mutation was detected in 3 (6.7%) tumors. A20 mutations and deletions were each detected in 7(15.6%) and 6(13.3%) of the tumors, respectively. Therefore, the observed genetic aberrations could account for the activation of NF-kB signaling pathway in only a minority of the cases. Further studies are needed to identify the molecular mechanisms underlying the pathogenesis of OAEMZL. PMID:23720088

Zhu, Daxing; Ikpatt, Offiong F; Dubovy, Sander R; Lossos, Chen; Natkunam, Yasodha; Chapman-Fredricks, Jennifer R.; Fan, Yao-Shan; Lossos, Izidore S.

2013-01-01

9

Biased Immunoglobulin Light Chain Use in the Chlamydophila psittaci Negative Ocular Adnexal Marginal Zone Lymphomas  

PubMed Central

Ocular adnexal mucosa associated lymphoid tissue lymphomas (OAMALTL) are the most common lymphomas of the eye. The potential roles for specific antigens in these lymphomas are still controversial. Previously we examined IGHV usage and mutations IGHVin Chlamydophila (C) psittaci-negative OAMALTL, demonstrating biased use of the IGHV4 family and IGHV4-34 gene and evidence for antigen selection. Herein, we examined the IKGV/IGLV gene usage and mutations in 34 C. psittaci-negative OAMALTL originating from the orbit (15), conjunctivae (14) and lacrimal gland (5). Clonal potentially functional IGKV/IGLV gene sequences were identified in 30 tumors (18 kappa and 12 lambda). An overrepresentation of the IGKV4 family (p<0.01) was observed. The IGKV3-20*01 allele was used at a greater frequency than in normal peripheral blood B-lymphocytes (p=0.02) and commonly paired with the IGHV4-34 allele. 27 of the 30 unique light chain sequences displayed mutations from germline and evidence for antigen selection. Overall our findings demonstrate that in C. psittaci-negative OAMALTL there is a biased usage of IGKV families and genes, which harbor somatic mutations. These findings and the specific paring between the IGKV3-20*01 and IGHV4-34 alleles suggest that specific antigens could play an important role in the pathogenesis of these lymphomas. PMID:23418012

Zhu, Daxing; Lossos, Chen; Chapman-Fredricks, Jennifer R.; Lossos, Izidore S

2013-01-01

10

IgG4-related cholecystitis presenting as biliary malignancy: report of three cases.  

PubMed

An increased awareness of IgG4-related diseases has led to an escalation in the number of sites known to be involved by this fibroinflammatory disease. We report three cases of IgG4-related cholecystitis which were thought to represent biliary malignancies both clinically and radiographically. All three cases underwent surgery tailored towards presumed malignant neoplasms. Only following pathologic examination was the true nature of the disease identified. Recognition of the clinical, radiographic, and pathologic presentation of IgG4-related cholecystitis is essential for the consideration of this disease process prior to surgical management for suspected gallbladder malignancies. However, the pre-operative diagnosis remains challenging and extensive surgical intervention is often necessary given the distressing presentation of IgG4-related cholecystitis. PMID:24944152

Feely, Michael M; Gonzalo, David H; Corbera, Montserrat; Hughes, Steven J; Trevino, Jose G

2014-09-01

11

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

PubMed Central

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.

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

2014-01-01

12

IgG4-related disease with sinonasal involvement: A case series  

PubMed Central

We present the imaging findings in two cases of IgG4-related disease involving the sinonasal region in the pediatric age group. Imaging findings in IgG4-related disease affecting the nasal cavity and paranasal sinuses have been rarely reported in literature. The diagnosis is made by a combination of clinical, imaging, and histopathologic findings. Radiologists should be aware of the imaging findings of this condition to ensure early diagnosis and treatment. PMID:25024517

Prabhu, Shailesh M; Yadav, Vikas; Irodi, Aparna; Mani, Sunithi; Varghese, Ajoy Mathew

2014-01-01

13

IgG4-related disease: a case report and review of cases reported in China.  

PubMed

IgG4-related inflammatory pseudotumors are lesions characterized by plasma cell-rich histologic pattern, abundant IgG4-positive plasma cells and high serum IgG4 levels. A 64-year-old man was admitted to our hospital for an ultrasound-documented space-occupying lesion of the left kidney. Renal tumor of the left kidney was suspected based upon results of computed tomography and nuclear magnetic resonance, and laparoscopic radical nephrectomy was conducted. The final diagnosis of IgG4-related inflammatory pseudotumor was made based on histopathological examination and IgG4 immunostaining. The patient received steroid therapy. To our knowledge, this is the first case of IgG4-related inflammatory pseudotumor of the kidney reported in China. PMID:23547805

Yang, Jian; Liu, Wei; Jiang, Rongjiang

2014-10-01

14

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

PubMed Central

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

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

2014-01-01

15

Systemic IgG4-related disease with extensive peripheral nerve involvement that progressed from localized IgG4-related lymphadenopathy: an autopsy case  

PubMed Central

A 77-year-old man, with a lengthy medical history of chronic dysuria, constipation, hypertension, myocardial infarction, and a submandibular lymphadenopathy that was excised 3 years ago, was hospitalized due to elevated liver enzyme levels. He demonstrated hypergammaglobulinemia, hyperproteinemia, high levels of IgG and IgG4, eosinophilia, sclerosing cholangitis, and retroperitoneal fibrosis. He was diagnosed with IgG4-related disease (IgG4-RD). While hospitalized, he had several episodes of syncope while standing and was diagnosed with autonomic nerve dysfunction. Thirty days after hospitalization, he died of nonocclusive mesenteric ischemia (NOMI). Post-mortem, his submandibular lymphadenopathy lesion was diagnosed with progressively transformed germinal center (PTGC)-type IgG4-related lymphadenopathy. At autopsy, small and large intestines showed mucosal necrosis and the wall muscles of the transverse to sigmoid colon were necrotic. The sigmoid colon was fibrotic and infiltrated with numerous IgG4+ plasma cells and eosinophils; infiltration into Auerbach’s plexus was also observed. The IgG4-RD lesions were also detected in the mesentery of the sigmoid colon, retroperitoneal soft tissue, abdominal aorta, liver, extrahepatic bile duct, bilateral lungs, bilateral kidneys, urinary bladder, prostate, epicardium, bilateral coronary arteries, and lymph nodes. Interestingly, infiltration into the lesions was most notable around the peripheral nerves in every organ. Thus, this case describes an IgG4-RD that progressed from PTGC-type IgG4-related lymphadenopathy to systemic IgG4-RD, suggesting that IgG4-RD may affect many organs through peripheral nerve involvement. Virtual slide The virtual slides for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9995992971155224. PMID:24559103

2014-01-01

16

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

PubMed

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

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

2014-03-25

17

IgG4-related disease: a new kid on the block or an old aquaintance?  

PubMed Central

IgG4-related systemic disease is a recently recognized systemic condition characterized by unique pathological features that can affect a variety of organs. It includes a growing number of medical conditions which have the following features in common: diffuse organ swelling or focal mass formation, sclerosing storiforme (whirl-shaped) fibrosis with a lymphoplasmacytic infiltrate rich in IgG4-bearing plasma cells, as well as elevated levels of serum IgG4. It invariably responds to steroid treatment and is mostly diagnosed in elderly men. Well-known syndromes like Mikulicz's disease of the salivary or lacrimal gland, Küttner's tumour of the submandibular gland, Riedel's thyroiditis, or retroperitoneal fibrosis, as well as novel entities such as autoimmune pancreatitis type 1, are now regarded to be manifestations of this systemic disease. This article provides an overview of the epidemiology, concepts of pathogenesis, clinical presentation, proposed diagnostic approaches, treatment options, and differential diagnosis of IgG4-related disease.

Beyer, Georg; Schwaiger, Theresa; Lerch, Markus M

2014-01-01

18

IgG4-related inflammatory pseudotumor of the central nervous system responsive to mycophenolate mofetil  

PubMed Central

Orbital apex and skull base masses often present with neuro-ophthalmic signs and symptoms. Though the localization of these syndromes and visualization of the responsible lesion on imaging is typically straightforward, definitive diagnosis usually relies on biopsy. Immunohistochemistry is important for categorization and treatment planning. IgG4 –related disease is emerging as a pathologically defined inflammatory process that can occur in multiple organ systems. We present two patients with extensive inflammatory mass lesions of the central nervous system with immunohistochemistry positive for IgG4 and negative for ALK-1 as examples of meningeal based IgG4-related inflammatory pseudotumors. In both patients, there was treatment response to mycophenolate mofetil. PMID:22546342

Moss, Heather E.; Mejico, Luis; de la Roza, Gustavo; Coyne, Thomas M.; Galetta, Steven L.; Liu, Grant T.

2012-01-01

19

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

PubMed Central

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

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

2014-01-01

20

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

PubMed Central

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

Lee, Leslie K; Sahani, Dushyant V

2014-01-01

21

Cholangiocarcinoma developed in a patient with IgG4-related disease  

PubMed Central

A 77-year-old man with jaundice and a pancreatic head tumor was referred to our hospital in August 2006. The initial laboratory tests, computed tomography (CT) scan, magnetic resonance imaging (MRI), and endoscopic retrograde cholangiopancreatography suggested IgG4-related cholangitis and autoimmune pancreatitis. Oral prednisolone (PSL) was then administered. This treatment reduced the size of the pancreatic parenchyma, and the lower common bile duct (CBD) returned to its normal size. Thus, the oral PSL was gradually tapered to a maintenance dose. In February 2010, a CT scan and MRI showed segmental wall thickening and stenosis of the middle CBD, the progression of which led to extrahepatic obstructive jaundice. We suspected the emergence of a cholangiocarcinoma rather than the exacerbation of the IgG4-related sclerosing cholangitis because the stricture of the CBD was short and localized. Then, a percutaneous transhepatic biliary drainage was performed. The biopsy specimens obtained via the percutaneous transhepatic tract indicated an abnormal glandular formation, suggesting the presence of a moderate, well-differencated adenocarcinoma. The gross examination, microscopic examination and immunohistochemical analysis of the pancreaticoduodenectomy specimen suggested that a cholangiocarcinoma developed from the IgG4-related sclerosing cholangitis. PMID:24009815

Douhara, Akitoshi; Mitoro, Akira; Otani, Emi; Furukawa, Masanori; Kaji, Kosuke; Uejima, Masakazu; Sawai, Masayoshi; Yoshida, Motoyuki; Yoshiji, Hitoshi; Yamao, Junichi; Fukui, Hiroshi

2013-01-01

22

Biopsy-Proven Recurrence of Unilateral IgG4-Related Orbital Inflammation after 20 years.  

PubMed

Abstract A 38-year-old female patient presented with a painful swelling in the lateral part of the upper eyelid, a diffuse scleritis and slight hypoglobus of the right eye. An orbital biopsy showed a fibrotic idiopathic orbital inflammation (IOI) with, on immunohistochemical staining, an increased number of IgG4-positive plasma cells scored as >200 per high-power field, with IgG4/IgG ratio >0.50, indicating orbital IgG4 related autoimmune disease. On treatment with oral prednisone and azathioprine the symptoms resolved within 6 months. Twenty years prior, the patient had been diagnosed with an IOI of at the same side, for which at that time a biopsy had been taken similarly. Reclassification of the previous biopsy specimen with immunohistological staining also showed evidence of orbital IgG4 related disease. To our knowledge this is the first report of a biopsy-proven unilateral IgG4-related orbitopathy that recurred after 20 years. PMID:24911364

Heidari, Pegah; Verdijk, Robert M; van den Bosch, W A; Paridaens, Dion

2014-10-01

23

An atypical case of IgG4-related sclerosing pancreatitis on PET/CT imaging.  

PubMed

A 62-year-old man presented with pain in the upper abdomen persisting for 2 months. He had the clinical history of diabetes for approximately 10 years. CT and MRI showed a mass located in processus uncinatus of caput pancreatis. The laboratory tests, including pancreas-originated amylase, tumor marker, IgG, IgG4, and so on, were normal. For suspicion of pancreatic cancer, the patient underwent F-FDG PET/CT, which demonstrated focal and high radioactivity accumulation in processus uncinatus of pancreas, without extrapancreatic radioactivity uptake observed. Finally, the surgical pathology confirmed IgG4-related sclerosing pancreatitis. PMID:23579979

Han, Lei; Jiang, Lei; Tan, Hui; Chen, Lingli; Hu, Pengcheng; Shi, Hongcheng

2014-03-01

24

IgG4-related renal disease: clinical and pathological characteristics  

PubMed Central

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

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

25

IgG4-Related Orbital Inflammation Presenting as Unilateral Pseudotumor.  

PubMed

IgG4 related systemic disease (IgG4-RSD) has been recognised in the last few years. Orbital pseudotumor as a presentation of IgG4-RSD is one of the rare complaints encountered in pediatric population. It is an inflammatory condition of unknown etiology characterized by tumorous swelling of the organs, characteristic histopathologic changes and elevated IgG4: IgG plasma cells ratio. The disease is also characterized by involvement of varied organ systems. The authors describe a seven-year-old boy with orbital pseudotumor after two years of initial onset with waxing and waning course, steroid responsive lesion and biopsy suggestive of IgG4-RSD involving the extraocular soft tissue. Treatment with oral corticosteroids and Azathioprine produced a significant decline in the pseudotumor size. It is important for pediatricians to be aware of this condition as appropriate recognition and management is important to prevent long-term damage of the tissue involved. This is the first case of IgG4 related orbital pseudotumor reported from India. PMID:24854367

Jariwala, Mehul Pravinchandra; Agarwal, Manjari; Mulay, Kaustubh; Sawhney, Sujata

2014-10-01

26

Risk Potentiality of Frontline Radiotherapy Associated Cataract in Primary Ocular Adnexal Mucosa-associated Lymphoid Tissue Lymphoma  

PubMed Central

Purpose To elucidate risk potentiality of frontline radiotherapy associated cataracts in primary ocular adnexal mucosa-associated lymphoid tissue lymphoma (OAML). Methods Data from eight consecutive patients of 41 total OAML patients who had undergone cataract surgery after frontline radiotherapy were analyzed. Results The median patient age was 46 years (range, 36 to 69 years). The median total radiation dose was 3,780 cGy (range, 3,060 to 4,500 cGy), and the mean duration from radiation irradiation to cataract surgery was 36.60 ± 8.93 months. Preoperative lens opacification was primarily at the posterior lens subcapsule, and best-corrected visual acuity (BCVA) was 0.43 ± 0.21. Patients underwent the phacoemulsification surgical procedure with posterior chamber intraocular lens insertion. The average BCVA improved to 0.90 ± 0.14 after cataract surgery. Two patients underwent posterior continuous curvilinear capsulorhexis, and one had posterior capsule rupture. For posterior capsule opacification (PCO), three patients received Nd:YAG laser posterior capsulotomy after the initial surgery, and one patient is currently under consideration for laser posterior capsulotomy. Conclusions Radiotherapy increased posterior subcapsule opacification at a relatively young age in primary OAML. Phacoemulsification was a manageable procedure without severe complications, and final visual outcomes were good. However, because after-cataracts progressed earlier than did senile cataracts, close follow-up should be considered for PCO management. PMID:23908569

Cho, Won-Kyung; Lee, Sung-Eun; Paik, Ji-Sun; Cho, Seok-Goo

2013-01-01

27

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

PubMed

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

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

2012-01-01

28

Concomitant occurrence of IgG4-related pleuritis and periaortitis: a case report with review of the literature.  

PubMed

IgG4-related sclerosing disease is an established disease entity with characteristic clinicopathological features. Some recent reports have demonstrated that this disease can occur in the respiratory system including the pleura. Herein, we describe the first documented case of concomitant occurrence of IgG4-related pleuritis and periaortitis. A 71-year-old Japanese female with a history of essential thrombocythemia presented with persistent cough and difficulty in breathing. Computed tomography demonstrated thickening of the right parietal pleura, pericardium, and periaortic tissue and pleural and cardiac effusions. Histopathological study of the surgical biopsy specimen of the parietal pleura revealed marked fibrous thickening with lymphoplasmacytic infiltration. Phlebitis was noted, however, only a few eosinophils had infiltrated. Immunohistochemical study revealed abundant IgG4-positive plasma cell infiltration and high ratio of IgG4-/IgG-positive plasma cells (84%). Therefore, a diagnosis of IgG4-related pleuritis was made with consideration of the elevated serum IgG4 level (684 mg/dL). Recently, the spectrum of IgG4-related sclerosing disease has expanded, and this disease can occur in the pleura, pericardium, and periaortic tissue. Although histopathological analysis of the pericardium and periaortic tissue was not performed in the present case, it was suspected that thickening of the pericardium and periaortic tissue was clinically due to IgG4-related sclerosing disease. Our clinicopathological analyses of IgG4-related pleuritis and pericarditis reveal that this disease can present as dyspnea and pleural and pericardial effusion as seen in the present case, therefore, it is important to recognize that IgG4-related sclerosing disease can occur in these organs for accurate diagnosis and treatment. PMID:24551308

Ishida, Mitsuaki; Hodohara, Keiko; Furuya, Aya; Fujishiro, Aya; Okuno, Hiroko; Yoshii, Miyuki; Horinouchi, Akiko; Shirakawa, Ayaka; Harada, Ayumi; Iwai, Muneo; Yoshida, Keiko; Kagotani, Akiko; Yoshida, Takashi; Okabe, Hidetoshi

2014-01-01

29

Ocular adnexal lymphomas: report of 2 cases of mantle cell lymphomas and short review of literature.  

PubMed

Mantle cell lymphoma in ocular region is a rare phenomenon which can be either primary or secondary. Most of these cases are usually diagnosed after excisional biopsy of the involved area with first visit being in the Ophthalmology OPD. We share our experience of two such cases being referred from Ophthalmology OPD. 1st case is about a 52-year-old man who came for complaints of redness of left eye with excessive lacrimation. Examination revealed congestion of left temporal bulbar conjunctiva and a small pinkish outgrowth 2 × 2 cm adherent to temporal bulbar conjunctiva. 2nd case is a 55-year-old gentlemen who presented with complaints for 8 months duration of swelling left eyelid. Excisional biopsy and histopathological examination in both the cases were done to confirm the diagnosis. CECT head and neck were done at baseline and during follow up. These cases are being presented due to the rarity and dramatic response to chemotherapy. PMID:25114401

Sahu, Kamal Kant; Uthamalingam, Preithy; Sampath, Santhosh; Jinagal, Jitender; Das, Ashim; Prakash, Gaurav; Malhotra, Pankaj; Varma, Subhash Chander

2014-09-01

30

Genome-wide DNA methylation profiles according to Chlamydophila psittaci infection and the response to doxycycline treatment in ocular adnexal lymphoma  

PubMed Central

Purpose To compare genome-wide DNA methylation profiles according to Chlamydophila psittaci (Cp) infection status and the response to doxycycline treatment in Korean patients with ocular adnexal extranodal marginal zone B-cell lymphoma (EMZL). Methods Twelve ocular adnexal EMZL cases were classified into two groups (six Cp-positive cases and six Cp-negative cases). Among the 12 cases, eight were treated with doxycycline as first-line therapy, and they were divided into two groups according to their response to the treatment (four doxy-responders and four doxy-nonresponders). The differences in the DNA methylation states of 27,578 methylation sites in 14,000 genes were evaluated using Illumina bead assay technology. We also validated the top-ranking differentially methylated genes (DMGs) with bisulfite direct sequencing or pyrosequencing. Results The Infinium methylation chip assay revealed 180 DMGs in the Cp-positive group (74 hypermethylated genes and 106 hypomethylated genes) compared to the Cp-negative group. Among the 180 DMGs, DUSP22, which had two significantly hypomethylated loci, was validated, and the correlation was significant for one CpG site (Spearman coefficient=0.6478, p=0.0262). Regarding the response to doxycycline treatment, a total of 778 DMGs were revealed (389 hypermethylated genes and 336 hypomethylated genes in the doxy-responder group). In a subsequent replication study for representative hypomethylated (IRAK1) and hypermethylated (CXCL6) genes, the correlation between the bead chip analysis and pyrosequencing was significant (Spearman coefficient=0.8961 and 0.7619, respectively, p<0.05). Conclusions Ocular adnexal EMZL showed distinct methylation patterns according to Cp infection and the response to doxycycline treatment in this genome-wide methylation study. Among the candidate genes, DUSP22 has a methylation status that was likely attributable to Cp infection. Our data also suggest that the methylation statuses of IRAK1 and CXCL6 may reflect the response to doxycycline treatment. PMID:25053874

Lee, Min Joung; Min, Byung-Joo; Choung, Ho-Kyung; Kim, Namju; Kim, Young A

2014-01-01

31

Skin lesions in a patient with IgG4-related disease.  

PubMed

IgG4-related disease (IgG4-RD) is a newly recognized condition that is characterized by raised levels of serum IgG4, tissue infiltration of IgG4-positive plasma cells and presence of fibrosis. It affects multiple organs, including the pancreas, bile duct, and lacrimal and salivary glands. Skin lesions have rarely been reported, and those that have were described as distributed mainly in the head and neck region. We report a case of IgG4-RD with autoimmune pancreatitis and skin lesions on the trunk and limbs. The skin lesions responded well to oral prednisolone (PSL); however, tapering of PSL to 5 mg/day resulted in recurrence. At present, the skin disease is well controlled at a dose of 7 mg/day. Interestingly, IgG4 levels fluctuated with changes in the PSL dose but did not coincide with the severity of the skin disease, implying that the raised levels of IgG4 did not directly influence the skin symptoms. PMID:24986022

Ise, M; Yasuda, F; Suzaki, R; Kurihara, S; Konohana, I

2014-08-01

32

Isolated IgG4-related sclerosing cholangitis: a report of 9 cases.  

PubMed

Extrahepatic bile ducts are the most commonly involved extrapancreatic organ site in patients with type 1 autoimmune pancreatitis. IgG4-related sclerosing cholangitis (IgG4-SC) alone, without evidence of pancreatic or other organ involvement, is uncommon and is difficult to distinguish from cholangiocarcinoma preoperatively. We describe 9 patients with isolated IgG4-SC over an approximate 10-year period, each clinically suspected to have cholangiocarcinoma. We examined the clinical, radiological, cytologic (including fluorescence in situ hybridization results), and histologic features. IgG and IgG4 immunohistochemistry were performed. All 9 patients were middle-aged men who presented with obstructive jaundice. The biliary strictures involved all parts of the extrahepatic biliary tree. Serum IgG4 was slightly elevated in three of eight patients. Cytologic findings were interpreted as negative in six, atypical in one, and suspicious for adenocarcinoma in one. Fluorescence in situ hybridization revealed aneuploidy in one and was equivocal (trisomy 7) in 2. Eight of 9 patients underwent radical resection for suspected cholangiocarcinoma. There was only one case diagnosed with IgG4-SC preoperatively based on biopsy. Histologic sections revealed a prominent lymphoplasmacytic infiltrate with storiform fibrosis and marked increased IgG4-positive plasma cells (?30/high-power field) in all specimens. Fifty percent of cases (4/8) had IgG4/IgG plasma cell ratio >40%. On median follow-up of 2.8 years, no relapse has occurred in any patient. Extrahepatic IgG4-SC may present as an isolated lesion mimicking cholangiocarcinoma. The diagnosis can be challenging. Clinicians and pathologists should recognize this to avoid major surgery. PMID:24890945

Graham, Rondell P D; Smyrk, Thomas C; Chari, Suresh T; Takahashi, Naoki; Zhang, Lizhi

2014-08-01

33

Idiopathic granulomatous orchitis: morphology and evaluation of its relationship to IgG4 related disease.  

PubMed

Idiopathic granulomatous orchitis (IGO) is rare, thought to result from an autoimmune reaction to spermatogenic elements. Its relationship to IgG4-related disease (IgG4-RD) has not been evaluated. Sixteen orchiectomy specimens (1984-2012) with a prominent intratubular granulomatous reaction were reviewed: IGO (n = 6); intratubular germ cell neoplasia unclassified (IGCNU) with a granulomatous reaction and associated seminoma (GS, n = 6); and unclassified intratubular granulomatous orchitis not fitting into a specific entity (UGO, n = 4). Men with IGO were 32 to 86 years old, presenting with a mass suspicious for malignancy. Only one patient had a history of an inflammatory disease. Clinical follow-up was available for 2 patients with IGO, and both had no evidence of systemic IgG4-RD. All IGO cases had an epithelioid granulomatous reaction confined to seminiferous tubules, an extensive interstitial lymphoplasmacytic inflammation, 3 of 6 had prominent interstitial fibrosis, and 3 of 6 cases had plasma cells with an IgG4+/IgG+ ratio >40%. In GS, 10% to 100% of tubules with IGCNU had a granulomatous reaction, which in 3 cases replaced IGCNU cells. In contrast to IGO, GS had more intratubular multinucleated giant cells, more peritubular sclerosis, fewer interstitial plasma cells, and no interstitial fibrosis. Of the 4 UGO cases, most had predominantly interstitial with less intratubular granulomatous inflammation. Only 1 non-IGO case had elevated tissue IgG4 (GS case). It is critical and sometimes difficult to distinguish GS from IGO. IGO shares some features with IgG4-RD, yet current evidence does not support its classification as a localized manifestation of IgG4-RD occurring in the testis. PMID:24656095

Karram, Sarah; Kao, Chia-Sui; Osunkoya, Adeboye O; Ulbright, Thomas M; Epstein, Jonathan I

2014-04-01

34

IgG4-related lung disease showing high standardized uptake values on FDG-PET: report of two cases  

PubMed Central

Immunoglobulin G4 (IgG4)-related lung disease is a disease in which IgG4-positive plasma cells and lymphocytes infiltrate lung tissues along with immunohistochemically evident fibrous interstitial proliferation in the background, in addition to hyper-IgG4 disease. The diagnosis of this disease can be difficult. Here, we report 2 cases with IgG4-related lung disease that was difficult to differentiate from malignant tumors because both cases had pulmonary lesions showing high standardized uptake values (SUV) on positron emission tomography (PET). Case 1: A 75-year-old man under treatment for autoimmune pancreatitis and diabetes mellitus was noted to have multiple nodular opacities in both lungs and a mass density in the right paravertebral region on computed tomography (CT). As high SUVmax was noted for both lesions on exploration by fluorodeoxyglucose (FDG)-PET/CT, an advanced malignant tumor was diagnosed and a video-assisted thoracoscopic (VATS) biopsy was performed and diagnosed IgG4-related lung disease. Case 2: A 48-year-old woman consulted our clinic with a chief complaint of bloody sputum. Chest CT revealed a mass density with 12-, 13-, and 16-mm spiculations in the S2 segment of the right upper lobe and irregular thickening of the pleura including the paravertebral region. The lesion was a mass showing high SUV in the S2 segment on FDG-PET. Malignancy was suspected from the imaging findings, and a VATS biopsy was performed and diagnosed IgG4-related lung disease. Actively undertaking VATS biopsy in cases with this disease is valuable for making the differential diagnosis between malignant tumors and IgG4-related lung disease, since the diagnosis can be difficult in some patients showing high SUV. PMID:23800259

2013-01-01

35

IgG4-related lung disease showing high standardized uptake values on FDG-PET: report of two cases.  

PubMed

Immunoglobulin G4 (IgG4)-related lung disease is a disease in which IgG4-positive plasma cells and lymphocytes infiltrate lung tissues along with immunohistochemically evident fibrous interstitial proliferation in the background, in addition to hyper-IgG4 disease. The diagnosis of this disease can be difficult. Here, we report 2 cases with IgG4-related lung disease that was difficult to differentiate from malignant tumors because both cases had pulmonary lesions showing high standardized uptake values (SUV) on positron emission tomography (PET). Case 1: A 75-year-old man under treatment for autoimmune pancreatitis and diabetes mellitus was noted to have multiple nodular opacities in both lungs and a mass density in the right paravertebral region on computed tomography (CT). As high SUVmax was noted for both lesions on exploration by fluorodeoxyglucose (FDG)-PET/CT, an advanced malignant tumor was diagnosed and a video-assisted thoracoscopic (VATS) biopsy was performed and diagnosed IgG4-related lung disease. Case 2: A 48-year-old woman consulted our clinic with a chief complaint of bloody sputum. Chest CT revealed a mass density with 12-, 13-, and 16-mm spiculations in the S2 segment of the right upper lobe and irregular thickening of the pleura including the paravertebral region. The lesion was a mass showing high SUV in the S2 segment on FDG-PET. Malignancy was suspected from the imaging findings, and a VATS biopsy was performed and diagnosed IgG4-related lung disease. Actively undertaking VATS biopsy in cases with this disease is valuable for making the differential diagnosis between malignant tumors and IgG4-related lung disease, since the diagnosis can be difficult in some patients showing high SUV. PMID:23800259

Kitada, Masahiro; Matuda, Yoshinari; Hayashi, Satoshi; Ishibashi, Kei; Oikawa, Kensuke; Miyokawa, Naoyuki; Ohsaki, Yoshinobu

2013-01-01

36

[Multiple cranial neuropathies in a patient with IgG4-related hypertrophic pachymeningitis: a case report].  

PubMed

We describe the case of a 75-year-old woman who presented with acute loss of vision. She experienced subacute headache, hearing loss on the left side, hoarseness, and dysphagia during the previous 10 months. On admission, she had bilateral loss of vision, without any ophthalmological abnormalities, and multiple cranial nerve palsies, including left hearing loss and right IX, X, and XI nerve palsies. Head magnetic resonance imaging with contrast enhancement revealed hypertrophic pachymeningitis. Laboratory findings showed no abnormalities except for an increased sedimentation rate and increased C-reactive protein levels. A biopsy of the dura mater was performed, and histopathological analysis revealed inflammatory thickening of the dura mater with plasma cell infiltration; the infiltrating cells were immunoreactive to an anti-IgG4 antibody, thereby indicating an IgG4-related disorder. Furthermore, the histopathological analysis revealed evidence of vasculitis in both veins and arteries. After corticosteroid treatment, her visual acuity dramatically improved. Acute loss of vision with multiple cranial nerve palsies may be an uncommon presentation of IgG4-related hypertrophic pachymeningitis. However, it should be recognized that these conditions might be underdiagnosed. The possibility of central nervous system involvement in IgG4-related disorders should be considered in patients with multiple cranial nerve neuropathies associated with hypertrophic pachymeningitis, even in the absence of systemic sclerosis symptoms. In our case, early treatment with corticosteroids showed immediate effectiveness in correcting the visual symptoms. PMID:24998832

Tsugawa, Jun; Ouma, Shinji; Fukae, Jiro; Tsuboi, Yoshio; Sakata, Noriyuki; Inoue, Toru

2014-07-01

37

Nonspecific Interstitial Pneumonia with Abundant IgG4-positive Cells Infiltration, Which was Thought as Pulmonary Involvement of IgG4-related Autoimmune Disease  

Microsoft Academic Search

Recently, great attention has been drawn to IgG4-related diseases such as autoimmune pancreatitis (AIP) sclerosing sialadenitis, retroperitoneum fibrosis, sclerosing cholangitis. IgG4-related diseases are characterized by high serum IgG4 concentrations, sclerosing inflammation with numerous IgG4-positive plasma cells, and steroid sensitivity irrespective of their organs of origin. In this report, we describe a case of nonspecific inter- stitial pneumonia, in which possible

Hazuki Takato; Masahide Yasui; Yukari Ichikawa; Masaki Fujimura; Shinji Nakao; Yoh Zen; Hiroshi Minato

2008-01-01

38

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

PubMed Central

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

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

2014-01-01

39

Cardiac structural abnormalities associated with IgG4-related coronary periarteritis and inflammation revealed by multimodality imaging.  

PubMed

A man presented with shortness of breath, and a globular heart was seen on a chest radiograph. An echocardiogram showed masses at the atrioventricular grooves. Computed tomography (CT) coronary angiography and fluorine-18 ((18)F) fluorodeoxyglucose positron emission tomography (FDG-PET)/CT confirmed coronary aneurysms with hypermetabolic perivascular masses at the coronary arteries and right internal iliac artery. Histologic features were highly suspicious for IgG4-related disease (IgG4-RD). IgG4-RD is a recently recognized fibroinflammatory condition, and FDG-PET/CT can provide information about the disease pattern, which may suggest IgG4-RD, as well as the optimal biopsy site. PMID:24951253

Tong, Aaron Kian-Ti; Tan, Soo-Yong; Go, Yun-Yun; Lam, Winnie Wing-Chuen

2014-08-01

40

IgG4-Related Sclerosing Disease Involving the Superior Vena Cava and the Atrial Septum of the Heart  

PubMed Central

A 55-year-old woman presented with frequent episodes of syncope due to sinus pauses. During ambulatory Holter monitoring, atrial fibrillation and first-degree atrioventricular nodal block were observed. Magnetic resonance imaging and CT scans showed a tumor-like mass from the superior vena cava to the right atrial septum. Open chest cardiac biopsy was performed. The tumor was composed of proliferating IgG4-positive plasma cells and lymphocytes with surrounding sclerosis. The patient was diagnosed with IgG4-related sclerosing disease. Because of frequent sinus pauses and syncope, a permanent pacemaker was implanted. The cardiac mass was inoperable, but it did not progress during the one-year follow-up. PMID:23918583

Song, Changho; Koh, Myoung Ju; Yoon, Yong-Nam; Joung, Boyoung

2013-01-01

41

Occurrence of anaplastic large cell lymphoma following IgG4-related autoimmune pancreatitis and cholecystitis and diffuse large B-cell lymphoma  

PubMed Central

IgG4-related sclerosing disease is an established disease entity with characteristic clinicopathological features. Recently, the association between IgG4-related sclerosing disease and the risk of malignancies has been suggested. IgG4-related autoimmune pancreatitis with pancreatic cancer has been reported. Further, a few cases of extraocular malignant lymphoma in patients with IgG4-related sclerosing disease have also been documented. Herein, we describe the first documented case of anaplastic large cell lymphoma (ALCL) following IgG4-related autoimmune pancreatitis and cholecystitis and diffuse large B-cell lymphoma (DLBCL). A 61-year-old Japanese male, with a past history of DLBCL, was detected with swelling of the pancreas and tumorous lesions in the gallbladder. Histopathological study of the resected gallbladder specimen revealed diffuse lymphoplasmacytic infiltration with fibrosclerosis in the entire gallbladder wall. Eosinophilic infiltration and obliterative phlebitis were also noted. Immunohistochemically, many IgG4-positive plasma cells had infiltrated into the lesion, and the ratio of IgG4/IgG-positive plasma cells was 71.6%. Accordingly, a diagnosis of IgG4-related cholecystitis was made. Seven months later, he presented with a painful tumor in his left parotid gland. Histopathological study demonstrated diffuse or cohesive sheet-like proliferation of large-sized lymphoid cells with rich slightly eosinophilic cytoplasm and irregular-shaped large nuclei. These lymphoid cells were positive for CD30, CD4, and cytotoxic markers, but negative for CD3 and ALK. Therefore, a diagnosis of ALK-negative ALCL was made. It has been suggested that the incidence of malignant lymphoma may be high in patients with IgG4-related sclerosing disease, therefore, intense medical follow-up is important in patients with this disorder. PMID:24228121

Ishida, Mitsuaki; Hodohara, Keiko; Yoshida, Keiko; Kagotani, Akiko; Iwai, Muneo; Yoshii, Miyuki; Okuno, Hiroko; Horinouchi, Akiko; Nakanishi, Ryota; Harada, Ayumi; Yoshida, Takashi; Okabe, Hidetoshi

2013-01-01

42

Long-Term Outcome and Patterns of Failure in Primary Ocular Adnexal Mucosa-Associated Lymphoid Tissue Lymphoma Treated With Radiotherapy  

SciTech Connect

Purpose: To evaluate the long-term treatment outcome and disease behavior of primary ocular adnexal MALT (mucosa-associated lymphoid tissue) lymphoma (POAML) after treatment with radiotherapy. Methods and Materials: Seventy-eight patients (42 male, 36 female) diagnosed with stage I POAML between 1991 and 2010 at Kobe University Hospital were included. The median age was 60 years (range, 22-85 years). The median radiation dose administered was 30.6 Gy. Rituximab-based targeted therapy and/or chemotherapy was performed in 20 patients (25.6%). Local control (LC), recurrence-free survival (RFS), and overall survival (OS) rates were calculated using the Kaplan-Meier method. Results: The median follow-up duration was 66 months. Major tumor sites were conjunctiva in 37 patients (47.4%), orbita in 29 (37.2%), and lacrimal glands in 12 (15.4%). The 5- and 10-year OS rates were 98.1% and 95.3%, respectively. The 5- and 10-year LC rates were both 100%, and the 5- and 10-year RFS rates were 88.5% and 75.9%, respectively. Patients treated with a combination of radiotherapy and targeted therapy and/or chemotherapy had a trend for a better RFS compared with those treated with radiotherapy alone (p = 0.114). None developed greater than Grade 2 acute morbidity. There were 14 patients who experienced Grade 2 morbidities (cataract: 14; retinal disorders: 7; dry eye: 3), 23 patients who had Grade 3 morbidities (cataract: 23; dry eye: 1), and 1 patient who had Grade 4 glaucoma. Conclusions: Radiotherapy for POAML was shown to be highly effective and safe for LC and OS on the basis of long-term observation. The absence of systemic relapse in patients with combined-modality treatment suggests that lower doses of radiation combined with targeted therapy may be worth further study.

Hashimoto, Naoki [Division of Radiation Oncology, Kobe University Graduate School of Medicine, Hyogo (Japan); Sasaki, Ryohei, E-mail: rsasaki@med.kobe-u.ac.jp [Division of Radiation Oncology, Kobe University Graduate School of Medicine, Hyogo (Japan); Nishimura, Hideki; Yoshida, Kenji; Miyawaki, Daisuke; Nakayama, Masao; Uehara, Kazuyuki; Okamoto, Yoshiaki; Ejima, Yasuo [Division of Radiation Oncology, Kobe University Graduate School of Medicine, Hyogo (Japan); Azumi, Atsushi [Division of Ophthalmology, Kobe University Graduate School of Medicine, Hyogo (Japan); Matsui, Toshimitsu [Division of Hematology, Kobe University Graduate School of Medicine, Hyogo (Japan); Sugimura, Kazuro [Division of Radiation Oncology, Kobe University Graduate School of Medicine, Hyogo (Japan)

2012-03-15

43

Usefulness of minor salivary gland biopsy in the diagnosis of IgG4-related disease: a case report  

PubMed Central

Although considered essential for diagnosing IgG4-related disease (IgG4-RD), biopsy of target organs is often difficult to perform. Such was the case of a 56-year-old man admitted with general malaise and weight loss. Computed tomography revealed swelling of the submandibular gland, mild dilatation of the main pancreatic duct, renal involvement, periaortitis, and swelling of the lymph nodes in the abdominal cavity. Laboratory testing revealed elevated serum IgG4 level. These findings were suggestive of IgG4-RD; however, the patient refused consent for biopsy of the target organs for a definitive diagnosis for the invasiveness. Therefore, we tried to perform a biopsy from minor salivary gland, which revealed no sign of clinical abnormality because the biopsy is not an invasive diagnostic procedure. As a result, the biopsy revealed significant IgG4-positive plasma cell infiltration, allowing for definitive IgG4-RD diagnosis. Administration of oral prednisolone (30 mg/day) effectively improved all symptoms. These findings indicate that minor salivary gland biopsy is an effective means of IgG4-RD diagnosis in patients for whom biopsy of target organs is difficult even if there were no sign of clinical abnormality in appearance. PMID:24966985

Doe, Kentaro; Nozawa, Kazuhisa; Okada, Takashi; Tada, Kurisu; Yamaji, Ken; Tamura, Naoto; Takasaki, Yoshinari

2014-01-01

44

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

PubMed Central

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

Divatia, Mukul; Kim, Sun A

2012-01-01

45

Are Classification Criteria for IgG4-RD Now Possible? The Concept of IgG4-Related Disease and Proposal of Comprehensive Diagnostic Criteria in Japan  

PubMed Central

Recent studies suggest simultaneous or metachronous lesions in multiorgans characterized by elevated serum levels of IgG4 and abundant infiltration of IgG4-positive plasma cells with various degrees of fibrosis. Two Japanese research committees for IgG4-RD, one from fibrosclerosis (Okazaki team) and the other from lymph proliferation (Umehara team) supported by the “Research Program for Intractable Disease” of the Ministry of Health, Labor, and Welfare of Japan, have agreed with the unified nomenclature as “IgG4-RD” and proposed the comprehensive diagnostic criteria (CDC) for IgG4-RD. Validation of the CDC demonstrated satisfactory sensitivity for the practical use of general physicians and nonspecialists but low sensitivity in the organs to be difficult in taking biopsy specimens such as type1 autoimmune pancreatitis (IgG4-related AIP), compared with IgG4-related sialadenitis/dacryoadenitis (Mikulicz's disease) and IgG4-related kidney disease. Although the diagnostic criteria covering all IgG4-RD are hard to be established, combination with the CDC and organ-specific diagnostic criteria should improve sensitivity. PMID:22690221

Okazaki, Kazuichi; Umehara, Hisanori

2012-01-01

46

A suspected case of coronary periarteritis due to IgG4-related disease as a cause of ischemic heart disease.  

PubMed

IgG4-related disease (IgG4-RD) is a systemic inflammatory disease characterized by marked infiltration of IgG4-positive (+) plasma cells into affected organs, but the concept of this disease has only recently been established. Coronary vasculitis is a rare disease that can cause sudden death, and it has recently been reported that IgG4-RD may be associated with vasculitis, including periarteritis and coronary disease. In this paper we report an autopsy case of sudden death of a man in his thirties, in which coronary periarteritis with features of IgG4-related periarteritis was detected. IgG4-RD was suspected from the presence of the following histopathological features: (1) markedly thickened adventitia and marked infiltration of the adventitia and periarterial fat by lymphocytes and plasma cells; and (2) infiltration of IgG4-positive plasma cells (ratio of IgG4+ cells to IgG4+ cells of >40 %, 50 IgG4+ plasma cells per high-power field) on immunostaining. The etiology and pathophysiology of IgG4-RD and IgG4-related periarteritis are still unclear, and further investigation of these conditions and their association with coronary lesions is needed. Careful consideration should be given to the possible presence of IgG4-RD when forensic pathologists encounter cases of sudden death accompanied by coronary periarteritis. PMID:24337948

Inokuchi, Go; Hayakawa, Mutsumi; Kishimoto, Takashi; Makino, Yohsuke; Iwase, Hirotaro

2014-03-01

47

[Orbital apex syndrome due to relapse during steroid tapering in a patient with MPO-ANCA-positive IgG4-related hypertrophic pachymeningitis].  

PubMed

A 75-year-old man developed hearing loss and hoarseness; 5 months later, he suffered from headache and loss of appetite. A blood test showed an inflammatory reaction, a high level of serum IgG4 (254.0 mg/dl), and positive reaction for MPO-ANCA. Gadolinium enhanced T1 weighted head magnetic resonance imaging (MRI) revealed dural thickening with marked enhancement. Infiltration of lymphocytes and anti-IgG4-positive plasma cells were detected in the dura mater by meningeal biopsy; thus, he was diagnosed with MPO-ANCA-positive IgG4-related hypertrophic pachymeningitis. His clinical manifestations, and serologic and MRI findings improved with steroid treatment; however, they recurred during steroid tapering and he presented with right orbital apex syndrome. We then added an immunosuppressive drug to his regimen. It was difficult to reduce the symptoms of this case, with oral steroid monotherapy, and its combination with an immunosuppressive drug was necessary. PMID:24429649

Iwanami, Masaoki; Ogawa, Tomohiro; Tanaka, Yoshinori; Hyoudo, Akio; Ueda, Yoshihiko; Miyamoto, Tomoyuki

2014-01-01

48

Management of ocular, orbital, and adnexal trauma  

SciTech Connect

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.

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

1988-01-01

49

Extra ocular sebaceous adenocarcinoma in HIV-positive patient--case report.  

PubMed

Sebaceous adenocarcinoma is a rare adnexal tumor that can affect the skin and is divided into ocular, a more common form and extra ocular, of a rarer occurrence. We report the case of a patient diagnosed with Acquired Immune Deficiency Syndrome (AIDS) who developed an extra ocular, bulky and fast-growing sebaceous adenocarcinoma on the face. The literature has suggested that transplanted patients and HIV-positive patients have an excess risk for developing adnexal tumors, including sebaceous adenocarcinoma. PMID:24346870

Menezes, Carla Kellen da Silva; Gomes, Nathália Matos; Jalkh, Alex Panizza; Franco, Emily dos Santos; Martins, Thalita Gomes

2013-01-01

50

Orbital and adnexal tuberculosis: a case series from a South Indian population  

PubMed Central

Background Orbital tuberculosis (OTb) is rare and may be regarded as a manifestation of extrapulmonary tuberculosis. We report an interesting case series of six patients with varied presentations of orbital and adnexal tuberculosis in a South Indian patient population. Results A retrospective, interventional case series of six patients diagnosed with orbital and adnexal tuberculosis on the basis of clinical, radiological and histopathological evaluations between 2010 and 2013 was performed. Among the six patients with histopathologically proven OTb, five were women. The varied presentations included tubercular dacryoadenitis (two cases), classical periostitis (two cases), OTb with bone involvement (one case) and ocular adnexal tuberculosis (one case). Systemic involvement was seen in one case. All cases were treated with a regimen of antitubercular therapy (ATT). Conclusions OTb, though rare, should form a part of the differential diagnosis of orbital lesions in a high tuberculosis (TB) endemic country like ours. Biopsy still remains the mainstay of diagnosis. PMID:24940452

2014-01-01

51

[Ocular cysticercosis].  

PubMed

Ocular cysticercosis results from development of Taenia solium larvae, Cysticercus cellulosae, in the eye. This condition is observed all over the world but is particularly common in developing countries. The eye, like nervous system and muscle tissue, is a prime location for parasitic development because of its rich vascularization. Intraorbital cysticercosis accounts for 75 to 85% of cases and if untreated leads to blindness. Intravitreal involvement is the most common followed by subretinal involvement. Involvement of other structures such as the camera aqueosa, iris, and crystalline lens is rare. Diagnosis of intraocular cysticercosis is straightforward when cysticerci are visible. Immunologic testing of aqueous humor using ELISA, western-blot, or immunodetection of circulating antigens can be useful diagnostic techniques in patients with opacification of the eye. Involvement of the orbit, palpebra, conjunctiva, and lacrimal glands is observed in 20 to 25% of cases. Diagnosis of adnexal involvement is facilitated by ultrasonography and CT-scan. Drug therapy for ocular manifestations of cysticercosis is ineffective and hastens progression of the disease by exacerbating the inflammatory response. Surgical treatment is the only alternative. Significant progress has been made thanks to new microsurgical vitreal and retinal procedures but these techniques are often unavailable in developing countries. The severity of ocular cysticercosis and poor management facilities in developing countries underlines the need for prevention by sanitary measures and health education. PMID:10906978

Auzemery, A; Andriantsimahavandy, A; Esterre, P; Bouat, C; Boitte, J P; Huguet, P

1995-01-01

52

Assessment of adnexal masses using ultrasound: a practical review  

PubMed Central

Pelvic ultrasound is commonly used as part of the routine gynecologic exams, resulting in diagnosis of adnexal masses, the majority of which are functional or benign. However, due to the possible complications involving benign adnexal cysts (ie, adnexal torsion, pelvic pain) and the utmost importance of early diagnosis and treatment of ovarian cancer, the correct ultrasound diagnosis of adnexal masses is essential in clinical practice. This review will describe the typical ultrasound appearance of the common physiologic, benign, and malignant adnexal masses with the aim of aiding the clinician to reach the correct diagnosis.

Smorgick, Noam; Maymon, Ron

2014-01-01

53

Surgical Management of Adnexal Masses in Pregnancy  

PubMed Central

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

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

2014-01-01

54

Managing Adnexal Masses: A Medical Quandary  

PubMed Central

Introduction: Management of Adnexal masses poses a double edged problem. There is a dilemma of performing extensive surgery in the form of staging laparotomy for a benign disease on one hand and the lurking fear of missing the diagnosis of malignancy on the other. Thus, it seems that it is important to establish risk profiles of all patients with adnexal masses so that they can reap the benefit of minimally invasive surgery wherever possible and be rightly subjected to staging laparotomy where indicated. Material and Methods: This prospective study was carried out at a Tertiary care Hospital. 136 women with an adnexal mass on ultrasound which met the said criteria were enrolled into the study from January 2008 to July 2011. They were then taken up for laparoscopic management. Results: All but 2 cases were found to be benign (134/136) after the final histopathology report using the said criteria. Conclusion: Hence, by using simple readily available investigations like ultrasound (pattern recognition approach, Tumour morphology and ascites) and CA–125, the nature of adnexal mass can be reliably predicted and these patients can be safely offered the benefits of laparoscopic surgery. PMID:24179912

Mohan, Surender; Kapoor, Garima; Nagpal, Praveen Kumar; Aggarwal, Raju; Gami, Neha

2013-01-01

55

Application of Robotics in Adnexal Surgery  

PubMed Central

This review discusses in detail robotic tubal reanastomosis as one of the classic reproductive surgery procedures. Other applications of robotics in adnexal surgery are also reviewed, including adult and pediatric adnexectomy, resection of endometriosis, benign ovarian mass resection, early ovarian cancer resection and staging, ovarian transposition, and treatment of ovarian remnant syndrome and ovarian vein syndrome. PMID:23687555

Tusheva, Olga A; Gargiulo, Antonio R; Einarsson, Jon I

2013-01-01

56

Ocular inflammation in neurorheumatic disease.  

PubMed

Neuroimmunologic and systemic rheumatic diseases are frequently accompanied by inflammation of the eye, ocular adnexa, and orbital tissues. An understanding of the diverse forms of ophthalmic pathology in these conditions aids the clinician in making appropriate preventative, diagnostic, therapeutic, and prognostic decisions. In this review, the authors address ocular inflammation in neurorheumatic disease in three sections: first, they highlight current perspectives on immune mechanisms in the development of these disorders; next, they provide a framework for the recognition and evaluation of ophthalmologic inflammatory entities; finally, they discuss in detail several inflammatory conditions that affect the nervous system and the eye, emphasizing the features that should alert neurologists to initiate ophthalmologic evaluation. The conditions discussed include multiple sclerosis, neuromyelitis optica, chronic relapsing inflammatory optic neuropathy, Susac syndrome, Cogan syndrome, acute posterior multifocal placoid pigment epitheliopathy, Vogt-Koyanagi-Harada disease, Behçet disease, sarcoidosis, systemic lupus erythematosus, granulomatosis with polyangiitis (Wegener granulomatosis), polyarteritis nodosa, giant cell arteritis, IgG4-related disease, and Sjögren syndrome. PMID:25369440

Vodopivec, Ivana; Lobo, Ann-Marie; Prasad, Sashank

2014-09-01

57

Adnexal torsion: review of the literature.  

PubMed

Adnexal torsion is one of a few gynecologic surgical emergencies. Misdiagnosis or delay in treatment can have permanent sequelae including loss of an ovary with effect on future fertility, peritonitis, and even death. A PubMed search was performed between 1985 and 2012 for reviews, comparative studies, and case reports to provide a review of the epidemiology, risk factors, clinical presentation, common laboratory and imaging findings, and treatments of adnexal torsion. Common symptoms of torsion include pain, nausea, and vomiting, with associated abdominal or pelvic tenderness, and may differ in premenarchal and pregnant patients. Laboratory and imaging findings including ultrasound with Doppler analysis, computed tomography, and magnetic resonance imaging can assist in making the diagnosis but should not trump clinical judgment; normal Doppler flow can be observed in up to 60% of adnexal torsion cases. Treatment depends on the individual patient but commonly includes detorsion, even if the adnexae initially seem necrotic, with removal of any associated cysts or salpingo-oophorectomy, because recurrence rates are higher with detorsion alone or detorsion with only cyst aspiration. PMID:24126258

Sasaki, Kirsten J; Miller, Charles E

2014-01-01

58

Case Series of Skin Adnexal Tumours  

PubMed Central

Background: Skin adnexal tumours (SATs) are a large and diverse group of benign and malignant neoplasms. They are uncommon. They can be single or multiple, sporadic or familial and they might be markers for syndromes associated with internal malignancies. Benign adnexal tumours are more common and malignant SATs are rare and are locally aggressive and have the potential for nodal involvement and distant metastasis with a poor clinical outcome.Therefore recognition of SATs and establishing a diagnosis of malignancy in SATs is important for therapeutic and prognostic reasons. Aims and Objectives: SATs are rare benign and malignant neoplasms. They are not commonly encountered in the routine surgical pathology practice.Hence this study aims at finding the frequency, clinical presentation and the histopathological appearances of SATS, and the differentiating features between benign and malignant tumours. Materials and Methods: This is partly a retrospective and partly a prospective study done in a tertiary care hospital over a period of four years .All the SATs reported during this period are analysed for their clinical features, age, sex incidence and their gross and histopathological features. Results: In the four years period 1,64,220 patients attended the hospital. The total number of SATS reported during this period were 21 cases (0.0128 %) Benign tumours were 19 (90.48%). Malignant tumours were 2(9.52%) The mean age for males 36.9 years and for females 35. Two years. There were 11 male patients and 10 female patients. Tumours of hair follicular differentiation were 7 (33.33%). Tumour like lesion of sebaceous origin was 1 (4.76%). Tumours of sweat gland origin were 11 (52.38%). Malignant tumours of eccrine origin were 2 (9.52%). Conclusion: SATs are not common. Their incidence in our study is only 0.0128 % of all cases. Eventhough benign SATs are more common than the malignant tumours, malignant SATs can occur both in young and elderly patients and they are aggressive and the SATs should be excised with wide tumour free margins. PMID:25386438

Selvakumar, Sathish; Rajeswari, K.; Meenakshisundaram, K.; G, Veena; Ramachandran, Padmini

2014-01-01

59

Conservative laparoscopic management of adnexal torsion  

PubMed Central

Objective To evaluate our experience with adnexal torsion (AT) in 36 patients and the outcomes of the patients who were managed conservatively via laparoscopy. Material and Methods A prospective study was conducted on 36 patients who underwent operations for AT via laparoscopy between January 2008 and December 2009. Data including age, previous history, time of onset of symptoms, time of admission to hospital, gray-scale and color Doppler US findings, time interval between hospital admission and surgery, type of intervention, operative findings and postoperative gray-scale and Doppler US findings were recorded. Results In 29 (80.5%) patients, a preoperative diagnosis of AT was confirmed clinically. The mean age of the patients was 26.5, with a range of 11 to 44. Ovarian blood flow was assessed by color Doppler US ultrasonography in 30 patients preoperatively. In 11 (36.6%) patients, this was found to be normal. In 19 (63.3%) patients, ovarian blood flow was found to be pathological or absent. Laparoscopic conservative treatment was performed in 34 patients. In two patients, salpingo-oophorectomy was performed. No thromboembolic complications were seen. Postoperative ultrasonographic examinations confirmed normal ovarian morphology and Doppler blood flow in all patients with no recurrence. Conclusion Early diagnosis and treatment are key factors in managing AT. According to the results of the present study, given its demonstrated safety and benefits, in women of reproductive age, a conservative approach of untwisting the adnexa and salvaging the ovary via laparoscopy should be considered in AT cases in which the time from the onset of symptoms to surgery does not exceed 44 hours, regardless of the color and number of twists. PMID:24591949

Karayalc?n, Rana; Ozcan, Sarp; Ozyer, Sebnem; Var, Turgut; Yesilyurt, Huseyin; Dumanl?, Huseyin; Soysal, Sunullah; Mollamahmutoglu, Leyla; Bat?oglu, Sertac

2011-01-01

60

Clinical and Histological Profile of Surgically Managed Benign Adnexal Masses  

PubMed Central

Objective To study the clinical and histological nature of benign adnexal masses managed surgically. Methods A retrospective descriptive study in a teaching hospital in Oman of all the women who had surgical management of benign adnexal masses from January 2008 to May 2012. Data pertaining to age, parity, presenting symptoms, imaging and tumor markers performed and the surgical intervention done on those women with benign adnexal masses was collected from the electronic health records of the patients. Results There were 198 women during this period operated for benign adnexal masses. The most common benign neoplasm was mature teratoma of the ovary followed by endometriosis. Conservative surgery in the form of ovarian cystectomy was necessary in three fourths of women and in about just less than 50% of women, the procedure was completed laparoscopically. Conclusion The most common benign tumor was teratoma but laparoscopic approach, which is the standard of care in these women, was possible only in just about 50% of the women. PMID:24936279

Gowri, Vaidyanathan; Al Shukri, Maryam; Al Khaduri, Maha; Machado, Lovina

2014-01-01

61

Perineural cysts resembling complex cystic adnexal masses on transvaginal sonography.  

PubMed

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

Saboo, Sachin S; Di Salvo, Donald

2013-01-01

62

[Cutaneous adnexal and salivary gland tumours. Similarities and differences].  

PubMed

Despite major discrepancies in basic microscopic anatomy, remarkable similarities are manifest within the wide spectrum of cutaneous adnexal and salivary gland tumors. In this study salivary gland and adnexal tumors were identified and investigated with respect to similarities in histology, terminology and pathogenesis. Histological similarities of certain types of salivary gland tumors relate to eccrine, apocrine and rarely sebaceous (but not trichofollicular) types of adnexal tumors. The most striking similarity was found with salivary gland pleomorphic adenoma and cutaneous mixed tumor. Multistep carcinogenesis starting with intraductal carcinoma, identified in carcinoma ex pleomorphic adenoma is identical to that found in cutaneous carcinoma ex spiradenoma. Further histological and terminological similarities are shown for mucinous and mucoepidermoid carcinoma, for lymphadenoma and lymphoepithelial carcinoma, for sebaceous adenoma and carcinoma, for adenoid-cystic carcinoma, as well as for salivary gland basal cell adenoma versus cutaneous spiradenoma. Manifest diagnostic problems related to histologically similar salivary gland and adnexal tumors are rare and are topographically limited to the parotid and oral areas. PMID:25103327

Ihrler, S; Weiler, C; Eckert, F; Mollenhauer, M

2014-09-01

63

Solid carcinoma revisited: a possible variant of microcystic adnexal carcinoma.  

PubMed

: Primary malignant apocrine and eccrine skin neoplasms are rare and their nosology is still evolving. First described in 1997, solid carcinoma is now considered a discrete entity by some, although this remains controversial. Apocrine differentiation was postulated. A single case since then was the first to include immunohistochemistry findings. The authors report an additional case of solid carcinoma, together with its immunohistochemical profile. A 63-year-old man presented with a firm nodule 3 cm in diameter on the posterior scalp. On punch biopsy, the lesion was interpreted as an adnexal neoplasm of indeterminate malignant potential. The subsequently excised tumor was initially interpreted as microcystic adnexal carcinoma with perineural invasion involving the surgical margins. Re-excision yielded clear surgical margins. After review of all the histologic material, a final diagnosis of solid carcinoma was rendered. Histologically, innumerable solid aggregations of neoplastic epithelial cells filled the dermis and extended into the subcutis. The aggregations varied in size and ranged from round or ovoid nests to elongated columns or cords embedded within a fibrotic stroma. The neoplastic cells were round and uniform in size with small nuclei and pale or clear cytoplasm. Tubular structures and mitoses were absent. Solid carcinoma is a rare skin neoplasm. Histologically, it closely resembles and may be indistinguishable from the solid areas of microcystic adnexal carcinoma. Biologically, solid carcinoma, like microcystic adnexal carcinoma, is an indolent but relentless locally destructive neoplasm that must be removed completely. The clinical, histologic, and biologic similarities suggest that solid carcinoma may be a variant of microcystic adnexal carcinoma. PMID:25343214

Lai, Jonathan H; Limacher, James J; Richards, Robert N

2014-11-01

64

[Ocular trauma. Blunt ocular trauma].  

PubMed

Ocular traumas represent a major public health problem with poorly understood ramifications at both the individual and community levels. Any of the ocular structures can be damaged in the case of closed globe injury. These lesions, often multiple, may appear immediately or in a delayed fashion. Classifications have been developed recently in order to better inform the patient of the visual prognosis. However, significant efforts are still needed, on the one hand, to assess and develop new therapies, and on the other hand, to implement effective policies to prevent ocular trauma. PMID:22463853

Saleh, M

2012-06-01

65

[Ocular syphilis].  

PubMed

Syphilis is a sexually transmitted disease caused by Treponema pallidum. Previously known as the "great imitator", this disease can have numerous and complex manifestations. The ophthalmologist should suspect the diagnosis in patients with uveitis or optic neuropathy and high-risk sexual behavior and/or another sexually transmitted disease (such as HIV) or those presenting with posterior placoid chorioretinitis or necrotising retinitis. Ocular involvement in acquired syphilis is rare, tending to occur during the secondary and tertiary stages of the disease. Syphilis may affect all the structures of the eye, but uveitis (accounting for 1-5% of the uveitis in a tertiary referral center) is the most common ocular finding. Granulomatous or non-granulomatous iridocyclitis (71%), panuveitis, posterior uveitis (8%) and keratouveitis (8%) are often described. In the secondary stage, the meninges and the central nervous system can be affected, sometimes with no symptoms, which justifies performing lumbar puncture in patients with uveitis and/or optic neuropathy. The diagnosis of ocular syphilis requires screening with a non-treponemal serology and confirmation with a treponemal-specific test. Parenterally administered penicillin G is considered first-line therapy for all stages of ocular syphilis. Systemic corticosteroids are an appropriate adjunct treatment for posterior uveitis, scleritis and optic neuritis if ocular inflammation is severe. Prolonged follow-up is necessary because of the possibility of relapse of the disease. With proper diagnosis and prompt antibiotic treatment, the majority of cases of ocular syphilis can be cured. PMID:24655791

Chiquet, C; Khayi, H; Puech, C; Tonini, M; Pavese, P; Aptel, F; Romanet, J-P

2014-04-01

66

Management and outcome of pregnancies complicated with adnexal masses.  

PubMed

Our purpose was to evaluate the pathologic features and outcome of pregnancies that were complicated with adnexal masses and were managed surgically. A review of patients who had persistent adnexal masses during pregnancy and needed surgical removal of tumours was performed from January 1998 to April 2001. There were 14 cases of persistent adnexal masses identified among 2000 deliveries. There were 13 patients who had surgical interventions: nine (69.2%) had surgery during ongoing pregnancy (at mean gestational age 17+/-3.7 weeks), two (15.3%) with caesarean section, one (7.6%) after evacuation of missed abortion and one (7.5%) after delivery. Out of 13, ten (76.9%) were benign [mature cystic teratoma, six (46.9%); serous cyst adenoma, two (15.3%); mucinous cyst adenoma, one (7.6%); paratubal cyst, one (7.6%)] and three (23%) were malignant (one immature teratoma, one papillary cyst adenocarcinoma and one krukenberg tumour]. Both patients operated on after 24 weeks had pre-term delivery. The worst outcome in the form of PPROM and preterm delivery at 28 weeks occurred in a patient who underwent emergency surgery. The incidence of malignancy was four- to fivefold greater in our series than reported in the literature. Ultrasound was unable to distinguish malignant cases. Pregnancy outcome was poorer if surgical intervention was done after >24 weeks and that, too, was done as emergency surgery. PMID:12580154

Agarwal, Nutun; Parul; Kriplani, Alka; Bhatla, Neerja; Gupta, Anjali

2003-01-01

67

Skin adnexal neoplasms--part 1: An approach to tumours of the pilosebaceous unit  

PubMed Central

Skin adnexal neoplasms comprise a wide spectrum of benign and malignant tumours that exhibit morphological differentiation towards one or more types of adnexal structures found in normal skin. Most adnexal neoplasms are relatively uncommonly encountered in routine practice, and pathologists can recognise a limited number of frequently encountered tumours. In this review, the first of two, the normal histology of the skin adnexal structures is reviewed, and the histological features of selected but important benign and malignant tumours and tumour?like lesions of pilosebaceous origin discussed, with emphasis on the diagnostic approach and pitfalls in histological diagnosis. PMID:16882696

Alsaad, K O; Obaidat, N A; Ghazarian, D

2007-01-01

68

Optical coherence tomography imaging of ocular and periocular tumours  

PubMed Central

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

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

2014-01-01

69

Ocular phototherapy  

PubMed Central

Phototherapy can be translated to mean ‘light or radiant energy-induced treatment.' Lasers have become the exclusive source of light or radiant energy for all applications of phototherapy. Depending on the wavelength, intensity, and duration of exposure, tissues can either absorb the energy (photocoagulation, thermotherapy, and photodynamic therapy (PDT)) or undergo ionization (photodisruption). For phototherapy to be effective, the energy has to be absorbed by tissues or more specifically by naturally occurring pigment (xanthophyll, haemoglobin, and melanin) within them. In tissues or tumours that lack natural pigment, dyes (verteporphin, Visudyne) with narrow absorption spectrum can be injected intravenously that act as focal absorbent of laser energy after they have preferentially localized within the tumour. Ocular phototherapy has broad applications in treatment of ocular tumours. Laser photocoagulation, thermotherapy, and PDT can be delivered with low rates of complications and with ease in the outpatient setting. Review of the current literature suggests excellent results when these treatments are applied for benign tumours, particularly for vascular tumours such as circumscribed choroidal haemangioma. For primary malignant tumours, such as choroidal melanoma, thermotherapy, and PDT do not offer local tumour control rates that are equivalent or higher than those achieved with plaque or proton radiation therapy. However, for secondary malignant tumours (choroidal metastases), thermotherapy and PDT can be applied as a palliative treatment. Greater experience is necessary to fully comprehend risks, comparative benefits, and complication of ocular phototherapy of ocular tumours. PMID:23238445

Singh, A D

2013-01-01

70

Autoamputation of the fallopian tube after chronic adnexal torsion.  

PubMed

Autoamputation of the adnexa, although very rare, can either be congenital or acquired. For affected women it can have future fertility implications. Although in some women it is asymptomatic, in most cases a history of acute followed by chronic pelvic pain can be elicited. This is a case of autoamputation of a fallopian tube after chronic adnexal torsion. We suggest that all patients of reproductive age with acute lower abdominal pain should have a pelvic ultrasound scan and, if symptoms persist, early recourse to laparoscopy. Misdiagnosis can lead to ovarian damage, loss of tubal function, infertility, or chronic pelvic pain. PMID:19249713

Sankaran, Sridevi; Shahid, Anupama; Odejinmi, F

2009-01-01

71

Laparoendoscopic single-site surgery for management of adnexal masses in pregnancy: case series.  

PubMed

The incidence of adnexal masses in pregnancy is estimated to be 1% to 4%. In select cases, surgical intervention is required. Recent studies have demonstrated that laparoscopy during pregnancy is safe and confers many advantages over laparotomy. Herein we present a series of nine cases collected prospectively that demonstrate the feasibility, safety, and putative benefits of laparoendoscopic single-site surgery for treatment of adnexal masses in pregnant women. PMID:24034540

Scheib, Stacey A; Jones, Howard H; Boruta, David M; Simpson, Khara; Bedaiwy, Mohamed; Grumbine, Francis C; Fader, Amanda N

2013-01-01

72

A quality improvement initiative to reduce unnecessary follow-up imaging for adnexal lesions.  

PubMed

Our objective was to improve the quality of pelvic ultrasound reports and decrease the number of physiologic and benign adnexal lesions unnecessarily referred for follow-up. We performed a prospective cohort study of 2 quality improvement interventions: academic detailing with education for the ultrasound radiologists and sonographers, and implementation of a national consensus guideline on adnexal cysts. Our primary quality outcome measure was the proportion of pelvic ultrasound exams in which follow-up was recommended for an adnexal lesion. Baseline data collection in January 2006 identified 252 pelvic ultrasound exams, of which 58 (23%) reported an adnexal lesion and 31 (12%) recommended follow-up. Retrospective review revealed that 17 of 31 (55%) reported adnexal lesions with follow-up recommended were physiologic or benign. After intervention 1, 59 of 214 (28%) pelvic ultrasound exams from January 2008 reported an adnexal lesion, with 18 (8%) recommending follow-up. After intervention 2, 64 of 296 (22%) pelvic ultrasound exams from January 2011 reported an adnexal lesion, with 16 (5%) recommending follow-up. Follow-up recommendations decreased 58% (12% versus 5%, P = .004), with significant increase in the proportion characterized as physiologic or benign (P = .001). Through a quality initiative aimed at appropriate description and follow-up recommendations for adnexal cystic lesions identified at ultrasound, we effectively reduced unnecessary imaging referrals. We conclude that: (1) acceptance of an expert consensus guideline was important to add credibility, (2) accessible image-rich charts are invaluable tools at point of use, and (3) elimination of some unnecessary imaging is under the control of the radiologist. PMID:24139962

Hui, Jamie S; Kramer, Dawna J; Blackmore, C Craig; Hashimoto, Beverly E; Coy, David L

2014-04-01

73

Ocular pentastomiasis in the Democratic Republic of the Congo.  

PubMed

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

Sulyok, Mihály; Rózsa, Lajos; Bodó, Imre; Tappe, Dennis; Hardi, Richard

2014-07-01

74

Ocular Pentastomiasis in the Democratic Republic of the Congo  

PubMed Central

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

Sulyok, Mihaly; Rozsa, Lajos; Bodo, Imre

2014-01-01

75

Adnexal Torsion in Pregnancy after Assisted Reproduction - Case Study and Review of the Literature  

PubMed Central

Purpose: Aim of the study was to investigate the incidence, progress, management and outcome of adnexal torsion after controlled ovarian hyperstimulation in embryo transfer cycles. Materials and Method: A retrospective analysis was done of 1007 patients of a private IVF centre. The literature on adnexal torsion is reviewed. Results: In the literature, the incidence of adnexal torsion after assisted reproductive technologies (ART) is given as around 0.2?%. A significant increase of up to 33?% has been reported for cases with additional ovarian hyperstimulation syndrome (OHSS) and in pregnant women. In our retrospective analysis of 1007 women (incidence 0.46?%) with 1411 fresh embryo transfer cycles, we found an incidence of 0.35?% per embryo transfer. All adnexal torsions were treated by laparoscopic derotation to preserve fertility. All 5 cases with torsion were pregnant, 2 patients had mild OHSS. We recorded 3 term deliveries, 1 induced abortion for sirenomelia, and 1 missed abortion. Conclusion: Adnexal torsion must be kept in mind after hyperstimulation and embryo transfer, especially when pregnancy or OHSS is also present. With early diagnosis, it should be possible to preserve fertility using laparoscopic derotation. PMID:25258463

Spitzer, D.; Wirleitner, B.; Steiner, H.; Zech, N. H.

2012-01-01

76

What Is Ocular Rosacea?  

MedlinePLUS

... later see rosacea begin on their skin. Ocular rosacea . When rosacea affects the eyes, you often see ... in the eye and on the eyelid. Ocular rosacea . Some people develop inflamed cysts (styes) on their ...

77

IgG4- related disease: an orphan disease with many faces  

PubMed Central

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

2014-01-01

78

A new clinicopathological entity of IgG4-related autoimmune disease  

Microsoft Academic Search

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-

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

2003-01-01

79

[Adnexal torsion during puerperium as a complication of delayed surgical treatment of ovarian tumor in pregnancy].  

PubMed

Ovarian tumors in pregnancy represent a significant issue both in terms of diagnostics and therapy. Increased use of the ultrasound in pregnancy in the last several decades has contributed to the rise in the number of diagnosed asymptomatic adnexal tumors with pregnant women. We present a case of a patient treated in our clinic for asymptomatic ovarian tumor, which was diagnosed in pregnancy. The patient underwent check-ups every four weeks, comprising clinical and sonographical examinations and relevant laboratory and tumor marker tests. The course of pregnancy was normal, with no detected tumor growth and with the tumor marker levels within the reference range. Following an uneventful delivery, she developed abdominal pains during the puerperium, and the adnexal torsion was diagnosed intraoperatively. The attitudes to treating of adnexal tumors in pregnancy are controversial, and there exist no defined treatment protocols. It is, therefore, necessary to make an individual evaluation of each case, and the relevant decisions should be made with the pregnant woman's informed consent. The adnexal torsion in the presented case can be explained by the size of the tumor as well as the progressive reduction of the size of the uterus due to the physical involution during puerperium. PMID:22924317

Spari?, Radmila; Buzadzi?, Snezana; Argirovi?, Rajka; Opali?, Jasna

2012-01-01

80

Imaging techniques for the pre-surgical diagnosis of adnexal tumours.  

PubMed

A correct diagnosis of any adnexal mass is essential to triage women to appropriate treatment pathways. Several imaging techniques are available that may be used to provide an assessment of a mass before treatment, such as transvaginal ultrasonography, magnetic resonance imaging, computed tomography, and positron emission tomography combined with computed tomography. In this chapter, we focus in depth on the role of transvaginal ultrasonography, as current evidence suggests it is the most appropriate initial imaging investigation to identify and characterise any mass if present in women suspected of having adnexal pathology. Subjective assessment by an experienced ultrasound examiner is the optimal approach to diagnose masses, followed by risk models and rules developed by the International Ovarian Tumor Analysis study. A group of tumours has proven difficult to classify with transvaginal ultrasound, and remain a diagnostic challenge for which accurate second-stage tests would be of value. Some studies suggest that magnetic resonance imaging (MRI), compared with other imaging modalities, may play a role in the assessment of this cohort of 'difficult to classify' adnexal masses. These studies, however, did not report quality of transvaginal ultrasonography (i.e. experience level of the examiner) and lacked uniformity in describing the criteria used to define such 'difficult' masses. On the basis of standardised terminology developed by the International Ovarian Tumor Analysis study to describe adnexal masses, as well as prediction models and rules developed in the course of the study, we propose new criteria that we can use to clearly define complex or 'difficult to classify' adnexal masses to focus the role for second-line imaging tests, such as conventional magnetic resonance imaging combined with dynamic contrast-enhanced or diffusion-weighted sequences on masses where further tests other than ultrasonography would be of value. PMID:24780415

Kaijser, Jeroen; Vandecaveye, Vincent; Deroose, Christophe M; Rockall, Andrea; Thomassin-Naggara, Isabelle; Bourne, Tom; Timmerman, Dirk

2014-07-01

81

Ocular paintball injuries.  

PubMed

Paintball sport-related ocular injuries represent an increasing problem as the popularity of the sport increases and the number of participants grows. Although eye protective devices designed specifically for paintball sports are extremely effective in preventing such injuries, the failure to properly wear these devices has resulted in an alarming number of severe ocular injuries. Recent trends have indicated that an increasing percentage of paintball sport-related ocular injuries have occurred in unsupervised, noncommercial settings (i.e., backyard games) where the use of eye protective devices is not required. Paintball industry standards for eye protection have recently been developed and should be implemented for all participants. PMID:11389344

Fineman, M S

2001-06-01

82

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

PubMed Central

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

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

2009-01-01

83

Custom-made ocular prosthesis  

PubMed Central

An ocular defect may affect a patient psychologically. An ocular prosthesis is given to uplift the patient psychologically and improve the confidence. Ocular prosthesis can be custom made or a stock shell. To improve the comfort and matching of the prosthesis with that of the adjacent natural eye an custom made ocular prosthesis is preferred. Different techniques are available to fabricate a custom ocular prosthesis, here we have used paper iris disk technique. PMID:23066246

Gunaseelaraj, Rajkumar; Karthikeyan, Suma; Kumar, Mohan N.; Balamurugan, T.; Jagadeeshwaran, A. R.

2012-01-01

84

Challenging ocular image recognition  

NASA Astrophysics Data System (ADS)

Ocular recognition is a new area of biometric investigation targeted at overcoming the limitations of iris recognition performance in the presence of non-ideal data. There are several advantages for increasing the area beyond the iris, yet there are also key issues that must be addressed such as size of the ocular region, factors affecting performance, and appropriate corpora to study these factors in isolation. In this paper, we explore and identify some of these issues with the goal of better defining parameters for ocular recognition. An empirical study is performed where iris recognition methods are contrasted with texture and point operators on existing iris and face datasets. The experimental results show a dramatic recognition performance gain when additional features are considered in the presence of poor quality iris data, offering strong evidence for extending interest beyond the iris. The experiments also highlight the need for the direct collection of additional ocular imagery.

Pauca, V. Paúl; Forkin, Michael; Xu, Xiao; Plemmons, Robert; Ross, Arun A.

2011-06-01

85

Glycobiology of ocular angiogenesis.  

PubMed

Ocular neovascularization can affect almost all the tissues of the eye: the cornea, the iris, the retina, and the choroid. Pathological neovascularization is the underlying cause of vision loss in common ocular conditions such as diabetic retinopathy, retinopathy of prematurity and age-related macular neovascularization. Glycosylation is the most common covalent posttranslational modification of proteins in mammalian cells. A growing body of evidence demonstrates that glycosylation influences the process of angiogenesis and impacts activation, proliferation, and migration of endothelial cells as well as the interaction of angiogenic endothelial cells with other cell types necessary to form blood vessels. Recent studies have provided evidence that members of the galectin class of ?-galactoside-binding proteins modulate angiogenesis by novel carbohydrate-based recognition systems involving interactions between glycans of angiogenic cell surface receptors and galectins. This review discusses the significance of glycosylation and the role of galectins in the pathogenesis of ocular neovascularization. PMID:25108228

Markowska, Anna I; Cao, Zhiyi; Panjwani, Noorjahan

2014-12-01

86

Clinical, surgical and pathologic findings of adnexal torsion in pregnant and nonpregnant women.  

PubMed

A series of 101 patients with adnexal torsion during a 12 year period are reviewed. Twenty patients were pregnant at the time of diagnosis and underwent surgical treatment. Preoperatively, the correct diagnosis was not established in four pregnant patients and in 30 nonpregnant patients. An operation was usually delayed for more than 24 hours. Unwinding of the twisted adnexa, regardless of its appearance, was the main surgical procedure in both groups. The outcome of the pregnancies was favorable. The main histopathologic findings in both groups were cysts of the follicular or corpora lutea. PMID:1948585

Bider, D; Mashiach, S; Dulitzky, M; Kokia, E; Lipitz, S; Ben-Rafael, Z

1991-11-01

87

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

PubMed Central

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

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

2014-01-01

88

Pattern of ocular trauma.  

PubMed

This prospective observational study was conducted in the department of Ophthalmology Mymensingh Medical College Hospital during the period of November, 2009 to October, 2010. Two hundred & fifty (250) patients of both sexes and all ages with ocular trauma were selected randomly for this study. A detailed history of patients, duration of trauma, relation of trauma with work, visual status prior to injury, any surgery prior to injury & patients were alcoholic or not were taken. Male patients were 190(76%) and female patients were 60(24%). Majority of patients were 11-20 years group (39.2%). Most of patients (40%) attended into hospital within 60 hours of ocular trauma. Accidental occupational trauma were more common (51.2%) and assault injury were less common (12.8%). Greater number of ocular trauma was caused by sharp objects (59.2%) and less number of ocular trauma was caused by chemical injuries (2.4%). Open globe injuries were more common (62%) than closed globe injury (38%). Visual acuity on admission between 6/60 to PL comprises highest number (64%) and also on discharge between 6/60 to PL comprises highest number of cases (50%). Most of the patients came from poor socioeconomic group (60%). PMID:21804497

Hossain, M M; Mohiuddin, A A; Akhanda, A H; Hossain, M I; Islam, M F; Akonjee, A R; Ali, M

2011-07-01

89

Ocular pharmacokinetics of tobramycin  

Microsoft Academic Search

The ocular pharmacokinetics of tobramycin were studied in human and rabbit eyes following topical and subconjunctival administration in humans and following intravitreal administration in rabbit eyes. Each aqueous and vitreous sample was analysed by radioimmunoassay and microbiological assay. Topical instillation of 0.3% eyedrops by a loading dose schedule provided rapid penetration of the drug into the aqueous humour with a

Sanjiv Desai; Rupal Gajjar

1993-01-01

90

Epigenetics in ocular diseases.  

PubMed

Epigenetics pertains to heritable alterations in gene expression that do not involve modification of the underlying genomic DNA sequence. Historically, the study of epigenetic mechanisms has focused on DNA methylation and histone modifications, but the concept of epigenetics has been more recently extended to include microRNAs as well. Epigenetic patterning is modified by environmental exposures and may be a mechanistic link between environmental risk factors and the development of disease. Epigenetic dysregulation has been associated with a variety of human diseases, including cancer, neurological disorders, and autoimmune diseases. In this review, we consider the role of epigenetics in common ocular diseases, with a particular focus on DNA methylation and microRNAs. DNA methylation is a critical regulator of gene expression in the eye and is necessary for the proper development and postmitotic survival of retinal neurons. Aberrant methylation patterns have been associated with age-related macular degeneration, susceptibility to oxidative stress, cataract, pterygium, and retinoblastoma. Changes in histone modifications have also been observed in experimental models of diabetic retinopathy and glaucoma. The expression levels of specific microRNAs have also been found to be altered in the context of ocular inflammation, retinal degeneration, pathological angiogenesis, diabetic retinopathy, and ocular neoplasms. Although the complete spectrum of epigenetic modifications remains to be more fully explored, it is clear that epigenetic dysregulation is an important contributor to common ocular diseases and may be a relevant therapeutic target. PMID:24179439

Liu, Melissa M; Chan, Chi-Chao; Tuo, Jingsheng

2013-05-01

91

Ocular allergic disease.  

PubMed

Ocular allergy is a common condition that usually affects the conjunctiva of the eye and is therefore often referred to as allergic conjunctivitis. The severity of the disease can range from mild itching and redness, as seen in seasonal allergic conjunctivitis, to the more serious vision threatening forms of ocular allergy which affect the cornea, such as atopic keratoconjunctivitis. The pathogenesis of allergic conjunctivitis involves a complex mechanism which centers around IgE-mediated mast cell degranulation and release of multiple preformed and newly formed inflammatory mediators. The diagnosis of allergic conjunctivitis is usually a clinical one which can be made based on a thorough history and careful examination. Treatment of ocular allergy should begin with conservative measures including allergen avoidance, environmental control, ocular irrigation and cold compresses. Pharmacotherapy of allergic conjunctivitis consists of several classes of drugs. Antihistamines are widely used to treat mild conditions such as seasonal and perennial conjunctivitis and potent new agents such as levocabastine and emedastine are now available. Mast cell stabilizers such as sodium cromoglycate are both safe and effective and are commonly used in ocular allergy. More effective mast cell stabilizers such as nedocromil, lodoxamide and olopatadine are now being used. Nonsteroidal antiinflammatory drugs have demonstrated only limited efficacy and, as such, are not widely used. Topical steroids are very effective in treating signs and symptoms but are reserved for only refractory cases due to their serious side effects. Loteprednol and rimexelone are newer corticosteroids which reportedly have less of an effect on intraocular pressure. Cyclosporine has recently been shown to be highly effective in cases of vernal keratoconjunctivitis and atopic keratoconjunctivitis while producing no adverse effects. PMID:14743264

Bhargava, A; Jackson, W B; El-Defrawy, S R

1998-11-01

92

Primary lymphoepithelioma-like carcinoma of ocular adnexa: clinicopathologic features and treatment  

PubMed Central

Background and Methods Lymphoepithelioma-like carcinoma (lelc) is a rare malignancy in ocular adnexa. Here, we report 4 patients with lelc and review 11 patients reported in the literature. Clinical profiles, association with Epstein–Barr virus (ebv), treatment, and outcomes are analyzed. Results Lacrimal glands and the lacrimal drainage system, eyelid, and conjunctiva are potential primary sites for lelc. The tumours are characterized histologically by nests of undifferentiated malignant cells surrounded by lymphoid infiltrates. Infection with ebv was confirmed in lelc of ocular adnexa, and that association seemed to be restricted to Asian populations. Results from our centre uniformly showed expression of ebv-encoded small rnas in primary tumour, locally recurrent tumour, and metastatic lymph nodes. This disease had a tendency to relapse regionally. Postoperative radiotherapy seems to improve disease-free survival. Tumours appear to be sensitive to radiotherapy and chemotherapy based on cisplatin and 5-fluorouracil. At our centre, 3 patients were still living at 22, 33, and 76 months after surgery. One patient died of distant metastasis after a survival of 38 months. Conclusions Lymphoepithelioma-like carcinoma is a heterogenous entity among ocular adnexal malignancies. Multimodality treatment provides a better chance at survival. Further investigation is required to achieve a better understanding of the biologic behavior of this entity and of its optimal treatment. PMID:23559878

Qiu, B.; Lin, Y.B.; Cai, Q.Q.; Hu, Y.M.; Wang, D.F.; Lin, Z.D.; Liang, Y.

2013-01-01

93

Ocular trauma in children.  

PubMed

1. The frequency of eye injuries in children is high. The frequency and severity of at least 90% of these injuries, however, could be prevented. 2. Toys, especially bicycles and BB guns, are a major source of eye injury. Another major cause of ocular trauma is sports-related injuries. 3. Ophthalmic professionals should emphasize the role of spectacles as a protective device for children and advise parents of the advantages of polycarbonate spectacles. PMID:7966381

Kutschke, P J

1994-01-01

94

Case of an appendiceal mucinous adenocarcinoma presenting as a left adnexal mass?  

PubMed Central

INTRODUCTION Appendiceal mucinous neoplasms represent an exceptionally rare form of pathology with an incidence rate ranging between 0.2 and 0.3% of all appendectomies.1,2 The most common presentation is right lower quadrant pain with a palpable abdominal mass present in 50% of cases.8–12 Patients may also present with nausea, vomiting, change in bowel habits, weight loss, appendicitis, intestinal obstruction, ureteral compression, or lower gastrointestinal bleeding. Early diagnosis and proper surgical precautions must be implemented to prevent iatrogenic rupture of the appendix and the widespread seeding of potentially malignant mucin-producing cells throughout the peritoneal cavity. PRESENTATION OF CASE A 50-year-old African-American female presented with complaints of left-sided pelvic pain. Pelvic examination revealed adnexal fullness with thickening behind the cervix. An adnexal mass was revealed on ultrasound and MRI. The patient was subsequently taken to the operating room for a planned robotic salpingectomy. During the procedure, she was unexpectedly found to have an abnormally large appendix displaced to the left lower quadrant. General surgery was consulted intra-operatively to perform an appendectomy. The final pathology report revealed a low-grade mucinous adenocarcinoma with mucin dissecting into the wall of the appendix. DISCUSSION Appendiceal mucinous cystadenomas are characterized by hyperplasia of glandular epithelium along with hypersecretion of mucous resulting in a grossly dilated appendix. The clinical manifestation of appendiceal mucoceles is often non-specific. The prevalence is higher in women than men (4:1) with the average age at the time of diagnosis being 54 years-old.14–17 Appendiceal mucinous cystadenomas can be particularly problematic for women as these tumors are commonly misdiagnosed pre-operatively as right-sided adnexal masses due to commonalities in clinical presentation and diagnostic findings.8–12 It is estimated that based on imaging studies only 15–29% of appendiceal mucinous cystadenomas are correctly diagnosed prior to surgical intervention.13 CONCLUSION To the best of our knowledge, only one other case of appendiceal adenocarcinoma with left-sided presentation has been reported. Appendiceal carcinomas can create a diagnostic dilemma due to non-specific clinical findings and inadequate imaging studies. Early recognition and careful intra-operative precautions must be taken to maintain the integrity of the appendix to prevent iatrogenic rupture and the spread of potentially malignant mucin-producing cells throughout the peritoneal cavity. PMID:24568943

Hajiran, A.; Baker, K.; Jain, P.; Hashmi, M.

2013-01-01

95

Recent advances in the concept and diagnosis of autoimmune pancreatitis and IgG4-related disease  

Microsoft Academic Search

Recent studies have suggested the existence of two subtypes of autoimmune pancreatitis (AIP): type 1 AIP, related to IgG4\\u000a (lymphoplasmacytic sclerosing pancreatitis); and type 2 AIP, related to a granulocytic epithelial lesion (idiopathic duct-centric\\u000a chronic pancreatitis). Compared with type 2 AIP, the clinicopathological features of type 1 AIP, with increased serum IgG4\\/IgE\\u000a levels, abundant infiltration of IgG4 + plasmacytes and lymphocytes, autoantibodies,

Kazuichi Okazaki; Kazushige Uchida; Masanori Koyabu; Hideaki Miyoshi; Makoto Takaoka

2011-01-01

96

Reverse masquerade syndrome: Fungal adnexal infection mimicking carcinoma in a HIV-positive patient  

PubMed Central

A known HIV-positive male patient presented with a rapidly progressive ulcerative lesion involving the conjunctiva, lids, and anterior orbit along with a decrease in vision in the right eye. He was on anti retro-viral and anti-tubercular therapy. In view of the clinical features, our provisional clinical diagnosis was a malignant lesion of the eyelid with orbital involvement, possibly squamous cell carcinoma. However, incisional biopsy revealed absence of malignant cells. On Gomori Methenamine Silver staining, plenty of fungal filaments were seen, which was confirmed by culture as Candida albicans. Hence, it turned out to be a case of fungal adnexal infection mimicking carcinoma in a HIV-positive patient. The patient responded well to systemic anti-fungals. PMID:24104715

Mukherjee, Bipasha; Chatterjee, Raka; Biswas, Jyotirmay

2013-01-01

97

Peritoneal mesotheliomas mimicking adnexal tumors. Clinicopathological characteristics of four cases and a short literature review.  

PubMed

Three cases of peritoneal benign cystic mesotheliomas in women 32-34 years of age and one case of peritoneal malignant mesothelioma in a 47-year-old woman are reported. All cases presented with abdominal discomfort and/or pain and the physical and radiological diagnostic methods showed adnexal tumors. The cystic mesotheliomas developed in the cul-de-sac and the right pelvic sidewall, presented as multiple small cysts or large multilocular cystic mass. The malignant mesothelioma showed extensive infiltration of the omentum the intestinal loops and the surface of the uterus and adnexa, with bilateral hydrosalpinx and ascites. All cases presented histological and immunohistochemical characteristics consistent with tumors of mesothelial origin. No history of asbestos exposure was reported. The correct diagnostic and therapeutic approaches to these neoplasms are discussed. PMID:22439416

Dellaportas, D; Kairi-Vassilatou, E; Lykoudis, P; Mavrigiannaki, P; Mellou, S; Kleanthis, C K; Kondi-Pafiti, A

2012-01-01

98

Wilkie's Syndrome and Left Adnexal Mass: Unusual Presentation of Duodenal Adenocarcinoma.  

PubMed

Duodenal adenocarcinoma (DACa) is a rare malignancy, the presenting symptoms of which are vague and nonspecific. We report the case of a patient presenting with symptoms of subacute small bowel obstruction whose CT scan revealed i) left adnexal mass and ii) compression of 3(rd) portion of duodenum with reduced aortomesentric angle consistent with Wilkie's syndrome (WS). Laparatomy in addition revealed a distal duodenal stricture, which showed a well differentiated DACa causing subtotal intestinal obstruction. The ovarian mass revealed adenocarcinoma with similar morphology. Immunophenotypic analysis revealed positive expression of CK 20 and CDX 2 and absence of CK 7 staining in the tumours consistent with Primary DACa with ovarian metastasis. We further concluded that the WS resulted from reduced mesenteric fat pad caused by DACa induced cachexia. The case highlights the elusive nature of duodenal malignancy and emphasises the importance of meticulous small bowel examination during exploration of ovarian masses. PMID:25302201

Devadass, Clement Wilfred; Okaly, Geetha V Patil; Hm, Sudha; Pai, Sreekar Agumbe; Sridher, H

2014-08-01

99

Wilkie's Syndrome and Left Adnexal Mass: Unusual Presentation of Duodenal Adenocarcinoma  

PubMed Central

Duodenal adenocarcinoma (DACa) is a rare malignancy, the presenting symptoms of which are vague and nonspecific. We report the case of a patient presenting with symptoms of subacute small bowel obstruction whose CT scan revealed i) left adnexal mass and ii) compression of 3rd portion of duodenum with reduced aortomesentric angle consistent with Wilkie’s syndrome (WS). Laparatomy in addition revealed a distal duodenal stricture, which showed a well differentiated DACa causing subtotal intestinal obstruction. The ovarian mass revealed adenocarcinoma with similar morphology. Immunophenotypic analysis revealed positive expression of CK 20 and CDX 2 and absence of CK 7 staining in the tumours consistent with Primary DACa with ovarian metastasis. We further concluded that the WS resulted from reduced mesenteric fat pad caused by DACa induced cachexia. The case highlights the elusive nature of duodenal malignancy and emphasises the importance of meticulous small bowel examination during exploration of ovarian masses. PMID:25302201

Okaly, Geetha V Patil; HM, Sudha; Pai, Sreekar Agumbe; Sridher, H.

2014-01-01

100

MRI in ocular drug delivery  

PubMed Central

Conventional pharmacokinetic methods for studying ocular drug delivery are invasive and cannot be conveniently applied to humans. The advancement of MRI technology has provided new opportunities in ocular drug-delivery research. MRI provides a means to non-invasively and continuously monitor ocular drug-delivery systems with a contrast agent or compound labeled with a contrast agent. It is a useful technique in pharmacokinetic studies, evaluation of drug-delivery methods, and drug-delivery device testing. Although the current status of the technology presents some major challenges to pharmaceutical research using MRI, it has a lot of potential. In the past decade, MRI has been used to examine ocular drug delivery via the subconjunctival route, intravitreal injection, intrascleral injection to the suprachoroidal space, episcleral and intravitreal implants, periocular injections, and ocular iontophoresis. In this review, the advantages and limitations of MRI in the study of ocular drug delivery are discussed. Different MR contrast agents and MRI techniques for ocular drug-delivery research are compared. Ocular drug-delivery studies using MRI are reviewed. PMID:18186077

Li, S. Kevin; Lizak, Martin J.; Jeong, Eun-Kee

2008-01-01

101

Ocular BB injuries.  

PubMed

Data from the United States Consumer Product Safety Commission indicate that air-powered guns were responsible for 22,800 injuries treated in emergency rooms during 1981, of which 1255 were eye injuries. From 1970 to 1981, 32 patients have undergone surgical intervention at the Wilmer Eye Institute for airgun-related eye injuries. Of the 22 patients with penetrating injuries from the pellets, 19 eyes were enucleated; final vision in the three remaining eyes was worse than 5/200. Of seven patients with nonpenetrating injuries, six had final vision of 20/40 or better. All three patients with penetrating injuries from shattered spectacle lenses had final vision of 20/40 or better. Histopathologic examination of the enucleated specimens demonstrated severe disruption of intraocular contents, particularly posteriorly. Despite the potential ocular dangers of airguns, only 11 states have enacted legislation that regulates their sale or use. BB injuries represent a devastating form of ocular trauma which can be prevented by adoption and enforcement of appropriate legislation. PMID:6514290

Sternberg, P; de Juan, E; Green, W R; Hirst, L W; Sommer, A

1984-10-01

102

Ocular drug delivery.  

PubMed

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

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

2010-09-01

103

Sports related ocular injuries  

PubMed Central

Every year > 600,000 sports and recreation related eye injuries occur, out of which roughly 13,500 of these result in permanent loss of sight. Up to 90% of these sports related eye injuries are preventable by using adequate eye protection equipment. Protective eyewear is made of polycarbonate, a highly impact-resistant plastic which is now easily available as prescription and non-prescription eyewear and all players should be encouraged to use them. The medical officers by educating their patients regarding the risks of eye injuries in various sports and the confirmed benefits of using protective equipment have the potential to prevent injury to over thousands of eyes every year. The medical fraternity can also play a very important role in educating the coaches, parents, and children and thus put an end to unnecessary blindness and vision loss from sports related ocular injuries, therefore ensuring a lifetime of healthy vision. PMID:24532883

Mishra, Avinash; Verma, Ashok K.

2012-01-01

104

Ocular neuromyotonia after radiation therapy  

SciTech Connect

Ocular neuromyotonia is a paroxysmal monocular deviation that results from spasm of eye muscles secondary to spontaneous discharges from third, fourth, or sixth nerve axons. We observed this rare disorder in four patients who had been treated with radiation for tumors in the region of the sella turcica and cavernous sinus. Based on these cases and four others identified in the literature it would appear that radiation predisposes to a cranial neuropathy in which ocular neuromyotonia may be the major manifestation. Radiation appears to be the most common cause of ocular neuromyotonia.

Lessell, S.; Lessell, I.M.; Rizzo, J.F. III

1986-12-15

105

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

PubMed Central

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.

2014-01-01

106

[Ocular toxicity of benzalkonium].  

PubMed

In order to meet the requirements of the pharmacopeia, ophthalmic preparations have to be manufactured in conditions that can secure their sterility before use and can prevent the development of micro-organisms after opening of the vial. The addition of an appropriate preservative is a way to meet this requirement. However, in addition to their lack of efficacy in certain conditions, they can be problematic in terms of formulation, stability and interaction with the packagings. Furthermore, their daily and repeated use in chronic pathologies such as glaucoma, dry eye or allergy has revealed their nuisance. Moreover, the recognition of certain parameters such as life quality and therapeutic observance has strengthened the proofs that have already been clinically shown. The review of the experimental and clinical data already published about the toxicity of the preservatives shows that almost every ocular structure is affected to various extents. From the first assumption data to preclinical and clinical proofs, this article highlights the evolution of the understanding process towards the toxic role of preservatives. PMID:21440103

Chibret, H

2011-03-01

107

Radiotherapy for ocular tumours.  

PubMed

Ocular tumours present a therapeutic challenge because of the sensitive tissues involved and the necessity to destroy the tumour while minimising visual loss. Radiotherapy (RT) is one of several modalites used apart from surgery, laser, cryotherapy, and chemotherapy. Both external beam RT (EBRT) and brachytherapy are used. Tumours of the bulbar conjunctiva, squamous carcinoma and malignant melanoma, can be treated with a radioactive plaque: strontium-90, ruthenium-106 (Ru-106), or iodine-125 (I-125), after excision. If the tumour involves the fornix or tarsal conjunctiva, proton therapy can treat the conjunctiva and spare most of the eye. Alternatively, an I-125 interstitial implant can be used with shielding of the cornea and lens. Conjunctival mucosal-associated lymphoid tissue lymphoma can be treated with an anterior electron field with lens shielding and 25-30 Gray (Gy) in 2?Gy fractions. Discrete retinoblastoma (RB), too large for cryotherapy or thermolaser, or recurrent after these modalities, can be treated with plaque therapy, I-125, or Ru-106. For large RB, multiple tumours, or vitreous seeds the whole eye can be treated with an I-125 applicator, sparing the bony orbit, or with EBRT, under anaesthetic, using X-rays or proton therapy with vacuum contact lenses to fix the eyes in the required position. Post-enucleated orbits at risk for recurrent RB can be treated with an I-125 implant with shielding to reduce the dose to the bony orbit. Uveal malignant melanomas can be treated with plaque or proton therapy with excellent local control. Preservation of vision will depend on the initial size and location of the tumour. PMID:23174750

Stannard, C; Sauerwein, W; Maree, G; Lecuona, K

2013-02-01

108

Purinergic Receptors in Ocular Inflammation  

PubMed Central

Inflammation is a complex process that implies the interaction between cells and molecular mediators, which, when not properly “tuned,” can lead to disease. When inflammation affects the eye, it can produce severe disorders affecting the superficial and internal parts of the visual organ. The nucleoside adenosine and nucleotides including adenine mononucleotides like ADP and ATP and dinucleotides such as P1,P4-diadenosine tetraphosphate (Ap4A), and P1,P5-diadenosine pentaphosphate (Ap5A) are present in different ocular locations and therefore they may contribute/modulate inflammatory processes. Adenosine receptors, in particular A2A adenosine receptors, present anti-inflammatory action in acute and chronic retinal inflammation. Regarding the A3 receptor, selective agonists like N6-(3-iodobenzyl)-5?-N-methylcarboxamidoadenosine (CF101) have been used for the treatment of inflammatory ophthalmic diseases such as dry eye and uveoretinitis. Sideways, diverse stimuli (sensory stimulation, large intraocular pressure increases) can produce a release of ATP from ocular sensory innervation or after injury to ocular tissues. Then, ATP will activate purinergic P2 receptors present in sensory nerve endings, the iris, the ciliary body, or other tissues surrounding the anterior chamber of the eye to produce uveitis/endophthalmitis. In summary, adenosine and nucleotides can activate receptors in ocular structures susceptible to suffer from inflammatory processes. This involvement suggests the possible use of purinergic agonists and antagonists as therapeutic targets for ocular inflammation. PMID:25132732

Guzman-Aranguez, Ana; Gasull, Xavier; Diebold, Yolanda; Pintor, Jesus

2014-01-01

109

X-Linked ocular albinism; Nettleship-Falls ocular albinism.  

PubMed

A 39-year-old man with foveal hypoplasia, nystagmus, and decreased visual acuity was found to have multiple, cutaneous, hypopigmented macules. Macromelanosomes were demonstrated in normal skin on histopathologic examination. The patient's constellation of findings along with a strong X-linked inheritance pattern in family members led to the diagnosis of X-linked ocular albinism, which is an uncommon condition that is characterized by congenital nystagmus, iris translucency, hypopigmentation of the ocular fundus, strabismus, foveal hypoplasia, photophobia, and impaired vision. PMID:18627740

Booth, Alexandria V; Soldano, Anthony C; Levine, Jonathan; Pomeranz, Miriam

2008-01-01

110

Ocular manifestations of rheumatologic disorders.  

PubMed

In the past year, advances have been made in our understanding of the genetics of Behçet disease. Indocyanine green angiography has allowed us to look at the pathologic changes seen in Behçet disease and sarcoidosis in more detail. New steroid-sparing treatment strategies for the control of ocular inflammatory disease are becoming better understood and better used, and their applications in sarcoidosis and juvenile chronic arthritis are reviewed here. The role of antiphospholipid antibodies in ocular disease has received attention, particularly in the context of systemic lupus erythematosus. Outcomes in HLA-B27-positive patients with uveitis and in ocular disease associated with the systemic vasculitides are discussed here, and scalp necrosis in giant-cell arteritis is reviewed. PMID:10662252

Poole, T R; Graham, E M

1999-12-01

111

The Ocular Surface Chemical Burns  

PubMed Central

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

Baradaran-Rafii, Alireza; Djalilian, Ali R.

2014-01-01

112

Cerebellum and ocular motor control.  

PubMed

An intact cerebellum is a prerequisite for optimal ocular motor performance. The cerebellum fine-tunes each of the subtypes of eye movements so they work together to bring and maintain images of objects of interest on the fovea. Here we review the major aspects of the contribution of the cerebellum to ocular motor control. The approach will be based on structural-functional correlation, combining the effects of lesions and the results from physiologic studies, with the emphasis on the cerebellar regions known to be most closely related to ocular motor function: (1) the flocculus/paraflocculus for high-frequency (brief) vestibular responses, sustained pursuit eye movements, and gaze holding, (2) the nodulus/ventral uvula for low-frequency (sustained) vestibular responses, and (3) the dorsal oculomotor vermis and its target in the posterior portion of the fastigial nucleus (the fastigial oculomotor region) for saccades and pursuit initiation. PMID:21909334

Kheradmand, Amir; Zee, David S

2011-01-01

113

Cerebellum and Ocular Motor Control  

PubMed Central

An intact cerebellum is a prerequisite for optimal ocular motor performance. The cerebellum fine-tunes each of the subtypes of eye movements so they work together to bring and maintain images of objects of interest on the fovea. Here we review the major aspects of the contribution of the cerebellum to ocular motor control. The approach will be based on structural–functional correlation, combining the effects of lesions and the results from physiologic studies, with the emphasis on the cerebellar regions known to be most closely related to ocular motor function: (1) the flocculus/paraflocculus for high-frequency (brief) vestibular responses, sustained pursuit eye movements, and gaze holding, (2) the nodulus/ventral uvula for low-frequency (sustained) vestibular responses, and (3) the dorsal oculomotor vermis and its target in the posterior portion of the fastigial nucleus (the fastigial oculomotor region) for saccades and pursuit initiation. PMID:21909334

Kheradmand, Amir; Zee, David S.

2011-01-01

114

Air bags and ocular injuries.  

PubMed Central

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

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

1999-01-01

115

Ocular Complications of Chloroquine Therapy  

PubMed Central

Ocular complications of long-term chloroquine therapy were observed in 18 of 45 patients so treated. This therapy was used in patients with rheumatoid arthritis, lupus erythematosus, sarcoidosis, discoid lupus and other chronic “collagen disease”. Thirteen patients had reversible corneal opacifications, and seven had irreversible retinal changes, with visual loss and visual field defects. Pathological evidence of chloroquine retinopathy was obtained in one patient. Physicians are therefore warned to use this drug only after careful consideration. If it is used, repeated ocular examinations should include assessment of visual acuity, visual fields on a tangent screen and fundus examination through a dilated pupil. ImagesFig. 4Fig. 7Fig. 8 PMID:14275038

Lloyd, Lois A.; Hiltz, John W.

1965-01-01

116

Handbook of Ocular Disease Management  

NSDL National Science Digital Library

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.

Gurwood, Andrew S.; Kabat, Alan R.; Sowka, Joseph W.

2006-12-19

117

Characteristics of the Human Ocular Surface Epithelium  

Microsoft Academic Search

An appreciation of the biological characteristics of the human ocular surface epithelium affords us a great insight into the physiology of the human ocular surface in health and disease. Here, we review five important aspects of the human ocular surface epithelium. First, we recognize the discovery of corneal epithelial stem cells, and note how the palisades of Vogt have been

Shigeru Kinoshita; Wakako Adachi; Chie Sotozono; Kohji Nishida; Norihiko Yokoi; Andrew J. Quantock; Kousaku Okubo

2001-01-01

118

Ultraviolet light and ocular diseases.  

PubMed

The objective of this study is to review the association between ultraviolet (UV) light and ocular diseases. The data are sourced from the literature search of Medline up to Nov 2012, and the extracted data from original articles, review papers, and book chapters were reviewed. There is a strong evidence that ultraviolet radiation (UVR) exposure is associated with the formation of eyelid malignancies [basal cell carcinoma (BCC) and squamous cell carcinoma (SCC)], photokeratitis, climatic droplet keratopathy (CDK), pterygium, and cortical cataract. However, the evidence of the association between UV exposure and development of pinguecula, nuclear and posterior subcapsular cataract, ocular surface squamous neoplasia (OSSN), and ocular melanoma remained limited. There is insufficient evidence to determine whether age-related macular degeneration (AMD) is related to UV exposure. It is now suggested that AMD is probably related to visible radiation especially blue light, rather than UV exposure. From the results, it was concluded that eyelid malignancies (BCC and SCC), photokeratitis, CDK, pterygium, and cortical cataract are strongly associated with UVR exposure. Evidence of the association between UV exposure and development of pinguecula, nuclear and posterior subcapsular cataract, OSSN, and ocular melanoma remained limited. There is insufficient evidence to determine whether AMD is related to UV exposure. Simple behaviural changes, appropriate clothing, wearing hats, and UV blocking spectacles, sunglasses or contact lens are effective measures for UV protection. PMID:23722672

Yam, Jason C S; Kwok, Alvin K H

2014-04-01

119

Adverse ocular reactions to drugs.  

PubMed Central

Drugs acting on various parts of the body may also affect the eye insidiously. Increased awareness of such drug toxicity by the prescribing doctor should encourage him to consider effects on the cornea, lens, retina, optic nerve and elsewhere when checking the patient's progress. The following review concerns adverse ocular effects of systemic drug administration. PMID:6356101

Spiteri, M. A.; James, D. G.

1983-01-01

120

Ocular injuries by durian fruit  

PubMed Central

AIM To report various ocular injuries caused by durian fruit. METHODS Three cases of ocular injuries were described in young patients, due to accidental fall of durian fruit on the forehead and face, while they were taking rest/sleeping /playing under the durian tree. RESULTS The ocular injuries observed were lacerating injury of cornea with iris incarceration, hyphema, superficial penetrating injury of sclera and angle recession glaucoma in the right eye of first patient; lacerating injury of cornea with iris prolapse in the left eye of second patient; subconjunctival haemorrhage, traumatic mydriasis and superficial penetrating injury of sclera, commotion retinopathy and macular edema in the left eye of third patient. Vision improved to normal in all the eyes following surgical/ medical/optical treatment. CONCLUSION Evidence of penetrating injury (because of thorns) and blunt injury (because of weight) can be seen in the eyes when durian fruit falls on the face. Vision can be recovered fully with immediate and appropriate treatment in these cases. The ocular injuries can be prevented by educating the public to wear protective metal frame wide goggles and not to sleep/take rest under the durian tree. PMID:22937520

Reddy, Sagili Chandrasekhara

2012-01-01

121

Therapeutics To Treat Ocular Diseases  

Cancer.gov

The National Eye Institute's Section on Epithelial and Retinal Physiology and Disease (SERPD) is seeking statements of capability or interest from parties interested in collaborative research to further develop, evaluate, or commercialize therapeutics for ocular diseases caused by accumulation of sub-retinal fluid.

122

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

PubMed Central

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

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

2013-01-01

123

Ocular surface foreign bodies: novel findings mimicking ocular malignant melanoma.  

PubMed

PurposeMalignant melanoma of the eye is an uncommon condition that is important to recognise. We describe three cases in which ocular foreign bodies have masqueraded as ocular malignant melanoma.MethodsInterventional case reports.ResultsCase 1 describes diathermy-induced carbon particle implantation, during plaque therapy for the treatment of uveal melanoma, mimicking recurrence with extra-scleral invasion. Case 2 shows a foreign body called 'mullite' mimicking conjunctival melanoma. Case 3 demonstrates a conjunctival foreign body called 'illite' that mimicked a limbal melanocytic lesion, clinically thought to be either melanocytoma or melanoma.ConclusionThis report highlights the importance of careful history taking, examination, and appropriate biopsy in cases of suspected malignant melanoma, to prevent unnecessary and potentially radical treatment. PMID:25104745

Maudgil, A; Wagner, B E; Rundle, P; Rennie, I G; Mudhar, H S

2014-11-01

124

Clinico-Pathological Profile of Adnexal Torsion Cases: A Retrospective Analysis from A Tertiary Care Teaching Hospital  

PubMed Central

Introduction: Torsion of the adnexa is a rare condition which can be potentially lethal for the women. The clinical presentation can be varied and can be seen in any age group. Understanding the clinical and pathological profile of patients suffering from adenexal torsion can guide the clinicians in diagnosing and managing the condition. Objective: To analyze the clinical and pathological profile of adnexal torsion cases in a tertiary care teaching hospital. Materials and Methods: The study was a retrospective analysis of hospital records. It included all cases of adnexal torsion that underwent laprotomy between January 2007 to December 2012 in a tertiary care teaching hospital. The study was approved by the Institute’s human Ethics Committee. Results: A total of 18 patients were included in the study. Majority (66.7%) of participants were in the reproductive age group. Abdominal pain was the most common symptom seen in 77.8% of patients. The other symptoms were abdominal distension, back ache and dysuria. Majority of the women belonged to Para 2 (44.4%) and Para 3 (27.8%). The proportion of women with one and two LSCS was 11.1% and 16.7% respectively. Tenderness (38.9%), mass (22.2%) were the common per abdomen findings. Perspeculum findings were normal in majority (88.9%) of the participants. About 39.2% of the patients presented with a mass in either fornices or pouch of Douglas on pervaginal examination. The side of lesion was only on right in 9 (50%) , only left in 7(38.9%) and both sides in 2 (11.1%) of cases. On histopathological examination, of the lesions there were mucinous cystadenoma (33.3%) serous cystadenoma (16.7%) and benign cystic teratoma (16.7%) as most common lesions. Conclusion: Adnexal torsion, though a rare clinical condition can present as an emergency most of the times. High index of suspicion is required for diagnosis, as the clinical presentation can be varied. But the diagnosis can be made certain only on the operating table, either by laparoscopy. Avoiding a delay in operating upon the patient will help prevent complications, and aid in conserving the ovary. PMID:25121032

Reddy, Gopireddy Murali Mohan; Subbiah, Vasantha Nagamma; Sathiya, Saktivel; Arjun, Balasubramanian

2014-01-01

125

Interfacial phenomena and the ocular surface.  

PubMed

Ocular surface disorders, such as dry eye disease, ocular rosacea, and allergic conjunctivitis, are a heterogeneous group of diseases that require an interdisciplinary approach to establish underlying causes and develop effective therapeutic strategies. These diverse disorders share a common thread in that they involve direct changes in ocular surface chemistry as well as the rheological properties of the tear film and topographical attributes of the cellular elements of the ocular surface. Knowledge of these properties is crucial to understand the formation and stability of the preocular tear film. The study of interfacial phenomena of the ocular surface flourished during the 1970s and 1980s, but after a series of lively debates in the literature concerning distinctions between the epithelial and the glandular origin of ocular surface disorders during the 1990s, research into this important topic has declined. In the meantime, new tools and techniques for the characterization and functionalization of biological surfaces have been developed. This review summarizes the available literature regarding the physicochemical attributes of the ocular surface, analyzes the role of interfacial phenomena in the pathobiology of ocular surface disease, identifies critical knowledge gaps concerning interfacial phenomena of the ocular surface, and discusses the opportunities for the exploitation of these phenomena to develop improved therapeutics for the treatment of ocular surface disorders. PMID:24999101

Yañez-Soto, Bernardo; Mannis, Mark J; Schwab, Ivan R; Li, Jennifer Y; Leonard, Brian C; Abbott, Nicholas L; Murphy, Christopher J

2014-07-01

126

The blood-ocular barriers.  

PubMed

The introduction of the concept of blood-ocular barriers in the ophthalmic literature is briefly reviewed. Two main blood-ocular barriers are proposed: the blood-aqueous barrier and the blood-retinal barrier. The blood-aqueous barrier is formed by an epithelial barrier located in the nonpigmented layer of the ciliary epithelium and in the posterior iridial epithelium, and by the endothelium of the iridial vessels. Both these layers have tight junctions of the "leaky" type. The pereability of the blood-aqueous barrier shows a significant degree of pressure-dependent diffusion associated with transport activity, resembling the standing gradient osmotic flow model. The blood-retinal barrier is located at two levels, forming an outer barrier in the retinal pigment epithelium and an inner barrier in the endothelial membrane of the retinal vessels. Both these membranes have tight junctions of the "nonleaky" type. The permeability of the blood-retinal barrier resembles cellular permeability in general, diffusion being directly related to the predominant roles of lipid solubility and transport mechanisms. Finally, the clinical significance of the blood-ocular barrier is analyzed. The metabolism of cornea and lens and the regulation of intraocular fluids are directly influenced by the blood-aqueous barrier. Similarly, an alteration of the blood-retinal barrier appears to play an important role in the development of vascular retinopathies, pigment epitheliopathies, and retinal edema. PMID:380030

Cunha-Vaz, J

1979-01-01

127

Drug therapy for ocular allergy.  

PubMed

The spectrum of ocular allergy ranges from mild, non-sight threatening disease, such as hay fever, to disorders such as atopic keratoconjunctivitis (AKC) which cause permanent ocular surface changes and reduced vision. The ideal treatment is with topical preparations. Launched topical preparations include anti-histamines and mast cell (MC) stabilisers, which are safe, but only moderately potent, steroids, which are very potent, but carry very serious side-effects, and cyclosporin A, which is not widely available and difficult to tolerate. There are a number of anti-histamines, MC stabilisers (and combinations thereof) and steroids in development which are of potential interest. Other possibilities for therapeutic intervention include inhibition of tryptase, cyclooxygenase (COX), leukotrienes (LTs), bradykinins (BKs), platelet activating factor (PAF) and immunoglobulin E (IgE). Therapies based on cytokine antagonism and agonism, T-cell inhibition and adhesion molecule antagonism might be expected to provide safe, but potent new modes of treatment. The increasing interest in research into the pathogenesis of ocular allergic inflammation may lead to more relevant approaches, such as eosinophil inhibition. Success will be highly dependent on the ability to produce suitable topical ophthalmic preparations. PMID:15991917

Hingorani, M

1998-01-01

128

Oxaliplatin-Related Ocular Toxicity  

PubMed Central

We report the case of a 52-year-old woman with advanced colorectal cancer who was treated with oxaliplatin on a FOLFOX schedule. After 3 cycles of chemotherapy, she started to complain of visual loss, altered color vision and neurological symptoms. Due to the suspicion of ocular and neurological toxicity, antineoplastic treatment was stopped. Her visual field showed a concentric bilateral scotoma and the electrooculogram test revealed severe impairment of the retinal pigment epithelium. Visual acuity, color vision and visual field recovered completely 8 months later, although electrooculogram remained abnormal. Ocular toxicity has been reported as an infrequent adverse event of oxaliplatin. Findings in this case indicate toxicity of this chemotherapeutic agent on the retinal pigment epithelium, which has not been reported before. This damage could be permanent, and it thus differs from previously described oxaliplatin-induced ocular toxicities, which are usually transient and reversible. With increasing use of oxaliplatin as first-line treatment in advanced colorectal cancer, we have to be aware of this possible toxicity. PMID:21151636

Mesquida, Marina; Sanchez-Dalmau, Bernardo; Ortiz-Perez, Santiago; Pelegrin, Laura; Molina-Fernandez, Juan Jose; Figueras-Roca, Marc; Casaroli-Marano, Ricardo; Adan, Alfredo

2010-01-01

129

Innate immunity of the ocular surface.  

PubMed

The ocular surface epithelium serves a critical function as the defensive front line of the innate immune system. While the detection of microbes is arguably its most important task, an exaggerated host defense reaction to endogenous bacterial flora may initiate and perpetuate inflammatory mucosal responses. The ability of cells to recognize pathogen-associated molecular patterns (PAMPs) mainly depends on the expression of a family of Toll-like receptors (TLRs). A healthy ocular surface is not inflammatory, even though ocular surface epithelium is in constant contact with bacteria and bacterial products. In this study, we show that human ocular surface epithelial cells, both corneal and conjuctival epithelial cells, respond to viral double-stranded RNA mimic polyI:C to produce pro-inflammatory cytokines through TLR3, while they fail to respond functionally to lipopolysaccharide, a TLR4 ligand. Moreover, human ocular surface epithelium responds to flagellins from ocular pathogenic, but not ocular non-pathogenic bacteria, to produce pro-inflammatory cytokines through TLR5. Thus, ocular surface epithelial cells selectively respond to microbial components and induce limited inflammation; immune-competent cells can recognize microbial components through TLRs and induce the inflammation. The unique innate immune response of the ocular surface epithelium may contribute to its coexistence with commensal bacteria. Inflammatory bowel disease is thought to result from an abnormal response to the gut microbiota. Thus, we also considered the possibility of an association between ocular surface inflammation and a disordered innate immune response. IkappaBzeta is important for TLR signaling, in mice, its knock-out produced severe, spontaneous ocular surface inflammation, the eventual loss of goblet cells, and spontaneous perioral inflammation, suggesting that dysfunction/abnormality of innate immunity can lead to ocular surface inflammation. PMID:19828129

Ueta, Mayumi; Kinoshita, Shigeru

2010-02-15

130

Ocular Syphilis among HIV-Infected Individuals  

PubMed Central

We describe a human immunodeficiency virus (HIV)–infected individual with ocular manifestations of secondary syphilis. Twelve other cases of HIV-associated ocular syphilis are also presented. Six of 12 individuals had normal cerebrospinal fluid study results, and 3 patients required retreatment within 1.5 years. In patients with HIV infection, clinicians should be vigilant for ocular syphilis despite normal cerebrospinal fluid measures and for syphilis reinfection. PMID:20604717

Li, Jonathan Z.; Tucker, Joseph D.; Lobo, Ann-Marie; Marra, Christina M.; Davis, Benjamin T.; Papaliodis, George N.; Felsenstein, Donna; Durand, Marlene L.; Yawetz, Sigal; Robbins, Gregory K.

2010-01-01

131

21 CFR 886.4360 - Ocular surgery irrigation device.  

...2014-04-01 false Ocular surgery irrigation device. 886.4360 Section 886...Devices § 886.4360 Ocular surgery irrigation device. (a) Identification. An ocular surgery irrigation device is a device intended to...

2014-04-01

132

21 CFR 886.4360 - Ocular surgery irrigation device.  

Code of Federal Regulations, 2012 CFR

...2012-04-01 false Ocular surgery irrigation device. 886.4360 Section 886...Devices § 886.4360 Ocular surgery irrigation device. (a) Identification. An ocular surgery irrigation device is a device intended to...

2012-04-01

133

21 CFR 886.4360 - Ocular surgery irrigation device.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false Ocular surgery irrigation device. 886.4360 Section 886...Devices § 886.4360 Ocular surgery irrigation device. (a) Identification. An ocular surgery irrigation device is a device intended to...

2011-04-01

134

21 CFR 886.4360 - Ocular surgery irrigation device.  

Code of Federal Regulations, 2013 CFR

...2013-04-01 false Ocular surgery irrigation device. 886.4360 Section 886...Devices § 886.4360 Ocular surgery irrigation device. (a) Identification. An ocular surgery irrigation device is a device intended to...

2013-04-01

135

Drug-induced ocular disorders.  

PubMed

While beneficial therapeutically, almost all medications have untoward effects on various body tissues and functions, including the eye in which organ toxic reactions are readily detectable. Every part of the eye and all ocular functions could be affected adversely. In this review, we describe the most commonly recognized drug-induced ocular disorders, their specific clinical features, the medications that can cause the problem, the differential diagnosis and possible mechanisms of action, as well as guidelines for the management of the adverse reactions. The eyelids are most frequently involved in drug toxicity that commonly manifests as inflammation, hypersensitivity reaction or dermatitis. Drug-induced keratoconjunctival disorders present mainly as conjunctival hyperaemia (red eye), with or without superficial corneal involvement. Frequently, drug preservatives in topical ocular medications induce these adverse effects. Treatment of blepharospasm with Botox may lead to drooping of the eyelids and corneal exposure. Intraoperative floppy iris syndrome is a drug-induced reaction in patients treated with tamsulosin and who undergo cataract surgery. Certain sulfa-based drugs can cause swelling of the ciliary body and lead to the development of angle-closure glaucoma. In addition, adrenergic agents, certain beta(2)-adrenergic agonists and anticholinergic agents may induce pupillary dilation and precipitate angle-closure glaucoma in susceptible patients. Glucocorticoids administered systemically, topically or intravitreally are known to increase intraocular pressure, which can lead to the development of open-angle glaucoma in susceptible patients. This painless form of glaucoma has also been associated with the use of the anticancer agents docetaxel and paclitaxel. The toxic effects of systemic and topically applied drugs may manifest as cloudiness of the lens. Long-term use of glucocorticoids produces a characteristic posterior subcapsular cataract and, although the opacities may remain stationary or progress, they rarely regress upon drug withdrawal. Systemic administration of phenothiazines or busulfan induce cataractous changes in the anterior or posterior cortex, respectively. Many systemic drugs reach the retina through the vascular supply. Aminoquinolines induce a characteristic bull's eye maculopathy. Phenothiazines bind to melanin granules and can cause a severe phototoxic retinopathy. Typical tamoxifen retinopathy manifests as crystalline deposits in the inner retina. Some patients treated with retinoids have decreased night vision and abnormal dark-adaptation. Patients on long-term treatment with linezolid may develop an optic neuropathy (swollen or pale optic disc), symmetric painless decrease of visual acuity and colour vision, and bilateral visual field defects. A probable link exists between amiodarone and a bilateral optic neuropathy that is very similar to nonarteritic ischaemic optic neuropathy (NAION). The most common adverse effects of cGMP-specific phosphodiesterase type 5 inhibitors (erectile dysfunction drugs) are changes in colour perception, blurry vision and increased light sensitivity; recently these drugs have been also implicated in the development of NAION. A bilateral, retrobulbar optic neuropathy that manifests as loss of visual acuity or colour vision and visual field defect is associated with the use of ethambutol. Many different kinds of medications can cause similar ocular adverse reactions. Conversely, a single medication may affect more than one ocular structure and cause multiple, clinically recognizable disorders. Clinicians should be mindful of drug-induced ocular disorders, whether or not listed in product package inserts, and, if in doubt, consult with an ophthalmologist. PMID:18217789

Li, Junping; Tripathi, Ramesh C; Tripathi, Brenda J

2008-01-01

136

Ocular complications of bungee jumping  

PubMed Central

Aim In this paper, we will try to highlight the importance of various investigations and their crucial role in identifying whether the defect is structural or functional. Case history A 24-year-old woman presented with ocular complications after bungee jumping. Subsequently, although all ophthalmic signs resolved, she complained of decreased vision in her left eye. Conclusion Initial ophthalmic injury was detected by optical coherence tomography scan showing a neurosensory detachment of the fovea. This was not initially detected on slit-lamp examination or fluorescein angiography. On later examination, although the optical coherence tomography scan showed no structural damage, electrodiagnostic tests showed a functional defect at the fovea. PMID:23055687

Hassan, H Mohammed J; Mariatos, Georgios; Papanikolaou, Theocharis; Ranganath, Akshatha; Hassan, Hala

2012-01-01

137

Ocular dirofilariasis in Dubai, UAE.  

PubMed

A rare occurrence of ocular subconjunctival dirofilariasis in a 53-year-old healthy Indian male working in Dubai, UAE presenting with an acute red eye is reported. Surgical excision under topical anesthesia was carried out uneventfully in the outpatient clinic. The live worm removed from the subconjunctival space was identified as Dirofilaria repens on the basis of microscopic examination and histopathology. Surgical excision of subconjunctival dirofilariasis is safe in an outpatient setting and curative precluding the need for further systemic antihelminthics. PMID:18579995

Mittal, Mamta; Sathish, K R; Bhatia, Prashant G; Chidamber, B S

2008-01-01

138

Raman Spectroscopy of Ocular Tissue  

NASA Astrophysics Data System (ADS)

The optically transparent nature of the human eye has motivated numerous Raman studies aimed at the non-invasive optical probing of ocular tissue components critical to healthy vision. Investigations include the qualitative and quantitative detection of tissue-specific molecular constituents, compositional changes occurring with development of ocular pathology, and the detection and tracking of ocular drugs and nutritional supplements. Motivated by a better understanding of the molecular mechanisms leading to cataract formation in the aging human lens, a great deal of work has centered on the Raman detection of proteins and water content in the lens. Several protein groups and the hydroxyl response are readily detectable. Changes of protein compositions can be studied in excised noncataractous tissue versus aged tissue preparations as well as in tissue samples with artificially induced cataracts. Most of these studies are carried out in vitro using suitable animal models and conventional Raman techniques. Tissue water content plays an important role in optimum light transmission of the outermost transparent ocular structure, the cornea. Using confocal Raman spectroscopy techniques, it has been possible to non-invasively measure the water to protein ratio as a measure of hydration status and to track drug-induced changes of the hydration levels in the rabbit cornea at various depths. The aqueous humor, normally supplying nutrients to cornea and lens, has an advantageous anterior location for Raman studies. Increasing efforts are pursued to non-invasively detect the presence of glucose and therapeutic concentrations of antibiotic drugs in this medium. In retinal tissue, Raman spectroscopy proves to be an important tool for research into the causes of macular degeneration, the leading cause of irreversible vision disorders and blindness in the elderly. It has been possible to detect the spectral features of advanced glycation and advanced lipooxydation end products in excised tissue samples and synthetic preparations and thus to identify potential biomarkers for the onset of this disease. Using resonance Raman detection techniques, the concentration and spatial distribution of macular pigment, a protective compound, can be detected in the living human retina Useable in clinical settings for patient screening, the technology is suitable to investigate correlations between pigment concentration levels and risk for macular degeneration and to monitor increases in pigment levels occurring as a result of dietary intervention strategies.

Ermakov, Igor V.; Sharifzadeh, Mohsen; Gellermann, Warner

139

Anomalous phosphenes in ocular protontherapy  

NASA Astrophysics Data System (ADS)

We have undertaken a clinical ground study of proton-induced light flashes (phosphenes). Patients treated at the Institut Curie - Centre de Protonthérapie in Orsay, France, received radiation therapy to cure ocular and skull-base cancers. Sixty percent of the patients treated for choroidal melanomas using 73 MeV protons report anomalous phosphenes. Delivering a radiation dose on the retina only is not sufficient to trigger the light flash. The present study may be the first indication of phosphenes triggered by protons of few tens of MeV.

Khan, E.; Maréchal, F.; Dendale, R.; Mabit, C.; Calugaru, V.; Desjardin, L.; Narici, L.

2010-04-01

140

Ocular associations of metabolic syndrome.  

PubMed

Metabolic syndrome is a cluster of diseases including central obesity, dyslipidemia, hyperglycemia, and high blood pressure. People with metabolic syndrome have been shown to be at an increased risk of developing cardiovascular disease, beyond the risk associated with individual components of the syndrome. The association of diabetes and hypertension with retinopathy, cataract, and raised intraocular pressure is well known. This review highlights the association of metabolic syndrome, including all its components, with various ocular conditions such as retinopathy, central retinal artery occlusion, cataracts, and raised intraocular pressure. PMID:22701846

Chopra, Rupali; Chander, Ashish; Jacob, Jubbin J

2012-03-01

141

Ocular injuries from automobile batteries.  

PubMed

The incidence of eye injuries related to automobile batteries has sharply increased, currently comprising nearly 1% of all unscheduled eye visits to one medical center. A series of 93 cases obtained over 81/2 years was reviewed and follow-up information obtained. While two thirds of the injuries were relatively minor, 10% (9) of the patients sustained permanent ocular damage or required hospitalization. All of the severe injuries and the majority of the other injuries were caused by battery explosions. Not only should the inherent danger of the lead-acid storage battery be reduced, but the public must be alerted to the hazard. PMID:929798

Holekamp, T L

1977-01-01

142

Ocular Manifestations of Candidemia in Children  

PubMed Central

Among 254 patients with candidemia who had a dilated retinal examination, 8 patients (3.2%) were diagnosed with ocular disease resulting in retinal detachment in two patients and globe rupture in one patient. This study found that ocular candidiasis is an uncommon but serious sight-threatening complication in pediatric patients with candidemia. PMID:23241990

Fierro, Julie L.; Prasad, Priya A.; Fisher, Brian T.; Gerber, Jeffrey S.; Coffin, Susan E.; Walsh, Thomas J.; Zaoutis, Theoklis E.

2012-01-01

143

Digital Ocular Fundus Imaging: A Review  

Microsoft Academic Search

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

Rui Bernardes; Pedro Serranho; Conceição Lobo

2011-01-01

144

Pattern of Pediatric Ocular Trauma in Kashan  

PubMed Central

Background: Ocular trauma is a significant health problem in pediatric patients. Objectives: The aim of this study was to analyze the characteristics of ocular-trauma-related hospitalization of children in Kashan. Patients and Methods: This descriptive, cross-sectional study included 131 children aged less than 16 years with ocular trauma, who were admitted to the Matini Hospital at the Kashan University of Medical Sciences between April 2006 and March 2009. After admission, detailed ocular examination was performed, and their ocular trauma was classified according to the International Ocular Trauma Classification and Birmingham Eye Trauma Terminology systems. Results: Mean age of the patients was 7.8 ± 2.2 years (age range, 0–16 years), and male to female ratio 5:1. The most common cause of admission was hyphema (38.1%), followed by corneoscleral laceration (27.5%). Ocular trauma most commonly occurred at home (43%), and 69% of the patients presented to the emergency room within 24 h of injury. In 30% of the patients, initial visual acuity at the time of presentation was less than 20/200 (Figure 1). Conclusions: Ocular trauma is a major cause of unilateral blindness, especially in young boys, and hence, preventive measures and education is required. PMID:24719840

Aghadoost, Davood; Fazel, Mohammad Reza; Aghadoost, Hamid Reza

2012-01-01

145

Ocular pigmentation in white and Siamese cats  

Microsoft Academic Search

Ocular pigmentation in white cats with blue and. yellow eyes and in Siamese cats was examined ophthalmoscopically and histologically. Yellow-eyed, white cats had. entirely normal ocular pigmentation. Blue eyes of white cats had. normal pigmentation of the iridial and. retinal pigment epithelia but no stromal pigmentation of the iris or choroid. This deficit is apparently due to the absence of

L. N. Thibos; W. R. Levick; R. Morstyn

1980-01-01

146

Ocular Injury Rates in College Sports  

Microsoft Academic Search

YOUN, J., R. E. SALLIS, G. SMITH, and K. JONES. Ocular Injury Rates in College Sports. Med. Sci. Sports Exerc., Vol. 40, No. 3, pp. 428-432,2008. Purpose: To determine the rate of eye injury sustained in 12 college sports in order to assess whether there is a high risk of ocular eye injury in some sports. Methods: From the fall

JAMES YOUN; ROBERT E. SALLISI; GARY SMITH; KIRK JONES

2008-01-01

147

Pain of ocular and periocular origin.  

PubMed

Most diseases of the eye and periocular regions that cause blindness are relatively painless. Headache pain of ocular and periocular origin represent a special challenge to the clinician. For patients with ocular and periocular pain that is unrelated to primary eye disease, identification and treatment of the painful condition usually become the responsibility of the clinician. PMID:23419627

Waldman, Corey W; Waldman, Steven D; Waldman, Reid A

2013-03-01

148

Increasing useful magnification in ocular systems  

NASA Astrophysics Data System (ADS)

The magnifying power of ocular systems is limited by the system exit pupil and Lagrange Invariant. This work shows that useful magnification is increased by separating the invariant. The impact on the specification for digital ocular systems, including a binocular example, is provided.

Youngworth, Richard N.; Yamanashi, Takanori; Betensky, Ellis I.

2014-09-01

149

Adult Ocular Toxocariasis Mimicking Ciliary Body Malignancy  

PubMed Central

Purpose. To discuss an unusual presentation of ocular toxocariasis. Methods. Case report. Results. A 40-year-old woman presented with decreased vision in the left eye with a long history of recurrent red eye from uveitis. Eosinophilia and positive ELISA titers for Toxocara canis favored the diagnosis of ocular toxocariasis. Over 3 months, an anterior scleral mass had a rapid growth raising the possibility of medulloepithelioma, which rarely can mimic uveitic syndromes. Surgical plan changed from local excision to enucleation. Histopathology demonstrated a large homogeneous mass of chronic inflammatory cells with inflammation of the overlying thinned out sclera, medial rectus insertion, and limbal cornea. The triad of peripheral granuloma, eosinophilia, and positive blood serology established the diagnosis of ocular toxocariasis. Conclusions. Ocular toxocariasis can mimic ocular malignancy such as medulloepithelioma in adults and rarely presents as an anterior scleral mass. PMID:25371681

Mansour, Ahmad M.; Abiad, Bachir; Boulos, Fouad I.; Alameddine, Ramzi; Maalouf, Fadi C.; Bu Ghannam, Alaa; Hamam, Rola N.

2014-01-01

150

Ocular Surface Development and Gene Expression  

PubMed Central

The ocular surface—a continuous epithelial surface with regional specializations including the surface and glandular epithelia of the cornea, conjunctiva, and lacrimal and meibomian glands connected by the overlying tear film—plays a central role in vision. Molecular and cellular events involved in embryonic development, postnatal maturation, and maintenance of the ocular surface are precisely regulated at the level of gene expression by a well-coordinated network of transcription factors. A thorough appreciation of the biological characteristics of the ocular surface in terms of its gene expression profiles and their regulation provides us with a valuable insight into the pathophysiology of various blinding disorders that disrupt the normal development, maturation, and/or maintenance of the ocular surface. This paper summarizes the current status of our knowledge related to the ocular surface development and gene expression and the contribution of different transcription factors to this process. PMID:23533700

Swamynathan, Shivalingappa K.

2013-01-01

151

Spontaneous Corneal Perforation in Ocular Rosacea  

PubMed Central

Rosacea is a dermatologic condition that affects the midfacial region. Ocular rosacea is most frequently diagnosed when cutaneous signs and symptoms are also present. Ocular manifestations are essentially confined to the eyelids and ocular surface. Ocular involvement ranges from minor irritation, dryness, and blurry vision to potentially severe ocular surface disruption including corneal ulcers, vascularization and rarely perforation. We present a 49-year-old Saudi Arabian female with the diagnosis of rosacea who presented with a peripheral corneal performation. The perforation was successfully managed by surgical repair, oral doxycycline and topical steroid. The final best corrected visual acuity was 20/30 after treatment. Early referral to an ophthalmologist and careful long-term follow-up are recommended. PMID:20616930

Al Arfaj, Khalid; Al Zamil, Waseem

2010-01-01

152

Clinical and Immunological Responses in Ocular Demodecosis  

PubMed Central

The purpose of this study was to investigate clinical and immunological responses to Demodex on the ocular surface. Thirteen eyes in 10 patients with Demodex blepharitis and chronic ocular surface disorders were included in this study and treated by lid scrubbing with tea tree oil for the eradication of Demodex. We evaluated ocular surface manifestations and Demodex counts, and analyzed IL-1?, IL-5, IL-7, IL-12, IL-13, IL-17, granulocyte colony-stimulating factor, and macrophage inflammatory protein-1? in tear samples before and after the treatment. All patients exhibited ocular surface manifestations including corneal nodular opacity, peripheral corneal vascularization, refractory corneal erosion and infiltration, or chronic conjunctival inflammatory signs before treatment. After treatment, Demodex was nearly eradicated, tear concentrations of IL-1? and IL-17 were significantly reduced and substantial clinical improvement was observed in all patients. In conclusion, we believe that Demodex plays an aggravating role in inflammatory ocular surface disorders. PMID:21935281

Kim, Jae Hoon; Chun, Yeoun Sook

2011-01-01

153

Anterior Segment Imaging in Combat Ocular Trauma  

PubMed Central

Purpose. To evaluate the use of ocular imaging to enhance management and diagnosis of war-related anterior segment ocular injuries. Methods. This study was a prospective observational case series from an ongoing IRB-approved combat ocular trauma tracking study. Subjects with anterior segment ocular injury were imaged, when possible, using anterior segment optical coherence tomography (AS-OCT), confocal microscopy (CM), and slit lamp biomicroscopy. Results. Images captured from participants with combat ocular trauma on different systems provided comprehensive and alternate views of anterior segment injury to investigators. Conclusion. In combat-related trauma of the anterior segment, adjunct image acquisition enhances slit lamp examination and enables real time In vivo observation of the cornea facilitating injury characterization, progression, and management. PMID:24191191

Ryan, Denise S.; Sia, Rose K.; Colyer, Marcus; Stutzman, Richard D.; Wroblewski, Keith J.; Mines, Michael J.; Bower, Kraig S.

2013-01-01

154

Human ocular angiostrongyliasis: a literature review.  

PubMed

Human ocular angiostrongyliasis caused by Angiostrongylus cantonensis infection in the eye is a very rare condition. Until now, there has been no comprehensive analysis of this disease. We searched and analysed the references found on the Internet that refer to human ocular angiostrongyliasis and reviewed the aetiology, clinical manifestations, diagnosis, epidemiology and treatment of the condition. Twenty-six references were found reporting 35 patients from 10 countries that were diagnosed with human ocular angiostrongyliasis. People are usually infected by eating raw or undercooked intermediate hosts of the parasite such as snails or contaminated vegetables. The most common symptom was visual loss. Although several treatments have been used, ocular angiostrongyliasis can still result in permanent visual impairment and may even cause blindness. As the eye is the site of infection and direct visualization is possible, ocular examination is crucial for diagnosis. The therapeutic success depended on early and complete surgical removal. PMID:21296846

Diao, Zongli; Wang, Jing; Qi, Haiyu; Li, Xiaoli; Zheng, Xiaoyan; Yin, Chenghong

2011-04-01

155

A comparison of clinical and surgical outcomes between laparo-endoscopic single-site surgery and traditional multiport laparoscopic surgery for adnexal tumors  

PubMed Central

Objective The purpose of this study was to compare clinical and surgical outcomes between laparo-endoscopic single-site (LESS) surgery and traditional multiport laparoscopic (TML) surgery for treatment of adnexal tumors. Methods Medical records were reviewed for patients undergoing surgery for benign adnexal tumors between January 2008 and April 2012 at our institution. All procedures were performed by the same surgeon. Clinical and surgical outcomes for patients undergoing LESS surgery using Glove port were compared with those patients undergoing TML surgery. Results A review of 129 patient cases undergoing LESS surgery using Glove port and 100 patient cases undergoing TML surgery revealed no significant differences in the baseline characteristics of the two groups. The median operative time was shorter in the LESS group using Glove port at 44 minutes (range, 19-126 minutes) than the TML group at 49 minutes (range, 20-196 minutes) (P=0.0007). There were no significant differences between in the duration of postoperative hospital stay, change in hemoglobin levels, pain score or the rate of complications between the LESS and TML groups. Conclusion LESS surgery showed comparable clinical and surgical outcomes to TML surgery, and required less operative time. Future prospective trials are warranted to further define the benefits of LESS surgery for adnexal tumor treatment.

Lee, In Ok; Yoon, Jung Won; Chung, Dawn; Yim, Ga Won; Nam, Eun Ji; Kim, Sunghoon; Kim, Sang Wun

2014-01-01

156

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

PubMed

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

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

2014-01-01

157

Ocular ischemic syndrome - a systematic review  

PubMed Central

Summary Ocular ischemic syndrome is a rare condition, which is caused by ocular hypoperfusion due to stenosis or occlusion of the common or internal carotid arteries. Atherosclerosis is the major cause of changes in the carotid arteries. Ocular ischemic syndrome is manifested as visual loss, orbital pain and, frequently, changes of the visual field, and various anterior and posterior segment signs. Anterior segment signs include iris neovascularization and secondary neovascular glaucoma, iridocyclitis, asymmetric cataract, iris atrophy and sluggish reaction to light. Posterior eye segment changes are the most characteristic, such as narrowed retinal arteries, perifoveal telangiectasias, dilated retinal veins, mid-peripheral retinal hemorrhages, microaneurysms, neovascularization at the optic disk and in the retina, a cherry-red spot, cotton-wool spots, vitreous hemorrhage and normal-tension glaucoma. Differential diagnosis of ocular ischemic syndrome includes diabetic retinopathy and moderate central retinal vein occlusion. Carotid artery imaging and fundus fluorescein angiography help to establish the diagnosis of ocular ischemic syndrome. The treatment can be local, for example, ocular (conservative, laser and surgical) or systemic (conservative and surgical treatment of the carotid artery). Since the condition does not affect the eyes alone, patients with ocular ischemic syndrome should be referred for consultation to the neurologist, vascular surgeon and cardiologist. PMID:22847215

Terelak-Borys, Barbara; Skonieczna, Katarzyna; Grabska-Liberek, Iwona

2012-01-01

158

Ocular allergy in the Asia Pacific region.  

PubMed

Allergic conjunctivitis (AC) represents a spectrum of disorders, comprising seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), atopic keratoconjunctivitis (AKC), vernal keratoconjunctivitis (VKC) and giant papillary conjunctivitis. Of these ocular allergy types, SAC and PAC are the most common.The most striking difference within this group of ocular diseases is that SAC and PAC remain self-limited without ocular surface damage, while AKC and VKC can compromise the cornea, causing ulcers and scarring and can ultimately lead to vision loss. Data on AC in the Asia Pacific is scarce however some understanding of prevalence of the condition has been obtained from the International Study of Asthma and Allergies in Childhood (ISAAC) studies and more recently from the Allergies in Asia Pacific study as well as some information from individual country surveys. Unfortunately none of this data has been collected using validated survey instruments specifically designed for AC. Surveys such as ISAAC have been predominantly concerned with respiratory allergic symptoms with questions added that incorporate some ocular symptoms. These questionnaires do not detect individuals who may have AC in the absence of allergic rhinitis. Using hospital ophthalmology outpatient populations for prevalence studies of ocular allergy immediately introduces a bias towards the more severe, complex forms of the condition as patients with the milder forms of SAR and PAR will rarely present to a hospital outpatient clinic. There is a real need for the development of validated questionnaires specifically addressing ocular allergy. There are no widely accessible studies examining prevalence of the complex forms of ocular allergy (AKC, VKC) in Asia Pacific region. This review will provide an overview of ocular allergy, its classification, clinical presentation and differential diagnosis, and will also discuss what is known about the epidemiology of ocular allergy in the Asian Pacific region. PMID:22053306

Katelaris, Constance H

2011-10-01

159

Ocular allergy in the Asia Pacific region  

PubMed Central

Allergic conjunctivitis (AC) represents a spectrum of disorders, comprising seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), atopic keratoconjunctivitis (AKC), vernal keratoconjunctivitis (VKC) and giant papillary conjunctivitis. Of these ocular allergy types, SAC and PAC are the most common.The most striking difference within this group of ocular diseases is that SAC and PAC remain self-limited without ocular surface damage, while AKC and VKC can compromise the cornea, causing ulcers and scarring and can ultimately lead to vision loss. Data on AC in the Asia Pacific is scarce however some understanding of prevalence of the condition has been obtained from the International Study of Asthma and Allergies in Childhood (ISAAC) studies and more recently from the Allergies in Asia Pacific study as well as some information from individual country surveys. Unfortunately none of this data has been collected using validated survey instruments specifically designed for AC. Surveys such as ISAAC have been predominantly concerned with respiratory allergic symptoms with questions added that incorporate some ocular symptoms. These questionnaires do not detect individuals who may have AC in the absence of allergic rhinitis. Using hospital ophthalmology outpatient populations for prevalence studies of ocular allergy immediately introduces a bias towards the more severe, complex forms of the condition as patients with the milder forms of SAR and PAR will rarely present to a hospital outpatient clinic. There is a real need for the development of validated questionnaires specifically addressing ocular allergy. There are no widely accessible studies examining prevalence of the complex forms of ocular allergy (AKC, VKC) in Asia Pacific region. This review will provide an overview of ocular allergy, its classification, clinical presentation and differential diagnosis, and will also discuss what is known about the epidemiology of ocular allergy in the Asian Pacific region. PMID:22053306

2011-01-01

160

Ocular chemical injuries and their management  

PubMed Central

Chemical burns represent potentially blinding ocular injuries and constitute a true ocular emergency requiring immediate assessment and initiation of treatment. The majority of victims are young and exposure occurs at home, work place and in association with criminal assaults. Alkali injuries occur more frequently than acid injuries. Chemical injuries of the eye produce extensive damage to the ocular surface epithelium, cornea, anterior segment and limbal stem cells resulting in permanent unilateral or bilateral visual impairment. Emergency management if appropriate may be single most important factor in determining visual outcome. This article reviews the emergency management and newer techniques to improve the prognosis of patients with chemical injuries. PMID:24082664

Singh, Parul; Tyagi, Manoj; Kumar, Yogesh; Gupta, K. K.; Sharma, P. D.

2013-01-01

161

[Penetrating ocular trauma with intraocular foreign body].  

PubMed

We present the case of a 65 years old pacient which was admitted for the sudden decrease of visual acuity in the left eye, accompanied by ocular pain and conjunctival hiperemia, simptoms appeared after an ocular trauma. After the clinical and paraclinical examination we determined the diagnosis of OS: Penetrating ocular trauma with retention of a foreign body; posttraumatic cataract. Surgical treatement was warrented and we performed OS : Facoemulsification + PFK implant in sulcus + 23 Ga posterior vitrectomy + peeling of the posterior hyaloid membrane + extraction of the foreign body + LASER endofotocoagulation + transscleral cryotherapy + SF6 gas injection. The post-operatory evolution was favorable. PMID:22888689

Musat, O; Ochinciuc, Uliana; Gutu, Tatiana; Cristescu, T R; Coman, Corina

2012-01-01

162

Segmentation-free ocular detection and recognition  

NASA Astrophysics Data System (ADS)

Iris recognition is a well-known technique to identify persons. However this technique requires high resolution images in order to automatically segment the iris. In some scenarios obtaining the required resolution may be difficult. In this paper, we investigate the recognition of ocular regions using correlation filters without segmenting the iris region. This method uses the whole eye region and surrounding areas, i.e., the ocular region, for identification. In our experiments we use the recently developed Quadratic Correlation Filter and show that at low resolutions segmentation-free ocular recognition can succeed while iris segmentation fails.

Rodriguez, Andres; Panza, Jeffrey; Vijaya Kumar, B. V. K.

2011-06-01

163

Sudden cardiac death due to coronary artery involvement by IgG4-related disease: a rare, serious complication of a rare disease.  

PubMed

Immunoglobulin G4-related disease (IgG4-RD) is a systemic disorder characterized by multiorgan fibrosis with IgG4-producing plasma cells, increased IgG4 serum concentration, and responsiveness to steroid therapy. Involvement of the pancreas, salivary glands, orbit, aorta, and other sites has been well documented in the literature; however, there have been limited reports of cases involving the coronary arteries. We report the case of a 53-year-old Hispanic man who was brought to the emergency center and diagnosed with sudden cardiac death. Autopsy was subsequently performed, revealing multiorgan involvement by IgG4-RD, including involvement of the coronary arteries. The inflammation and fibrosis, in combination with concomitant atherosclerotic disease, resulted in severe stenosis of the coronary arteries. Two of the coronary arteries were further occluded by thrombosis. These factors led to cardiac hypoperfusion, myocardial infarction and, ultimately, sudden cardiac death. Fatal involvement of the coronary arteries has not been previously reported, raising a new concern for a severe complication of IgG4-RD. PMID:24878025

Patel, Nimesh R; Anzalone, Mary L; Buja, L Maximilian; Elghetany, M Tarek

2014-06-01

164

The role of cytotoxic T cells in IgG4-related dacryoadenitis and sialadenitis, the so-called Mikulicz's disease.  

PubMed

Abstract Objectives. Immunoglobulin (Ig) G4-related dacryoadenitis and sialadenitis, the so-called Mikulicz's disease (MD), is a chronic inflammatory disease. However, little is known about its pathogenesis and pathological condition. In the present study, we used immunohistological techniques to compare the roles of cytotoxic T lymphocytes (CTLs) in MD and primary Sjogren's syndrome (SS). We examined the state of CTLs [cytotoxic granule-positive rate and programmed death-1 (PD-1) expression rate] in the salivary glands. Methods. The study samples comprised 12 submaxillary glands from untreated MD patients and 12 labial glands from SS patients. We performed immunofluorescence and multicolor immunofluorescence to stain CD8, perforin (PRF), granzyme B (GZMB), and PD-1. We measured the total number of CTLs as well as the PRF(+)CTLs, GZMB(+)CTLs, and PD-1(+)CTLs. Results. We found that the degree of infiltration of CTLs was equal in MD and SS, but the rate of CTLs with cytotoxic granules, especially PRF, in MD was less than in SS. In addition, the frequency of PD-1(+)CTLs in MD was higher than that in SS. Conclusions. Cytotoxic granule-positive CTLs were in the minority in MD salivary glands, and this regulation might relate to PD-1 signals like the state of exhaustion and anergy. PMID:24593171

Tabeya, Tetsuya; Yamamoto, Motohisa; Naishiro, Yasuyoshi; Ishigami, Keisuke; Shimizu, Yui; Yajima, Hidetaka; Suzuki, Chisako; Seki, Nobuhiko; Takano, Kenichi; Himi, Tetsuo; Imai, Kohzoh; Takahashi, Hiroki; Shinomura, Yasuhisa

2014-11-01

165

Fibrosis of the thyroid gland caused by an IgG4-related sclerosing disease: three years of follow-up.  

PubMed

Immunoglobulin G4-related sclerosing disease (IgG4-RSD) represents a recently identified inflammatory disorder in which infiltration of IgG4 plasma cells causes fibrosis in organs. While IgG4-RSD is well documented in the pancreas and other organs, it is poorly characterized in the thyroid gland. We report a case of a 48-year-old female with a fibrotic thyroid mass associated with a retroperitoneal fibrosis. Diagnosed early as Riedel disease, the high serum IgG4, immunohistopathology and decreased fibrosis with corticosteroid therapy, finally confirm for the first time, the origin of IgG4-RSD fibrosis of the thyroid. PMID:25224542

Oriot, P; Amraoui, A; Rousseau, E; Malvaux, P; Dechambre, S; Delcourt, A

2014-12-01

166

Characteristic ocular findings in Asian children with Down syndrome  

Microsoft Academic Search

Aims\\/Purpose To identify the characteristic ocular findings in Asian children with Down syndrome.Methods A total of 123 Korean children with Down’s syndrome between 6 months and 14 years of age were examined for ocular findings from March 1999 to April 2000. Ocular examinations including visual acuity assessment, slit-lamp biomicroscopy, ocular motility, cycloplegic refraction, and ophthalmoscopy were performed.Results The ocular findings

J H Kim; J-M Hwang; H J Kim; Y S Yu

2002-01-01

167

Clinical Features and Treatment of Ocular Toxoplasmosis  

PubMed Central

Ocular toxoplasmosis is a disease caused by the infection with Toxoplasma gondii through congenital or acquired routes. Once the parasite reaches the retina, it proliferates within host cells followed by rupture of the host cells and invasion into neighboring cells to make primary lesions. Sometimes the restricted parasite by the host immunity in the first scar is activated to infect another lesion nearby the scar. Blurred vision is the main complaint of ocular toxoplasmic patients and can be diagnosed by detection of antibodies or parasite DNA. Ocular toxoplasmosis needs therapy with several combinations of drugs to eliminate the parasite and accompanying inflammation; if not treated it sometimes leads to loss of vision. We describe here clinical features and currently available chemotherapy of ocular toxoplasmosis. PMID:24039281

Park, Young-Hoon

2013-01-01

168

Ocular findings in a case of fucosidosis.  

PubMed Central

The ocular findings in a case of fucosidosis are described and the differential diagnosis is discussed. It is suggested that the level of alpha-L-fucosidase should be estimated in cases of bull's eye retinopathy. Images PMID:952824

Snodgrass, M. B.

1976-01-01

169

Ocular toxicity of systemic anticancer chemotherapy  

PubMed Central

The increased use of chemotherapeutic agents has resulted in longer cancer patient survival. Consequently the ophthalmologist is seeing more patients with adverse ocular side effects secondary to these antineoplastic agents. Ocular toxicity induced by cancer chemotherapy includes a broad spectrum of disorders, reflecting the unique anatomical, physiological and biochemical features of the eye. Understanding the ocular side effects will assist the ophthalmologist and oncologist to recognize them early and intervene before blindness occurs. Anticipation of various treatment-related toxicities may also provide the opportunity for pharmacists to develop intervention strategies that could minimize or eliminate an expected side effect. The ophthalmologist should examine patients on anticancer therapy at baseline and three monthly thereafter. The various ocular side effects of anticancer chemotherapeutic agents, tamoxifen, and interferon on the adnexia, anterior segment, posterior segment and neuro-ophthalmic structures were reviewed.

Omoti, Afekhide Ernest; Omoti, Caroline Edijana

170

Ocular findings following trauma from paintball sports  

Microsoft Academic Search

PurposeTo raise awareness of potential significant ocular damage and visual loss secondary to paintballs in those not wearing ocular protection and to report high incidence of chorioretinitis sclopetaria from paintball contusion.MethodsWe reviewed cases of eye injury presenting to a single institution from 2000 to 2005. Those cases in which the injury was attributed to paintballs were identified and evaluated to

M Taban; J E Sears

2008-01-01

171

Ocular sports injuries: the current picture  

PubMed Central

Objectives—To determine the recent incidence of eye injury due to sport in Scotland, identify any trend, and establish which sports are responsible for most injury? The type of injury and final visual outcome is also evaluated. Methods—A prospective observational study of ocular injuries sustained during sport was performed over a one year period. Only patients requiring hospital admission were included. Data were collected on a standardised proforma and entered into a central database. Patients were followed up for at least three months. Results—Of 416 patients admitted because of ocular injury, 52 (12.5%) resulted from playing a sport. Although all racquet sports together accounted for 47.5% of these injuries, football was the single most common sport associated with ocular trauma, being responsible for 32.5% of cases. The most common clinical finding was macroscopic hyphaema occurring in 87.5% of patients. Overall the final visual acuity was 6/6 in 92.5% of patients. Conclusions—The incidence of eye injury due to sport at 12.5% is lower than previously reported, suggesting a change in the pattern of ocular trauma. Football is the single most common cause of ocular injury from sport in Scotland, but the wearing of protective headgear would be difficult to instigate. The incidence of hyphaema in sport related ocular trauma (87.5%) is almost double that of all ocular injury (47.8%), so the potential for serious visual loss as the result of a sports injury should not be underrated. Ophthalmologists have a role in protecting this young population at risk by actively encouraging the design and use of protective eyewear. Key Words: eye injury; ocular trauma; hyphaema; protective eyewear PMID:11131235

Barr, A; Baines, P; Desai, P; MacEwen, C

2000-01-01

172

Ocular complications of childhood rheumatic diseases: Uveitis  

Microsoft Academic Search

Ocular involvement is common in pediatric rheumatologic diseases, supporting the concept that these conditions cannot be understood\\u000a simply as isolated entities, but rather as multisystem disorders. The reasons for the breach of the eye-brain barrier and\\u000a the targeting of the usually well-shielded eye during a pan-inflammatory process remains unclear. Pediatric rheumatologists\\u000a should become familiar with these ocular disorders, because as

Andreas Reiff

2006-01-01

173

Cockpit Ocular Recording System (CORS)  

NASA Technical Reports Server (NTRS)

The overall goal was the development of a Cockpit Ocular Recording System (CORS). Four tasks were used: (1) the development of the system; (2) the experimentation and improvement of the system; (3) demonstrations of the working system; and (4) system documentation. Overall, the prototype represents a workable and flexibly designed CORS system. For the most part, the hardware use for the prototype system is off-the-shelf. All of the following software was developed specifically: (1) setup software that the user specifies the cockpit configuration and identifies possible areas in which the pilot will look; (2) sensing software which integrates the 60 Hz data from the oculometer and heat orientation sensing unit; (3) processing software which applies a spatiotemporal filter to the lookpoint data to determine fixation/dwell positions; (4) data recording output routines; and (5) playback software which allows the user to retrieve and analyze the data. Several experiments were performed to verify the system accuracy and quantify system deficiencies. These tests resulted in recommendations for any future system that might be constructed.

Rothenheber, Edward; Stokes, James; Lagrossa, Charles; Arnold, William; Dick, A. O.

1990-01-01

174

Postural studies in pulsatile ocular blood flow: I. Ocular hypertension and normotension.  

PubMed Central

Measurements of pulsatile ocular blood flow (POBF) have been recorded in a group of healthy, ocular normotensive volunteers and ocular hypertensive patients recruited from outpatients. Use of a pneumotonometric probe linked to a Langham ocular blood flow system enabled readings of intraocular pressure and its variation with heart rate (ocular pulse) to be taken in erect and supine positions. Pulsatile ocular blood flow was calculated from these values by means of the pressure-volume relationship previously described for living human eyes. Assumption of the supine posture was accompanied by a significant rise in intraocular pressure; in normal eyes (mean, with SEM) (3.1 (0.4) mmHg, p less than 0.0001) and to a greater extent in ocular hypertensive eyes (4.7 (0.6) mmHg, p less than 0.0001). The POBF did not differ significantly between normotensive and ocular hypertensive groups in either the erect or supine postures. In both groups, however, assumption of the supine posture was accompanied by a significant fall in POBF (normals: -121 (21) microliters/min, p less than 0.0001; ocular hypertensives: -75 (16) microliters/min, p less than 0.0002). These reductions in POBF represent decrements of 27.5 (3.0)% and 17.1 (3.8)% respectively. Pulsatile ocular blood flow is reduced in the supine posture, and this may result in tissue hypoxia in subjects at risk of developing glaucoma. A companion paper describes the measurement of POBF in a group of patients with chronic open angle glaucoma treated with topical timolol 0.25%. PMID:1995045

Trew, D R; Smith, S E

1991-01-01

175

Polymeric vectors for ocular gene delivery  

PubMed Central

Gene therapy holds promise for the treatment of many inherited and acquired diseases of the eye. Successful ocular to targeted cells with minimal toxicity. A major gene therapy interventions depend on challenge is to overcome both intracellular and extracellular barriers associated with ocular gene delivery. Numerous viral and nonviral vectors were explored to improve transfection efficiency. Among nonviral delivery systems, polymeric vectors have gained significant attention in recent years owing to their nontoxic and non-immunogenic nature. Polyplexes or nanoparticles can be prepared by interaction of cationic polymers with DNA, which facilitate cellular uptake, endolysosomal escape and nuclear entry through active mechanisms. Chemical modification of these polymers allows for the generation of flexible delivery vectors with desirable properties. In this article several synthetic and natural polymeric systems utilized for ocular gene delivery are discussed. PMID:21858246

Tamboli, Viral; Mishra, Gyan P; Mitra, Ashim K

2011-01-01

176

Lymphocyte transformation in presumed ocular histoplasmosis  

SciTech Connect

Lymphocytes from individuals with inactive macular disciform lesions of presumed ocular histoplasmosis challenged with three histoplasmin antigens incorporated tritiated thymidine at a significantly higher rate than histoplasmin-stimulated lymphocytes of matched control and peripheral scar groups. This finding is consistent with the etiologic association of the disciform ocular syndrome and previous systemic infection with Histoplasma capsulatum. The disciform group had a higher mean response than the other two groups to pokeweed mitogen but not to phytohemagglutinin and had higher mean counts per minute to the specific antigens Toxoplasma gondii, Blastomyces dermatitidis, Cryptococcus neoformans, Mycobacterium tuberculosis, M battery, and M gaus, but not to Candida albicans. These data would suggest that individuals with the disciform lesion of presumed ocular histoplasmosis have a hyperreactive cellular immune response; this response may play an important role in the development of the disciform.

Ganley, J.P.; Nemo, G.J.; Comstock, G.W.; Brody, J.A.

1981-08-01

177

Ocular trauma resulting from paintball injury  

Microsoft Academic Search

Background  Paintball-related ocular injuries result in severe damage and loss of vision. Despite efforts to increase public awareness\\u000a and improve safety features, the incidence of eye injuries has increased over time. We examined the characteristics and ocular\\u000a effects of paintball injury at our tertiary referral center.\\u000a \\u000a \\u000a \\u000a Methods  Retrospective review of charts of patients with paintball injury between 1998–2005.\\u000a \\u000a \\u000a \\u000a Results  Fourteen patients were evaluated

Patricia J. Pahk; Ron A. Adelman

2009-01-01

178

Macromelanosomes in X-linked ocular albinism.  

PubMed

Examination of clinically normal skin from four patients with X-linked ocular albinism of the Nettleship-Falls type by light and electron microscopy revealed the presence of macromelanosomes in some melanocytes and keratinocytes. Measuring up to 5 micron many of the abnormal melanosomes showed a concentrically laminated structure suggestive of a phasic growth pattern. Epidermis from three female carriers contained similar but fewer macromelanosomes. These findings indicate that skin biopsy could be of value not only in confirming the diagnosis of ocular albinism in affected males, but also to establish carrier status in asymptomatic females. PMID:7390409

Garner, A; Jay, B S

1980-05-01

179

Dry eye: an inflammatory ocular disease.  

PubMed

Keratoconjunctivitis sicca, or dry eye, is a common ocular disease prompting millions of individuals to seek ophthalmological care. Regardless of the underlying etiology, dry eye has been shown to be associated with abnormalities in the pre-corneal tear film and subsequent inflammatory changes in the entire ocular surface including the adnexa, conjunctiva and cornea. Since the recognition of the role of inflammation in dry eye, a number of novel treatments have been investigated designed to inhibit various inflammatory pathways. Current medications that are used, including cyclosporine A, corticosteroids, tacrolimus, tetracycline derivatives and autologous serum, have been effective for management of dry eye and lead to measurable clinical improvement. PMID:25279127

Hessen, Michelle; Akpek, Esen Karamursel

2014-04-01

180

Dry Eye: an Inflammatory Ocular Disease  

PubMed Central

Keratoconjunctivitis sicca, or dry eye, is a common ocular disease prompting millions of individuals to seek ophthalmological care. Regardless of the underlying etiology, dry eye has been shown to be associated with abnormalities in the pre-corneal tear film and subsequent inflammatory changes in the entire ocular surface including the adnexa, conjunctiva and cornea. Since the recognition of the role of inflammation in dry eye, a number of novel treatments have been investigated designed to inhibit various inflammatory pathways. Current medications that are used, including cyclosporine A, corticosteroids, tacrolimus, tetracycline derivatives and autologous serum, have been effective for management of dry eye and lead to measurable clinical improvement.

Hessen, Michelle; Akpek, Esen Karamursel

2014-01-01

181

Automatic Composition of Color Ocular Fundus Images  

Microsoft Academic Search

This paper describes a PC-based system that is able to automatically combine color ocular fundus images captured from different angles by a digital retinal camera. The system matches the locations of retinal vascular nodes (crossing points or branches) in the different images by comparing the correlation values of all nodes in a particular rectangular area with all other nodes in

K. Tanabe; T. Tsubouchi; H. Okuda; M. Oku

2006-01-01

182

Damage control surgery in ocular traumatology  

Microsoft Academic Search

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

Ferenc Kuhn; Zlatko Slezakb

2004-01-01

183

X linked ocular albinism in Japanese patients  

Microsoft Academic Search

Thirteen affected Japanese male patients and 13 female carriers with X linked ocular albinism from seven families were examined to assess their clinical findings and to compare them with those of white and black patients. Affected Japanese patients had poor visual acuity, horizontal nystagmus, macular hypoplasia, and loss of stereopsis. Some affected patients had non-albinotic fundus with moderate pigmentation. The

T Shiono; M Tsunoda; Y Chida; M Nakazawa; M Tamai

1995-01-01

184

Ocular disorders in children with Down syndrome  

Microsoft Academic Search

Seventy-three patients with Down syndrome between the ages of 5 to 18 years were initially enrolled in this study and there were 68 patients in the final sample. Information was obtained from previous ophthalmologic examina- tions and parents completed a questionnaire pertaining to ocular disorders. Subsequently, the patients' visual acuity was assessed using Snellen or Kindergarten Test Charts for far

Stefan Gieswein

1993-01-01

185

Visual function in human ocular toxoplasmosis  

PubMed Central

Aim To assess functional impairment in terms of visual acuity reduction and visual field defects in inactive ocular toxoplasmosis. Methods 61 patients with known ocular toxoplasmosis in a quiescent state were included in this prospective, cross?sectional study. A complete ophthalmic examination, retinal photodocumentation and standard automated perimetry (Octopus perimeter, program G2) were performed. Visual acuity was classified on the basis of the World Health Organization definition of visual impairment and blindness: normal (?20/25), mild (20/25 to 20/60), moderate (20/60 to 20/400) and severe (<20/400). Visual field damage was correspondingly graded as mild (mean defect <4?dB), moderate (mean defect 4–12?dB) or severe (mean defect >12?dB). Results 8 (13%) patients presented with bilateral ocular toxoplasmosis. Thus, a total of 69 eyes was evaluated. Visual field damage was encountered in 65 (94%) eyes, whereas only 28 (41%) eyes had reduced visual acuity, showing perimetric findings to be more sensitive in detecting chorioretinal damage (p<0.001). Correlation with the clinical localisation of chorioretinal scars was better for visual field (in 70% of the instances) than for visual acuity (33%). Moderate to severe functional impairment was registered in 65.2% for visual field, and in 27.5% for visual acuity. Conclusion In its quiescent stage, ocular toxoplasmosis was associated with permanent visual field defects in >94% of the eyes studied. Hence, standard automated perimetry may better reflect the functional damage encountered by ocular toxoplasmosis than visual acuity. PMID:16987904

Scherrer, Janine; Iliev, Milko E; Halberstadt, Markus; Kodjikian, Laurent; Garweg, Justus G

2007-01-01

186

[Clinical management of severe ocular surface disease].  

PubMed

Severe ocular surface diseases, such as Stevens-Johnson syndrome, ocular cicatricial pemphigoid or severe ocular burns may result in a significant loss of corneal stem cells, eventually leading to vision impairment or even corneal blindness. In case of unilateral involvement, limbal autografting, by means of transplanting limbal stem cells from the healthy fellow eye, has proved to be an effective procedure for restoring the integrity of the ocular surface. Limbal allografts may be performed in patients with bilateral disease, however, systemic immunosuppression is mandatory in these cases, with a long-term outcome that is frequently reduced compared to limbal autografts due to acute or chronic graft rejection. In recent years, amniotic membrane transplantation has been successfully employed as an additional tool in ocular surface reconstruction. The AlphaCor synthetic cornea, which is made of flexible acrylic may be considered as an alternative in patients with repeated corneal graft failures. Both limbal transplantation and the AlphaCor have been shown to be effective in eyes with an adequate tear film, but are most likely to fail in severe dry eyes or in patients with cicatrising diseases. Such conditions are the domain of keratoprostheses (KPros) with rigid optics, which certainly can be considered as the 'last resort' to restore vision in patients with profound corneal blindness not amenable to conventional corneal and limbal grafting. The osteo-odonto-keratoprosthesis according to Strampelli and modified by Falcinelli makes use of a "biological" support consisting of a longitudinal section of one of the patient's teeth that is also supported by the surrounding alveolar bone tissue. Compared to other devices favourable long-term results have been reported. In patients lacking any usable teeth, implantation of a keratoprosthesis with haptics made of Dacron (Pintucci-KPro) or tibial bone (Temprano-KPro) might be considered. PMID:16034721

Stoiber, J; Grabner, G

2005-07-01

187

Ocular Drug Delivery; Impact of in vitro Cell Culture Models  

PubMed Central

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

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

2009-01-01

188

Ocular pulse amplitude in diabetes mellitus  

PubMed Central

BACKGROUND—The influence of diabetes mellitus on ocular pulse amplitude (OPA), an indirect measure of choroidal perfusion, is unclear.?METHODS—OPA, using the Langham ocular blood flow (OBF) system, applanation intraocular pressure (IOP), systemic blood pressure (BP), heart rate, and haemoglobin (Hb) A1c were measured in patients with insulin dependent diabetes mellitus (IDDM) with no (DR-0, n = 22) non-proliferative (DR-1, n = 24), and proliferative (DR-2, n = 18) diabetic retinopathy.?RESULTS—Neither local (OPA, IOP) nor systemic perfusion parameters (BPs, HR) nor HbA1c were significantly altered in DR-0, DR-1, or DR-2 IDDM patients.?CONCLUSION—Choroidal circulation remains unaffected as diabetic retinopathy advances.?? PMID:11049955

Schmidt, K.; von Ruckmann, A.; Kemkes-Matthes, B.; Hammes, H.

2000-01-01

189

Ocular motility of aging and dementia.  

PubMed

Visual complaints in patients with dementia are varied and attributable to both visual sensory (afferent) and ocular motor (efferent) dysfunction. This review focuses exclusively on the efferent visual dysfunction associated with dementia and aging. It provides a brief overview of the most common ocular motility disturbances associated with dementia, including Alzheimer's disease, Parkinson's disease, diffuse Lewy body disease, corticobasal syndrome, progressive supranuclear palsy, frontotemporal lobar degeneration, Creutzfeldt-Jakob disease, and others. An introduction to the six eye movement systems and the terminology associated with the evaluation of each system are reviewed. Assessment of efferent visual function in patients with dementia may be challenging, but familiarity with the potential pathologic eye movement findings in patients with dementia will allow for a focused assessment, diagnosis, and treatment when possible. PMID:20697981

Pelak, Victoria S

2010-11-01

190

Ocular screening tests of elementary school children  

NASA Technical Reports Server (NTRS)

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.

Richardson, J.

1983-01-01

191

Vestibular-ocular accommodation reflex in man  

NASA Technical Reports Server (NTRS)

Stimulation of the vestibular system by angular acceleration produces widespread sensory and motor effects. The present paper studies a motor effect which has not been reported in the literature, i.e., the influence of rotary acceleration of the body on ocular accommodation. The accommodation of 10 young men was recorded before and after a high-level deceleration to zero velocity following 30 sec of rotating. Accommodation was recorded continuously on an infrared optometer for 110 sec under two conditions: while the subjects observed a target set at the far point, and while they viewed the same target through a 0.3-mm pinhole. Stimulation by high-level rotary deceleration produced positive accommodation or a pseudomyopia under both conditions, but the positive accommodation was substantially greater and lasted much longer during fixation through the pinhole. It is hypothesized that this increase in accommodation is a result of a vestibular-ocular accommodation reflex.

Clark, B.; Randle, R. J.; Stewart, J. D.

1975-01-01

192

Ocular Toxicity Testing of Lunar Dust  

NASA Technical Reports Server (NTRS)

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.

Meyers, Valerie E.

2010-01-01

193

[Rare ocular manifestation with suspect alport syndrome].  

PubMed

The authors mention a case report of a 13 year old girl with renal disease, who visited the outpatient Department of Pediatric Ophthalmology, University Hospital Brno with subjective complaints on decreased vision of both eyes. Ophthalmologic examination showed physiological foveolar reflex on fundus and very discrete changes of the retinal pigment epithelium in macula, the fundus periphery was without pathology. OCT images showed bilateral atrophy of central macula and changes at the level of the photoreceptors. The authors describe a rare ocular manifestation of macular atrophy with suspect Alport syndrome, which strengthened the suspicion of this disease. The authors also mention other possible ocular manifestations of Alport syndrome and compare the findings with the up to date international references. Key words: Alport syndrome, X heterozygot Alport syndrome, macular atrophy, lentikonus. PMID:25032798

Krej?í?ová, I; Varadyová, B; Doležel, Z; Autrata, R; Matúšová, J; Gregorová, E

2014-06-01

194

Distinctive features of adult ocular dominance plasticity  

PubMed Central

Sensory experience profoundly shapes neural circuitry of juvenile brain. Although the visual cortex of adult rodents retains a capacity for plasticity in response to monocular visual deprivation, the nature of this plasticity and the neural circuit changes that accompany it remain enigmatic. Here we investigate differences between adult and juvenile ocular dominance plasticity using Fourier optical imaging of intrinsic signals in mouse visual cortex. This comparison reveals that adult plasticity takes longer than in the juvenile mouse, is of smaller magnitude, has a greater contribution from the increase in response to the open eye, and has less effect on the hemisphere ipsilateral to the deprived eye. Binocular deprivation also causes different changes in the adult. Adult plasticity is similar to juvenile plasticity in its dependence on signaling through NMDA receptors. We propose that adult ocular dominance plasticity arises from compensatory mechanisms that counterbalance the loss of afferent activity caused by visual deprivation. PMID:18842887

Sato, Masaaki; Stryker, Michael P.

2008-01-01

195

Ocular manifestations of genetic and development diseases.  

PubMed

Significant advances were reported this year in the identification of the chromosomal location of mutated genes on the 13 and 6 chromosomes which cause forms of autosomal dominant Stargardt's macular dystrophy. Observations in monozygotic twins with age-related macular dystrophy were described. Mitochondrial DNA mutations in Cubans with optic and peripheral neuropathy were reported. A new autosomal dominant proximal myotonic myopathy was described. Persistence of the tunica vasculosa lentis was suggested as a helpful sign of congenital myotonic dystrophy. The panoply of ocular findings in acromesomelic dysplasia were presented. Genetic characterization of the ocular findings in Duchenne type and Becker's muscular dystrophy was reported. Finally, a new syndrome of autosomal dominant cerebellar ataxia with retinal degeneration was described. PMID:10160422

Diamond, G R

1995-12-01

196

An alternate impression technique for ocular prostheses.  

PubMed

This article describes an alternative two-step ocular prosthesis impression technique that employs two materials of different consistencies. The method is intended to provide better adaptation to underlying tissues, increased mobility of the prosthesis owing to improvements in facial contours, and improved esthetics, as well as offering the patient greater comfort and security. These advantages and this prosthesis' relative ease of fabrication mean it should be considered as the first step in the management of untreated anophthalmic sockets. PMID:23106824

Goiato, Marcelo Coelho; Dos Santos, Daniela Micheline; Moreno, Amália; Filié Haddad, Marcela; Turcio, Karina Helga Leal

2013-06-01

197

Ocular injury due to bungee jumping.  

PubMed

BACKGROUND: Bungee jumping is a well-established recreational activity in New Zealand and Australia which may be associated with injuries to the eyes and other tissues. CASE HISTORY: A patient with a retinal haemorrhage which resulted from bungee jumping is reported and the clinical characteristics described. DISCUSSION: There have been several reports of injury due to bungee jumping. The types of ocular injury are reviewed and the aetiological theories discussed. PMID:12482279

Curtis, Edward B; Collin, H Barry

1999-01-01

198

Ocular allergy guidelines: a practical treatment algorithm.  

PubMed

The treatment of ocular allergy requires a better understanding of the spectrum of clinical disorders involving various components of the immune system, and of interactions at the conjunctival surface. The immune response focuses primarily on the different levels of activity of Th2 lymphocytes and various other immune cells associated with allergic disorders, including mast cells, eosinophils, fibroblasts, and epithelial and endothelial cells. Ocular allergic disorders include seasonal allergic conjunctivitis (SAC), perennial allergic conjunctivitis (PAC), vernal keratoconjunctivitis (VKC), giant papillary conjunctivitis (GPC) and atopic keratoconjunctivitis (AKC), which, through immunopathological and molecular immunological techniques, can all be better appreciated as being part of a larger spectrum of an atopic disease state. In SAC, pathological changes, such as increased mast-cell activation, the presence of migratory inflammatory cells, and early signs of cellular activation at the molecular level, are minimal. In PAC, these changes are more pronounced in line with the increased duration of allergenic stimulation. In more chronic forms of allergic conjunctivitis, such as VKC in children and AKC in adults, the following changes are evident: a persistent state of mast cell, eosinophil and lymphocyte activation; noted switching from connective-tissue to mucosal-type mast cells; increased involvement of corneal pathology; and follicular development and fibrosis. The treatment of acute and more chronic forms of allergic conjunctivitis has focused in the past on symptomatic relief of symptoms, but with a better understanding of the mechanisms involved we can now provide interventional therapeutic strategies and symptomatic relief. Our advances in the basic understanding of these conditions are providing the foundation for guidelines that improve the ocular health of patients with ocular allergies. PMID:12109924

Bielory, Leonard

2002-01-01

199

Intranasal corticosteroids: Do they improve ocular allergy?  

Microsoft Academic Search

Allergic rhinoconjunctivitis (ARC) is a common allergic condition associated with high financial costs and decreased quality\\u000a of life. Medical treatment options are extensive and include oral, ophthalmic, and intranasal agents. Intranasal corticosteroids\\u000a (INS) have traditionally been used for chronic management of nasal symptoms, but have also demonstrated an impact on decreasing\\u000a ocular symptoms of itching, tearing, and redness. Study design,

Catherine Origlieri; Leonard Bielory

2009-01-01

200

Ocular Manifestations of Crystal Methamphetamine Use  

Microsoft Academic Search

Numerous medical sequelae associated with illicit drug use have been reported. Nevertheless, there has been scarce documentation\\u000a of the effects of these drugs on the eyes. Drug-induced ocular symptoms include decreased visual acuity, disturbances in perception,\\u000a and even flashbacks. Methamphetamine (METH) is a highly addictive drug whose abuse has spread worldwide during the past two\\u000a decades. METH abuse is associated

Ribhi Hazin; Jean Lud Cadet; Malik Y. Kahook; Dunia Saed

2009-01-01

201

Thymectomy in myasthenia with pure ocular symptoms.  

PubMed Central

Eighteen patients with exclusively ocular symptoms of myasthenia were thymectomised. Suspected thymoma, resistance to pyridostigmine therapy or relapse following immunosuppressive therapy were taken as indications for surgery. The mean preoperative observation period before operation was 40 months, and after operation was 26 months. There was no operative or postoperative morbidity or mortality. Histological thymic abnormalities were found in all patients (in one case, thymoma; in four, persistent thymus; in 13, thymic hyperplasia). The histological abnormalities were identical to those found in generalised myasthenia. This included the distribution of T-cell subtypes as identified by use of monoclonal antibodies. The severity of ocular symptoms was rated using a score developed for this purpose. The score progressively declined after surgery to an average of 70% of its initial amount in 80% of patients. Full remission occurred in three cases. No patient developed generalized myasthenia. Antibody titres against acetylcholine receptors if elevated preoperatively also dropped following surgery, with one exception. Clear criteria for the expected therapeutic success of thymectomy could not be identified. Based on our results, and on the assumed significance of the thymus gland for pathogenesis, thymectomy should be considered in patients with pure ocular symptoms. Images PMID:3998738

Schumm, F; Wiethölter, H; Fateh-Moghadam, A; Dichgans, J

1985-01-01

202

The effect of trabeculectomy on ocular hemodynamics.  

PubMed Central

PURPOSE: To evaluate the effects of chronic reduction of intraocular pressure (IOP) on ocular hemodynamics. METHODS: Multisite, prospective evaluation of patients requiring trabeculectomy for treatment of glaucoma. Patients were recruited from the glaucoma service of 2 university hospitals. Patients were evaluated prior to surgery and at 3, 6, and 12 months after trabeculectomy. Color Doppler imaging was used to measure blood flow in the ophthalmic artery, central retinal artery, and short posterior ciliary arteries. Heidelberg retinal flowmetry was used to evaluate perfusion in the peripapillary and optic disc capillary beds. IOP was measured at baseline and at each study visit. RESULTS: There were highly significant reductions in IOP from presurgical baseline measures. At 3 months, mean IOP reduction was 17.1 mm Hg (62.3%; P < .001). At the 6- and 12-month evaluations, the mean IOP reductions were 15.7 mm Hg (57.3%) and 15.5 mm Hg (56.5%), respectively, P < .001. Despite the significant reduction in IOP, there were no significant differences in any ocular blood flow parameters before and after trabeculectomy. CONCLUSIONS: The findings of this study suggest that chronic reduction of IOP does not alter ocular blood flow and that IOP may be an independent risk factor for progression of glaucoma. These findings also suggest that the eye has the ability to autoregulate to chronically increased IOP over time and that additional studies evaluating the long-term effects of IOP changes are needed to further define this relationship. PMID:11797313

Cantor, L B

2001-01-01

203

Experimental models of autoimmune inflammatory ocular diseases.  

PubMed

Ocular inflammation is one of the leading causes of blindness and loss of vision. Human uveitis is a complex and heterogeneous group of diseases characterized by inflammation of intraocular tissues. The eye may be the only organ involved, or uveitis may be part of a systemic disease. A significant number of cases are of unknown etiology and are labeled idiopathic. Animal models have been developed to the study of the physiopathogenesis of autoimmune uveitis due to the difficulty in obtaining human eye inflamed tissues for experiments. Most of those models are induced by injection of specific photoreceptors proteins (e.g., S-antigen, interphotoreceptor retinoid-binding protein, rhodopsin, recoverin, phosducin). Non-retinal antigens, including melanin-associated proteins and myelin basic protein, are also good inducers of uveitis in animals. Understanding the basic mechanisms and pathogenesis of autoimmune ocular diseases are essential for the development of new treatment approaches and therapeutic agents. The present review describes the main experimental models of autoimmune ocular inflammatory diseases. PMID:22760810

Gasparin, Fabio; Takahashi, Beatriz Sayuri; Scolari, Mariana Ramos; Gasparin, Filipe; Pedral, Lycia Sampaio; Damico, Francisco Max

2012-01-01

204

Ocular Complications of Leprosy in Yemen  

PubMed Central

Objectives: This study was conducted to identify the main ocular- and vision-threatening complications of leprosy in Yemen. Methods: This is a cross-sectional observational study which took place from February to July 2010. Leprosy patients attending the Skin and Venereal Diseases Hospital in the City of Light in Taiz, Yemen, who consented to participate in the study, were enrolled. Detailed demographic and medical histories were taken and clinical examination findings were recorded. A detailed eye examination, including visual acuity (VA), slit-lamp, and fundus examinations, was conducted on each patient by a qualified ophthalmologist. Results: A total of 192 patients (180 male, 12 female, with a male to female ratio of 15:1) were included in the study. The majority of the patients (157; 81.8%) were over 40 years. Over two-thirds of the patients (129; 67.2%) had had leprosy for more than 20 years. Ocular complications were found in 97% of cases; 150 (39.1%) of the patients’ eyes had at least one pathology. Eyelid involvement was the most common problem observed in 102 (26.5%) patients. Half of the eyes (192; 50%) had a VA of <6/60. The main cause of blindness among these patients was corneal opacity detected in 69 out of 192 patients (35.9%). Conclusion: Ocular complications are frequent among leprosy patients in Yemen. They are true vision-threatening lesions. It is important to prevent these lesions through early diagnosis and adequate treatment. PMID:23275842

Salem, Raga A. A.

2012-01-01

205

Cell-based therapies for ocular disease.  

PubMed

Cell therapy for ocular disease has made significant progress within the last decade. Stem and progenitor populations for many ocular cell types have been identified, and their behavior is now understood well enough to enable clinical application. Corneal epithelial progenitor cell therapy has benefited many patients and is now transitioning from a research technique to established clinical therapy. The application of embryonic stem cell-based therapy is in clinical development for Stargardt's macular dystrophy and dry age-related macular degeneration. These advances have been made possible, in part, by the inherent advantages of the eye as a place to develop and apply cell therapies and the foundation built on transplantation studies. Despite these advances, there are still areas of high unmet need that could benefit from cell therapy when further research identifies methods to identify, generate, and manipulate the progenitor populations. This review discusses, in practical terms, the application of cell therapies to the eye, progress that has been made and progress which remains to be made in the application of cell therapy to ocular disease. PMID:24050306

Eveleth, David D

2013-12-01

206

Monochromatic ocular wave aberrations in young monkeys  

PubMed Central

High-order monochromatic aberrations could potentially influence vision-dependent refractive development in a variety of ways. As a first step in understanding the effects of wave aberration on refractive development, we characterized the maturational changes that take place in the high-order aberrations of infant rhesus monkey eyes. Specifically, we compared the monochromatic wave aberrations of infant and adolescent animals and measured the longitudinal changes in the high-order aberrations of infant monkeys during the early period when emmetropization takes place. Our main findings were that (1) adolescent monkey eyes have excellent optical quality, exhibiting total RMS errors that were slightly better than those for adult human eyes that have the same numerical aperture and (2) shortly after birth, infant rhesus monkeys exhibited relatively larger magnitudes of high-order aberrations predominately spherical aberration, coma, and trefoil, which decreased rapidly to assume adolescent values by about 200 days of age. The results demonstrate that rhesus monkey eyes are a good model for studying the contribution of individual ocular components to the eye’s overall aberration structure, the mechanisms responsible for the improvements in optical quality that occur during early ocular development, and the effects of high-order aberrations on ocular growth and emmetropization. PMID:16750549

Ramamirtham, Ramkumar; Kee, Chea-su; Hung, Li-Fang; Qiao-Grider, Ying; Roorda, Austin; Smith, Earl L.

2006-01-01

207

Laser exposure analysis for a near-infrared ocular interferometer  

NASA Astrophysics Data System (ADS)

Ocular interferometry has potential value in a variety of ocular measurement applications, including measuring ocular thicknesses, topography of ocular surfaces or the wavefront of the eye. Of particular interest is using interferometry for characterizing corneal shape and irregular corneal features, making this technology attractive due to its inherent accuracy and spatial resolution. A particular challenge of designing an ocular interferometer is determining safe laser exposure levels to the eye, including both the retina and anterior segment. Described here are the laser exposure standards relevant in the interferometer design and the corresponding calculations and results. The results of this work can be used to aid in the design of similar laser-based systems for ocular evaluation.

Primeau, Brian C.; Goldstein, Goldie L.; Greivenkamp, John E.

2012-06-01

208

Albinism: Particular Attention to the Ocular Motor System  

PubMed Central

The purpose of this report is to summarize an understanding of the ocular motor system in patients with albinism. Other than the association of vertical eccentric gaze null positions and asymmetric, (a) periodic alternating nystagmus in a large percentage of patients, the ocular motor system in human albinism does not contain unique pathology, rather has “typical” types of infantile ocular oscillations and binocular disorders. Both the ocular motor and afferent visual system are affected to varying degrees in patients with albinism, thus, combined treatment of both systems will maximize visual function. PMID:24014991

Hertle, Richard W.

2013-01-01

209

Plasticity of the human otolith-ocular reflex  

NASA Technical Reports Server (NTRS)

The eye movement response to earth vertical axis rotation in the dark, a semicircular canal stimulus, can be altered by prior exposure to combined visual-vestibular stimuli. Such plasticity of the vestibulo-ocular reflex has not been described for earth horizontal axis rotation, a dynamic otolith stimulus. Twenty normal human subjects underwent one of two types of adaptation paradigms designed either to attenuate or enhance the gain of the semicircular canal-ocular reflex prior to undergoing otolith-ocular reflex testing with horizontal axis rotation. The adaptation paradigm paired a 0.2 Hz sinusoidal rotation about a vertical axis with a 0.2 Hz optokinetic stripe pattern that was deliberately mismatched in peak velocity. Pre- and post-adaptation horizontal axis rotations were at 60 degrees/s in the dark and produced a modulation in the slow component velocity of nystagmus having a frequency of 0.17 Hz due to putative stimulation of the otolith organs. Results showed that the magnitude of this modulation component response was altered in a manner similar to the alteration in semicircular canal-ocular responses. These results suggest that physiologic alteration of the vestibulo-ocular reflex using deliberately mismatched visual and semicircular canal stimuli induces changes in both canal-ocular and otolith-ocular responses. We postulate, therefore, that central nervous system pathways responsible for controlling the gains of canal-ocular and otolith-ocular reflexes are shared.

Wall, C. 3rd; Smith, T. R.; Furman, J. M.

1992-01-01

210

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

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

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

211

Ocular safety of Viagra, (sildenafil citrate).  

PubMed Central

To date, sildenafil citrate (Viagra) gives every evidence of being a safe drug for the eye despite a series of expressed concerns. A review of how its ocular safety profile has been identified offers insights into the strengths and weaknesses of present systems and resources for judging the ocular safety of Viagra or, for that matter, of any new drug. Such insights include: The great value of careful, informed assessment of preclinical information gleaned from laboratory experiments. By and large, such assessments point the way toward appropriate clinical evaluation. For Viagra, early in its development it was noted that besides exerting a major inhibitory effect on the intended target, the vascular-associated enzyme phosphodiesterase 5 (PDE5), the drug also exerts a lesser but definite inhibitory effect on the closely related PDE6, located in the retina. For this reason, preclinical evaluation of the drug included electroretinography plus postmortem histology. In addition, an extended eye examination was incorporated into clinical protocols. The often chaotic but invaluable information stream that becomes available once marketing approval has been gained and large populations begin to use a drug. False alarms, misattribution, and erroneous information are the order of the day. Nevertheless, as information accumulates, patterns of response clarify and the true nature of special susceptibility for subpopulations, if any, becomes apparent. A role for the astute clinician remains: Subtle changes or unusual risks for subpopulations can be missed entirely for long periods of time. A manifest need for improvement in evaluation of postmarketing side-effects. This need has led to the establishment of a new discipline: pharmacoepidemiology. In ophthalmology, the National Registry of Drug Induced Ocular Side-Effects maintains a constant and invaluable surveillance. Examples are supplied to illustrate each of these major points: Our presentation will include data gleaned from clinical trials plus postmarketing information on the incidence, duration, and type of color vision defects observed at different doses of Viagra. PMID:10703120

Laties, A M; Fraunfelder, F T

1999-01-01

212

Silk film biomaterials for ocular surface repair  

NASA Astrophysics Data System (ADS)

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.

Lawrence, Brian David

213

Ocular Phenotype of Fbn2-Null Mice  

PubMed Central

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

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

2013-01-01

214

An unusual ocular emergency in severe dengue.  

PubMed

Dengue, one of the most common mosquito-borne flavivirus diseases affecting humans, is spread by the Aedes aegypti mosquito. Most people infected with dengue virus are asymptomatic or only have mild symptoms such as an uncomplicated fever; few have more severe features, while in a small proportion it is life-threatening. Severe dengue is defined as that associated with severe bleeding, severe organ dysfunction, or severe plasma leakage. Ophthalmic manifestations can involve both the anterior and posterior segment. We report an ocular emergency of proptosis and globe rupture in a patient with severe dengue. PMID:25371643

Nagaraj, Kalpana Badami; Jayadev, Chaitra; Yajmaan, Soumya; Prakash, Savitha

2014-10-01

215

Penetrating ocular trauma associated with blank cartridge  

PubMed Central

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

2014-01-01

216

[Ocular toxoplasmosis: from pathophysiology to microbiological diagnosis].  

PubMed

Toxoplasmosis is the most common cause of posterior uveitis in immunocompetent subjects: 30% of the world population may be affected, with wide variability. However, despite high seroprevalence, the incidence of ocular toxoplasmosis (OT) is limited to about 2% of infected patients; thus, about one million patients in France may be estimated to have active or cicatricial OT. Microbiological tools available to the clinician have considerably advanced over the last two decades, allowing the diagnosis of toxoplasmosis to be confirmed in the vast majority of suspected cases. Regardless of the route of infection (congenital or acquired), laboratory confirmation of OT plays a major role in the patient's management, particularly in atypical cases. PMID:23219508

Sauer, A; Villard, O; Bourcier, T; Speeg-Schatz, C; Candolfi, E

2013-01-01

217

Ocular complications in renal transplant recipients.  

PubMed Central

The occurrence of ocular complications among 62 recipients of functioning renal transplants was reviewed 6 months to 7 1/2 years after transplantation. Posterior subcapsular cataracts were found in 29 (46.7%). A positive correlation was found between the development of cataracts and the total dose of corticosteroid, the number of days on which the dose exceeded 100 mg, and the number of rejection episodes treated with high doses of corticosteroid. Identification of specific high-risk periods in regard to cataract formation could lead to use of preventive therapy, as yet undetermined, during these periods. Lower doses of corticosteroids should be used to treat rejection episodes. PMID:329970

Pavlin, C. R.; deVeber, G. A.; Cook, G. T.; Chisholm, L. D.

1977-01-01

218

[Surgical treatment of ocular surface diseases].  

PubMed

Pathomechanisms leading to ocular surface diseases are difficult to influence, and conservative treatment efforts are inefficient in most cases. However, the development of microsurgical techniques, the clinical application of molecular biologic methods and the localisation and identification of the function of limbal stem cells made it possible to achieve visual improvement and quality of life in these cases. The authors review the methods of tissue harvesting, cell culturing, transplantation techniques and indications. They provide a detailed survey on the most recommended modern surgical procedures, especially focusing on amniotic membrane and limbal stem cell transplantation. PMID:19648078

Módis, László; Tóth, Eniko; Berta, András

2009-08-23

219

Ocular Trauma from the "Knockout Game"  

PubMed Central

The “knockout game” is a new form of urban violence receiving much attention in local and national media. Apart from the obvious head trauma, eye injuries may be subtle and overlooked. This report brings awareness of potential eye damage with this type of assault. This report is of a young woman, victim of the knockout game, who sustained a submacular hemorrhage. Beyond a neurologic evaluation for anyone knocked unconscious following the knockout game, patients should be counseled regarding potential ocular injury and encouraged to seek eye care promptly should symptoms develop. PMID:25126433

2014-01-01

220

Ocular sequelae from the illicit use of class A drugs  

Microsoft Academic Search

Aim: To highlight the changes that may take place in the visual system of the class A drug abuser. Methods: A literature review was carried out of ocular\\/visual sequelae of the more common class A drugs. These include stimulants (cocaine and crack cocaine), narcotics (heroin, morphine, methadone) and hallucinogenics (ecstasy, lysergic acid diethyl- amide, magic mushrooms, mescaline, phencyclidine). Results: Ocular

ALISON Y. FIRTH

221

Foveomacular retinitis as a result of ocular contusion.  

PubMed

Foveomacular retinitis is typically associated with eclipse burns. However a macular hole similar to that seen in cases of solar retinopathy, may be observed after ocular contusion or after whiplash injury. The case histories of 3 men, who sustained an ocular contusion and subsequently developed as aspect typical for foveomacular retinopathy, are described. PMID:1302149

Abebe, M T; De Laey, J J

1992-01-01

222

Ocular Toxicity of Benzalkonium Chloride Homologs Compared with Their Mixtures  

PubMed Central

This study was performed to assess the in vivo ocular toxicity of benzalkonium chloride (BAK) homologs compared with commercially available BAK (BAK mixture) and to assess the ocular toxicity of BAK homolog after repeated ocular application. Rabbit eyes were examined by ophthalmology and scanning electron microscopy (SEM) after 10 applications of BAK homologs with C12 (C12-BAK) and C14 (C14-BAK) alkyl chain lengths and a BAK mixture at concentrations of 0.001% (w/v), 0.003% (w/v), 0.005% (w/v), 0.01% (w/v) and 0.03% (w/v). The ocular toxicity of C12-BAK to rabbit eyes was examined by ophthalmology and histopathology after repeated ocular application for 39 weeks. In addition, the antimicrobial activities of C12-BAK and C14-BAK against A. niger, S. aureus and P. aeruginosa were assessed. Ocular toxicity of C12-BAK was less than those of the BAK mixture and C14-BAK. No ocular toxicity was noted after ocular application of 0.01% C12-BAK to rabbits for 39 weeks. C12-BAK showed antimicrobial activities at a concentration of 0.003%. These results suggest that the use of C12-BAK to replace BAK mixture as a preservative in ophthalmic solutions should be considered in order to reduce the incidence of the corneal epithelial cell injury induced clinically by BAK. PMID:24526806

Okahara, Akihiko; Tanioka, Hidetoshi; Takada, Koichi; Kawazu, Kouichi

2013-01-01

223

Microemulsion: New Insights into the Ocular Drug Delivery  

PubMed Central

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

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

2013-01-01

224

Transplantable cultivated mucosal epithelial sheet for ocular surface reconstruction  

Microsoft Academic Search

Ocular surface reconstruction by tissue engineering using somatic stem cells is a second-generation therapeutic modality. In view of future treatment of bilaterally affected, severe ocular surface disorders, two types of transplantable cultivated mucosal epithelial sheets can be used for reconstruction. One is an allogeneic corneal epithelial stem cell sheet, and the other is an autologous oral mucosal epithelial cell sheet.

Shigeru Kinoshita; Noriko Koizumi; Takahiro Nakamura

2004-01-01

225

Design and evaluation of moxifloxacin hydrochloride ocular inserts.  

PubMed

The objective of the present investigation was to prepare and evaluate ocular inserts of moxifloxacin. An ocular insert was made from an aqueous dispersion of moxifloxacin, sodium alginate, polyvinyl alcohol, and dibutyl phthalate by the film casting method. The ocular insert (5.5 mm diameter) was cross-linked by CaCl2 and was coated with Eudragit S-100, RL-100, RS-100, E-100 or L-100. The in vitro drug drainage/permeation studies were carried out using an all-glass modified Franz diffusion cell. The drug concentration and mucoadhesion time of the ocular insert were found satisfactory. Cross-linking and coating with polymers extended the drainage from inserts. The cross-linked ocular insert coated with Eudragit RL-100 showed maximum drug permeation compared to other formulations. PMID:22472452

Pawar, Pravin K; Katara, Rajesh; Majumdar, Dipak K

2012-03-01

226

Ocular air-gun injury: 19 cases  

PubMed Central

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

Shuttleworth, G N; Galloway, P H

2001-01-01

227

Primary intraocular (retinal) lymphoma following ocular toxoplasmosis.  

PubMed

PURPOSE: Toxoplasmosis gondii (T. gondii) is a common world-wide parasite that presents in the eye with focal retinochoriditis and vitritis. Although it is rare, ocular toxoplamosis has been linked to primary intraocular (retinal) lymphoma, which is mostly a diffuse large B-cell lymphoma. METHODS: An elderly female patient was treated for recurrent ocular toxoplasmosis, and because of progressive vitritis, a diagnostic vitrectomy was performed. Shortly afterwards she developed multiple brain lesions. Pathological examinations of the vitreous specimen and cerebral tissues were conducted including tests for T. gondii, EBV, and CMV DNA. RESULTS: The patient initially responded to anti-toxoplasmosis treatment, but continued to have persistent vitritis. She was diagnosed with primary intraocular lymphoma and a repeated MRI revealed cerebral lesions. Brain biopsy confirmed lymphoma. T. gondii DNA was found in malignant vitreous cells, but was absent in the non-malignant vitreous cells and brain lymphoma cells. CMV and EBV genes were not found in any of the lymphoma cells. CONCLUSION: T. gondii may have played a role in lymphoproliferation and PIOL development. PMID:20454548

Sauer, Theodor C; Meyers, Sanford M; Shen, Defen; Vegh, Sara; Vygantas, Charles; Chan, Chi-Chao

2010-04-01

228

Primary intraocular (retinal) lymphoma following ocular toxoplasmosis  

PubMed Central

Purpose Toxoplasmosis gondii (T. gondii) is a common world-wide parasite that presents in the eye with focal retinochoriditis and vitritis. Although it is rare, ocular toxoplamosis has been linked to primary intraocular (retinal) lymphoma, which is mostly a diffuse large B-cell lymphoma. Methods An elderly female patient was treated for recurrent ocular toxoplasmosis, and because of progressive vitritis, a diagnostic vitrectomy was performed. Shortly afterwards she developed multiple brain lesions. Pathological examinations of the vitreous specimen and cerebral tissues were conducted including tests for T. gondii, EBV, and CMV DNA. Results The patient initially responded to anti-toxoplasmosis treatment, but continued to have persistent vitritis. She was diagnosed with primary intraocular lymphoma and a repeated MRI revealed cerebral lesions. Brain biopsy confirmed lymphoma. T. gondii DNA was found in malignant vitreous cells, but was absent in the non-malignant vitreous cells and brain lymphoma cells. CMV and EBV genes were not found in any of the lymphoma cells. Conclusion T. gondii may have played a role in lymphoproliferation and PIOL development. PMID:20454548

Sauer, Theodor C.; Meyers, Sanford M.; Shen, DeFen; Vegh, Sara; Vygantas, Charles; Chan, Chi-Chao

2009-01-01

229

Keratin films for ocular surface reconstruction.  

PubMed

Human amniotic membrane (AM) is frequently used as a substrate for ocular surface reconstruction. Its disadvantages (e.g., reduced transparency and biomechanical strength, heterogeneity depending on donor) create the need for standardized alternatives. Keratin from hair or wool has been proposed as an appropriate material for producing films or cell cultivation scaffolds. The current study was performed to develop transparent, stable and transferable films based on human hair keratin that support cellular adhesion and proliferation. The films were engineered by a multi-step procedure including keratin extraction, neutral and alkaline dialysis, drying and a curing process. Keratin films were investigated by SDS-PAGE, SEM and X-ray analyses. Furthermore, swelling and water absorption of the films were studied, as were tensile strength and light transmission (UV/VIS). Finally, the growth behavior of corneal epithelial cells on the keratin films and AM was estimated in proliferation studies. In addition, we assessed the seeding efficiency and cell detachment behavior during trypsinization. The film-forming process resulted in transparent films composed of nanoparticulate keratin structures. The film characteristics could be varied by changing the protein composition, adding softening agents or varying the curing temperature and duration. Based on these findings, an optimized protocol was developed. The films showed improved light transmission and biomechanical strength in comparison to AM. Furthermore, cell behavior on the films was similar to that found on AM. We conclude that keratin films may represent a new, promising alternative for ocular surface reconstruction. PMID:21316757

Reichl, Stephan; Borrelli, Maria; Geerling, Gerd

2011-05-01

230

Limbal autograft transplantation for ocular surface disorders.  

PubMed

Limbal autograft transplantation is presented in 26 consecutive cases comprising both acute and chronic chemical injury (20 cases), thermal burns (2 cases), contact lens-induced keratopathy (3 cases), and ocular surface failure after multiple surgical procedures (1 case), with follow-up ranging from 2 to 45 months (mean, 18 months). The operative technique usually involved transfer of two free grafts of limbal tissue from the uninjured or less injured donor eye to the severely injured recipient eye, the latter having been prepared by limited conjunctival research and superficial dissection of fibrovascular pannus without keratectomy. Clinical results in 21 patients with follow-up of 6 months or more have consistently shown improved visual acuity (17 cases), rapid surface healing (19 cases), stable epithelial adhesion without recurrent erosion or persistent epithelial defect (20 cases), arrest or regression of corneal neovascularization (15 cases), and probable increased success for lamellar or penetrating keratoplasty (8 cases). No intraoperative complications were encountered, and no adverse reactions developed in donor eyes. Impression cytology in selected cases showed restoration of the corneal epithelial phenotype and regression of goblet cells from the recipient cornea. Therefore, limbal autograft transplantation is recommended for treatment of widespread ocular surface damage with loss of limbal epithelial stem cells and, specifically, for chemical or thermal burns, contact lens-induced keratopathy, and selected persistent corneal epithelial defects. PMID:2748125

Kenyon, K R; Tseng, S C

1989-05-01

231

Nanoliposomal minocycline for ocular drug delivery  

PubMed Central

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

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

232

Interleukin-6 blockade in ocular inflammatory diseases.  

PubMed

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

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

2014-06-01

233

[Antibioprophylaxis in ocular surgery: AFSSAPS recommendations].  

PubMed

According to the literature and to the advice of experts, the French Agency for the Safety of Health Products (AFSSAPS) edited recommendations about the antibioprophylaxis in ocular surgery. One goal was to avoid the extensive use of oral and topical fluoroquinolones in antibioprophylaxis, in order to preserve their antibacterial activity for curative treatments of severe eye infections. The medical team decides for the indication and the type of antibioprophylaxis for each patient. A topical antibiotic is recommended for any eye surgery until the etancheity of incisions. Due to the risk of selection of bacterial resistance topical fluoroquinolones are not recommended in this indication. In open eye surgery, an additional antibioprophylaxis is recommended: in cataract surgery, injection in the anterior chamber at the end of the procedure of 1mg of cefuroxime; in other open eye surgeries, only in case of risk factors for endophthalmitis, administration of 500 mg oral levofloxacin tablet 12 hours and two hours before surgery. For ocular punctures and intravitreal injections, only a topical postoperative antibiotic is recommended until healing. PMID:21652109

Cochereau, I; Korobelnik, J-F; Robert, P-Y; Hajjar, J

2011-06-01

234

Ocular immune privilege in the year 2010: ocular immune privilege and uveitis.  

PubMed

The phrase "immune privilege" was coined by Peter Medawar to describe the absence of an immune response to allografts placed into the anterior chamber of the eye or brain. We now understand that immune privilege is more than a passive microenvironment with a distinctive anatomical structure that holds back immunity. The ocular microenvironment actively engages the immune system with immunosuppressive biochemical mechanisms. The unique characteristics of ocular immune privilege appear designed to protect the eye from damage while preserving foveal vision, thus providing the host with a definite survival advantage. However, the protection is not always sufficient and the eye becomes susceptible to uveitis. Uveitis is an intraocular inflammatory disorder that encompasses a wide range of underlying etiologies. It may be idiopathic or associated with systemic disease or infection. Understanding the biochemistry of immune privilege has the potential to identify its weaknesses that allow for immunity to break through. PMID:21091058

Taylor, Andrew W; Kaplan, Henry J

2010-12-01

235

Ocular Hemodynamics and Glaucoma: The Role of Mathematical Modeling  

PubMed Central

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

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

2013-01-01

236

Electrical signaling in control of ocular cell behaviors.  

PubMed

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

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

2012-01-01

237

Review of the ocular angiogenesis animal models.  

PubMed

Increasing interest in developing reliable and reproducible models to study angiogenesis has emerged due to recent advances in the treatment of eye disease with pathologic angiogenesis. This review provides a summary of the principal ocular animal models for angiogenesis. Models of anterior segment neovascularization include the corneal micropocket assay, used to study the influence of specific molecules/proteins in angiogenesis, and corneal chemical and suture induced injury, which mimic more closely the complex nature of the human disease. Angiogenesis models of the posterior segment include the well-known laser-induced injury of the choroid/Bruch's membrane, as well as the oxygen induced retinopathy and models of injections of pro-angiogenic/inflammatory molecules. In addition, knockout or knock-in transgenic mice provide powerful tools in studying the role of specific proteins in angiogenesis. PMID:19373687

Montezuma, Sandra R; Vavvas, Demetrios; Miller, Joan W

2009-01-01

238

Chromatic dispersion of the ocular media.  

PubMed

Measurements of chromatic dispersion of aqueous and vitreous humors, cornea and lens of the eye are sparse and incomplete. The wavelength variation in refractive index of the ocular media of cow, pig, frog (Rana pipiens), chicken, rock bass (Ambloplites rupestris), albino rat and cat as well as human lenses was determined by means of Abbe and Pulfrich refractometry. While the humors are somewhat less dispersive than water, the cornea is more dispersive at short wavelengths. In general, the lens is significantly more dispersive than water with dispersion increasing asymptotically at the blue end of the spectrum. The exaggerated dispersion taking place at short wavelengths should be taken into account in calculations of chromatic aberration. PMID:6982563

Sivak, J G; Mandelman, T

1982-01-01

239

Complimentary imaging technologies in blunt ocular trauma.  

PubMed

We describe complimentary imaging technologies in traumatic chorioretinal injury. Color and fundus autofluorescence (FAF) images were obtained with a non-mydriatic retinal camera. Optical coherence tomography (OCT) helped obtain detailed images of retinal structure. Microperimetry was used to evaluate the visual function. A 40-year-old man sustained blunt ocular trauma with a stone. Color fundus image showed a large chorioretinal scar in the macula. Software filters allowed detailed illustration of extensive macular fibrosis. A 58-year-old man presented with blunt force trauma with a tennis ball. Color fundus imaging showed a crescentric area of macular choroidal rupture with fibrosis. FAF imaging delineated an area of hypofluorescence greater on fundus imaging. OCT showed chorioretinal atrophy in the macula. Microperimetry delineated an absolute scotoma with no response to maximal stimuli. Fundus imaging with digital filters and FAF illustrated the full extent of chorioretinal injury, while OCT and microperimetry corroborated the structure and function correlations. PMID:24082670

Kolomeyer, Anton M; Szirth, Bernard C; Nayak, Natasha V; Khouri, Albert S

2013-05-01

240

Penetrating ocular injury from contaminated eating utensils.  

PubMed

Although the rate of infectious endophthalmitis following penetrating ocular injury is generally less than 10%, certain settings may carry a greater risk of infection. One such setting is penetrating injury resulting from eating utensils contaminated with oral flora. We reviewed six of these injuries. Culture-positive bacterial endophthalmitis developed in four of the six eyes; only one of the eyes retained reading visual acuity (greater than 20/50) and two eyes lost light perception. The potential for infection and limited visual outcome in this series warrants aggressive prophylaxis and treatment. The unexpected isolation of Haemophilus influenzae in two of the four infections suggests that broad-spectrum antibiotic treatment should be considered in all such injuries since less common organisms may be encountered. PMID:1987951

Feist, R M; Lim, J I; Joondeph, B C; Pflugfelder, S C; Mieler, W F; Ticho, B H; Resnick, K

1991-01-01

241

Optical coherence tomography findings in ocular argyrosis.  

PubMed

A 68-year-old Caucasian man with a remote history of daily colloidal silver ingestion presented for ophthalmic examination in which he was noted to have a distinct slate gray skin discoloration. Funduscopy revealed confluent perimacular drusenoid deposits bilaterally, most of which localized at the level of or anterior to the inner segment ellipsoid band by optical coherence tomography (OCT) imaging. Enhanced depth imaging OCT demonstrated marked choroidal thinning. Fluorescein angiogram displayed a dark or silent choroid. Confirmatory serum silver levels were found to be markedly elevated. This report describes a unique geographic maculopathy with large drusenoid deposits anterior to the ellipsoid layer and severe choroidal thinning in association with ocular argyrosis. PMID:24256711

Rahimy, Ehsan; Beardsley, Robert; Ferrucci, Steven; Ilsen, Pauline; Sarraf, David

2013-01-01

242

Optical coherence tomography findings in ocular argyrosis.  

PubMed

A 68-year-old Caucasian man with a remote history of daily colloidal silver ingestion presented for ophthalmic examination in which he was noted to have a distinct slate gray skin discoloration. Funduscopy revealed confluent perimacular drusenoid deposits bilaterally, most of which localized at the level of or anterior to the inner segment ellipsoid band by optical coherence tomography (OCT) imaging. Enhanced depth imaging OCT demonstrated marked choroidal thinning. Fluorescein angiogram displayed a dark or silent choroid. Confirmatory serum silver levels were found to be markedly elevated. This report describes a unique geographic maculopathy with large drusenoid deposits anterior to the ellipsoid layer and severe choroidal thinning in association with ocular argyrosis. PMID:24548762

Rahimy, Ehsan; Beardsley, Robert; Ferrucci, Steven; Ilsen, Pauline; Sarraf, David

2013-01-01

243

Ocular pterygium-Digital keloid dysplasia.  

PubMed

We describe an adolescent Peruvian male with marked, aggressive ingrowth of conjunctiva (pterygium-like) over the cornea associated with keloid formation on his distal limbs. He has in addition camptodactyly of all fingers and to some extent of his toes, and unusual skin pigmentations. He resembles an earlier described family from Norway in which a mother and two children showed a similar combination of signs. We present the follow-up of the Norwegian family. The entity resembles the Penttinen syndrome but can be differentiated due to the early aging in the latter, which is lacking in the presently reported entity. We suggest naming this entity ocular pterygium-digital keloid dysplasia. The condition follows likely an autosomal dominant pattern of inheritance. © 2014 Wiley Periodicals, Inc. PMID:25124224

Abarca, Hugo; Mellgren, Anne E Christensen; Trubnykova, Milana; Haugen, Olav H; Høvding, Gunnar; Tveit, Kåre Steinar; Houge, Gunnar; Bredrup, Cecilie; Hennekam, Raoul C

2014-11-01

244

Nanotechnology Approaches for Ocular Drug Delivery  

PubMed Central

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

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

2013-01-01

245

Ocular Infection Preceding Major Epidural Abscess  

PubMed Central

Staphylococcal bacteremia is an important clinical entity. A 74-year-old lady presented with an isolated staphylococcal ocular infection; this was treated with a short course of antibiotics, a prolonged course of steroids, and discharge from hospital with outpatient clinic followup. She represented three weeks later to the emergency department with back pain, raised inflammatory markers, and positive blood cultures. On magnetic resonance imaging (MRI), an extensive epidural collection was seen. This was surgically decompressed, and she was treated with appropriate intravenous antibiotics. Despite a complicated postoperative course, she made an excellent recovery. This case reviews the important clinical and radiological features of the presentation of a major epidural abscess and it also suggests a potentially unusual primary source. The clinician is reminded to always have a high index of suspicion regarding staphylococcal bacteremia and the potential for seeding to the epidural space.

Johnstone, Ryan

2014-01-01

246

Ocular Manifestations of Oblique Facial Clefts  

PubMed Central

Introduction In the Tessier classification, craniofacial clefts are numbered from 0 to 14 and extend along constant axes through the eyebrows, eyelids, maxilla, nostrils, and the lips. We studied a patient with bilateral cleft 10 associated with ocular abnormalities. Method Clinical report with orbital and cranial computed tomography. Results After pregnancy complicated by oligohydramnios, digoxin, and lisinopril exposure, a boy was born with facial and ocular dysmorphism. Examination at age 26 months showed bilateral epibulbar dermoids, covering half the corneal surface, and unilateral morning glory anomaly of the optic nerve. Ductions of the right eye were normal, but the left eye had severely impaired ductions in all directions, left hypotropia, and esotropia. Under anesthesia, the left eye could not be rotated freely in any direction. Bilateral Tessier cleft number 10 was implicated by the presence of colobomata of the middle third of the upper eyelids and eyebrows. As the cleft continued into the hairline, there was marked anterior scalp alopecia. Computed x-ray tomography showed a left middle cranial fossa arachnoid cyst and calcification of the reflected tendon of the superior oblique muscle, trochlea, and underlying sclera, with downward and lateral globe displacement. Discussion Tessier 10 clefts are very rare and usually associated with encephalocele. Bilateral 10 clefts have not been reported previously. In this case, there was coexisting unilateral morning glory anomaly and arachnoid cyst of the left middle cranial fossa but no encephalocele. Conclusions Bilateral Tessier facial cleft 10 may be associated with alopecia, morning glory anomaly, epibulbar dermoids, arachnoid cyst, and restrictive strabismus. PMID:20856062

Ortube, Maria Carolina; Dipple, Katrina; Setoguchi, Yoshio; Kawamoto, Henry K.; Demer, Joseph L.

2014-01-01

247

ABCB6 Mutations Cause Ocular Coloboma  

PubMed Central

Ocular coloboma is a developmental defect of the eye and is due to abnormal or incomplete closure of the optic fissure. This disorder displays genetic and clinical heterogeneity. Using a positional cloning approach, we identified a mutation in the ATP-binding cassette (ABC) transporter ABCB6 in a Chinese family affected by autosomal-dominant coloboma. The Leu811Val mutation was identified in seven affected members of the family and was absent in six unaffected members from three generations. A LOD score of 3.2 at ? = 0 was calculated for the mutation identified in this family. Sequence analysis was performed on the ABCB6 exons from 116 sporadic cases of microphthalmia with coloboma (MAC), isolated coloboma, and aniridia, and an additional mutation (A57T) was identified in three patients with MAC. These two mutations were not present in the ethnically matched control populations. Immunostaining of transiently transfected, Myc-tagged ABCB6 in retinal pigment epithelial (RPE) cells showed that it localized to the endoplasmic reticulum and Golgi apparatus of RPE cells. RT-PCR of ABCB6 mRNA in human cell lines and tissue indicated that ABCB6 is expressed in the retinae and RPE cells. Using zebrafish, we show that abcb6 is expressed in the eye and CNS. Morpholino knockdown of abcb6 in zebrafish produces a phenotype characteristic of coloboma and replicates the clinical phenotype observed in our index cases. The knockdown phenotype can be corrected with coinjection of the wild-type, but not mutant, ABCB6 mRNA, suggesting that the phenotypes observed in zebrafish are due to insufficient abcb6 function. Our results demonstrate that ABCB6 mutations cause ocular coloboma. PMID:22226084

Wang, Lejing; He, Fei; Bu, Juan; Liu, Xiaqi; Du, Wei; Dong, Jiamei; Cooney, Jeffrey D.; Dubey, Sushil Kumar; Shi, Yi; Gong, Bo; Li, Jing; McBride, Paul F.; Jia, Yanlei; Lu, Fang; Soltis, Kathleen A.; Lin, Ying; Namburi, Prasanthi; Liang, Chen; Sundaresan, Periasamy; Paw, Barry H.; Li, Dean Y.; Phillips, John D.; Yang, Zhenglin

2012-01-01

248

Risk factors for ocular toxoplasmosis in Brazil.  

PubMed

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

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

249

Toy gun ocular injuries associated with festive holidays in Kuwait  

Microsoft Academic Search

Background  Ocular trauma is one of the important causes of preventable blindness and visual impairment among children worldwide. Prevalence\\u000a of pediatric ocular trauma associated with toy guns appear to be on the rise, although they are fully preventable. The purpose\\u000a of this study is to report ocular trauma secondary to toy-gun pellets in Kuwait.\\u000a \\u000a \\u000a \\u000a Methods  We conducted a non-comparative case series based

Manal Bouhaimed; Manar Alwohaib; Shaikhah Alabdulrazzaq; Mohammad Jasem

2009-01-01

250

Laser applications and system considerations in ocular imaging  

PubMed Central

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

Elsner, Ann E.; Muller, Matthew S.

2009-01-01

251

Ocular flutter as the presenting sign of lung adenocarcinoma.  

PubMed

Ocular flutter is a rare ophthalmic finding that could represent paraneoplastic phenomena. In adults it is most commonly associated with small cell lung cancer (SCLC). Most patients also present with other neurological defects. We report the case of a 75-year-old woman who presented with isolated ocular flutter. The ensuing workup was significant for an early lung adenocarcinoma that would not have been biopsied otherwise due to its small size. To our knowledge, this is the first reported case of isolated ocular flutter as the presenting symptom of non-SCLC. PMID:25097456

Kruger, Joshua M; Yonekawa, Yoshihiro; Skidd, Philip; Cestari, Dean M

2014-01-01

252

Ocular manifestations in a child with systemic brucellosis  

PubMed Central

Brucellosis is a zoonotic disease with widespread prevalence. It presents with in various range and often with the presence of non-specific clinical signs and symptoms. Brucellosis also may cause different manifestations in eyes such as uveitis, keratitis, conjunctivitis and neuro-ophthalmic defects. Ocular brucellosis is rare among children. Herein, we present a 7-year-old girl with systemic and ocular brucellosis. After treatment with systemic steroid and antibiotics, her signs and symptoms disappeared. Since early treatment is important in preventing permanent visual loss and the other complications of ocular brucellosis, examination of the eyes in brucellosis patients must always be noticed by clinicians working in this field. PMID:25364370

Mohammadi, Zahra; Dehghani, Alireza; Ghanbari, Heshmat Ollah; Akhlaghi, Mohammad Reza; Nasrollahi, Kobra; Salam, Hasan

2014-01-01

253

Lesions in the ocular posterior segment of raptors.  

PubMed

Thirty-eight free-living raptors, including various hawks, owls, and an eagle, had lesions of the ocular posterior segment believed to be the result of trauma. Although lesions of the anterior ocular segment and of the rest of the body often were seen, the lesions of the posterior segment of the eye were disproportionately more severe and usually were not suspected by rehabilitation personnel. The tightly encased raptor eye, with its anteriorly placed scleral ossicles, may have rendered the eye more susceptible to contrecoup damage. In the birds that were treated, ocular lesions were resolved and some vision was restored. PMID:4077621

Buyukmihci, N C

1985-12-01

254

High temporal resolution ocular aberrometry with pupil tracking  

NASA Astrophysics Data System (ADS)

More cost effective and robust designs of ocular adaptive optics systems could probably be derived from a thorough knowledge of ocular time-varying aberrations. This would in particular benefit to therapeutic systems where the problem of robustness is critical. Unfortunately, high frequency temporal statistical behavior of ocular aberrations remains poorly characterized. We set up an original high resolution custom-built Shack-Hartmann aberrometer running at a frequency of 236Hz additionally featuring pupil tracking and performedmeasurements on a 50-eye population. First analyses are carried out over 20 eyes. Qualitative correlation between dynamic aberrations and saccadic pupil movements is highlighted.

Jarosz, Jessica; Meimon, Serge; Conan, Jean-Marc; Paques, Michel

2014-02-01

255

The importance of vitamin D in systemic and ocular wellness  

PubMed Central

Vitamin D is good for bones and teeth. It may also have a role in preventing and treating diabetes, certain cancers, atherosclerosis, multiple sclerosis, hip fractures and ocular conditions such as age-related macular degeneration.

Richer, Stuart P.; Pizzimenti, Joseph J.

2013-01-01

256

Functions of ocular surface mucins in health and disease  

PubMed Central

Purpose of review The purpose of the present review is to describe new concepts on the role of mucins in the protection of corneal and conjunctival epithelia and to identify alterations of mucins in ocular surface diseases. Recent findings New evidence indicates that gel-forming and cell surface-associated mucins contribute differently to the protection of the ocular surface against allergens, pathogens, extracellular molecules, abrasive stress, and drying. Summary Mucins are high molecular weight glycoproteins characterized by their extensive O-glycosylation. Major mucins expressed by the ocular surface epithelia include cell surface-associated mucins MUC1, -4 and -16, and the gel-forming mucin MUC5AC. Recent advances using functional assays have allowed the examination of their roles in the protection of corneal and conjunctival epithelia. Alterations in mucin and mucin O-glycan biosynthesis in ocular surface disorders, including allergy, non-autoimmune dry eye, autoimmune dry eye, and infection, are presented. PMID:18769205

Mantelli, Flavio; Argueso, Pablo

2009-01-01

257

Anatomical origins of ocular dominance in mouse primary visual cortex  

E-print Network

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 ...

Coleman, Jason E.

258

Ocular complications of childhood rheumatic diseases: Nonuveitic inflammatory eye diseases  

Microsoft Academic Search

Ocular involvement is common in pediatric rheumatologic diseases, supporting the concept that these conditions do not manifest\\u000a in isolation but are components of a multisystem inflammatory process. It remains unclear why the eye and its adjacent tissues\\u000a become a target during paninflammatory disease. Pediatric rheumatologists must recognize ocular disorders, as these conditions\\u000a significantly concern the treatment team managing serious cases

Andreas Reiff

2009-01-01

259

Profile of ocular trauma in industries-related hospital  

PubMed Central

Introduction: Ocular trauma is a worldwide cause of visual morbidity, a significant proportion of which occurs in the industrial workplace and includes a spectrum of simple ocular surface foreign bodies, abrasions to devastating perforating injuries causing blindness. Being preventable is of social and medical concern. Aim: A prospective case series study, to know the profile of ocular trauma at a hospital caters exclusively to factory employees and their families, to co-relate their demographic and clinical profile and to identify the risk factors. Materials and Methods: Patients with ocular trauma who presented at ESIC Model hospital, Rajajinagar, Bangalore, from June 2010 to May 2011 were taken a detailed demographic data, nature and cause of injury, time interval between the time of injury and presentation along with any treatment received. Ocular evaluation including visual acuity, anterior and posterior segment findings, intra-ocular pressure and gonio-scopy in closed globe injuries, X-rays for intraocular foreign body, B-scan and CT scan were done. Data analyzed as per the ocular trauma classification group. The rehabilitation undertaken medically or surgically was analyzed. At follow-up, the final best corrected visual acuity was noted. Results: A total of 306 cases of ocular trauma were reported; predominantly in 20-40 year age group (72.2%) and in men (75%). The work place related cases were 50.7%and of these, fall of foreign bodies led the list. Visual prognosis was poorer in road traffic accidents rather than work place injuries owing to higher occurrence of open globe injuries and optic neuropathy. Finally, 11% of injured cases ended up with poor vision. Conclusion: Targeting groups most at risk, providing effective eye protection, and developing workplace safety cultures may together reduce occupational eye injuries. PMID:24421593

Shashikala, P; Sadiqulla, Mohammed; Shivakumar, D; Prakash, K H

2013-01-01

260

Evaluation of Magnetic Micro and Nanoparticle Toxicity to Ocular Tissues  

Microsoft Academic Search

PurposeMagnetic nanoparticles (MNPs) may be used for focal delivery of plasmids, drugs, cells, and other applications. Here we ask whether such particles are toxic to ocular structures.MethodsTo evaluate the ocular toxicity of MNPs, we asked if either 50 nm or 4 µm magnetic particles affect intraocular pressure, corneal endothelial cell count, retinal morphology including both cell counts and glial activation,

Hemalatha B. Raju; Ying Hu; Anil Vedula; Sander R. Dubovy; Jeffrey L. Goldberg; Neeraj Vij

2011-01-01

261

An unusual case of penetrating ocular trauma with metallic spoon  

PubMed Central

Ocular trauma is an important cause of vision loss. The agents incriminated in such injuries are diverse. We present a case of ocular trauma with a metallic spoon causing deep laceration of lid and temple region with sclerocorneal laceration. After assessment of the general condition and stabilization of the systemic parameters the operative procedure was undertaken on elective basis. Though the final visual outcome was not rewarding due to the severity of the injury, any potential hemostatic catastrophe was averted. PMID:20534927

Bhaduri, Gautam; Chattopadhyay, Soumya Swarup; Ghosh, Rudra Prasad; Saurabh, Kumar; Goyal, Mukesh

2010-01-01

262

Continuous Intra Ocular Pressure Measurement Sensor for Glaucoma Diagnostic  

Microsoft Academic Search

\\u000a Glaucoma is an ocular pathology usually associated with an increase in Intra Ocular Pressure (IOP). In this study, we are\\u000a developing disposable eye lenses including a specific micro fabricated pressure sensor to measure IOP all day long. The information\\u000a data will be wireless transferred via magnetic coupling to an external receiver. Our first work deals with the sensor design\\u000a and

Gaëlle Lissorgues; Lionel Rousseau; Patrick Poulichet; Laurie Valbin; Serge Picaud; Laurent Chicaud; Serge Bernard; Philippe Bergonzo; Francois Dedieuleveult; Philippe Auvray

263

Reduction of ocular counter-rolling by adaptation to space  

NASA Technical Reports Server (NTRS)

We studied the three-dimensional vestibulo-ocular reflex (VOR) of rhesus monkeys before and after the COSMOS Biosatellite 2229 Mission of 1992-1993. This included tests of ocular counter-rolling (OCR), the gain of the vestibulo-ocular reflex (VOR), and spatial orientation of velocity storage. A four-axis vestibular and oculomotor stimulator was transported to the Institute of Biomedical Problems in Moscow for the pre- and postflight ground-based testing. Twelve normal juvenile male rhesus monkey were implanted surgically with eye coils and tested 60-90 days before spaceflight. Two monkey (7906 and 6151), selected from the twelve as flight animals, flew from 12/29/92 to 1/10/93. Upon recovery, they were tested for 11 days postflight along with three control animals. Compensatory ocular torsion was produced in two ways: (1) Lateral head tilts evoked OCR through otolith-ocular reflexes. OCR was also measured dynamically during off-vertical axis rotation (OVAR). (2) Rotation about a naso-occipital axis that was either vertical of horizontal elicited torsional nystagmus through semicircular canal-ocular reflexes (roll VOR). OCR from the otoliths was substantially reduced (70 percent) for 11 days after reentry on both modes of testing. The gain of the roll VOR was also decreased, but less than OCR. These data demonstrate that there was a long-lasting depression of torsional or roll eye movements after adaptation to microgravity in these monkeys, especially those movements produced by the otolith organs.

Dai, Mingjia; Mcgarvie, Leigh; Kozlovskaya, Inessa; Sirota, Mischa; Raphan, Theodore; Cohen, Bernard

1993-01-01

264

Bilateral corneal ulceration in ocular graft-versus-host disease  

PubMed Central

Purpose To report on corneal ulceration in ocular graft-versus-host disease (GVHD). Methods This was a retrospective, observational case series investigating corneal ulceration and perforation in a cohort of ocular GVHD patients seen between June 2007 and October 2012. Results Four of 243 ocular GVHD patients developed corneal ulcerations attributable to ocular GVHD, and all four cases involved bilateral corneal ulceration. The median length of time from the diagnosis of ocular GVHD to the diagnosis of the first corneal ulceration was 317 days (range 168–434). The median length of time between the diagnosis of corneal ulceration in each patient’s first and second eye was 248 days (range 9–645). Outcomes varied from complete resolution with medical treatment to corneal perforation necessitating penetrating keratoplasty. In cases of corneal perforation, the median length of time from the diagnosis of corneal ulceration to perforation was 10 days (range 0–20). Common clinical features included: centrally or paracentrally located ulcerations and perforations, concomitant dry eye, and the use of topical or systemic corticosteroids. Conclusion Frequent follow-up and bilateral monitoring are highly recommended in cases of ocular GVHD-associated stromal thinning, as bilateral involvement or rapid progression to corneal perforation can occur. PMID:24204119

Stevenson, William; Shikari, Hasanain; Saboo, Ujwala S; Amparo, Francisco; Dana, Reza

2013-01-01

265

Fundus Autofluorescence Imaging in an Ocular Screening Program  

PubMed Central

Purpose. To describe integration of fundus autofluorescence (FAF) imaging into an ocular screening program. Methods. Fifty consecutive screening participants were included in this prospective pilot imaging study. Color and FAF (530/640?nm exciter/barrier filters) images were obtained with a 15.1MP Canon nonmydriatic hybrid camera. A clinician evaluated the images on site to determine need for referral. Visual acuity (VA), intraocular pressure (IOP), and ocular pathology detected by color fundus and FAF imaging modalities were recorded. Results. Mean ± SD age was 47.4 ± 17.3 years. Fifty-two percent were female and 58% African American. Twenty-seven percent had a comprehensive ocular examination within the past year. Mean VA was 20/39 in the right eye and 20/40 in the left eye. Mean IOP was 15?mmHg bilaterally. Positive color and/or FAF findings were identified in nine (18%) individuals with diabetic retinopathy or macular edema (n = 4), focal RPE defects (n = 2), age-related macular degeneration (n = 1), central serous retinopathy (n = 1), and ocular trauma (n = 1). Conclusions. FAF was successfully integrated in our ocular screening program and aided in the identification of ocular pathology. Larger studies examining the utility of this technology in screening programs may be warranted. PMID:23316224

Kolomeyer, A. M.; Nayak, N. V.; Szirth, B. C.; Khouri, A. S.

2012-01-01

266

Validating and troubleshooting ocular in vitro toxicology tests.  

PubMed

In vitro organotypic models for testing ocular irritants have warranted sufficient interest as methods to replace in vivo ocular testing. The in vitro organotypic models claim to maintain short-term normal physiological and biochemical functions of the mammalian cornea in an isolated system. In these test methods, damage by the test substance is assessed by quantitative measurements of changes in corneal opacity and permeability using opacitometry and spectrophotometry, respectively. Both measurements are used quantitatively for irritancy classification for prediction of the in vivo ocular irritation potential of a test substance. Examples of organotypic models that incorporate these criteria include: the bovine corneal opacity and permeability (BCOP) assay, the isolated chicken eye (ICE) test method and the isolated rabbit eye (IRE) assay. A fourth method, the hen's egg test-chorioallantoic membrane (HET-CAM) assay, differs in the evaluation criteria but is also normally included among this class of in vitro protocols. Each of these protocols is discussed in detail as representative candidate in vitro methods for assessing ocular irritation and corrosion. The methodologies, protocol details, applications, and their validation status are discussed. A brief historical perspective of the development of original in vitro ocular testing models is also mentioned. More importantly, improving and troubleshooting the current techniques, in order to present the models as stand-alone in vitro tools for ocular toxicity assessment, is emphasized. PMID:20096797

Barile, Frank A

2010-01-01

267

Posterior segment ocular manifestations of HIV/AIDS patients  

PubMed Central

Abstract Human immunodeficiency virus (HIV) has the ability to affect any organ in the body. In 70% of HIV -infected patients ocular manifestations were observed, these, in the vast majority reflect the systemic disease and may be the first signs of disseminated infections. Aim: The purpose of this paper is to determine the prevalence of posterior segment ocular manifestations in HIV / AIDS (Acquired Immunodeficiency Syndrome) patients. Method: The study is retrospective, conducted in the Cabinet of Ophthalmology of "Matei Bals" Infectious Diseases Hospital in Bucharest, during the period 1 August 2007 - 1 August 2013 . Each patient was examined thoroughly at the biomicroscope ocular slit by using 90D microscope lens and 20D indirect lens after the administration of topical mydriatics. Results: 348 patients with HIV/AIDS and ocular disorders were followed. There was a high number of children and young people with HIV who had eye disorders (194 patients aged between 14 and 25 years). 44.25% of patients had posterior segment ocular damage, 17.55% of them had the anterior segment affected. 22.90% of the 131 patients with compromised posterior segment microangiopathy have been diagnosed with HIV / AIDS. Conclusions: Doctors should be aware of the existence of ocular damage in HIV / AIDS and to emphasize the importance of regular ophthalmologic examination of patients with HIV / AIDS. Abbreviations: HIV- human immunodeficiency virus, AIDS- acquired immunodeficiency syndrome, CMV retinitis-cytomegalovirus retinitis PMID:25408764

Chiotan, C; Radu, L; Serban, R; Corn?cel, C; Cioboat?, M; Anghelie, A

2014-01-01

268

Multiple congenital ocular anomalies in Icelandic horses  

PubMed Central

Background Multiple congenital ocular anomalies (MCOA) syndrome is a hereditary congenital eye defect that was first described in Silver colored Rocky Mountain horses. The mutation causing this disease is located within a defined chromosomal interval, which also contains the gene and mutation that is associated with the Silver coat color (PMEL17, exon 11). Horses that are homozygous for the disease-causing allele have multiple defects (MCOA-phenotype), whilst the heterozygous horses predominantly have cysts of the iris, ciliary body or retina (Cyst-phenotype). It has been argued that these ocular defects are caused by a recent mutation that is restricted to horses that are related to the Rocky Mountain Horse breed. For that reason we have examined another horse breed, the Icelandic horse, which is historically quite divergent from Rocky Mountain horses. Results We examined 24 Icelandic horses and established that the MCOA syndrome is present in this breed. Four of these horses were categorised as having the MCOA-phenotype and were genotyped as being homozygous for the PMEL17 mutation. The most common clinical signs included megaloglobus, iris stromal hypoplasia, abnormal pectinate ligaments, iridociliary cysts occasionally extending into the peripheral retina and cataracts. The cysts and pectinate ligament abnormalities were observed in the temporal quadrant of the eyes. Fourteen horses were heterozygous for the PMEL17 mutation and were characterized as having the Cyst-phenotype with cysts and occasionally curvilinear streaks in the peripheral retina. Three additional horses were genotyped as PMEL17 heterozygotes, but in these horses we were unable to detect cysts or other forms of anomalies. One eye of a severely vision-impaired 18 month-old stallion, homozygous for the PMEL17 mutation was examined by light microscopy. Redundant duplication of non-pigmented ciliary body epithelium, sometimes forming cysts bulging into the posterior chamber and localized areas of atrophy in the peripheral retina were seen. Conclusions The MCOA syndrome is segregating with the PMEL17 mutation in the Icelandic Horse population. This needs to be taken into consideration in breeding decisions and highlights the fact that MCOA syndrome is present in a breed that are more ancient and not closely related to the Rocky Mountain Horse breed. PMID:21615885

2011-01-01

269

Vitrectomy for intra ocular foreign body removal.  

PubMed

Ten consecutive cases of perforating ocular injuries with retained intraocular foreign bodies over a period of 2 years were reviewed retrospectively in this study. All cases were operated upon by a 3 port pars plana vitrectomy and if necessary endolaser done. All ten cases (100%) were successful in terms of intraocular foreign body removal through the pars plana sclerotomy but ultimately we lost three [3] [30%] cases of which two had retinal detachments with P.V.R. D-3 preoperatively and the other had endophthalmitis. Of the seven (70%) successful cases four eyes (40%) had a post-operative vision of 6/12 or better while 2 [20%] had 6/24 and the last had 6/60 [10%]. Nine cases [90%] had a magnetic Intraocular foreign body. Various complications of Intraocular foreign bodies like vitreous haemorrhage, retinal incarceration, cataract and retinal detachment were noted preoperatively. Silicone oil was used in three (30%) cases. Sulfur Hexafluoride was used in 5 cases (50%). Endolaser photocoagulation was done in 7 cases (70%). PMID:1452279

Saroya, J S; Sasikanth, R R; Agarwal, T; Agarwal, S; Agarwal, A

1992-01-01

270

Effect of gravitoinertial force on ocular counterrolling.  

NASA Technical Reports Server (NTRS)

The effect of G loading on the magnitude of ocular counterrolling at various angles of tilt up to 63 deg. was measured on normal subjects and compared with the effect on persons with severe or complete loss of vestibular function. The group of six normal subjects manifested a compensatory eye roll which increased as a direct and essentially linear function of the component of the gravitoinertial force acting laterally on the subject. This increase in response was not observed in the five deaf subjects with severe or complete bilateral loss of their vestibular organs. These findings confirmed similar results found by other authors using other measuring techniques which show that the reflex eye movement is dependent on and limited to the magnitude of the gravitoinertial stimulus (within the range used) when the otolithocular system is functioning normally. However when this function is severely impaired or lost, the magnitude of the compensatory eye roll is limited to that manifested at 1 G and possibly to nonotolithic contributions. These findings offer means for differentiation between otolithic-defective and ?normal' persons who exhibit little counterrolling.

Miller, E. F., II; Graybiel, A.

1971-01-01

271

Mycoplasma arthritidis-induced ocular inflammatory disease.  

PubMed Central

Mycoplasma arthritidis was demonstrated to incite experimental conjunctivitis and uveitis in Swiss Webster mice which have a known susceptibility to the arthritis customarily associated with infection by this mycoplasma. The initial symptom of ocular involvement was conjunctivitis, which appeared as early as 1 day after intravenous injection with viable culture concentrates of M. arthritidis. By day 2, histological analysis showed intraocular localized inflammatory reactions that were confined primarily to the anterior portion of the uvea and produced results which were compatible with those seen in iridocyclitis. Serological assays of the titer and the class of antibodies involved in the early humoral immune response to infection confirmed the predominance of immunoglobulin G (IgG) concentrations over IgM concentrations that was described by others (Cole et al., Infect. Immun. 4:431-440, 1971) and revealed significant titers of the IgG2a and IgG2b subclasses of complement-fixing antibodies. The rapid onset of acute conjunctivitis, together with the early appearance of immunoglobulins of the IgG class, suggests that the M. arthritidis-infected Swiss Webster mice may have experienced an anamnestic response to the mycoplasma antigens. These observations introduce a new animal model for the study of mycoplasma-induced experimental uveitis and conjunctivitis, which are demonstrated here to accompany a disseminated systemic disease process. Images PMID:7200961

Thirkill, C E; Gregerson, D S

1982-01-01

272

Robust approach to ocular fundus image analysis  

NASA Astrophysics Data System (ADS)

The analysis of morphological and structural modifications of retinal blood vessels plays an important role both to establish the presence of some systemic diseases as hypertension and diabetes and to study their course. The paper describes a robust set of techniques developed to quantitatively evaluate morphometric aspects of the ocular fundus vascular and micro vascular network. They are defined: (1) the concept of 'Local Direction of a vessel' (LD); (2) a special form of edge detection, named Signed Edge Detection (SED), which uses LD to choose the convolution kernel in the edge detection process and is able to distinguish between the left or the right vessel edge; (3) an iterative tracking (IT) method. The developed techniques use intensively both LD and SED in: (a) the automatic detection of number, position and size of blood vessels departing from the optical papilla; (b) the tracking of body and edges of the vessels; (c) the recognition of vessel branches and crossings; (d) the extraction of a set of features as blood vessel length and average diameter, arteries and arterioles tortuosity, crossing position and angle between two vessels. The algorithms, implemented in C language, have an execution time depending on the complexity of the currently processed vascular network.

Tascini, Guido; Passerini, Giorgio; Puliti, Paolo; Zingaretti, Primo

1993-07-01

273

In vitro alternatives for ocular irritation.  

PubMed

The necessity of using animals to test whether new chemicals and products are eye irritants has been questioned with increasing frequency and fervor over the last 20 years. During this time many new nonanimal methods have been proposed as reliable alternatives to the traditional rabbit (Draize) test. To date, however, none of these nonanimal (in vitro) tests have become universally accepted as a complete replacement for the Draize test. To understand why a complete replacement has not been found, one has to first understand the reasonably complex structure of the eye, the standard Draize scoring scale--which is based on a qualitative evaluation of three different tissues--the differences between human and rabbit eyes, the intrinsic variability of the animal test, and the details of the different in vitro tests that have been proposed as replacements. The in vitro tests vary from relatively simple assays using single cells to more sophisticated assays that use discarded animal tissue or artificially constructed human tissue. It is clear that appropriately designed in vitro tests will eventually give more useful mechanistic information about ocular injury from which we can more comfortably predict the risk of human eye irritation from new products and ingredients. PMID:9599696

Curren, R D; Harbell, J W

1998-04-01

274

[Systemic treatment of ocular cicatricial pemphigoid].  

PubMed

Ocular cicatricial pemphigoid (OCP) is a blistering autoimmune disease that can produce severe conjunctival damage. Its response to immunosuppressive treatment is poorly known. We describe a group of 76 patients, 62 women and 14 men. Mean age at diagnosis was 67±14 years old, with a delay to diagnosis of 7.5±10 years. Sixty patients continued their follow up in our services for 19±21 months. Nineteen out of 51 had mild disease, 19 moderate, 5 severe and 8 very severe at onset of treatment. The more frequently prescribed drugs were dapsone, in 35 (23 discontinued it because of adverse effects), and methotrexate in 42 patients, nine of them stopped it. Other patients received azathioprine, cyclophosphamide and ciclosporine. Seventeen received oral steroids in addition to immunosuppressive drugs. Four patients combined two immunosuppressive drugs to control their disease. In three refractory cases IV immunoglobulin (Ig) was administered with good response. From 48 evaluated patients, 39 improved with treatment, eight remained stable and one progressed. In our experience, methotrexate and azathioprine were effective drugs, with low toxicity. Dapsone was useful in mild cases, with frequent adverse effects. IVIg was effective for refractory cases. PMID:22522849

Juri, María Cecilia; Fernández Romero, Diego S; Devoto, Martín H; Georgiett, Daniel; Zárate, Jorge O; Malbrán, Alejandro

2012-01-01

275

Ocular and systemic manifestations of exfoliation syndrome.  

PubMed

Exfoliation syndrome is an age-related disease characterized by the production and progressive accumulation of a fibrillar extracellular material in many ocular tissues. It leads to the most common identifiable cause of open-angle glaucoma worldwide, comprising the majority of glaucoma in some countries. The material in the eye appears as white deposits on the anterior lens surface and/or pupillary border. During pupillary movement, the iris scrapes exfoliation material from the lens surface, while the material on the lens causes rupture of iris pigment epithelial cells, with concomitant pigment dispersion into the anterior chamber and its deposition on anterior chamber structures. Exfoliation material can be found in many different organs. It is an ischemic disease and is associated with elevated serum homocysteine. Systemic associations include transient ischemic attacks, hypertension, angina, myocardial infarction, cerebrovascular and cardiovascular disease, aortic aneurysm, Alzheimer disease, and hearing loss. The discovery in 2007 of nonsynonymous single nucleotide polymorphisms in the LOXL1 (lysyl oxidase-like 1) gene are expected to make a major impact not only in understanding exfoliation syndrome, but in leading to new avenues of therapy. PMID:25275896

Ritch, Robert

2014-01-01

276

Risk Factors for Ocular Chlamydia after Three Mass Azithromycin Distributions  

PubMed Central

Background An important component of the World Health Organization's comprehensive trachoma elimination strategy is the provision of repeated annual mass azithromycin distributions, which are directed at reducing the burden of ocular chlamydia. Knowledge of characteristics associated with infection after mass antibiotic treatments could allow trachoma programs to focus resources to those most likely to be infected with ocular chlamydia. Methodology/Principal Findings We monitored 12 communities in rural Ethiopia that had received 3 annual mass azithromycin treatments as part of a cluster-randomized trial for trachoma. One year after the third treatment, a random sample of children from each village received conjunctival examination for follicular trachomatous inflammation (TF) and intense trachomatous inflammation (TI), conjunctival swabbing for chlamydial RNA and DNA, and a household survey. The primary outcome for this study was RNA evidence of ocular chlamydia, which we detected in 41 of 573 swabbed children (7.2%, 95%CI 2.7–17.8). In multivariate mixed effects logistic regression models, ocular chlamydial RNA was significantly associated with ocular discharge (OR 2.82, 95%CI 1.07–7.42), missing the most recent mass azithromycin treatment (OR 2.49, 95%CI 1.02–6.05), having a sibling with ocular chlamydia (OR 4.44, 95%CI 1.60–12.29), and above-median community population (OR 7.81, 95%CI 1.56–39.09). Ocular chlamydial infection was also independently associated with TF (OR 3.42, 95%CI 1.56–7.49) and TI (OR 5.39, 95%CI 2.43–11.98). Conclusions/Significance In areas with highly prevalent trachoma treated with multiple rounds of mass azithromycin, trachoma programs could consider continuing mass azithromycin treatments in households that have missed prior mass antibiotic treatments, in households with clinically active trachoma, and in larger communities. PMID:22180804

Ayele, Berhan; Gebre, Teshome; Moncada, Jeanne; House, Jenafir I.; Stoller, Nicole E.; Zhou, Zhaoxia; Porco, Travis C.; Gaynor, Bruce D.; Emerson, Paul M.; Schachter, Julius; Keenan, Jeremy D.

2011-01-01

277

Ocular Immune Privilege and Ocular Melanoma: Parallel Universes or Immunological Plagiarism?  

PubMed Central

Evidence of immune privilege in the eye was recorded almost 140?years ago, yet interest in immune privilege languished for almost a century. However, the past 35?years have witnessed a plethora of research and a rekindled interest in the mechanisms responsible for immune privilege in the anterior chamber of the eye. This research has demonstrated that multiple anatomical, structural, physiological, and immunoregulatory processes contribute to immune privilege and remind us of the enormous complexity of this phenomenon. It is widely accepted that immune privilege is an adaptation for reducing the risk of immune-mediated inflammation in organs such as the eye and brain whose tissues have a limited capacity to regenerate. Recent findings suggest that immune privilege also occurs in sites where stem cells reside and raise the possibility that immune privilege is also designed to prevent the unwitting elimination of stem cells by immune-mediated inflammation at these sites. Uveal melanoma arises within the eye and as such, benefits from ocular immune privilege. A significant body of research reveals an intriguing parallel between the mechanisms that contribute to immune privilege in the eye and those strategies used by uveal melanoma cells to evade immune elimination once they have disseminated from the eye and establish metastatic foci in the liver. Uveal melanoma metastases seem to have “plagiarized” the blueprints used for ocular immune privilege to create “ad hoc immune privileged sites” in the liver. PMID:22707951

Niederkorn, Jerry Y.

2012-01-01

278

Design of an Implantable Device for Ocular Drug Delivery  

PubMed Central

Ocular diseases, such as, glaucoma, age-related macular degeneration (AMD), diabetic retinopathy, and retinitis pigmentosa require drug management in order to prevent blindness and affecting million of adults in USA and worldwide. There is an increasing need to develop devices for drug delivery to address ocular diseases. This study focuses on the design, simulation, and development of an implantable ocular drug delivery device consisting of micro-/nanochannels embedded between top and bottom covers with a drug reservoir made from polydimethylsiloxane (PDMS) which is silicon-based organic and biodegradable polymer. Several simulations were carried out with six different micro-channel configurations in order to see the feasibility for ocular drug delivery applications. Based on the results obtained, channel design of osmotic I and osmotic II satisfied the diffusion rates required for ocular drug delivery. Finally, a prototype illustrating the three components of the drug delivery design is presented. In the future, the device will be tested for its functionality and diffusion characteristics. PMID:22919500

Lee, Jae-Hwan; Pidaparti, Ramana M.; Atkinson, Gary M.; Moorthy, Ramana S.

2012-01-01

279

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

PubMed

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

Dementi, B

1994-01-01

280

Ocular manifestations of graft-versus-host disease  

PubMed Central

Allogeneic hematopoietic stem cell transplantation (HSCT) has evolved over the past two decades to become the standard of care for hematologic and lymphoid malignancies. Major ocular complications after allogeneic HSCT have been increasing in number and severity. Graft-versus-host disease (GVHD) remains a major cause of ocular morbidity after allogeneic HSCT. The main objective of this review is to elucidate the ocular complications in patients developing GVHD following HSCT. Ocular complications secondary to GVHD are common and include dry eye syndrome, acquisition of ocular allergy from donors with allergic disorders. Eyelid changes may occur in GVHD leading to scleroderma-like changes. Patients may develop poliosis, madarosis, vitiligo, lagophthalmos, and entropion. The cornea may show filamentary keratitis, superficial punctate keratitis, corneal ulcers, and peripheral corneal melting which may lead to perforation in severe cases. Scleritis may also occur which can be anterior or posterior. Keratoconjunctivis sicca appears to be the most common presentation of GVHD. The lacrimal glands may be involved with mononuclear cell infiltration of both the major and accessory lacrimal glands and decrease in tear production. Severe dry eye syndrome in patients with GVHD may develop conjunctival scarring, keratinization, and cicatrization of the conjunctiva. Therapy of GVHD includes systemic immunosuppression and local therapy. Surgical treatment in refractory cases includes surgical intervention to improve the manifestation of GVHD of the eye. This may include tarsorrhapy, prose lenses, punctal occlusions and corneal transplantation. PMID:24227989

Nassar, Amr; Tabbara, Khalid F.; Aljurf, Mahmoud

2013-01-01

281

Management of conjunctival cicatrizing diseases and severe ocular surface dysfunction.  

PubMed

Physical or chemical injuries, infections, immunologic oculocutaneous disorders, drugs, and various systemic disorders may cause scarring of the conjunctiva and disturbances of the ocular surface. Trichiasis, lid margin malposition, and dry eye may result in persistent ocular irritation. The cornea may be primarily or secondarily involved. If severe, disturbances of the ocular surface may lead to significant visual impairment. Thorough evaluation of patients and of the underlying disease process is required for optimal management. Treatment may be challenging and should be comprehensive, combining medical measures and surgical correction of structural changes. Suppression of exogenous irritants, treatment of dry eye, antiinflammatory therapy, and immunosuppressants are paramount to control the underlying disease and allow optimal surgical results. Surgical correction of trichiasis and lid margin malposition, conjunctival grafting, mucous membrane transplantation, limbal stem cell transplantation, amniotic membrane transplantation, and penetrating keratoplasty help reestablish a physiologic ocular surface. Severe cases may require keratoprosthetics for visual rehabilitation. Corneal ulceration or perforation requires prompt attention to maintain ocular integrity. Special measures should be considered for patients who require cataract or glaucoma surgery. PMID:9716191

Chiou, A G; Florakis, G J; Kazim, M

1998-01-01

282

Ocular Surface Temperature in Age-Related Macular Degeneration  

PubMed Central

Background. The aim of this study is to investigate the ocular thermographic profiles in age-related macular degeneration (AMD) eyes and age-matched controls to detect possible hemodynamic abnormalities, which could be involved in the pathogenesis of the disease. Methods. 32 eyes with early AMD, 37 eyes with atrophic AMD, 30 eyes affected by untreated neovascular AMD, and 43 eyes with fibrotic AMD were included. The control group consisted of 44 healthy eyes. Exclusion criteria were represented by any other ocular diseases other than AMD, tear film abnormalities, systemic cardiovascular abnormalities, diabetes mellitus, and a body temperature higher than 37.5°C. A total of 186 eyes without pupil dilation were investigated by infrared thermography (FLIR A320). The ocular surface temperature (OST) of three ocular points was calculated by means of an image processing technique from the infrared images. Two-sample t-test and one-way analysis of variance (ANOVA) test were used for statistical analyses. Results. ANOVA analyses showed no significant differences among AMD groups (P value?>0.272). OST in AMD patients was significantly lower than in controls (P > 0.05). Conclusions. Considering the possible relationship between ocular blood flow and OST, these findings might support the central role of ischemia in the pathogenesis of AMD.

Sodi, Andrea; Giacomelli, Giovanni; Corvi, Andrea; Menchini, Ugo

2014-01-01

283

Characterization of the normal microbiota of the ocular surface.  

PubMed

The ocular surface is continually exposed to the environment and as a consequence to different types of microbes, but whether there is a normal microbiota of the ocular surface remains unresolved. Using traditional microbial culture techniques has shown that <80% of swabs of the conjunctiva yield cultivable microbes. These usually belong to the bacterial types of the coagulase-negative staphylococci, Propionibacterium sp., with low frequency of isolation of bacteria such as Staphylococcus aureus, Micrococcus sp., Gram-negative bacteria or fungi. Even when these are grown, the numbers of colony forming units (cfu) per swab of the conjunctiva is usually much less than 100 cfu. Swabs of the lid more commonly result in microbial growth, of the same species as from the conjunctiva and slightly higher cfu. Contact lenses have also been cultured, and they yield similar microbial types. Microbes can be isolated from the ocular surface almost immediately after birth. The advent of molecular techniques for microbial identification based on 16S rRNA sequencing has opened up the possibility of determining whether there are non-cultivable microbes that can colonise the ocular surface. Additionally, use of these techniques with cross-sectional and longitudinal studies may help to understand whether the ocular surface harbours its own unique microbiota, or whether the microbiota are only transiently present. PMID:23797046

Willcox, Mark D P

2013-12-01

284

Ocular toxoplasmosis II: clinical features, pathology and management  

PubMed Central

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

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

2014-01-01

285

A survey on computer aided diagnosis for ocular diseases  

PubMed Central

Background Computer Aided Diagnosis (CAD), which can automate the detection process for ocular diseases, has attracted extensive attention from clinicians and researchers alike. It not only alleviates the burden on the clinicians by providing objective opinion with valuable insights, but also offers early detection and easy access for patients. Method We review ocular CAD methodologies for various data types. For each data type, we investigate the databases and the algorithms to detect different ocular diseases. Their advantages and shortcomings are analyzed and discussed. Result We have studied three types of data (i.e., clinical, genetic and imaging) that have been commonly used in existing methods for CAD. The recent developments in methods used in CAD of ocular diseases (such as Diabetic Retinopathy, Glaucoma, Age-related Macular Degeneration and Pathological Myopia) are investigated and summarized comprehensively. Conclusion While CAD for ocular diseases has shown considerable progress over the past years, the clinical importance of fully automatic CAD systems which are able to embed clinical knowledge and integrate heterogeneous data sources still show great potential for future breakthrough. PMID:25175552

2014-01-01

286

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

MedlinePLUS

... disorder catalog Conditions > Short stature, hyperextensibility, hernia, ocular depression, Rieger anomaly, and teething delay (often shortened to ... is SHORT syndrome? Short stature, hyperextensibility, hernia, ocular depression, Rieger anomaly, and teething delay, commonly known by ...

287

PCR-Based Detection of Toxoplasma gondii DNA in Blood and Ocular Samples for Diagnosis of Ocular Toxoplasmosis.  

PubMed

PCR detection of Toxoplasma gondii in blood has been suggested as a possibly efficient method for the diagnosis of ocular toxoplasmosis (OT) and furthermore for genotyping the strain involved in the disease. To assess this hypothesis, we performed PCR with 121 peripheral blood samples from 104 patients showing clinical and/or biological evidence of ocular toxoplasmosis and from 284 (258 patients) controls. We tested 2 different extraction protocols, using either 200 ?l (small volume) or 2 ml (large volume) of whole blood. Sensitivity was poor, i.e., 4.1% and 25% for the small- and large-volume extractions, respectively. In comparison, PCR with ocular samples yielded 35.9% sensitivity, while immunoblotting and calculation of the Goldmann-Witmer coefficient yielded 47.6% and 72.3% sensitivities, respectively. Performing these three methods together provided 89.4% sensitivity. Whatever the origin of the sample (ocular or blood), PCR provided higher sensitivity for immunocompromised patients than for their immunocompetent counterparts. Consequently, PCR detection of Toxoplasma gondii in blood samples cannot currently be considered a sufficient tool for the diagnosis of OT, and ocular sampling remains necessary for the biological diagnosis of OT. PMID:25210066

Bourdin, C; Busse, A; Kouamou, E; Touafek, F; Bodaghi, B; Le Hoang, P; Mazier, D; Paris, L; Fekkar, A

2014-11-01

288

Toll-Like Receptors in Ocular Surface Disease  

PubMed Central

The ability of the ocular surface to mount an immune response is in part attributed to a family of proteins called toll-like receptors (TLRs). The latter are evolutionary conserved receptors that recognize and respond to various microbes and endogenous ligands. In addition to their recognition function, TLR activation triggers a complex signal transduction cascade that induces the production of inflammatory cytokines and co-stimulatory molecules, thus initiating innate and adaptive immunity. Toll-like receptor expression at the ocular surface is modulated during infection (e.g. Herpes simplex, bacterial keratitis and fungal keratitis) as well as during various inflammatory conditions (allergic conjunctivitis and dry eye syndrome). Here recent findings regarding TLR expression and their involvement in various ocular surface diseases are discussed. PMID:20346359

Redfern, Rachel L.; McDermott, Alison M.

2010-01-01

289

Screening for tamoxifen ocular toxicity: a prospective study.  

PubMed

Specific ocular complications, namely retinopathy, keratopathy and optic neuritis, have been described in women being treated with tamoxifen for metastatic breast cancer or taking this drug as an adjuvant postoperative therapy. We examined 61 patients who had been using tamoxifen for at least one year, in order to detect the incidence of ocular complications. Two patients had retinopathy after having taken high cumulative doses of tamoxifen. Another had corneal deposits and a fourth had optic neuritis. It thus appears that systematic screening of all symptom-free patients using this drug for metastatic breast cancer is superfluous. However, an ophthalmological assessment every two years or earlier in case of visual complaints for patients taking tamoxifen as an adjuvant therapy remains useful, because the oncological therapy can be adjusted if serious ocular complications arise. PMID:8963159

Therssen, R; Jansen, E; Leys, A; Rutten, J; Meyskens, J

1995-01-01

290

Recurrent ocular involvement in pediatric atypical hemolytic uremic syndrome.  

PubMed

Atypical hemolytic uremic syndrome (HUS) is a subtype of thrombotic microangiopathy associated with complement alternative pathway dysregulation. It is clinically characterized by a relapsing course and a poor prognosis. Multiple organ systems are commonly affected by thrombotic microangiopathy in pediatric atypical HUS; however, ocular involvement is rarely reported. The case of an 11-year-old girl diagnosed as having atypical HUS who presented with bilateral central retinal vein occlusions with macular subhyaloid hemorrhage during her initial onset and ophthalmoplegia, diplopia, and optic disc edema during her relapsing episode 1 year later is described. All ocular manifestations occurred in the convalescence phase of atypical HUS. No other extrarenal complications were found and full recovery was achieved following typical treatment for atypical HUS (ie, plasma infusion, steroid, and supportive therapy). This is thought to be the first reported case of recurrent ocular involvement in pediatric atypical HUS. [J Pediatr Ophthalmol Strabismus 2014;51:e62-e65.]. PMID:25347082

Zheng, Xiaoyu; Gorovoy, Ian R; Mao, Jianhua; Jin, Ji; Chen, Xi; Cui, Qi N

2014-01-01

291

Dry eye disease: an immune-mediated ocular surface disorder  

PubMed Central

Dry eye disease is a multifactorial disorder of the tears and ocular surface characterized by symptoms of dryness and irritation. Although the pathogenesis of dry eye disease is not fully understood, it is recognized that inflammation has a prominent role in the development and propagation of this debilitating condition. Factors that adversely affect tear film stability and osmolarity can induce ocular surface damage and initiate an inflammatory cascade that generates innate and adaptive immune responses. These immunoinflammatory responses lead to further ocular surface damage and the development of a self-perpetuating inflammatory cycle. Herein, we review the fundamental links between inflammation and dry eye disease and discuss the clinical implications of inflammation in disease management. PMID:22232476

Stevenson, William; Chauhan, Sunil K.; Dana, Reza

2013-01-01

292

Subcutaneous phaeohyphomycosis in a patient with IgG4-related sclerosing disease caused by a novel ascomycete, Hongkongmyces pedis gen. et sp. nov.: first report of human infection associated with the family Lindgomycetaceae.  

PubMed

No members of the freshwater ascomycetes family Lindgomycetaceae have been associated with human infections. We isolated a mould (HKU35(T)) from the biopsy specimen of a patient with invasive foot infection and underlying immunoglobulin G4-related sclerosing disease. Histology showed florid, suppurative, granulomatous inflammation in the dermis, with central microabscess formation surrounded by epithelioid histiocytes, scattered giant cells, and a small number of lymphocytes. A Grocott stain revealed fungal elements in the center of the lesion. On Sabouraud glucose agar, HKU35(T) grew as gray and velvety colonies. Among the members of the family Lindgomycetaceae, HKU35(T) was the only strain that grew at 37°C. Microscopically, only sterile mycelia, but no fruiting bodies, were observed. HKU35(T) was susceptible to itrazonazole, voriconazole, and posaconazole, which was in line with the patient's clinical response to itraconazole treatment. Internal transcribed spacer and partial 18S nuclear rDNA (nrDNA), 28S nrDNA, ?-tubulin gene, and EF1? gene sequencing showed that HKU35(T) occupied a unique phylogenetic position, most closely related to but distinct from members of the genera Clohesyomyces and Lindgomyces. We propose a new genus and species, Hongkongmyces pedis gen. et sp. nov., to describe this fungus, which belongs to the family Lindgomycetaceae in the orderPleosporales of class Dothideomycetes. This case also represents the first report of human infection associated with the family Lindgomycetaceae. PMID:25147085

Tsang, Chi-Ching; Chan, Jasper F W; Trendell-Smith, Nigel J; Ngan, Antonio H Y; Ling, Ian W H; Lau, Susanna K P; Woo, Patrick C Y

2014-10-01

293

Relationship of Spontaneous Retinal Vein Pulsation with Ocular Circulatory Cycle  

PubMed Central

Purpose To determine the timing of spontaneous venous pulsation (SVP) relative to the ocular circulatory cycle by using the movie tool of confocal scanning laser ophthalmoloscope. Methods A video recording of the fundus was obtained using a confocal scanning laser ophthalmoscope (Spectralis HRA, Heidelberg Engineering, Heidelberg, Germany) at 8 frames/s in 47 eyes (15 glaucoma patients and 32 glaucoma suspects) with visible pulsation of both the central retinal artery (CRA) and vein (CRV). The timing of the maximum and minimum diameters of the CRA (CRAmax and CRAmin, respectively) and CRV (CRVmax and CRVmin, respectively) was identified during four pulse cycles. The interval between CRVmin and CRAmin, and between CRVmax and CRAmax was expressed as the number of frames and as a percentage of the ocular circulatory cycle. Results The ocular circulatory cycle (from one CRAmax to the next) lasted 7.7±1.0 frames (958.8±127.2 ms, mean±SD), with a mean pulse rate of 62.6 beats/min. The diameter of the CRA was increased for 2.4±0.5 frames (301.9±58.8 ms) and decreased for 5.3±0.9 frames (656.9±113.5 ms). CRVmax occurred 1.0±0.2 frames after CRAmax (equivalent to 13.0% of the ocular circulatory cycle), while CRVmin occurred 1.1±0.4 frames after CRAmin (equivalent to 14.6% of the ocular circulatory cycle). Conclusions During SVP, the diameter of the CRV began to decrease at early diastole, and the reduction persisted until early systole. This finding supports that CRV collapse occurs during ocular diastole. PMID:24844298

Kim, Mijin; Lee, Eun Ji; Seo, Je Hyun; Kim, Tae-Woo

2014-01-01

294

Primary calvarial bone grafting in oro-ocular clefts.  

PubMed

Oro-ocular clefts were classified by Tessier as 3-11 or 4-10 facial clefts. These rare clefts require both bony and soft tissue correction and present a significant challenge to the innovative skill of the craniofacial surgeon. A review of three male children with oro-ocular clefts and their management (including surgical planning and operative treatment) is presented. We would propose that the use of calvarial bone grafting as part of the primary closure is regarded as desirable based on our experience. PMID:19464971

O'Sullivan, J B; Earley, M J

2010-05-01

295

Ocular safety limits for 1030nm femtosecond laser cataract surgery  

NASA Astrophysics Data System (ADS)

Application of femtosecond lasers to cataract surgery has added unprecedented precision and reproducibility but ocular safety limits for the procedure are not well-quantified. We present an analysis of safety during laser cataract surgery considering scanned patterns, reduced blood perfusion, and light scattering on residual bubbles formed during laser cutting. Experimental results for continuous-wave 1030 nm irradiation of the retina in rabbits are used to calibrate damage threshold temperatures and perfusion rate for our computational model of ocular heating. Using conservative estimates for each safety factor, we compute the limits of the laser settings for cataract surgery that optimize procedure speed within the limits of retinal safety.

Wang, Jenny; Sramek, Christopher; Paulus, Yannis M.; Lavinsky, Daniel; Schuele, Georg; Anderson, Dan; Dewey, David; Palanker, Daniel V.

2013-03-01

296

Treating ocular surface disease: new agents in development  

PubMed Central

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

Fahmy, Ahmad M; Hardten, David R

2011-01-01

297

Location and Clonal Analysis of Stem Cells and Their Differentiated Progeny in the Human Ocular Surface  

Microsoft Academic Search

We have analyzed the proliferative and dif- ferentiation potential of human ocular keratinocytes. Holoclones, meroclones, and paraclones, previously identified in skin, constitute also the proliferative com- partment of the ocular epithelium. Ocular holoclones have the expected properties of stem cells, while tran- sient amplifying cells have variable proliferative poten- tial. Corneal stem cells are segregated in the limbus, while conjunctival

Graziella Pellegrini; Osvaldo Golisano; Patrizia Paterna; Alessandro Lambiase; Stefano Bonini; Paolo Rama; Michele De Luca

1999-01-01

298

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

PubMed

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

Mathurm, Manish; Gilhotra, Ritu Mehra

2011-01-01

299

Gaussian weighting of ocular wave-front measurements  

Microsoft Academic Search

The measurement of ocular wave-front error gives insight into the optical performance of the eye and possibly a means for assessing visual performance. The visual system responds not only to the quality of the optical image formed on the retina but also to the processing that occurs in the retina and the brain. To develop a metric of visual performance

Jim Schwiegerling

2004-01-01

300

Frequent association of delayed tear clearance in ocular irritation  

PubMed Central

AIM—To explore the pathogenic role of delayed tear clearance.?METHODS—By comparing 10 patients with punctal obstruction and 20 asymptomatic normals, delayed tear clearance was diagnosed in 70 patients without apparent punctal obstruction using fluorescein clearance test.?RESULTS—The majority were older (71.4 (SD 1.2) years) and women (66%). Frequent complaints included redness, itching, mucus discharge, and crusting, which tended to be worse upon awakening. Common associated problems were medicamentosa (13%), drug induced pseudo pemphigoid, ocular hypertension (27%), and glaucoma (7%). Topical non-preserved 1% methylprednisolone resulted in subjective (83%) and objective (80%) improvement and resolution of delayed tear clearance (87%).?CONCLUSION—These results indicate strong association of delayed tear clearance with intrinsically and extrinsically generated ocular surface inflammation. The presence of delayed tear clearance may set up a vicious cycle to aggravate the existing inflammation. Future prospective studies are needed to delineate the pathogenic role of delayed tear clearance in various ocular surface disorders.?? Keywords: medicamentosa; ocular irritation; tear clearance; tear turnover PMID:9797670

Prabhasawat, P.; Tseng, S.

1998-01-01

301

Consensus statement on the immunohistochemical detection of ocular lymphatic vessels.  

PubMed

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

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

2014-01-01

302

Vestibulo-ocular and optokinetic impairments in left unilateral neglect  

Microsoft Academic Search

Right brain damaged patients affected by left unilateral neglect (N+) typically fail to explore the contralesional space. For the first time, this study investigates the dynamic and spatial features of the horizontal vestibular–ocular response (VOR), the optokinetic response (OKR) and the VOR–OKR interaction in six N+ and in five right brain damaged patients without neglect (N?). No lateral asymmetry of

Fabrizio Doricchi; Isabelle Siegler; Giuseppe Iaria; Alain Berthoz

2002-01-01

303

Vestibulo-ocular pathways modulate extraocular muscle myosin expression patterns  

Microsoft Academic Search

The genetic and epigenetic influences that establish and maintain the unique phenotype of the extraocular muscles (EOMs) are poorly understood. The vestibulo-ocular reflex (VOR) represents an important input into the EOMs, as it stabilizes eye position relative to the environment and provides a platform for function of all other eye movement systems. A role for vestibular cues in shaping EOM

Jennifer K. Brueckner; Laura P. Ashby; Jennifer R. Prichard; John D. Porter

1999-01-01

304

Deficient FGF signaling causes optic nerve dysgenesis and ocular coloboma  

PubMed Central

FGF signaling plays a pivotal role in eye development. Previous studies using in vitro chick models and systemic zebrafish mutants have suggested that FGF signaling is required for the patterning and specification of the optic vesicle, but due to a lack of genetic models, its role in mammalian retinal development remains elusive. In this study, we show that specific deletion of Fgfr1 and Fgfr2 in the optic vesicle disrupts ERK signaling, which results in optic disc and nerve dysgenesis and, ultimately, ocular coloboma. Defective FGF signaling does not abrogate Shh or BMP signaling, nor does it affect axial patterning of the optic vesicle. Instead, FGF signaling regulates Mitf and Pax2 in coordinating the closure of the optic fissure and optic disc specification, which is necessary for the outgrowth of the optic nerve. Genetic evidence further supports that the formation of an Frs2?-Shp2 complex and its recruitment to FGF receptors are crucial for downstream ERK signaling in this process, whereas constitutively active Ras signaling can rescue ocular coloboma in the FGF signaling mutants. Our results thus reveal a previously unappreciated role of FGF-Frs2?-Shp2-Ras-ERK signaling axis in preventing ocular coloboma. These findings suggest that components of FGF signaling pathway may be novel targets in the diagnosis of and the therapeutic interventions for congenital ocular anomalies. PMID:23720040

Cai, Zhigang; Tao, Chenqi; Li, Hongge; Ladher, Raj; Gotoh, Noriko; Feng, Gen-Sheng; Wang, Fen; Zhang, Xin

2013-01-01

305

The effects of Qi-Qong ocular exercise on accommodation.  

PubMed

Visual-training methods in management of myopia are suggested as possibly leading to normal vision or an improvement in the refractive state. The purpose of this work was to investigate the hypothesis that a Qi-Qong ocular exercise improves visual function by training the accommodation bias. Variations of pupil size, accommodative amplitude, latency and speed of accommodative response and accommodative adaptation were evaluated objectively. The accommodative state was monitored with an objective infrared refractometer (Nidek AA-2000). Subjects were divided into two groups: experimental (n = 9), and control (n = 8). Subjects of the experimental group undertook the Qi-Qong ocular exercise for at least three years, and were able to perform the exercise smoothly and gently. Subjects of the control group had no knowledge of the Qi-Qong ocular exercise, but were given the same testing procedures as the experimental group. Results showed that Qi-Qong ocular exercise can improve the accommodative amplitude and accelerate the accommodative response slightly, but there was no effect on the latency of accommodative response. Furthermore, the level of accommodative adaptation was elevated, and the pupil became slight miotic. Therefore, the mechanism of visual improvement may undergo a great accommodative adaptation and produce a pinhole effect by miosis of the pupil. Methods of visual training can produce a false image of visual improvement from an enhanced parasympathetic response to a task, but this effect may be a factor that induces progression of myopia. PMID:8549234

Shih, Y F; Lin, L L; Hwang, C Y; Huang, J K; Hung, P T; Hou, P K

1995-01-01

306

Human ocular torsional position before and after unilateral vestibular neurectomy  

Microsoft Academic Search

The static ocular torsional position of both eyes of 23 patients was measured by means of fundus photographs one day before and one week after unilateral vestibular neurectomy for the treatment of acoustic neuroma, Ménière's disease or paroxysmal vertigo. The results showed that in all patients the vestibular neurectomy caused both eyes to tort (i.e. to roll around the visual

I. S. Curthoys; M. J. Dai; G. M. Halmagyi

1991-01-01

307

Effects of ocular aberrations on contrast detection in noise.  

PubMed

We use adaptive optics (AO) techniques to manipulate the ocular aberrations and elucidate the effects of these ocular aberrations on contrast detection in a noisy background. The detectability of sine wave gratings at frequencies of 4, 8, and 16 circles per degree (cpd) was measured in a standard two-interval force-choice staircase procedure against backgrounds of various levels of white noise. The observer's ocular aberrations were either corrected with AO or left uncorrected. In low levels of external noise, contrast detection thresholds are always lowered by AO correction, whereas in high levels of external noise, they are generally elevated by AO correction. Higher levels of external noise are required to make this threshold elevation observable when signal spatial frequencies increase from 4 to 16 cpd. The linear-amplifier-model fit shows that mostly sampling efficiency and equivalent noise both decrease with AO correction. Our findings indicate that ocular aberrations could be beneficial for contrast detection in high-level noises. The implications of these findings are discussed. PMID:22869925

Liang, Bo; Liu, Rong; Dai, Yun; Zhou, Jiawei; Zhou, Yifeng; Zhang, Yudong

2012-01-01

308

Autophagy and mitophagy participate in ocular lens organelle degradation  

E-print Network

Autophagy and mitophagy participate in ocular lens organelle degradation M. Joseph Costello a, *, 1 autophagy mitophagy cataract electron microscopy a b s t r a c t The eye lens consists of a layer lens epithelial cells upon serum starvation. These data provide evidence that autophagy occurs

Johnsen, Sönke

309

Measurement of ocular torsion using digital fundus image  

Microsoft Academic Search

Computer-based objective measurement of the ocular cyclotorsion using digital fundus photograph was developed. Color digital fundus photographs acquired with the field angle of 60°, 1520 × 1080 in resolution were analyzed. Optic disc and macula were segmented by the program developed on MATLAB, which executed the serial analysis of the Otsu threshold, labeling, Canny edge. The angle between the horizontal

J. M. Seo; K. K. Kim; J. H. Kim; K. S. Park; H. Chung

2004-01-01

310

[Ocular alterations associated with bungee jumping: case report].  

PubMed

The popularization of bungee jumping is causing an increase in occurrences of lesions associated with its practice, including ocular lesions. The purpose of this study is to describe a case of acute decrease in vision and visual field defects following a bungee jump. The authors present a case of a 48-year-old woman, without history of systemic or ocular disorders, seen at an ophthalmologic emergency service with visual loss complaint following a bungee jump. On initial ophthalmologic evaluation, hemorrhages in the posterior pole of both eyes were found. Fluorescein angiography showed hypofluorescent areas, without other vascular alterations. The patient was evaluated after 14 weeks, the hemorrhages cleared up and there was atrophy of the pigmented epithelium of the retina in the posterior pole, but the patient remained with complaint of scotoma and visual field defects even 5 months after the initial event. The occurrence of body lesions, including ocular lesions, with risk of decrease in visual acuity should be informed to candidates for the practice of this sport, and the ophthalmologist would do well to provide information to the population about possible ocular disorders, in this sport and in daily life. PMID:17344993

Diniz, José Ricardo; Arantes, Tiago Eugênio Faria e; Urbano, Roberta Ventura; Danda, Diana Maria Rodrigues; Almeida, Denízio Dantas

2005-01-01

311

Ocular Safety: A Silent (In Vitro) Success Story  

Microsoft Academic Search

Summary — Ocular irritation testing has been one of the animal test methods most criticised by animal welfare advocates. Additional criticism has arisen from within the scientific community, based on the vari- ability of the animal test results and the questionable relevance of the extremely high dose levels employed. As a result, the Draize eye irritation test has been one

Rodger D. Curren; John W. Harbell

2002-01-01

312

Comparative analysis of deformable mirrors for ocular adaptive optics  

E-print Network

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

Dainty, Chris

313

Epigallocatechin Gallate Inhibits Biofilm Formation by Ocular Staphylococcal Isolates  

Microsoft Academic Search

Epigallocatechin gallate (EGCg), the main polyphenol component of green tea, has several antibacterial properties. Here we show that sub-MICs of EGCg appear to decrease slime production, therefore inhibiting biofilm formation by ocular staphylococcal isolates previously characterized for the presence of ica genes by the Congo red agar plate assay and for adhesion to microtiter plates. Biofilm formation is a three-stage

Anna Rita Blanco; Andrea Sudano-Roccaro; Giovanna Carmela Spoto; Antonia Nostro; Dario Rusciano

2005-01-01

314

Imaging of Adult Ocular and Orbital Pathology - a Pictorial Review  

PubMed Central

Orbital pathology often presents a diagnostic challenge to the reporting radiologist. The aetiology is protean, and clinical input is therefore often necessary to narrow the differential diagnosis. With this manuscript, we provide a pictorial review of adult ocular and orbital pathology. PMID:24967016

Grech, Reuben; Cornish, Kurt Spiteri; Galvin, Patrick Leo; Grech, Stephan; Looby, Seamus; O’Hare, Alan; Mizzi, Adrian; Thornton, John; Brennan, Paul

2014-01-01

315

High-Dose Intravenous Corticosteroids for Ocular Inflammatory Diseases  

PubMed Central

Purpose To evaluate the effectiveness and risk of complications of high-dose intravenous pulsed corticosteroids for non-infectious ocular inflammatory diseases. Methods Retrospective cohort study. One hundred four eyes of seventy patients who received high-dose intravenous corticosteroids for treatment of active ocular inflammation were identified from five centers. The main outcome measures were control of inflammation and occurrence of ocular or systemic complications within one month after treatment. Results Within ?1 month of starting treatment, 57% of eyes achieved complete control of inflammation (95% confidence interval (CI): 33-83%), improving to 82% when near-complete control was included (95% CI: 61-96%). Most eyes (85%; 95% CI: 70-95%) gained clinically significant improvement in anterior chamber inflammation. One patient developed a colon perforation during treatment. No other major complications were recorded. Conclusions Treatment of ocular inflammation with high-dose intravenous corticosteroids resulted in substantial clinical improvement for most cases within one month. Complications of therapy were infrequent. PMID:22409561

Charkoudian, Leon D.; Ying, Gui-shuang; Pujari, Siddharth S.; Gangaputra, Sapna; Thorne, Jennifer E.; Foster, C. Stephen; Jabs, Douglas A.; Levy-Clarke, Grace A.; Nussenblatt, Robert B.; Rosenbaum, James T.; Suhler, Eric B.; Kempen, John H.

2011-01-01

316

In vitro NIR laser tissue welding of porcine ocular tissues  

Microsoft Academic Search

In this study, 72 different combinations of laser welding parameters were compared for their effectiveness in welding ocular tissue. The laser employed in the welding system was a near infrared (NIR) erbium fiber laser with a wavelength of 1.455 mum . The laser system used a motorized translational stage and shutter to control the laser exposure of the tissue being

Richard B. Rosen; Howard E. Savage; Rabindra K. Halder; Uladzimir Kartazayeu; Steven A. McCormick; Alvin Katz; Henry D. Perry; Robert R. Alfano

2005-01-01

317

Method for non-invasive detection of ocular melanoma  

DOEpatents

There is described an apparatus and method for diagnosing ocular cancer that is both non-invasive and accurate which comprises two radiation detectors positioned before each of the patient's eyes which will measure the radiation level produced in each eye after the administration of a tumor-localizing radiopharmaceutical such as gallium-67.

Lambrecht, Richard M. (Quogue, NY); Packer, Samuel (Floral Park, NY)

1984-01-01

318

Method for non-invasive detection of ocular melanoma  

DOEpatents

An apparatus and method is disclosed for diagnosing ocular cancer that is both non-invasive and accurate. The apparatus comprises two radiation detectors positioned before each of the patient's eyes which will measure the radiation level produced in each eye after the administration of a tumor-localizing radiopharmaceutical such as gallium-67. 2 figs.

Lambrecht, R.M.; Packer, S.

1984-10-30

319

The epidemiology and etiology of pediatric ocular trauma.  

PubMed

Eighteen million people worldwide have uniocular blindness from traumatic injury. Injuries occur disproportionally commonly in childhood. Every year a quarter of a million children present with serious ocular trauma. For the vast majority the injury is preventable. We review the international literature that identifies high-risk circumstances. PMID:23969021

Abbott, Joseph; Shah, Peter

2013-01-01

320

Clinical study on Hypotony following blunt ocular trauma  

PubMed Central

AIM To evaluate the incidence and risk factors of hypotony in patients with blunt ocular trauma. METHODS The medical records of 145 patients with blunt ocular trauma were reviewed. Hypotony was defined as an average intraocular pressure (IOP) of 5mmHg or less for three times. RESULTS Among these 145 patients, hypotony was noted in 10 (6.9%) patients. The rate of hypotony in patients with ciliochoroidal detachment was 66.7% (2 out of 3 eyes), and 5.6% (8 out of 142 eyes) in patients without ciliochoroidal detachment, the difference was statistically significant (P=0.003). The rate of hypotony in patients with traumatic retinal detachment was 18.5% (5 out of 27 eyes), and 4.2% (5 out of 118 eyes) in patients without traumatic retinal detachment, the difference was statistically significant (P=0.026). The rate of hypotony in the patients with anterior proliferative vitreoretinopathy was 42.9% (3 out of 7 eyes) and 5.1% (7 out of 138 eyes) in the patients without anterior proliferative vitreoretinopathy, the difference was statistically significant (P=0.002). CONCLUSION Ocular hypotension is a complication of blunt ocular trauma. The risk factors include ciliochoroidal detachment, traumatic retinal detachment, and anterior proliferative vitreoretinopathy. PMID:23275915

Ding, Chun; Zeng, Jun

2012-01-01

321

The Role of Antimicrobial Peptides at the Ocular Surface  

Microsoft Academic Search

Antimicrobial peptides (AMPs) such as defensins and cathelicidins are small peptides with broad-spectrum activity against bacteria, fungi and viruses. In addition, several AMPs modulate mammalian cell behaviours including migration, proliferation and cytokine production. This review describes findings from recent studies showing the presence of various AMPs at the human ocular surface and discusses their mechanism of antimicrobial action and potential

Alison M. McDermott

2009-01-01

322

Vitrified collagen-based conjunctival equivalent for ocular surface reconstruction.  

PubMed

The main functions of the conjunctiva, an essential part of the ocular surface, are to maintain the equilibrium of the tear film and to protect the eye. Upon injuries, the prerequisite to successful ocular surface repair is conjunctival reconstruction. Tissue engineering techniques, including transplantation of autografts, amniotic membranes and numerous synthetic/natural materials, have been developed. However, none of these strategies is completely satisfactory due to lack of goblet cell repopulation, poor mechanical properties or non-standardized preparation procedure. Here, we cultured conjunctival epithelial cells on vitrified collagen membranes and developed a tissue equivalent for repairing damaged conjunctiva. Optimized vitrified collagen has superior mechanical and optical properties to previous biomaterials for ocular surface application, and its unique fibrillar structure significantly benefited conjunctival epithelial cell growth and the phenotypic development in vitro. In a rabbit model, vitrified collagen greatly promoted conjunctival regeneration with rapid re-epithelization, sufficient repopulation of goblet cells and minimized fibrosis and wound contracture, proved by gene expression analyses and histological staining. In conclusion, we have demonstrated the potential suitability of utilizing vitrified collagen-based tissue equivalent in ocular surface reconstruction. PMID:24933512

Zhou, Huifang; Lu, Qiaozhi; Guo, Qiongyu; Chae, Jemin; Fan, Xianqun; Elisseeff, Jennifer H; Grant, Michael P

2014-08-01

323

Transforming ocular surface stem cell research into successful clinical practice.  

PubMed

It has only been a quarter of a century since the discovery of adult stem cells at the human corneo-scleral limbus. These limbal stem cells are responsible for generating a constant and unending supply of corneal epithelial cells throughout life, thus maintaining a stable and uniformly refractive corneal surface. Establishing this hitherto unknown association between ocular surface disease and limbal dysfunction helped usher in therapeutic approaches that successfully addressed blinding conditions such as ocular burns, which were previously considered incurable. Subsequent advances in ocular surface biology through basic science research have translated into innovations that have made the surgical technique of limbal stem cell transplantation simpler and more predictable. This review recapitulates the basic biology of the limbus and the rationale and principles of limbal stem cell transplantation in ocular surface disease. An evidence-based algorithm is presented, which is tailored to clinical considerations such as laterality of affliction, severity of limbal damage and concurrent need for other procedures. Additionally, novel findings in the form of factors influencing the survival and function of limbal stem cells after transplantation and the possibility of substituting limbal cells with epithelial stem cells of other lineages is also discussed. Finally this review focuses on the future directions in which both basic science and clinical research in this field is headed. PMID:24492499

Sangwan, Virender S; Jain, Rajat; Basu, Sayan; Bagadi, Anupam B; Sureka, Shraddha; Mariappan, Indumathi; Macneil, Sheila

2014-01-01

324

Light sensors in ocular fluorescence imaging: assessment of parameters  

NASA Astrophysics Data System (ADS)

Ocular fluorometry has been recognized as a relevant noninvasive technique in ophthalmology diagnosis and research. Fluorometric methods are widely used namely for measuring some of the major physiological parameters of clinical significance: measurement of corneal epithelial and endothelial permeability, use of sodium fluorescein (a well known exogenous fluorophore) to estimate the aqueous flow, and, most important, to measure the permeability of blood-ocular barriers that can give an early indication of diabetic retinopathy, etc. Ocular fluorometry instrumentation relies on the performance of light detectors based on different technologies. The trend, over the past few years, seems to be the increasing use of solid state ones, namely the so-called photodiode arrays (PDA). Good quantum efficiency, wide spectral range, inherent spatial resolution, good reproducibility and low dark current make them appropriate to measure ocular fluorescence light intensity distribution along the eye optical axis. When the light levels to be measured are very low, special care must be focused on the parameters and the working conditions of these devices so that their quantitative results can be meaningful and reliable. Cooling to reduce dark current, slow data rates to allow for longer exposure times increasing sensitivity, high gain and low noise amplification can be listed as some of the operation requirements. The study of the specific nonuniformity profile of the sensor used is another important procedure.

Domingues, Jose P.; Correia, Carlos M.; Cunha-Vaz, Jose G.

1995-01-01

325

Renal Magnesium Wasting with Hypercalciuria, Nephrocalcinosis and Ocular Disorders  

Microsoft Academic Search

We report a case of congenital magnesium-losing kidney with associated hypercalciuria and ocular derangements consisting of myopia, bilateral macular colobomata and bilateral papillary dysversion and hypoplasia. Our patient provides further evidence of the existence of an oculorenal syndrome associating abnormalities in the renal handling of magnesium and calcium, and myopia and chorioretinal disease.Copyright © 1995 S. Karger AG, Basel

Antonio Torralbo; Emeterio Pina; José Portolés; Ana Sánchez-Fructuoso; Alberto Barrientos

1995-01-01

326

Pulsatile ocular blood flow in patients with low tension glaucoma  

Microsoft Academic Search

Measurements of the intraocular pressure (IOP) pulse and pulsatile ocular blood flow (POBF) have been made in 22 patients with bilateral low tension glaucoma (LTG) and 29 healthy subjects matched as closely as possible for age, refractive error, IOP, systemic pulse pressure, and heart rate. Recordings were made in both the standing and supine positions. The amplitude of the intraocular

C B James; S E Smith

1991-01-01

327

A case of ocular canine transmissible venereal tumor  

PubMed Central

A 1-year-old, intact female mixed-breed dog was presented to St. George’s University Small Animal Clinic in Grenada for a third eyelid mass. The dog was diagnosed with a rare ocular transmissible venereal tumor (TVT) and concurrent anaplasmosis, ehrlichiosis and dirofilariasis. Treatment with vincristine sulfate resulted in complete resolution of the TVT. PMID:24381345

Milo, Jewel; Snead, Elisabeth

2014-01-01

328

A new approach to the study of ocular chromatic aberrations  

Microsoft Academic Search

We measured the ocular wavefront aberration at six different visible wavelengths (between 450 and 650 nm) in three subjects, using a spatially resolved refractometer. In this technique, the angular deviation of light rays entering the pupil at different locations is measured with respect to a target viewed through a centered pupil. Fits of the data at each wavelength to Zernike

Susana Marcos; Stephen A. Burns; Esther Moreno-Barriusop; Rafael Navarro

329

Reliability and Validity of the Ocular Surface Disease Index  

Microsoft Academic Search

Results: Factor analysis identified 3 subscales of the OSDI: vision-related function, ocular symptoms, and en- vironmental triggers. Reliability (measured by Cron- bach a) ranged from good to excellent for the overall in- strument and each subscale, and test-retest reliability was good to excellent. The OSDI was valid, effectively dis- criminating between normal, mild to moderate, and se- vere dry eye

Rhett M. Schiffman; Murray Dale Christianson; Gordon Jacobsen; Jan D. Hirsch; Brenda L. Reis

2000-01-01

330

Ocular Vaccinia Infection in Laboratory Worker, Philadelphia, 2004  

PubMed Central

We report a case of ocular vaccinia infection in an unvaccinated laboratory worker. The patient was infected by a unique strain used in an experiment performed partly outside a biosafety cabinet. Vaccination should continue to be recommended, but laboratories with unvaccinated workers should also implement more stringent biosafety practices. PMID:16494730

Chernak, Esther; Goldman, Erinn; Li, Yu; Karem, Kevin; Damon, Inger K.; Henkel, Richard; Newbern, E. Claire; Ross, Patrina; Johnson, Caroline C.

2006-01-01

331

Lyin' Eyes: Ocular-motor Measures of Reading Reveal Deception  

PubMed Central

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

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

2013-01-01

332

Protective role of nitric oxide in ocular toxoplasmosis.  

PubMed Central

AIMS: To evaluate the role of nitric oxide (NO) in ocular involvement during systemic toxoplasmosis. METHODS: C57B1/6 mice were infected with Toxoplasma gondii strain ME49. The synthesis of NO was inhibited by an intraperitoneal injection of aminoguanidine every 8 hours, starting on the day of infection. Control infected mice received phosphate buffered saline vehicle alone. After 14 days, the ocular lesions were evaluated by histopathological examination. The expression of NO synthase induced in the spleen by toxoplasma infection was evaluated by immunostaining. The production of NO by the spleen cells of infected mice was measured by the colorimetric assay of Griess in the supernatant of cultures stimulated with toxoplasma antigen or concanavalin A. RESULTS: The inhibition of NO production in T gondii infected mice resulted in a marked increase in the symptoms of ocular inflammation. We observed a strong induction of NO synthase expression in the spleen of infected animals. In culture, the spleen cells from these mice produced high levels of NO in response to T gondii antigens. This elevation of NO synthesis was suppressed in the presence of aminoguanidine. CONCLUSION: This study indicates that NO plays a crucial role in the protection against T gondii infection as reflected by the severity of the ocular involvement. Images PMID:8795379

Hayashi, S.; Chan, C. C.; Gazzinelli, R. T.; Pham, N. T.; Cheung, M. K.; Roberge, F. G.

1996-01-01

333

Successfully Improving Ocular Drug Delivery Using the Cationic Nanoemulsion, Novasorb  

PubMed Central

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

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

2012-01-01

334

Ocular Paintball Injury with and without Eye Protection  

Microsoft Academic Search

'Paintball' is a war game in which 2 teams use special carbon dioxide or air compressed guns to shoot gelatin or latex balls filled with paint. The balls rupture on impact marking the victim with the extruded dye. Ocular paintball injuries are increasingly being reported, probably due to the popularity and unrestricted use of this game without consideration for safety.

Hanna Garzozi

335

Absorption and ocular deposition of dietary lutein in marine mammals.  

PubMed

Cataracts and ocular disease are common lesions of marine mammals in zoological collections. Lutein, an oxygenated carotenoid, may have therapeutic or prophylactic effects on ocular disorder. Therefore, this study examined the ability of marine mammals to absorb dietary lutein. Two preliminary trials examined lutein in two forms (beadlet or ester) in a small sample size of marine mammals representing pinnipeds and cetaceans. Lutein was fed daily in tablets providing 0.89-3.6 mg lutein/kg body weight(0.75) per day for 15 days to 2 years. A third study was conducted using lutein beadlet fed at 3.6 mg lutein/kg body weight(0.75) per day for 15-21 days. Blood was analyzed for lutein pre- and postsupplementation. In the preliminary trials, lutein beadlet was observed to result in greater blood lutein levels than lutein esters, and cetaceans had more noticeable responses than pinnipeds. In Study 3, serum lutein and zeaxanthin increased postsupplementation in beluga whales (P < 0.05), and serum lutein tended to increase postsupplementation in dolphins (P < 0.10), but little change was seen in serum lutein in pinnipeds or manatee. Opportunistic retinal samples demonstrated some detectable lutein in the retina of a dolphin and several harp seals. The lutein levels in dolphins after supplementation are similar to those reported in free-ranging animals. Ocular lutein in harp seals demonstrates that ocular deposition occurs despite low circulating lutein levels. PMID:22753123

Koutsos, Elizabeth A; Schmitt, Todd; Colitz, Carmen M H; Mazzaro, Lisa

2013-01-01

336

Estimation of the ocular point spread function by retina modeling  

E-print Network

Estimation of the ocular point spread function by retina modeling N.Meitav and E.N. Ribak.5310, 330.6100, 100.1830 High resolution retinal imaging is one of the direct tools to examine the retina. Thus high quality images of the retina could help shed more light on the retinal cellular structure

Ribak, Erez

337

A Case of Ocular Syphilis in a 36-Year-Old HIV-Positive Male  

PubMed Central

The incidence of syphilis in the United States has increased markedly over the last decade, particularly among men who have sex with men (MSM). Although uncommon, ocular involvement is a potentially devastating clinical manifestation of syphilis. Human immunodeficiency virus (HIV) infection appears to increase the risk of ocular syphilis. Because of the lack of pathognomonic features for ocular syphilis and its ability to occur in both immunocompetent and immunosuppressed individuals, prompt diagnosis requires a high index of suspicion. Ocular syphilis should therefore be considered in MSM and HIV-infected patients presenting with unexplained visual complaints. Herein, we present a case of ocular syphilis in a patient with newly diagnosed HIV.

Jenkins, Timothy C.

2014-01-01

338

A novel educational tool for teaching ocular ultrasound.  

PubMed

Ocular ultrasound is now in increasing demand in routine ophthalmic clinical practice not only because it is noninvasive but also because of ever-advancing technology providing higher resolution imaging. It is however a difficult branch of ophthalmic investigations to grasp, as it requires a high skill level to interface with the technology and provide accurate interpretation of images for ophthalmic diagnosis and management. It is even more labor intensive to teach ocular ultrasound to another fellow clinician. One of the fundamental skills that proved difficult to learn and teach is the need for the examiner to "mentally convert" 2-dimensional B-scan images into 3-dimensional (3D) interpretations. An additional challenge is the requirement to carry out this task in real time. We have developed a novel approach to teach ocular ultrasound by using a novel 3D ocular model. A 3D virtual model is built using widely available, open source, software. The model is then used to generate movie clips simulating different movements and orientations of the scanner head. Using Blender, Quicktime motion clips are choreographed and collated into interactive quizzes and other pertinent pedagogical media. The process involves scripting motion vectors, rotation, and tracking of both the virtual stereo camera and the model. The resulting sequence is then rendered for twinned right- and left-eye views. Finally, the twinned views are synchronized and combined in a format compatible with the stereo projection apparatus. This new model will help the student with spatial awareness and allow for assimilation of this awareness into clinical practice. It will also help with grasping the nomenclature used in ocular ultrasound as well as helping with localization of lesions and obtaining the best possible images for echographic diagnosis, accurate measurements, and reporting. PMID:21760711

Mustafa, Ms; Montgomery, J; Atta, Hr

2011-01-01

339

Am. J. Hum. Genet. 62:800809, 1998 OA1 Mutations and Deletions in X-Linked Ocular Albinism  

E-print Network

Am. J. Hum. Genet. 62:800­809, 1998 800 OA1 Mutations and Deletions in X-Linked Ocular Albinism-linked ocular albinism (OA1), Nettleship-Falls type, is characterized by decreased ocular pigmentation, fo- veal- length OA1 gene in 29 unrelated North American and Australian X-linked ocular albinism (OA) probands, in

Kidd, Kenneth

340

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

ERIC Educational Resources Information Center

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…

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

2014-01-01

341

Design of liposomal colloidal systems for ocular delivery of ciprofloxacin  

PubMed Central

Ophthalmic drug bioavailability is limited due to protective mechanisms of the eye which require the design of a system to enhance ocular delivery. In this study several liposomal formulations containing ciprofloxacin (CPX) have been formulated using reverse phase evaporation technique with final dispersion of pH 7.4. Different types of phospholipids including Phosphatidylcholine, Dipalmitoylphosphatidylcholine and Dimyristoyl-sn-glycero-3-phosphocholine were utilized. The effect of formulation factors such as type of phospholipid, cholesterol content, incorporation of positively charging inducing agents and ultrasonication on the properties of the liposomal vesicles was studied. Bioavailability of selected liposomal formulations in rabbit eye aqueous humor has been investigated and compared with that of commercially available CPX eye drops (Ciprocin®). Pharmacokinetic parameters including Cmax, Tmax, elimination rate constant, t1/2, MRT and AUC0–?, were determined. The investigated formulations showed more than three folds of improvement in CPX ocular bioavailability compared with the commercial product. PMID:25061409

Taha, Ehab I.; El-Anazi, Magda H.; El-Bagory, Ibrahim M.; Bayomi, Mohsen A.

2013-01-01

342

Ocular Surface Squamous Neoplasia Masquerading as Superior Limbic Keratoconjunctivitis  

PubMed Central

To report a case of ocular surface squamous neoplasia (OSSN) masquerading as superior limbic keratoconjunctivitis (SLK). A 62-year-old woman was referred with foreign body sensation, irritation, photophobia and decreased vision in the left eye. She was initially treated for 10 months with intermittent topical corticosteroids for a presumed diagnosis of SLK. She underwent excisional biopsy of the superior conjunctiva and was found, on histopathologic evaluation, to have OSSN with moderate to marked dysplasia. This is the first reported case of OSSN masquerading with signs and symptoms of SLK. Any ocular surface lesion refractory to standard medical treatment should raise suspicion for a malignant process and warrant further cytologic or histopathologic evaluation. PMID:21572741

Moshirfar, Majid; Khalifa, Yousuf M.; Kuo, Annie; Davis, Don; Mamalis, Nick

2011-01-01

343

Ocular surface squamous neoplasia masquerading as superior limbic keratoconjunctivitis.  

PubMed

To report a case of ocular surface squamous neoplasia (OSSN) masquerading as superior limbic keratoconjunctivitis (SLK). A 62-year-old woman was referred with foreign body sensation, irritation, photophobia and decreased vision in the left eye. She was initially treated for 10 months with intermittent topical corticosteroids for a presumed diagnosis of SLK. She underwent excisional biopsy of the superior conjunctiva and was found, on histopathologic evaluation, to have OSSN with moderate to marked dysplasia. This is the first reported case of OSSN masquerading with signs and symptoms of SLK. Any ocular surface lesion refractory to standard medical treatment should raise suspicion for a malignant process and warrant further cytologic or histopathologic evaluation. PMID:21572741

Moshirfar, Majid; Khalifa, Yousuf M; Kuo, Annie; Davis, Don; Mamalis, Nick

2011-01-01

344

Image analysis of ocular fundus for retinopathy characterization  

SciTech Connect

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.

Ushizima, Daniela; Cuadros, Jorge

2010-02-05

345

Noninfectious immune-mediated uveitis and ocular inflammation.  

PubMed

Noninfectious uveitis encompasses a diverse group of ocular inflammatory disorders that share an underlying immune etiology and may be associated with systemic disease or confined primarily to the eye. Uveitis is commonly classified by anatomical location of inflammation into anterior, intermediate, posterior, and panuveitis. The treatment of noninfectious uveitis consists of corticosteroids, immunosuppressive agents, and surgically placed steroid implants. We review the epidemiology, immunopathology, and clinical features of several noninfectious immune-mediated uveitides, including HLA-B27 acute anterior uveitis, juvenile idiopathic arthritis, intermediate uveitis, sarcoidosis, Behcet's disease, Vogt-Koyanagi-Harada syndrome, sympathetic ophthalmia, and white dot syndromes. We also discuss the stepwise approach to medical treatment of immune-mediated uveitis as well as the characteristics, safety, and efficacy of immunosuppressive agents used to treat ocular inflammatory disease. PMID:24338488

Pan, Jennifer; Kapur, Manuj; McCallum, Rex

2014-01-01

346

X-linked ocular albinism. An oculocutaneous macromelanosomal disorder.  

PubMed

Three unrelated kindreds with the Nettleship-Falls type of X-linked ocular albinism were studied. Postmortem examination of the eyes of an affected man revealed the presence of macromelanosomes in the pigment epithelia. Skin biopsy specimens of this patient, seven other affected male, and nine carrier female kindred members revealed the presence of Fontana-positive and dopa oxidase-positive macromelanosomes within the epidermis and dermis. Although clinically this disorder has been considered to be a form of albinism confined to the eyes, these findings indicate that an unusual disturbance in melanosome production characterized by macromelanosome formation affects the skin and the eyes. Histopathologic study of the skin is a useful adjunct in the diagnosis of X-linked ocular albinism, both in the affected and the carrier states. Linkage studies confirmed the close association of the Xg blood group with this disorder. PMID:985163

O'Donnell, F E; Hambrick, G W; Green, W R; Iliff, W J; Stone, D L

1976-11-01

347

Aquaporins and CFTR in ocular epithelial fluid transport.  

PubMed

Aquaporins (AQPs) and the cystic fibrosis transmembrane conductance regulator (CFTR) provide the molecular routes for transport of water and chloride, respectively, through many epithelial tissues. In ocular epithelia, fluid transport generally involves secondary active chloride transport, which creates the osmotic gradient to drive transepithelial water transport. This review is focused on the role of AQPs and CFTR in water and ion transport across corneal/conjunctival epithelia, corneal endothelium, ciliary epithelium, and retinal pigment epithelium. The potential relevance of water and chloride transport to common disorders of ocular fluid balance is also considered. Recent data suggest AQPs and CFTR as attractive targets for drug development for therapy of keratoconjunctivitis sicca, recurrent corneal erosions, corneal edema, glaucoma, retinal detachment, and retinal ischemia. PMID:16868675

Levin, M H; Verkman, A S

2006-03-01

348

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

PubMed

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

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

2014-01-01

349

Ocular melanoma and mammary mucinous carcinoma in an African lion  

PubMed Central

Background Reports of neoplasms in Panthera species are increasing, but they are still an uncommon cause of disease and death in captive wild felids. The presence of two or more primary tumor in large felids is rarely reported, and there are no documented cases of ocular melanoma and mammary mucinous carcinoma in African lions. Case presentation An ocular melanoma and a mammary mucinous carcinoma are described in an African lion (Panthera leo). The first tumour was histologically characterized by the presence of epithelioid and fusiform melanocytes, while the latter was composed of mucus-producing cells with an epithelial phenotype that contained periodic acid-Schiff (PAS) and Alcian blue staining mucins. Metastases of both tumor were identified in various organs and indirect immunohistochemistry was used to characterize them. Peribiliary cysts were observed in the liver. Conclusions This is the first description of these tumor in African lions. PMID:23009723

2012-01-01

350

Ranibizumab for the treatment of degenerative ocular conditions  

PubMed Central

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

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

2014-01-01

351

Application of small molecules/macromolecules in ocular inflammatory diseases.  

PubMed

Macrobiomolecular treatments for ocular inflammatory diseases have been described in a previous review. This article mainly discusses the application of small molecules in uveitis therapy, which includes corticosteroids, salicylic acid (aspirin), metabolite analogs, and anti-oxidative agents. Additionally, we update recent advances in peptide and nucleic acid related therapies, and focus mainly on the calcineurin inhibitor, cyclosporine, oral tolerant retinal proteins/peptides, gene therapy and ribonucleic acid interference strategies. We classify these immunomodulatory agents by their molecular signatures and highlight the molecular structure and mechanisms of function. These developments in understanding molecular mechanisms of the diseases, with the advent of new technologies, advance current therapeutic approaches. The future direction is to tailor treatments to individual patients in order to provide the safest and most effective therapies for ocular inflammatory diseases. PMID:22934741

Liu, Baoying; Chan, Chi-Chao; Nussenblatt, Robert B

2012-01-01

352

Long acting betaxolol ocular inserts based on polymer composite.  

PubMed

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

Gevariya, Hitesh B; Patel, Jayvadan K

2013-08-01

353

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

PubMed Central

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

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

354

Aquaporins and CFTR in Ocular Epithelial Fluid Transport  

Microsoft Academic Search

Aquaporins (AQPs) and the cystic fibrosis transmembrane conductance regulator (CFTR) provide the molecular routes for transport\\u000a of water and chloride, respectively, through many epithelial tissues. In ocular epithelia, fluid transport generally involves\\u000a secondary active chloride transport, which creates the osmotic gradient to drive transepithelial water transport. This review\\u000a is focused on the role of AQPs and CFTR in water and

M. H. Levin; A. S. Verkman

2006-01-01

355

Spontaneous Intraocular Hemorrhage in Rats during Postnatal Ocular Development  

PubMed Central

To study spontaneous intraocular hemorrhage in rats during postnatal ocular development and to elucidate the underlying mechanism, postnatal ocular development in the albino Wistar Hannover (WH) and Sprague–Dawley (SpD) and pigmented Long–Evans (LE) strains was analyzed. Pups (n = 2 to 5) from each strain were euthanized daily on postnatal days (PND) 0 through 21 and their eyes examined macroscopically and histologically; similar analyses were performed in 26 to 39 additional WH pups daily from PND 7 to 14. At necropsy, ring-shaped red regions and red spots were present in the eyes of WH and SpD rats. These lesions were attributed histologically to hemorrhage of the tunica vasculosa lentis or of the retina, choroid, and hyaloid artery, respectively. Similar intraocular hemorrhages occurred in LE rats, although the macroscopic alterations found in WH and SpD rats were not present in this strain. Among the 3 strains evaluated, the incidence of the intraocular hemorrhage was highest in WH rats. We here showed that intraocular hemorrhage occurs spontaneously during normal ocular development in rats regardless of the strain; however, the region, degree, and incidence of intraocular hemorrhage differ among strains. Hemorrhage in the tunica vasculosa lentis and hyaloid artery may result from the leakage of erythrocytes from the temporary vasculature of these tissues during regression. The mechanisms underlying hemorrhage in the retina and choroid remain unclear. To our knowledge, this report is the first to describe the spontaneous intraocular hemorrhage that occurs during postnatal ocular development in rats. PMID:24512959

Inagaki, Katsuhiro; Koga, Hiroyasu; Inoue, Kazuyoshi; Suzuki, Katsushi; Suzuki, Hiroetsu

2014-01-01

356

Convergence reduces ocular counterroll (OCR) during static roll-tilt  

Microsoft Academic Search

When humans are roll-tilted around the naso-occipital axis, both eyes roll or tort in the opposite direction to roll-tilt, a phenomenon known as ocular counterroll (OCR). While the magnitude of OCR is primarily determined by vestibular, somatosensory, and proprioceptive input, direction of gaze also plays a major role. The aim of this study was to measure the interaction between some

D. Ooi; E. D. Cornell; I. S. Curthoys; A. M. Burgess; H. G. MacDougall

2004-01-01

357

Results of Ocular Dominance Testing Depend on Assessment Method  

PubMed Central

Purpose We developed a near ocular dominance test modeled after the distance hole-in-the card test, and assessed both test-retest reliability of four tests of ocular dominance and agreement between tests. Methods 46 subjects ages 18 to 78 years with visual acuity 20/40 or better in each eye were enrolled from a primary care practice. All subjects had normal eye examinations, with the exception of refractive error, and were examined in their habitual correction. Subjects were tested twice each with the distance hole-in-the-card test, new near hole- in-the-card test, near convergence test, and the Pediatric Eye Disease Investigator Group (PEDIG) fixation preference test. Test-retest reliability and agreement between tests were evaluated with the Kappa statistic. Results There was substantial to almost perfect test-retest reliability for the distance hole-in-the-card test, new near hole-in-the-card test, convergence test, and PEDIG fixation preference test (Kappa, k=0.77, 0.62, 0.84, 0.77, respectively). In contrast, the agreement between the new near hole in the card test and the other three tests – distance hole in the card, near convergence, and PEDIG fixation preference– was moderate to slight (k=0.41, 0.19, 0.11, respectively). Agreement was moderate to fair (k=0.47, 0.32) between the distance hole in the card test and the near convergence test, and between the distance-hole-in-the-card test and the PEDIG fixation preference test. Agreement was fair (k=0.27) between the near convergence test and the PEDIG fixation preference test. Conclusions Although there was excellent test-retest reliability of each ocular dominance test, there was only moderate to slight agreement between tests. Results of ocular dominance tests seem to vary depending on both the testing distance and the specific activity performed as part of the testing procedure. PMID:18455935

Rice, Melissa L.; Leske, David A.; Smestad, Christina E.; Holmes, Jonathan M.

2008-01-01

358

Light-controlled pupil size for ocular prosthesis  

NASA Astrophysics Data System (ADS)

Ocular prosthesis requires great skill in craftsmanship and technology to match the appearance of the natural eye for cosmetic reasons. All the effort and cost going into the prosthesis is neutralized by the effect of a fixed pupil size. The possibility of replacing the fixed pupil in the prosthetic eye with a light controlled liquid crystal light valve (LCLV), to match the pupil size of the healthy eye, is discussed.

Leuschner, F. Wilhelm

1992-08-01

359

Limbal cell autograft transplantation for severe ocular surface disorders  

Microsoft Academic Search

Background: Limbal cell transplantation may improve the visual outcome after chemical trauma and ocular surface diseases.\\u000a Methods: Nine eyes of nine consecutive patients (eight males and one female, age 9–60 years), underwent limbal autograft\\u000a transplantation (LAUT). In five cases LAUT was done for severe chemical burns in the acute stage (group 1). In four patients\\u000a with old chemical trauma LAUT

Joseph Frucht-Pery; Charalambos Socrates Siganos; Avraham Solomon; Leontina Scheman; Chaim Brautbar; Hanan Zauberman

1998-01-01

360

Ocular and Orbital Infections in the Immunocompromised Cancer Patient  

Microsoft Academic Search

\\u000a Significant progress has been made in the treatment of cancer patients, and the proportion of cancer patients achieving complete\\u000a remission and longer survival has increased in recent years. However, a significant proportion of patients still do not achieve\\u000a complete remission, and infection remains a frequent cause of treatment failure, particularly in patients with hematologic\\u000a malignancies. Ocular and orbital infections are

Viet H. Ho; Hao H. Ho

361

Intracranial fibromuscular dysplasia presenting as various ocular manifestations.  

PubMed

Fibromuscular dysplasia (FMD) is a nonatherosclerotic, noninflammatory vascular disease that mainly affects renal, extracranial carotid, and vertebral arteries. Intracranial FMD is uncommon unlike extracranial or renal FMD, and the primary manifestation of intracranial FMD is intracranial aneurysm. We report an unusual case of intracranial FMD showing various ocular manifestations, including central retinal artery occlusion, transient monocular blindness, and oculomotor nerve palsy without renal involvement. PMID:24360187

Choi, Jae-Hwan; Jung, Jaeho; Park, Kyung-Pil; Baik, Seung Kuk; Choi, Kyung Un; Choi, Kwang-Dong; Choi, Hee-Young; Shin, Jong-Hoon

2014-02-15

362

Bimatoprost: mechanism of ocular surface hyperemia associated with topical therapy.  

PubMed

Bimatoprost is a safe and well-tolerated intraocular pressure (IOP) lowering drug that was approved in the United States in 2001 for the treatment of glaucoma and ocular hypertension. It is highly efficacious and produces greater mean reductions in IOP than other currently available antiglaucoma drugs. Conjunctival hyperemia is a common side effect of bimatoprost, but the hyperemia is typically mild and transient. No association has been found between signs of inflammation and the presence of hyperemia in bimatoprost-treated patients. Preclinical studies have elucidated the pharmacological mechanism of bimatoprost-related hyperemia and have examined the possible involvement of inflammation. Bimatoprost, as well as the free acid of latanoprost, elicited endothelium-dependent vasorelaxation in the rabbit jugular vein preparation, a quantitative in vitro model for ocular surface hyperemia (OSH). The vasorelaxant responses to either bimatoprost or latanoprost free acid were significantly inhibited by L-NAME, a nitric oxide synthase inhibitor. Similarly, the in vivo OSH responses to topically applied bimatoprost or latanoprost in dog eyes were significantly inhibited by L-NAME. As predicted, prostaglandin E(2) (PGE(2))-induced conjunctival hyperemia was not inhibited by L-NAME, since PGE(2) has a direct relaxant effect on the vascular smooth muscle. In-life observations and histopathological assessment of ocular surface tissues following bimatoprost treatment were performed for multiple-dose one month, 6 month, or 12 month safety studies in rabbits, dogs, and non-human primates. Results of these studies showed no evidence of bimatoprost-related inflammation in the ocular surface tissues. In summary, OSH related to bimatoprost treatment in laboratory animals occurs by endothelial-derived nitric oxide-mediated vasodilatation and is not associated with inflammation. These studies suggest that conjunctival hyperemia, a side effect of bimatoprost treatment, results from non-inflammatory, pharmacologically based vasodilatation. PMID:16252016

Chen, June; Dinh, Tim; Woodward, David F; Holland, Michael; Yuan, Yang-Dar; Lin, Tsung-Hua; Wheeler, Larry A

2005-01-01

363

Piceatannol Suppresses endotoxin-induced ocular inflammation in Rats  

PubMed Central

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

Kalariya, Nilesh M.; Shoeb, Mohammad; Reddy, Aramati B. M.; Sawhney, Rahul; Ramana, Kota V.

2013-01-01

364

Ocular surface reconstruction by cultivated epithelial sheet transplantation.  

PubMed

: Recent advances in ocular surface reconstruction for patients with severe ocular surface diseases have significantly improved the prognosis of patients with vision-impairing corneal abnormalities. The history of cultivated epithelial sheet transplantation is short, and debate on the current approaches for these procedures is continuing. Limbal stem cell transplantation, including conjunctivolimbal autograft and keratolimbal allograft, has brought opportunities for vision improvement. In addition, the use of cultivated limbal epithelial transplantation from both allogeneic and autologous sources has provided further options for immediate postoperative epithelialization of the corneal surface. Finally, cultivated oral mucosal epithelial transplantation, which allows autologous transplantation for patients with bilateral limbal stem cell deficiency, has provided the best overall midterm and long-term results. Its biggest advantages are the absence of rejection reactions and the reduction of postoperative complications associated with steroid therapy. However, a solitary surgical approach is not sufficient for obtaining a good clinical outcome. To maximize the possibility of success using these procedures, it is important to preoperatively enhance aggressive treatment of the ocular surface, especially with factors that facilitate moisture retention. In this review article, we also discuss our clinical experience in relation to these surgical procedures. PMID:25289723

Satake, Yoshiyuki; Yamaguchi, Takefumi; Hirayama, Masatoshi; Higa, Kazunari; Shimazaki-Den, Seika; Dogru, Murat; Kawakita, Tetsuya; Kawashima, Motoko; Shimmura, Shigeto; Tsubota, Kazuo; Shimazaki, Jun

2014-11-01

365

Ocular Surface Disorders in Intensive Care Unit Patients  

PubMed Central

Patients in intensive care units (ICU) are at increased risk of corneal abrasions and infectious keratitis due to poor eyelid closure, decreased blink reflex, and increased exposure to pathogenic microorganisms. The aim of this retrospective study was to evaluate the ocular surface problems in patients who stayed in ICU more than 7 days and were consulted by an ophthalmologist. There were 26 men and 14 women with a mean age of 40.1 ± 18.15 years (range 17–74 years). Conjunctiva hyperemia, mucopurulent or purulent secretion, corneal staining, and corneal filaments were observed in 56.25%, 36.25%, 15%, and 5% of the eyes, respectively. Keratitis was observed in 4 patients (10%) who were treated successfully with topical antibiotics. Mean Schirmers test results were 7.6 ± 5.7?mm/5?min (median 6.5?mm/5?min) in the right, and 7.9 ± 6.3?mm/5?min (median 7?mm/5?min) in the left eyes. Schirmers test results were <5?mm/5?min in 40% of the subjects. The parameters did not show statistically significant difference according to mechanical ventilation, sedation, and use of inotropes. As ICU patients are more susceptible to develop dry eye, keratopathy, and ocular infections, they should be consulted by an ophthalmologist for early diagnosis of ocular surface disorders. PMID:24285933

Saritas, Tuba Berra; Bozkurt, Banu; Simsek, Baris; Cakmak, Zeynep; Ozdemir, Mehmet; Yosunkaya, Alper

2013-01-01

366

Current Treatment of Vestibular, Ocular Motor Disorders and Nystagmus  

PubMed Central

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

Brandt, Thomas

2009-01-01

367

Evaluation of seven in vitro alternatives for ocular safety testing.  

PubMed

Seven in vitro assays were evaluated to determine if any were useful as screening procedures in ocular safety assessment. Seventeen test materials (chemicals, household cleaners, hand soaps, dishwashing liquids, shampoos, and liquid laundry detergents) were tested in each assay. In vivo ocular irritation scores for the materials were obtained from existing rabbit low volume eye test (LVET) data. The seven assays evaluated included the silicon microphysiometer (SM), luminescent bacteria toxicity test (LBT), neutral red assay (NR), total protein assay (TP), Tetrahymena thermophila motility assay (TTMA), bovine eye/chorioallantoic membrane assay (BE/CAM), and the EYTEX system (ETS). For the seventeen materials used in this study there was a significant correlation between the in vivo irritant potential and in vitro data for all the tests except the EYTEX System (SM, r = -0.87; LBT, r = -0.91; NR, r = -0.85; TTMA, r = 0.78; TP, r = -0.86; ETS, r = 0.29). The irritation classifications provided by the BE/CAM also did not correspond with the actual in vivo irritancy potential of the test materials. The result of this study suggested it may be possible to classify materials into broad irritancy categories with some of the assays. This would allow their use as screens prior to limited in vivo confirmation in the ocular safety assessment process. PMID:1916072

Bruner, L H; Kain, D J; Roberts, D A; Parker, R D

1991-07-01

368

Cephalometric evaluation of ocular protrusion at stages of growth.  

PubMed

The sagittal relationships between the orbital globe and the ocular orbit have great importance in aesthetic and functional evaluations. These relationships are useful in diagnosis and treatment of some malformations in which the orbital volume is reduced such as craniostenosis. The aim of the present study was the cephalometric evaluation of the ocular protrusion at different growth stages. Ninety-two patients with negative history of craniosynostosis, severe myopia, and skeletal class I were selected for the present study. Lateral teleradiography x-ray was performed for all the patients, and 5 groups were carried out based on the dentition phase. Cephalometric analyses were performed on the lateral teleradiography x-ray. Mean values of ocular protrusion (B-Or post) for females and males were found and digitized for the 5 groups tested. All other sagittal and vertical measurements were successfully computed by the trained operator. B-Or post showed values between -14.93 mm and -16.90 mm among the groups. The cephalometric analysis proposed in the present study allowed to successfully evaluate sagittal and vertical relationship of the orbital globe and the orbital cavity in growing patients. Moreover, the B-Or post maintained its value during growth in the present study. PMID:24777028

Caprioglio, Alberto; Panzi, Silvia; Fastuca, Rosamaria; Mortellaro, Carmen; Lucchina, Alberta Greco; Mangano, Francesco; Meazzini, Maria Costanza

2014-05-01

369

Predicting chemical ocular toxicity using a combinatorial QSAR approach.  

PubMed

Regulatory agencies require testing of chemicals and products to protect workers and consumers from potential eye injury hazards. Animal screening, such as the rabbit Draize test, for potential environmental toxicants is time-consuming and costly. Therefore, virtual screening using computational models to tag potential ocular toxicants is attractive to toxicologists and policy makers. We have developed quantitative structure-activity relationship (QSAR) models for a set of small molecules with animal ocular toxicity data compiled by the National Toxicology Program Interagency Center for the Evaluation of Alternative Toxicological Methods. The data set was initially curated by removing duplicates, mixtures, and inorganics. The remaining 75 compounds were used to develop QSAR models. We applied both k nearest neighbor and random forest statistical approaches in combination with Dragon and Molecular Operating Environment descriptors. Developed models were validated on an external set of 34 compounds collected from additional sources. The external correct classification rates (CCR) of all individual models were between 72 and 87%. Furthermore, the consensus model, based on the prediction average of individual models, showed additional improvement (CCR = 0.93). The validated models could be used to screen external chemical libraries and prioritize chemicals for in vivo screening as potential ocular toxicants. PMID:23148656

Solimeo, Renee; Zhang, Jun; Kim, Marlene; Sedykh, Alexander; Zhu, Hao

2012-12-17

370

Spectral and time-resolved studies on ocular structures  

NASA Astrophysics Data System (ADS)

Measurements of endogeous fluorophores open the possibility for evaluation of metabolic state at the eye. For interpretation of 2-dimensional measurements of time-resolved auto fluorescence in 2 separate spectral ranges at the human eye, comparing measurements were performed on porcine eyes. Determining excitation and emission spectra, attention was drawn of proof of coenzymes NADH and FAD in isolated anatomical structures cornea, aqueous humor, lens, vitreous, neuronal retina, retinal pigment epithelium (RPE), choroid, and sclera. All these structures exhibit auto fluorescence, highest in lens. Excitation at 350 nm results in local fluorescence maxima at 460 nm, corresponding to NADH, in all structures. This short-wave excitation allows metabolic studies only at the anterior eye, because of the limited transmission of the ocular media. During excitation at 446 nm the existence of FAD is expressed by local fluorescence maxima at 530 nm. The composition fluorescence spectra allow no discrimination between single ocular structures. Approximating the dynamic fluorescence by a double exponential function, the shortest lifetimes were detected in RPE and neuronal retina. The histograms of mean lifetime t M cover each other on lens with cornea and also on sclera with choroid. Despite the lifetimes are close between RPE and neuronal retina, the relative contributions Q I are wide different. The gradient of trend lines in cluster diagrams of amplitudes ? II vs. ? I allows a discrimination of ocular structures.

Schweitzer, D.; Jentsch, S.; Schenke, S.; Hammer, M.; Biskup, C.; Gaillard, E.

2007-07-01

371

Ocular involvement in fetal alcohol spectrum disorder: a review.  

PubMed

Fetal Alcohol Syndrome (FAS), the most severe manifestation of Fetal Alcohol Spectrum Disorder (FASD) is considered the leading non-hereditary cause of mental retardation and neurological deficit in the Western world. There lie a huge associated human cost to both FASD victims and their families and a considerable financial burden. This problem is being tackled on many fronts including community awareness programs, biomarker development for fetal alcohol exposure, research into preventative treatments and the development of more robust diagnostic systems for the early detection of FASD. Although ethanol can affect many of the major systems of the body, the eye is a primary target. Ocular aberrations including optic nerve hypoplasia, tortuosity of retinal vessels, coloboma and microphthalmia are frequently observed in children diagnosed with FAS. In this regard, ocular involvement in FAS has gained importance, particularly in relation to early diagnosis and identification of FAS. Furthermore, our considerable knowledge of the molecular mechanisms underlying eye development has provided a powerful tool for the investigation of the teratogenic actions of ethanol. In this review, we initially provide an overview of FASD in terms of historical background, epidemiology and current status. Next, we explore the role of ocular involvement in FASD and the use of eye measurements in the diagnosis of FAS. Lastly, we review how current knowledge of early eye development can be used to gain new insights into the molecular mechanisms of ethanol teratogenicity with particular reference to the sonic hedgehog pathway. PMID:24502600

Brennan, Deirdre; Giles, Seamus

2014-01-01

372

Ocular melanoma: an overview of the current status  

PubMed Central

Ocular melanoma is the second most common type of melanoma after cutaneous and the most common primary intraocular malignant tumor in adults. Large majority of ocular melanomas originate from uvea, while conjunctival melanomas are far less frequent. Incidence of uveal melanoma has remained stable over last three decades. Diagnosis is in most cases established by clinical examination with great accuracy. Local treatment of uveal melanoma has improved, with increased use of conservative methods and preservation of the eye, but survival rates have remained unchanged. Recent advances in cytogenetics and genetics enhanced prognostication and enabled to determine tumors with high metastatic potential. However, due to lack of effective systemic therapy, prognosis of patients with metastasis remains poor and metastatic disease remains the leading cause of death among patients with uveal melanoma. Conjunctival melanoma is rare, but its incidence is increasing. It mostly occurs among white adults. In majority of cases it originates from preceding primary acquired melanosis. Current standard treatment for conjunctival melanoma is wide local excision with adjuvant therapy, including brachytherapy, cryotherapy and topical application of chemotherapeutic agent. Rarity of this tumor limits conduction of controlled trials to define the best treatment modality. As well as for uveal melanoma, prognosis of patients with metastasis is poor because there is no effective systemic therapy. Better understanding of underlying genetic and molecular abnormalities implicated in development and progression of ocular melanomas provides a great opportunity for development of targeted therapy, which will hopefully improve prognosis of patients with metastatic disease. PMID:23826405

Jovanovic, Predrag; Mihajlovic, Marija; Djordjevic-Jocic, Jasmina; Vlajkovic, Slobodan; Cekic, Sonja; Stefanovic, Vladisav

2013-01-01

373

Pharmacotherapy of vestibular and ocular motor disorders, including nystagmus.  

PubMed

We review current pharmacological treatments for peripheral and central vestibular disorders, and ocular motor disorders that impair vision, especially pathological nystagmus. The prerequisites for successful pharmacotherapy of vertigo, dizziness, and abnormal eye movements are the "4 D's": correct diagnosis, correct drug, appropriate dosage, and sufficient duration. There are seven groups of drugs (the "7 A's") that can be used: antiemetics; anti-inflammatory, anti-Ménière's, and anti-migrainous medications; anti-depressants, anti-convulsants, and aminopyridines. A recovery from acute vestibular neuritis can be promoted by treatment with oral corticosteroids. Betahistine may reduce the frequency of attacks of Ménière's disease. The aminopyridines constitute a novel treatment approach for downbeat and upbeat nystagmus, as well as episodic ataxia type 2 (EA 2); these drugs may restore normal "pacemaker" activity to the Purkinje cells that govern vestibular and cerebellar nuclei. A limited number of trials indicate that baclofen improves periodic alternating nystagmus, and that gabapentin and memantine improve acquired pendular and infantile (congenital) nystagmus. Preliminary reports suggest suppression of square-wave saccadic intrusions by memantine, and ocular flutter by beta-blockers. Thus, although progress has been made in the treatment of vestibular neuritis, some forms of pathological nystagmus, and EA 2, controlled, masked trials are still needed to evaluate treatments for many vestibular and ocular motor disorders, including betahistine for Ménière's disease, oxcarbazepine for vestibular paroxysmia, or metoprolol for vestibular migraine. PMID:21461686

Strupp, Michael; Thurtell, Matthew J; Shaikh, Aasef G; Brandt, Thomas; Zee, David S; Leigh, R John

2011-07-01

374

Characterization of Ocular Tissues Using Microindentation and Hertzian Viscoelastic Models  

PubMed Central

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

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

375

Topical Ocular Anesthetic Abuse Among Iranian Welders: Time for Action  

PubMed Central

Purpose: The purpose of this study is to estimate the prevalence of topical ocular anesthetic abuse among welders in Iran and suggest public health solutions for this issue. Methods: In this cross-sectional study, 390 welders were randomly recruited and queried on the use of anesthetic drops. A questionnaire was administered through structured one-on-one interviews conducted by the first author. Results: A total of 314 welders (80.5%) declared that they had used topical anesthetics at least once during their working lives. Almost 90% of them stated a preference for self-treatment over seeking help from a physician due to cultural and financial reasons. The most commonly used topical anesthetic was tetracaine. Most of the subjects (97.4%) had obtained the drugs from pharmacies without a prescription. Conclusions: The prevalence of topical ocular anesthetic abuse among welders in Iran is alarmingly high and may partially be due to cultural issues. Although most physicians are aware that topical anesthetics should only be used as a diagnostic tool, there is a crucial need to re-emphasize the ocular risks associated with chronic use of these medications. Educational programs for both physicians and the public are necessary to address the problem. PMID:24339685

Sharifi, Ali; Sharifi, Hamid; Karamouzian, Mohammad; Mokhtari, Mahmoud; Esmaeili, Hamidreza Hosein; Nejad, Afshin Sarafi; Rahmatian, Mohammad

2013-01-01

376

Ocular Surface Alterations and Topical Antiglaucomatous Therapy: A Review  

PubMed Central

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

Actis, Alessandro G; Rolle, Teresa

2014-01-01

377

Breakdown of the Blood-Ocular Barrier as a Strategy for the Systemic Use of Nanosystems  

PubMed Central

Several drug delivery systems have been proposed to overcome physiological barriers, improving ocular bioavailability. Systemic routes are seldom used due to the blood-ocular barrier. Novel drug delivery systems based on nanotechnology techniques have been developed to overcome ocular physiological barriers. This non-systematic review suggests the utilization of a transitory blood-ocular breakdown to allow the access of drugs by nanotechnology drug delivery systems via the systemic route. We discuss the possible ways to cause the breakdown of the blood-ocular barrier: acute inflammation caused by intraocular surgery, induced ocular hypotony, and the use of inflammatory mediators. The suitability of use of the systemic route and its toxic effects are also discussed in this article. PMID:24300231

Occhiutto, Marcelo L.; Freitas, Fatima R.; Maranhao, Raul C.; Costa, Vital P.

2012-01-01

378

Cataract surgery in patients with ocular surface disease: An update in clinical diagnosis and treatment  

PubMed Central

In this article we review essentials of diagnosis and management of ocular surface disease in patients who undergo cataract surgery. It is clearly shown that dry eye disease worsens following the cataract surgery in patients with prior history of ocular surface disease, Also new cases of dry eye might appear. Current strategies for the timely diagnosis and proper management of dry eye syndrome in the face of cataract surgery patients are mainly emphasized. To achieve the best outcome in cataract surgery, a healthy ocular surface is crucial. While ocular surface preparation is indispensable in patients with established ocular surface disease, it is also helpful in those with minimal signs or symptoms of surface disease. The current approach begins with early diagnosis and drastic management of ocular surface disease before cataract surgery using a stepwise regimen customized to each patient and disease severity. These measures are continued throughout and after the surgery.

Afsharkhamseh, Neda; Movahedan, Asadolah; Motahari, Hooman; Djalilian, Ali R.

2014-01-01

379

Epidemiology, pathophysiology, and the future of ocular toxoplasmosis.  

PubMed

Despite large advances in the field of ocular toxoplasmosis, large gaps still exist in our knowledge concerning the epidemiology and pathophysiology of this potentially blinding infectious disease. Although ocular toxoplasmosis is considered to have a high health burden, still little is known about its exact prevalence and how it affects the quality of life. The epidemiology of toxoplasmosis depends on local habits throughout the globe, and changes are likely in view of increased meat consumption in developing countries and demands for higher animal welfare in the Western world. Water is increasingly seen as an important risk factor and more studies are needed to quantitate and control the role of water exposure (drinking, swimming). Tools are now becoming available to study both the human host as well as parasite genetic factors in the development of ocular toxoplasmosis. Further research on the role of Toxoplasma strains as well as basic studies on parasite virulence is needed to explain why Toxoplasma associated eye disease is so severe in some countries, such as Brazil. Although genetic analysis of the parasite represents the gold standard, further developments in serotyping using peptide arrays may offer practical solutions to study the role of parasite strains in the pathogenesis of Toxoplasma retinochoroiditis. More research is needed concerning the pathways whereby the parasite can infect the retina. Once in the retina further tissue damage may be due to parasite virulence factors or could be caused by an aberrant host immune response. Local intraocular immune responses are nowadays used for diagnostic procedures. Future developments may include the use of Raman technology or the direct visualization of a Toxoplasma cyst by optical coherence tomography (OCT). With the availability of ocular fluid specimens obtained for diagnostic purposes and the development of advanced proteomic techniques, a biomarker fingerprint that is unique for an eye with toxoplasmosis may become available. It is hoped that such a biomarker analysis may also be able to distinguish between acquired versus congenital disease. Recently developed mouse models of congenital ocular toxoplasmosis are extremely promising with regard to disease pathogenesis, diagnosis, and treatment. PMID:24131274

Kijlstra, Aize; Petersen, Eskild

2014-04-01

380

Therapeutic dosing of fingolimod (FTY720) prevents cell infiltration, rapidly suppresses ocular inflammation, and maintains the blood-ocular barrier.  

PubMed

Fingolimod (FTY720) is an FDA-approved therapeutic drug with efficacy demonstrated in experimental models of multiple sclerosis and in phase III human multiple sclerosis trials. Fingolimod prevents T-cell migration to inflammatory sites by decreasing expression of the sphingosine-1 phosphate receptor normally required for egress from secondary lymphoid tissue. As a preclinical model of human uveitis, experimental autoimmune uveoretinitis permits assessment of immunotherapeutic efficacy. Murine experimental autoimmune uveoretinitis is induced by activation of retinal antigen-specific CD4(+) T cells that infiltrate the eye. High-dose fingolimod treatment administered before disease onset reduces ocular infiltration within hours of administration and suppresses clinicopathologic expression of experimental autoimmune uveoretinitis. In the present investigation of the efficacy of fingolimod treatment for established disease, single-dose treatment was effective and immunosuppressive ability was maintained through a dose range, demonstrating significant and rapid reduction in CD4(+) cell infiltration at clinically relevant therapeutic doses of fingolimod. A repeated-treatment regimen using a dose similar to that in current multiple sclerosis patient protocols significantly reduced infiltration within 24 hours of administration; importantly, repeated doses did not compromise the vascular integrity of the blood-ocular barrier. On withdrawal of fingolimod, drug-induced remission was lost and recrudescence of clinical disease was observed. These results support a strong therapeutic potential for fingolimod as an acute rescue therapy for the treatment of ocular immune-mediated inflammation. PMID:22119714

Copland, David A; Liu, Jian; Schewitz-Bowers, Lauren P; Brinkmann, Volker; Anderson, Karen; Nicholson, Lindsay B; Dick, Andrew D

2012-02-01

381

Therapeutic dosing of FTY720 (Fingolimod) prevents cell infiltrate, rapidly suppresses ocular inflammation and maintains blood-ocular barrier  

PubMed Central

Fingolimod (FTY720) is a FDA-approved therapeutic, with efficacy demonstrated in experimental models of MS, and phase III human MS trials. FTY720 prevents T-cell migration to inflammatory sites, by down-regulating expression of the sphingosine-1 phosphate receptor normally required for egress from secondary lymphoid tissue. Experimental autoimmune uveoretinitis (EAU) serves as a preclinical model of human uveitis, permitting assessment of immunotherapeutic efficacy. Murine EAU is initiated by activation of retinal–antigen specific CD4+ T cells that infiltrate the eye, and previous studies demonstrate that high dose FTY720 treatment administered before disease onset reduces ocular infiltrate within hours of administration and suppresses clinico-pathological expression of EAU. The present study investigates the efficacy of FTY720 treatment for established disease. Single dose treatment is effective and its immunosuppressive ability is maintained through a dose range of FTY720, demonstrating significant and rapid reduction in the CD4+ cell infiltrate at clinically relevant therapeutic doses. Furthermore, a repeated treatment regimen using a comparable dose to current MS patient protocols significantly reduces infiltrate within 24 hours of administration, and importantly repeated doses do not compromise the vascular integrity of the blood-ocular barrier. Upon withdrawal of FTY720, drug induced remission is lost and recrudescence of clinical disease is observed. These results support the great therapeutic potential for FTY720 as an acute rescue therapy for the treatment of ocular immune-mediated inflammation. PMID:22119714

Copland, David A.; Liu, Jian; Schewitz-Bowers, Lauren; Brinkmann, Volker; Anderson, Karen; Nicholson, Lindsay B.; Dick, Andrew D.

2013-01-01

382

Epithelial transplantation for the management of severe ocular surface disease.  

PubMed Central

PURPOSE: First, to present a new classification of epithelial transplantation procedures for ocular surface disease; second, to present our experience with a keratolimbal allograft procedure for limbal stem cell deficiency; and third, to make recommendations for the indications and postoperative management of epithelial transplantation procedures. METHODS: A review of all epithelial transplantation procedures was performed. A classification of these procedures based on the source of donor tissue and the tissue transplanted was proposed. In addition, a review of 25 eyes of 21 patients who underwent a keratolimbal allograft was completed. Ocular surface stability, improvement of visual acuity, success of subsequent keratoplasties, and preoperative risk factors were evaluated. Results were compared with those of other epithelial transplantation procedures for ocular surface disease. On the basis of the results of published studies, as well as ours, a recommendation for the indication of the various procedures was made. RESULTS: Epithelial transplantation for ocular surface disease can be classified as one of the following procedures: conjunctival autograft (CAU), conjunctival allograft (CAL), conjunctival limbal autograft (CLAU), cadaveric conjunctival limbal allograft (c-CLAL), living related conjunctival limbal allograft (lr-CLAL), or keratolimbal allograft (KLAL). Evaluation of our keratolimbal allograft patients revealed that 18 of 25 eyes (72%) developed a stable ocular surface. Fifteen eyes (60%) demonstrated a significant improvement in visual acuity. Persistent epithelial defects and symblephara were successfully managed with this procedure. Six of 13 (46%) subsequent keratoplasties were successful. Patients with limbal deficiency due to Stevens-Johnson syndrome had a significantly worse outcome. Patients with preoperative conjunctival keratinization also had a significantly worse outcome. Indications for epithelial transplantation are as follows: For patients with unilateral cicatrizing conjunctival disease, the first option should be CAU. For patients with unilateral limbal deficiency, CLAU is the procedure of choice. For patients with bilateral disease Ir-CLAL should be considered first. If this procedure is not available, then consideration of KLAL is warranted. CONCLUSIONS: Classification of the various epithelial transplantation procedures based on anatomy is useful for an accurate comparison and discussion of the procedures. KLAL is a useful technique in the management of severe ocular surface disease due to limbal deficiency. However, patients with preoperative conjunctival keratinization have a poor prognosis. Consideration of a CLAU or a Ir-CLAL should be made for ocular surface disease on the basis of whether the disease is unilateral or bilateral. The importance of HLA and ABO typing, as well as the protocol for immunosuppression in the allograft procedures for limbal deficiency, needs further study. Images FIGURE 2 FIGURE 3A FIGURE 3B FIGURE 3C FIGURE 3D FIGURE 4 FIGURE 5A FIGURE 5B FIGURE 5C FIGURE 5D FIGURE 6A FIGURE 6B FIGURE 6C FIGURE 6D FIGURE 6E FIGURE 6F FIGURE 6G FIGURE 6H FIGURE 7A FIGURE 7B FIGURE 7C FIGURE 8 FIGURE 9A FIGURE 9B FIGURE 9C FIGURE 9D FIGURE 9E FIGURE 9F FIGURE 10A FIGURE 10B FIGURE 10C FIGURE 11 FIGURE 12A FIGURE 12B FIGURE 12C FIGURE 12D FIGURE 12E FIGURE 12F FIGURE 12G FIGURE 12H FIGURE 12I FIGURE 13A FIGURE 13B FIGURE 13C FIGURE 14 FIGURE 15 PMID:8981714

Holland, E J

1996-01-01

383

Ocular surface discomfort and Demodex: effect of tea tree oil eyelid scrub in Demodex blepharitis.  

PubMed

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

Koo, Hyun; Kim, Tae Hyung; Kim, Kyoung Woo; Wee, Sung Wook; Chun, Yeoun Sook; Kim, Jae Chan

2012-12-01

384

Oseltamivir Inhibits H7 Influenza Virus Replication in Mice Inoculated by the Ocular Route  

PubMed Central

The majority of human infections associated with H7 influenza viruses have resulted in ocular and not respiratory disease. While oseltamivir has been prescribed to individuals presenting with conjunctivitis following H7 virus exposure, it is unknown if oseltamivir inhibits virus replication in ocular tissue. We demonstrate that H7 viruses possess sensitivity to neuraminidase inhibitors and that administration of oseltamivir before ocular virus challenge in mice inhibits H7N7 and H7N3 virus replication in ocular and respiratory tissues. PMID:22155827

Belser, Jessica A.; Sleeman, Katrina; Pearce, Melissa B.; Katz, Jacqueline M.; Gubareva, Larisa V.

2012-01-01

385

Ocular Surface Discomfort and Demodex: Effect of Tea Tree Oil Eyelid Scrub in Demodex Blepharitis  

PubMed Central

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

Koo, Hyun; Kim, Tae Hyung; Kim, Kyoung Woo; Wee, Sung Wook; Chun, Yeoun Sook

2012-01-01

386

Testing ocular irritancy in vitro with the silicon microphysiometer.  

PubMed

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

Bruner, L H; Miller, K R; Owicki, J C; Parce, J W; Muir, V C

1991-01-01

387

Biodegradable levofloxacin nanoparticles for sustained ocular drug delivery.  

PubMed

Drug delivery to ocular region is a challenging task. Only 1-2% of drug is available in eye for therapeutic action, rest of the drug is drained out through nasolachrymal drainage system and other ocular physiological barriers. To overcome these problems of conventional dosage form, novel drug delivery systems are explored like nanoparticles. In our present work, levofloxacin encapsulated poly(lactic-co-glycolic acid) nanoparticles were developed and evaluated for various parameters like particle size, ? potential, in vitro drug release and ex vivo transcorneal permeation. Microbiological efficacy was tested against Staphylococcus aureus using cup-plate method. Precorneal residence time was studied on albino rabbits by ? scintigraphy after radiolabeling of levofloxacin by Tc-99m. Ocular tolerance was evaluated using hen's egg chorioallantoic membrane (HET-CAM) test. The developed nanoparticles were of spherical shape with a mean particle size of 190-195 nm with a ? potential of -25 mV. The drug entrapment efficiency was found to be near 85%. In vitro drug release profile shows initial burst release followed by extended release up to 24 h. Microbiological assay showed equivalent zone of inhibition compared to marketed formulation. ? Scintigraphy images of developed formulation, suggested a good spread and good retention over precorneal area. The nanosuspension thus developed was retained for the longer time and drained out from the eye very slowly compared to marketed formulation as significant radioactivity was recorded in later in kidney and bladder. The developed nanosuspension with a mean score of 0.33 up to 24 h in HET-CAM assay, showed the nonirritant efficacy of developed formulation. The stability studies yielded a degradation constant less then 5 × 10(-4), proving a stable formulation with an arbitrary shelf life of 2 years. PMID:20678034

Gupta, Himanshu; Aqil, M; Khar, R K; Ali, Asgar; Bhatnagar, Aseem; Mittal, Gaurav

2011-07-01

388

Presumed ocular histoplasmosis syndrome and linear streak lesions.  

PubMed Central

Five cases of subretinal neovascular membranes in the macula associated with punched out chorioretinal scars and linear streaks were seen in five Dutch patients. Clinically the fundus lesions are consistent with those of presumed ocular histoplasmosis syndrome (POHS) seen in the United States of America. Cutaneous serological testing for histoplasmin reactivity was negative in the three patients tested. Of special interest is the presence of linear streaks in association with POHS. They have not been previously described in patients from Europe with this syndrome. Images PMID:2757993

Bottoni, F G; Deutman, A F; Aandekerk, A L

1989-01-01

389

Ocular Hypotension: Involvement of Serotonergic 5HT 2 Receptors  

Microsoft Academic Search

\\u000a Serotonergic nerves innervate various parts of the eye, including the ciliary body, and serotonin (5-hydroxytryptamine, or\\u000a 5-HT) has been found in the aqueous humor in the anterior chamber of animal and human eyes. 5-HT2A-C receptor mRNAs are present in human ocular tissues involved in modulation of intraocular pressure (IOP) including ciliary\\u000a body (5-HT2A > 5-HT2B > 5-HT2C), ciliary epithelium (5-HT2A

Najam A. Sharif

390

Challenges in the management of ocular snake-bite injuries.  

PubMed

Ocular snake-bite injuries are quite rare away from natural habitats. However, when exotic animals are kept in captivity, the injuries sustained and their management can pose challenges when they present to their local eye department. This report describes an atypical eye injury inflicted by a python and its successful management involving surgical, laser and medical interventions. The case highlights the possible pitfalls resulting from the unusual mechanism of injury and the steps to avoid them. The article goes on to discuss the background of the injuries that can be caused by venomous and non-venomous snakes. PMID:20063177

Ashwin, Pammal T; Mehta, Purnima; Tailor, Rajen; McDonnell, Peter J

2010-12-01

391

Multiple ocular colobomas in the snow leopard (Uncia uncia).  

PubMed

Two singleton female snow leopard cubs are reported with bilateral central upper lid colobomas. In addition, one cub had a coloboma of the fundus in one eye extending from the lower optic disc region. Surgical treatment by wedge resection was successful in both cases. Details of ocular colobomas in other snow leopards reported in the literature are described and it is suggested that the exact etiology of the condition in this species may be discovered by further study of similar colobomas in the domestic cat. PMID:12236871

Barnett, K C; Lewis, J C M

2002-09-01

392

Ocular Toxicity Secondary to Asclepias physocarpa: The Balloon Plant  

PubMed Central

We report a case of a 65-year-old woman with symptoms of blurred vision and ocular irritation a few hours after accidental contact of the right eye with Asclepias physocarpa milky latex. Observation showed a diffuse conjunctival hyperemia and stromal corneal edema with Descemet's membrane folds. Recovery was fast and apparently complete in less than one month. However, specular microscopy at 6-months follow-up showed an abnormal endothelial morphology as sequelae, suggesting this condition is not as innocuous as it has been suggested. PMID:25105044

Pina, Susana; Pedrosa, Catarina; Santos, Cristina; Feijoo, Bernardo; Pego, Peter; Vendrell, Cristina; Santos, Maria Joao; Prieto, Isabel

2014-01-01

393

Measurement of ocular parameters under various directions of gaze  

NASA Astrophysics Data System (ADS)

Lid angles and aperture size are important factors for fitting and on-eye performance of contact lenses. In particular, toric and translating bifocal lenses rely on predictable interaction with the eyelid for successful positioning and orientation. Traditionally, lid assessment and fitting evaluation is performed under slit lamp observation. Observations are limited to primary gaze and nasal or temporal directions. Quantification of lid parameters and lens positioning is subjective and depended on the skill of the practitioner. No commercial instrument is available off the shelf, which would be suitable to measure objectively ocular parameters and/or contact lens positioning under different directions of gaze. This is the likely reason why only one study has been published in which ocular characteristics for different gaze angles were obtained [1]. However, only a limited number of parameters and gaze directions were investigated. Almost all contact lenses are designed for and assessed under primary gaze. Considering that patients constantly change their gaze while wearing contact lenses, the quantification of contact lens movement and changes in ocular parameters with eye movement can contribute substantially to the understanding of lens performance and thereby lead to improved lens designs. This is of particular importance for toric and translating bifocal lenses. Their complex optical and topographical design requires precise positioning, orientation and movement with changes in gaze direction in order to provide adequate vision. Baron [2] suggested that the lower eyelid is the most important factor for lens movement of translating bifocal lenses, but questions still remained on the complete dynamics of on eye behaviour. For toric contact lenses, the rotational orientation is more important than vertical translation to obtain optimum visual correction. Most toric lenses feature a prism ballast design. Blinking movements, mainly of the upper eyelid, interact with the wedge like shape and squeeze the thick part downwards. It has been observed that the upper eyelid does not move in a straight downward movement, but also twists slightly to close the temporal side first [3]. Precise quantification of this motion and how it affects the contact lens movement have not been reported. A new instrument was designed and constructed to provide objective measurements of ocular parameters.

Ehrmann, Klaus; Conrad, Fabian; Papas, Eric B.; Ho, Arthur

2006-02-01

394

Low Potential Ocular Irritation of Arginine-Based Gemini Surfactants and Their Mixtures with Nonionic and Zwitterionic Surfactants  

Microsoft Academic Search

Purpose. The aim of this study was to find new biocompatible surfactants and mixtures with low ocular irritant action for application in pharmaceutical formulations and to establish a relationship between their structure and their potential ocular irritant activity.

Montserrat Mitjans; Verónica Martínez; Pere Clapés; Lourdes Pérez; M. Rosa Infante; M. Pilar Vinardell

2003-01-01

395

A passive MEMS drug delivery pump for treatment of ocular diseases  

E-print Network

pharmaceuticals to treat chronic ocular diseases. Devices are fabricated by molding and bonding three structured necessitates frequent injections (as many as 1-3 per week) for disease management (Lee et al. 2004A passive MEMS drug delivery pump for treatment of ocular diseases Ronalee Lo & Po-Ying Li

Meng, Ellis

396

Visual-Ocular Control of Normal and Learning-Disabled Children.  

ERIC Educational Resources Information Center

Differences in visual-ocular function, particularly optokinetic nystagmus (OKN), were compared with 40 learning disabled and 40 normal children (8-12 years-old). No significant differences were found between groups on the variables tested (refixation saccades, smooth ocular pursuit, spontaneous nystagmus, gaze nystagmus, and OKN). (Author/DB)

Polatajko, H. J.

1987-01-01

397

Static Ocular Counterroll Is Implemented Through the 3-D Neural Integrator J. Douglas Crawford,13  

E-print Network

report Static Ocular Counterroll Is Implemented Through the 3-D Neural Integrator J. Douglas. Static ocular counterroll is implemented through the 3-D neural integrator. J Neurophysiol 90: 2777­2784, 2003; 10.1152/jn.00231.2003. Static head roll about the naso-occipital axis is known to produce an oppo

Vilis, Tutis

398

Enhanced Ocular Anti-Inflammatory Activity of Ibuprofen Carried by an Eudragit RS100® Nanoparticle Suspension  

Microsoft Academic Search

Purpose: To investigate the ocular pharmacodynamic profile of a polymer nanoparticle system loaded with sodium ibuprofen (IBU-RS) in comparison to an aqueous solution of ibuprofen lysinate (IBL) in the rabbit eye both being applied topically. Methods: Ocular inflammation was elicited by topical application of sodium arachidonate. Inflammation was quantified according to a modified Draize test. The protein level and the

Claudio Bucolo; Adriana Maltese; Giovanni Puglisi; Rosario Pignatello

2002-01-01

399

Ocular trauma in the United States Army: hospitalization records from 1985 through 1994  

Microsoft Academic Search

PURPOSE: To determine the incidence of hospitalized ocular injury in the United States Army and evaluate specific types and external causes of these injuries.METHODS: A US Army database that captured all hospital discharge records for Army personnel admitted to military and civilian hospitals was used to determine incident episodes of ocular injury requiring hospitalization from 1985 through 1994. Denominator data

Tien Yin Wong; Gordon S Smith; Andrew E Lincoln; James M Tielsch

2000-01-01

400

An ocular wavefront sensor based on binary phase element: design and analysis  

Microsoft Academic Search

A modal wavefront sensor for ocular aberrations exhibits two main advantages compared to a conventional Shack–Hartmann sensor. As the wavefront is detected in the Fourier plane, the method is robust against local loss of information (e.g. local opacity of ocular lens as in the case of cataract), and is not dependent on the spatial distribution of wavefront sampling. We have

Sanjay Kumar Mishra; Arun Kumar Gupta; Anurag Sharma

2012-01-01

401

Trends in the incidence of ocular melanoma in the United States, 1974–1998  

Microsoft Academic Search

Background: A recent report noted a fourfold risk of ocular melanoma associated with employment in occupations involving use of cellular telephones. Methods: To aid interpretation of this finding, and clarify how subsite-specific temporal variation in incidence of ocular melanoma compares with that for cutaneous melanoma, we examined time trends in the incidence of melanoma among whites in the United States,

Peter D. Inskip; Susan S. Devesa; Joseph F. Fraumeni

2003-01-01

402

Ocular manifestations of Alport's syndrome: a hereditary disorder of basement membranes?  

Microsoft Academic Search

The ocular manifestations in 16 patients with Alport's syndrome were lenticonus and retinal flecks in the macula and mid periphery. These 3 features appear to be specific for this syndrome and are a considerable aid to diagnosis. Lens opacities are common, and other ocular abnormalities occur sporadically. The present evidence indicates that this is a hereditary, widespread disorder of basement

J A Govan

1983-01-01

403

Ocular parasitic diseases: a review on toxocariasis and diffuse unilateral subacute neuroretinitis.  

PubMed

Parasitic infections may damage various ocular tissues, thereby causing visual dysfunction. In 1950, Wilder described the first case in which larval forms of nematodal intestinal roundworms (Ascaridoidea: Ascaris, Toxocara, Ancylostoma, Necator, and Strongyloides) were implicated as a cause of intraocular disease. This review focuses on two disorders associated with parasitic infections: ocular toxocariasis and diffuse unilateral subacute neuroretinitis. PMID:20669882

Cortez, Rafael T; Ramirez, Gema; Collet, Lucienne; Giuliari, Gian Paolo

2011-01-01

404

New testing software for quantifying discrimination capacity in subjects with ocular pathologies  

Microsoft Academic Search

We develop a new visual test, designed as software for quantifying discrimination capacity under low-illumination conditions. This is an important task in the presence of visual disturbances, such as those perceived by subjects with some ocular pathologies. For this purpose, we propose a visual-disturbance index, checking the test with two groups of observers having different ocular pathologies: a group with

José J. Castro; José R. Jiménez; Carolina Ortiz; Aixa Alarcón; Rosario G. Anera

2011-01-01

405

Complete pattern of ocular dominance stripes in V1 of a New World monkey, Cebus apella  

Microsoft Academic Search

The presence of ocular dominance (OD) stripes in layer IVc of striate cortex (V1) is characteristic of all Old World simians so far studied. In contrast, some species of New World monkeys do not have ocular dominance stripes, and in those that do, the pattern of stripes may be different from that shown in Old World monkeys. This difference has

M. G. P. Rosa; R. Gattass; M. Fiorani

1988-01-01

406

The Importance of Nutrition in the Prevention of Ocular Disease with Special Reference to Cataract  

Microsoft Academic Search

Background: The lens is the ocular structure most susceptible to oxidative damage. Antioxidants, micronutrients and phytochemicals have been extensively studied for their possible effects to prevent or delay the progression of various eye diseases. Objectives: A brief overview of the updated literature on the role of antioxidants and micronutrients in the prevention and treatment of ocular diseases is to be

Vaishali Agte; Kirtan Tarwadi

2010-01-01

407

Ocular and extra-ocular features of patients with Leber congenital amaurosis and mutations in CEP290  

PubMed Central

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

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

408

[The organization of emergency actions for ocular burns in conditions of military unit (of the ship)].  

PubMed

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

2014-06-01

409

Ocular rosacea: an underdiagnosed cause of relapsing conjunctivitis-blepharitis in the elderly.  

PubMed

Red eye and relapsing conjunctivitis-blepharitis are among the most common ocular disease in elderly patients. In these cases the search for causes is difficult and frustrating. We report the case of a 79-year-old woman with a long history of red eye and relapsing conjunctivitis-blepharitis caused by ocular rosacea. In this patient the proper diagnosis was performed after 10?years of ocular disease, and repeated evaluations by general practitioners and clinical specialists, only after the appearance of facial signs of erythematotelangiectatic rosacea. Adequate therapy with oral doxycycline led to the improvement of the clinical picture that previously had shown a poor response to several topical treatments. The possibility of ocular rosacea should be considered in evaluating an elderly patient with persistent red eye and relapsing conjunctivitis-blepharitis. Making the proper diagnosis is crucial because ocular rosacea does not respond as expected to topical therapy and may lead to severe corneal involvement. PMID:25239991

De Marchi, Sergio Umberto; Cecchin, Emanuela; De Marchi, Sergio

2014-01-01

410

Photochemical toxicity of drugs intended for ocular use.  

PubMed

The present investigation was undertaken to evaluate the possible ocular phototoxicity of drugs used in ophthalmic formulations. Sulphacetamide, ketoconazole, voriconazole, diclofenac, and ketorolac were assessed in the concentrations available in the market for their ocular use. The suitable models viz Hen's Egg Test Chorioallantoic Membrane (HET-CAM) test, Isolated Chicken Eye (ICE) test, and Red Blood Cell (RBC) haemolysis test as recommended by ECVAM, ICCVAM, and OECD guidelines were performed. Results of HET-CAM and ICE tests suggest that sulphacetamide is moderately toxic in the presence of light/UV-A and very slightly irritant without irradiation. Ketoconazole and voriconazole were found slightly irritant in presence of light/UV-A and non-irritant in dark. Diclofenac and ketorolac demonstrated slight irritancy in the light and were found to be non-irritant in dark. The results suggest that some of the drugs have potential toxic effect in the presence of light. The extent of phototoxicity might get extended when used for longer time. The recommendation is that these drugs should be stored and used in the dark for a specified time and be labelled with specific instructions for patients, especially for those working longer in the sunlight. PMID:24846953

Sahu, Roshan Kumar; Singh, Bhupendra; Saraf, Shubhini A; Kaithwas, Gaurav; Kishor, Kamal

2014-06-01

411

Ocular tolerance of preservatives on the murine cornea.  

PubMed

We investigated the effects of instilling 13 commonly used preservatives on the murine cornea in vivo. Due to the instillation of preservatives, micro-lesions are formed on the cornea and can be selectively marked by fluorescein. The sum of the resulting fluorescent areas was measured using an episcopic microscope coupled to an image processing system. All the tested preservatives proved to be well-tolerated by the eye at commonly used concentrations. However, in some cases, increased concentrations of preservatives or combinations resulted in significant increase of the amount of corneal damage. With increasing the concentration, corneal lesion increased the most in the case of cetylpyridinium. While a combination of chlorobutanol 0.5% and phenylethylalcohol 0.5% did not result in an increase in corneal damage (when compared to the use of each separately), the associations of thiomersal 0.02% and phenylethylalcohol 0.4% on one hand and of edetate disodium (EDTA) 0.1% and benzalkonium 0.01% on the other, resulted in significant increases in the amount of corneal damage. However, in none of the tested combinations, the increase in the observed damage exceed the limit of ocular intolerance we had defined beforehand: thus, they were all deemed relatively well-tolerated. In the last part of the study, we investigated the effects of combining several preservatives, at usual concentrations, with an anesthetic solution of oxybuprocaine and found no notable increase in ocular damage. PMID:10234533

Furrer, P; Mayer, J M; Plazonnet, B; Gurny, R

1999-03-01

412

The context and consequences of ocular injuries from air guns.  

PubMed

There is little available information on the context of air-gun inflicted ocular injuries. To address this need, we performed a systematic telephone survey of victims of severe air-gun ocular injuries, collected between January 1986 and August 1992, through the auspices of the National Eye Trauma System and the Alabama Eye Injury Registry. One hundred forty interviews were completed with injury victims or their parents. Pump-action rifles with BB ammunition were the most common weapons. Victims and shooters were predominantly male (91% and 89%, respectively) and their mean age was 13 years. Of the injuries, 95% were inflicted by individuals known to the victim; 40% of these were relatives. People were the intended targets in 45% of the injuries. Ricochets accounted for 26% of the injuries. Of those victims with penetrating injuries, 84% had visual acuity less than 20/200 despite numerous surgical attempts. Adults were present at the scene of the injury in only 11% of the incidents, implying that unrestricted access to these weapons by children is likely the principal risk factor for injury. PMID:8154533

Schein, O D; Enger, C; Tielsch, J M

1994-04-15

413

The Role of Antimicrobial Peptides at the Ocular Surface  

PubMed Central

Antimicrobial peptides (AMPs) such as defensins and cathelicidins are small peptides with broad-spectrum activity against bacteria, fungi and viruses. In addition, several AMPs modulate mammalian cell behaviours including migration, proliferation and cytokine production. This review describes findings from recent studies showing the presence of various AMPs at the human ocular surface and discusses their mechanism of antimicrobial action and potential non-microbicidal roles. Corneal and conjunctival epithelial cells produce ?-defensins and the cathelicidin LL-37, whereas neutrophils, infiltrating in response to a specific stimulus, supply additional LL-37 as well as ?-defensins. In vitro studies suggest that LL-37 and human ?-defensin-3 are the most likely to have significant independent antimicrobial activity, while other AMPs may act synergistically to help protect the ocular surface from invading pathogens. Current evidence also supports a role for some AMPs in modulating wound healing responses. Although yet to be brought to fruition, AMPs hold significant potential as therapeutic agents for the prophylaxis and treatment of infection, promotion of wound healing and immune modulation. PMID:19122467

McDermott, Alison M.

2009-01-01

414

Cationic Polyene Phospholipids as DNA Carriers for Ocular Gene Therapy  

PubMed Central

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

Machado, Susana; Calado, Sofia; Bitoque, Diogo; Oliveira, Ana Vanessa; ?pstad, Christer L.; Zeeshan, Muhammad; Sliwka, Hans-Richard; Partali, Vassilia; Pungente, Michael D.; Silva, Gabriela A.

2014-01-01

415

Genetic studies of ocular albinism in a large Virginia kindred.  

PubMed

Nettleship-Falls ocular albinism is an X-linked disorder characterized by variable degrees of impaired visual acuity, nystagmus, and macular hypoplasia in affected males and variable fundus pigmentation but normal acuities in females. Because of extreme variability in clinical manifestation, examination of family members may be necessary to confirm the diagnosis and is essential for genetic counseling purposes. This study reports the pedigree analysis and clinical findings in a large kindred from rural Virginia with 31 males reported to be affected among the 287 individuals in the pedigree. Clinical findings were quite variable, even within sibships, and some cases had been previously misdiagnosed, even in the presence of this remarkable family history. Linkage analysis in this family did not show the expected linkage with the Xg blood group. Examination of skin biopsies clearly indicated the cutaneous abnormality of giant pigment melanosomes (GPM) in both affected males and carrier females. Our use of light microscopy for detection of characteristic GPM may be easily employed as a carrier detection test, and therefore, provide the basis for accurate genetic counseling in families with ocular albinism. PMID:6703591

Szymanski, K A; Boughman, J A; Nance, W E; Olansky, D C; Weinberg, R S

1984-02-01

416

Ocular safety: a silent (in vitro) success story.  

PubMed

Ocular irritation testing has been one of the animal test methods most criticised by animal welfare advocates. Additional criticism has arisen from within the scientific community, based on the variability of the animal test results and the questionable relevance of the extremely high dose levels employed. As a result, the Draize eye irritation test has been one of the main targets for in vitro replacement. Despite extensive efforts, however, there is still no in vitro method that is fully validated as a regulatory replacement. In spite of this, many individual companies are using diverse in vitro ocular irritation tests to gain important safety and efficacy information about their products and raw materials, eliminating the need for animal testing in the process. This is done in a safe fashion by applying intelligent testing paradigms. ECVAM has played a major role in this success, through its many programmes that have emphasised the importance of understanding the true toxicological need, and then using in vitro tests to provide that information. Thus, even in the absence of a successfully validated regulatory assay, the desired result of reducing animal testing is being met. PMID:12513653

Curren, Rodger D; Harbell, John W

2002-12-01

417

Robotic consolle for ocular surgery: a preliminary study  

NASA Astrophysics Data System (ADS)

Minimally invasive surgery has recently been improved by the use of robot-assisted procedures in several medical fields. Among the ocular surgeries there are a few examples of sophisticated vitreoretinal procedures, while robotic-assisted surgery of the anterior eye segment is still under study. In this paper we propose a new approach to the robotic assisted ocular surgery: a CO2 laser system is equipped with a micromanipulator and scanner, and it is proposed to induce photothermal effects for the removal of neoformations. A sensorized tool is connected to the patient eye and to the robotic arm. This tool is equipped with force and position sensors: by the use of the spatial information from the robotic console and from the patient it is possible to control the position of the target itself and to block it in the correct position for performing surgery. The system is provided by a feedback alarm that remove the block of the patient head in any moment. The optimized robotic consolle can be used in performing scleral cuts and in the treatment of pterigium or neoformations.

Rossi, Francesca; Pini, Roberto; Menabuoni, Luca; Lenzetti, Ivo; Russo, Sheila; Menciassi, Arianna; Fortuna, Damiano

2014-02-01

418

Towards understanding ocular motility: III, IV and VI.  

PubMed

The study of the ocular-motor nerves must be exhaustive from their source (nuclei in the brainstem) down to the effector muscles (orbit). Visual disturbances have to be analysed by differentiating between a decrease in visual acuity and ocular-motor disorders. Imaging tests are dominated by MRI, including fine slices and gadolinium injection. A study of the Circle of Willis vessels is often useful, and essential in the case of type III impairment. A further CT scan is essential for analysis of the foramina, base of the skull and orbital walls. Impairment of CN VI requires a CT scan of the apex of petrous. The study of the cavernous sinuses must be in-depth (T2 and T1 after gadolinium and elimination of fats) and always comparative. Impairment of CN III is often complex, difficult to identify precisely (complete or partial, with or without a pupil impairment, associated with other neurological signs) and requires a reasoned study based on anatomical, semiological and pathological knowledge. Other than tumour diseases, it is necessary to consider less well known malformative, ischemic and inflammatory aetiology. PMID:24080508

Koskas, P; Héran, F

2013-10-01

419

Use of liquid crystal display technology in ocular prosthesis  

NASA Astrophysics Data System (ADS)

Use of liquid crystal display technology for ocular prosthesis was recently proposed. Liquid crystal light valves are used for the purpose of light modulation to control pupil size proportional to incident light intensity. In the current study two different types of liquid crystal technology are tested for use in a prosthetic eye. The first type is the conventional twisted nematic (TN) cell. The second type of technology is a color dispersion system consisting of liquid crystal droplets in a polymer binder. Because of the principle of operation of the prosthetic device, in the off state the display should block light and appear black. This is easily achieved with TN cells. For the dispersed technology, a colored dispersed system using a black dichroic dye is used so that the display is black in the off state. The response of the two types of technology are measured and compared for ocular prosthesis. Factors such as photostability, battery life, alternate modes of operation, and the use of other types of liquid crystal display technology are also discussed.

Seekola, Desmond L.; Leuschner, F. Wilhelm

1995-04-01

420

Estimation of the surface tension of ocular cornea  

NASA Astrophysics Data System (ADS)

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.

Zhang, Xueyong; Ma, Jianguo; Lu, Rongsheng; Xia, Ruixue

2008-12-01