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1

Diagnostic criteria for IgG4-related ophthalmic disease.  

PubMed

Immunoglobulin G4 (IgG4)-related disease is a novel clinical entity characterized by infiltration of IgG4-immunopositive plasmacytes and elevated serum IgG4 concentration accompanied by enlargement of and masses in various organs, including the lacrimal gland, salivary gland, and pancreas. Recent studies have clarified that conditions previously diagnosed as Mikulicz disease as well as various types of lymphoplasmacytic infiltrative disorders of the ocular adnexa are consistent with a diagnosis of IgG4-related disease. Against this background, the diagnostic criteria for IgG4-related ophthalmic disease have recently been established, based on both the clinical and the histopathologic features of the ocular lesions. This article reviews these new criteria with reference to the comprehensive diagnostic criteria for IgG4-related disease for all systemic conditions reported in 2012. PMID:25392273

Goto, Hiroshi; Takahira, Masahiro; Azumi, Atsushi

2014-11-14

2

An overview of ocular adnexal lymphoid tumors.  

PubMed Central

In comparison with our earlier colleagues quoted in the introduction, we have made substantial progress in understanding the biology of ocular adnexal lymphoid tumors. While we have refined various categories with prognostic clinical value regarding possible associated systemic disease, none is foolproof and all have varying degrees of unpredictability. Comparatively well-differentiated histologic subtypes predominate among ocular adnexal lymphoid tumors. Polyclonal lesions occur less than half as often as monoclonal B-cell lesions. Molecular genetic studies have revealed small clones of monoclonal populations among the B-cells comprising most of the immunophenotypically polyclonal lesions, but no clonal genetic rearrangements have been uncovered within the preponderant constituent T-cell populations. The overall prognosis for ocular adnexal lymphoid tumors is excellent; when lumped together, 67% are not found to be associated with systemic disease with mean follow-ups of over 4 years. This is similar to experience with extranodal and extralymphatic lesions in other sites of the body, which also frequently have a small lymphocyte composition. The incidence of nonocular disease in all categories of our studies, however, will probably increase with the acquisition of longer follow-ups. Careful histopathologic evaluation is as good as immunophenotypic analysis of these lesions in predicting clinical outcome in terms of associated nonocular disease. Polyclonal and well-differentiated B-cell monoclonal lesions displayed equivalent clinical behavior. Benign polyclonal lesions may be associated with systemic disease but in a minority of cases (27%), as has also been determined in earlier studies. Clinical staging is the single most important predictor of associated monocular disease. In this study, patients with stage I-E disease had an 87% chance of not developing any nonocular lymphomatous lesion. We believe that this figure may also somewhat decrease with the passage of time. Precise anatomic localization of the lesion within the adnexa had considerable predictive value. Lesions of the conjunctiva fared the best; those of the orbit had an intermediate prognosis; while lid lesions had the worst prognosis. The most favorable prognosis would be held by a conjunctival lymphoid lesion in stage I-E composed of small lymphocytes. The fact that there is a fairly close equivalence in outcome between polyclonal and monoclonal well-differentiated lesions indicates that these lesions are in the vast majority of cases primary hyperplasias or primary lymphomas. The discovery by genetic probes of small monoclonal populations in immunophenotypically polyclonal lesions suggests that there is an evolution that goes on in situ.(ABSTRACT TRUNCATED AT 400 WORDS) Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5 PMID:2562543

Jakobiec, F A; Knowles, D M

1989-01-01

3

IgG4-related disease.  

PubMed

IgG4-related disease is a protean condition that mimics many malignant, infectious, and inflammatory disorders. This multi-organ immune-mediated condition links many disorders previously regarded as isolated, single-organ diseases without any known underlying systemic condition. It was recognised as a unified entity only 10 years ago. Histopathology is the key to diagnosis. The three central pathology features of IgG4-related disease are lymphoplasmacytic infiltration, storiform fibrosis, and obliterative phlebitis. The extent of fibrosis is an important determinant of responsiveness to immunosuppressive therapies. IgG4-related disease generally responds to glucocorticoids in its inflammatory stage, but recurrent or refractory cases are common. Important mechanistic insights have been derived from studies of patients treated by B-cell depletion. Greater awareness of this disease is needed to ensure earlier diagnoses, which can prevent severe organ damage, disabling tissue fibrosis, and even death. Identification of specific antigens and T-cell clones that drive the disease will be the first steps to elucidate the pathogenesis of IgG4-related disease. PMID:25481618

Kamisawa, Terumi; Zen, Yoh; Pillai, Shiv; Stone, John H

2014-12-01

4

Prognostic value of cell-cycle markers in ocular adnexal lymphoma: an assessment of 230 cases  

Microsoft Academic Search

Background To determine the prognostic value of cell-cycle associated markers in ocular adnexal lymphoma (OAL). Methods Two hundred sixty-one consecutive cases of ocular adnexal lymphoproliferative lesions were subdivided into reactive lymphoid hyperplasia (RLH), atypical lymphoid hyperplasia (ALH) and OAL. The latter were sub-typed according to the new WHO Lymphoma Classification. All lesions were investigated applying standard immunohistochemical methods with antibodies

Sarah E. Coupland; Martin Hellmich; Claudia Auw-Haedrich; William R. Lee; Harald Stein

2004-01-01

5

[IgG4-related disease].  

PubMed

IgG4-related disease is a systemic fibroinflammatory syndrome of unknown etiology characterized by local inflammatory swelling and tumefactive lesions in one or several organs. It unifies several diseases previously thought to be unrelated. Recently, diagnostic criteria for the disease have been formulated and were complemented by an international consensus on histopathological assessment. In general, the disease activity can be rapidly controlled by high doses of prednisolone (0.6 mg/kg body weight); however, relapses, either local or in other regions, are frequent during tapering of the steroid dose. Commonly used steroid-sparing agents are only partially effective. Persistent local inflammatory activity may result in permanent organ damage. In refractory cases rituximab treatment has been used with good success. In the long-term care of affected patients a probable increased risk of malignancies (e.g. solid tumors and lymphoma) requires attention. PMID:23459998

Loock, J; Manger, B

2013-03-01

6

IgG4-related skin disease.  

PubMed

IgG4-related disease (IgG4-RD) is a recently established clinical entity characterized by high levels of circulating IgG4, and tissue infiltration of IgG4(+) plasma cells. IgG4-RD exhibits a distinctive fibroinflammatory change involving multiple organs, such as the pancreas and salivary and lacrimal glands. The skin lesions of IgG4-RD have been poorly characterized and may stem not only from direct infiltration of plasma cells but also from IgG4-mediated inflammation. Based on the documented cases together with ours, we categorized the skin lesions into seven subtypes: (1) cutaneous plasmacytosis (multiple papulonodules or indurations on the trunk and proximal part of the limbs), (2) pseudolymphoma and angiolymphoid hyperplasia with eosinophilia (plaques and papulonodules mainly on the periauricular, cheek and mandible regions), (3) Mikulicz disease (palpebral swelling, sicca syndrome and exophthalmos), (4) psoriasis-like eruption (strikingly mimicking psoriasis vulgaris), (5) unspecified maculopapular or erythematous eruptions, (6) hypergammaglobulinaemic purpura (bilateral asymmetrical palpable purpuric lesions on the lower extremities) and urticarial vasculitis (prolonged urticarial lesions occasionally with purpura) and (7) ischaemic digit (Raynaud phenomenon and digital gangrene). It is considered that subtypes 1-3 are induced by direct infiltration of IgG4(+) plasma cells, while the other types (4-7) are caused by secondary mechanisms. IgG4-related skin disease is defined as IgG4(+) plasma-cell-infiltrating skin lesions that form plaques, nodules or tumours (types 1-3), but may manifest secondary lesions caused by IgG4(+) plasma cells and/or IgG4 (types 4-7). PMID:25065694

Tokura, Y; Yagi, H; Yanaguchi, H; Majima, Y; Kasuya, A; Ito, T; Maekawa, M; Hashizume, H

2014-11-01

7

IgG4-related disease.  

PubMed

Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is an immune-mediated condition that can affect almost any organ and is now being recognized with increasing frequency. IgG4-RD is characterized by a lymphoplasmacytic infiltrate composed of IgG4(+) plasma cells, storiform fibrosis, obliterative phlebitis, and mild to moderate eosinophilia. The diagnosis of IgG4-RD unifies many eponymous fibroinflammatory conditions that had previously been thought to be confined to single organs. IgG4-RD lesions are infiltrated by T helper cells, which likely cause progressive fibrosis and organ damage. IgG4 antibodies are generally regarded as noninflammatory. Although autoreactive IgG4 antibodies are observed in IgG4-RD, there is no evidence that they are directly pathogenic. Rituximab-induced B cell depletion in IgG4-RD leads to rapid clinical and histological improvement accompanied by swift declines in serum IgG4 concentrations. Although IgG autoantibodies against various exocrine gland antigens have been described in IgG4-RD, whether they are members of the IgG4 subclass is unknown. The contribution of autoantibodies to IgG4-RD remains unclear. PMID:24111912

Mahajan, Vinay S; Mattoo, Hamid; Deshpande, Vikram; Pillai, Shiv S; Stone, John H

2014-01-01

8

IgG4-related diseases.  

PubMed

Immunoglobulin G4 (IgG4)-related disease (IgG4-RD) is a fascinating condition recognised as a systemic disease in 2003 [1,2]. The first link between autoimmunity affecting the pancreas, elevated serum IgG4 concentrations and large numbers of IgG4-positive plasma cells in pancreatic tissue was described only 2 years earlier [3]. Since then, many diseases that have long been viewed organ-specific are now considered within the spectrum of IgG4-RD. Practically any organ can be affected, having in common a key pathological feature consisting in dense lymphocyte and plasma cell infiltrate rich in IgG4-positive plasma cells, storiform fibrosis and often an elevated serum IgG4 concentration. While good clinical response to steroid therapy is observed, immunosuppressive or B-cell depleting therapy can be required. It is important to distinguish the IgG4-RD from traditional organ-specific autoimmune disease to guide therapy. PMID:23040358

Guma, Monica; Firestein, Gary S

2012-08-01

9

The Role of Infectious Agents in the Etiology of Ocular Adnexal Neoplasia  

PubMed Central

Given the fact that infectious agents contribute to around 18% of human cancers worldwide, it would seem prudent to explore their role in neoplasms of the ocular adnexa: primary malignancies of the conjunctiva, lacrimal glands, eyelids, and orbit. By elucidating the mechanisms by which infectious agents contribute to oncogenesis, the management, treatment, and prevention of these neoplasms may one day parallel what is already in place for cancers such as cervical cancer, hepatocellular carcinoma, gastric mucosa-associated lymphoid tissue lymphoma and gastric adenocarcinoma. Antibiotic treatment and vaccines against infectious agents may herald a future with a curtailed role for traditional therapies of surgery, radiation, and chemotherapy. Unlike other malignancies for which large epidemiological studies are available, analyzing ocular adnexal neoplasms is challenging as they are relatively rare. Additionally, putative infectious agents seemingly display an immense geographic variation that has led to much debate regarding the relative importance of one organism versus another. This review discusses the pathogenetic role of several microorganisms in different ocular adnexal malignancies, including human papilloma virus in conjunctival papilloma and squamous cell carcinoma, human immunodeficiency virus in conjunctival squamous carcinoma, Kaposi sarcoma-associated herpes virus or human herpes simplex virus-8 (KSHV/HHV-8) in conjunctival Kaposi sarcoma, Helicobacter pylori (H. pylori,), Chlamydia, and hepatitis C virus in ocular adnexal mucosa-associated lymphoid tissue lymphomas. Unlike cervical cancer where a single infectious agent, human papilloma virus, is found in greater than 99% of lesions, multiple organisms may play a role in the etiology of certain ocular adnexal neoplasms by acting through similar mechanisms of oncogenesis, including chronic antigenic stimulation and the action of infectious oncogenes. However, similar to other human malignancies, ultimately the role of infectious agents in ocular adnexal neoplasms is most likely as a cofactor to genetic and environmental risk factors. PMID:18572051

Verma, Varun; Shen, Defen; Sieving, Pamela C.; Chan, Chi-Chao

2008-01-01

10

IgG4-related systemic disease and lymphoplasmacytic aortitis.  

PubMed

We describe herein a patient who developed a dissection of the ascending aorta in the setting of IgG4-related systemic disease, linking IgG4-related systemic disease with a newly-recognized subset of noninfectious aortitis. At the time of aortic surgery, a transmural lymphoplasmacytic infiltrate was detected in the patient's aorta, with a principal focus of inflammation within the media. Immunohistochemical studies demonstrated that >50% of the plasma cells in the lesion stained for IgG4. By in situ hybridization, the plasma cells showed polytypic staining for kappa and lambda light chains, consistent with a polyclonal plasma cell infiltrate. Serologic evaluation revealed that the patient's IgG4 levels were elevated nearly 10-fold. Four years before aortic surgery, the patient had undergone a mediastinal lymph node biopsy. Reexamination of the lymph node revealed features consistent with IgG4-related systemic disease, which had not been recognized at the time of the original biopsy. Glucocorticoid therapy for the IgG4-related systemic disease yielded a prompt response. Recognition that IgG4-related systemic disease can involve the ascending as well as the descending abdominal aorta indicates the need for a change in the way idiopathic aortitis is regarded. This case offers new potential considerations for short- and long-term management of noninfectious aortitis, because of the frequent good response of IgG4-related systemic disease to glucocorticoid treatment without additional therapy. Treatment of the aortitis may prevent progression of the IgG4-related systemic disease to involvement of other organs. IgG4-related systemic disease should be considered in all patients with aortitis judged to be of unknown etiology. PMID:19790067

Stone, John H; Khosroshahi, Arezou; Hilgenberg, Alan; Spooner, Amy; Isselbacher, Eric M; Stone, James R

2009-10-01

11

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

12

IgG4-Related Disease in a Urachal Tumor  

PubMed Central

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.; Lee, Eugene K.

2014-01-01

13

IgG4-related kidney disease – an update  

PubMed Central

Purpose of review IgG4-related disease (IgG4-RD) is a recently recognized systemic inflammatory disorder that can affect most organs/tissues such as sarcoidosis. The kidney is a frequently affected organ with tubulointerstitial nephritis (TIN), the representative lesion of IgG4-RD. This review focuses on the latest knowledge of IgG4-related kidney disease (IgG4-RKD). Recent findings A wide range of renal manifestations of IgG4-RD, that is TIN, membranous glomerulonephritis (MGN) and other glomerular lesions, and pyelitis, are collectively referred to as IgG4-RKD. Clinically, decreased renal function, or characteristic imaging findings such as multiple low-density lesions on contrast-enhanced computed tomography or diffuse thickening of the renal pelvic wall, are typical presenting features. Although a rapid response to corticosteroid therapy is a very important feature of IgG4-TIN, in cases in which renal function is moderately to severely decreased before therapy, only partial recovery of renal function is obtained. Summary TIN with characteristic imaging findings is a typical manifestation of IgG4-RKD in the interstitium, while MGN is a representative manifestation of the glomerular lesions. Although IgG4 is a central feature of IgG4-RD, the recent discovery of IgG4-negative IgG4-RD raises questions about the causative role of the IgG4 molecule in this context. PMID:25594543

Kawano, Mitsuhiro; Saeki, Takako

2015-01-01

14

IgG4-related dacryoadenitis in a 13-year-old girl.  

PubMed

IgG4-related disease is a recently described fibroinflammatory condition, often with systemic involvement. Several authors have reported IgG4-related orbital inflammation in adults. Pediatric cases of IgG4-related disease have been reported in the literature involving other areas of the body, with only 1 recent report of probable orbital involvement. The first case of probable IgG4-related dacryoadenitis is reported in a child. PMID:24814270

Notz, Gregory; Intili, Alessandra; Bilyk, Jurij R

2014-01-01

15

Autoimmune pancreatitis and IgG4-related systemic diseases  

PubMed Central

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

Zhang, Lizhi; Smyrk, Thomas C

2010-01-01

16

IgG4-Related Disease: A Multispecialty Condition  

PubMed Central

IgG4-related disease (IgG4-RD) is a recently recognized group of conditions, characterized by tumor-like swelling of involved organs, lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells, variable degrees of fibrosis, and elevated serum IgG4 concentrations. Currently IgG4-RD is recognized as a systemic condition that can affect several organs and tissues. Herein we report the case of a 34-year-old male patient who was admitted to our hospital with diffuse abdominal pain, weight loss, and painful stiffness in his neck. He had a history of tumoral mass of the left maxillary region, right palpebral ptosis with protrusion of the eyeball, and chronic dry cough for about 6 years. Laboratory tests revealed polyclonal hypergammaglobulinemia and increased serum IgG4 levels. Immunohistochemical staining of the maxillary biopsy was compatible with IgG4-RD. He had an excellent response to corticosteroid therapy. This case highlights that IgG4-RD should be included in the differential diagnosis with multisystem diseases. PMID:25506457

da Fonseca, Emanuela Pimenta; Santiago, Mittermayer Barreto

2014-01-01

17

Diagnosis of IgG4-related sclerosing cholangitis  

PubMed Central

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

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

2013-01-01

18

The clinical spectrum of IgG4-related disease.  

PubMed

IgG4-related disease (IgG4-RD) is an emerging immune-mediated disease with the capability of involving essentially any organ. The epidemiology of this disease has not been explored in detail. A majority of patients reported in the literature to date are from Japan, but the condition has been described all across the world and there is no strong evidence to suggest a predilection for Asian populations. The mean age at diagnosis is approximately 60years and there is a decided male predominance for many clinical features, with an overall male:female ratio of 8:3. A cardinal feature of IgG4-RD is single or multiple organ swelling that often raises concern for malignancy. IgG4-RD should be suspected in patients presenting with unexplained enlargement or swelling of one or more organs. Presenting features vary substantially according to the specialty to which patients present first; in addition, the disease can be diagnosed unexpectedly in pathological specimens or identified incidentally on radiology studies. Involvement of major organs is common and IgG4-RD may lead to organ failure, particularly in the pancreas, liver and biliary tree, kidneys, thyroid gland, lungs, and aorta. The diagnosis of IgG4-RD relies on the coexistence of various clinical, laboratory and histopathological findings, although none is pathognomonic by itself. PMID:25151972

Brito-Zerón, Pilar; Ramos-Casals, Manuel; Bosch, Xavier; Stone, John H

2014-12-01

19

Systemic Rituximab Immunotherapy in the Management of Primary Ocular Adnexal Lymphoma: Single Institution Experience.  

PubMed

Abstract Purpose: To evaluate the efficacy of systemic rituximab immunotherapy in the management of primary ocular adnexal lymphomas (OAL). Materials and methods: Clinical records of 10 consecutive patients (11 eyes) with biopsy-proven OAL managed with systemic anti-CD20 monoclonal antibody (rituximab; 375?mg/m(2) intravenously once every three weeks for 6-8 cycles) between June 2008-March 2013 were evaluated retrospectively. Orbital magnetic resonance imaging and positron emission tomography were performed to evaluate any orbital and systemic involvement, respectively. Clinical response was classified as complete or partial. Results: The age of patients ranged between 27-85 (median, 55) years. Nine patients (90%) presented with unilateral and one (10%) with bilateral conjunctival involvement. Orbit was affected in 4 patients (40%), one of which had also choroidal involvement (10%). None of the patients had systemic involvement at initial presentation. All patients received an average of 7 cycles (range, 6-8) of systemic immunotherapy. After a median follow-up of 31 months (range, 10-61 months), complete response without recurrence could be achieved in 4 eyes (36%) with rituximab monotherapy. No systemic or ocular side effects were observed in any patient. Additional radiotherapy was required in 6 patients (7 eyes; 64%) with partial response or recurrence. Conclusions: Complete regression of primary OALs without recurrence was observed in about one-third of eyes after systemic rituximab monotherapy. Adjunctive radiotherapy was required in remaining two-thirds of the cases to achieve complete response. Thus, considering the balance between high rate of local control and potential ocular complications of radiotherapy, systemic rituximab can be considered as a first-line therapeutic option in the management of primary OAL. PMID:25247376

Tuncer, Samuray; Tany?ld?z, Burak; Basaran, Mert; Buyukbabani, Nesimi; Dogan, Oner

2014-09-23

20

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

PubMed

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

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

2014-06-01

21

The emerging mysteries of IgG4-related disease.  

PubMed

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

Smit, Wouter; Barnes, Eleanor

2014-12-01

22

Biased immunoglobulin light chain use in the Chlamydophila psittaci negative ocular adnexal marginal zone lymphomas.  

PubMed

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 in 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 IGKV/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. Twenty-seven 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

2013-05-01

23

Molecular and genomic aberrations in Chlamydophila psittaci negative ocular adnexal marginal zone lymphomas.  

PubMed

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 three tumors harbored IGH translocations to an unidentified partner. CARD11 mutations were not found in all analyzed tumors, while the MYD88 L265P mutation was detected in three (6.7%) tumors. A20 mutations and deletions were each detected in seven (15.6%) and six (13.3%) tumors, respectively. Therefore, the observed genetic aberrations could account for the activation of the nuclear factor (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

2013-09-01

24

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

25

IgG4 related renal disease: A wolf in sheep's clothing  

PubMed Central

IgG4 related disease is a fibro-inflammatory condition with involvement of renal and extra renal organs, characterized by lymphoplasmacytic infiltration with organ dysfunction. We describe three cases of IgG4 related renal disease from a tertiary care hospital in south India. PMID:25484534

Rohan, A.; Ravishankar, B.; Vishwanath, S.; Vankalakunti, M.; Kishore, B.; Ballal, H. S.

2014-01-01

26

IgG4 related renal disease: A wolf in sheep's clothing.  

PubMed

IgG4 related disease is a fibro-inflammatory condition with involvement of renal and extra renal organs, characterized by lymphoplasmacytic infiltration with organ dysfunction. We describe three cases of IgG4 related renal disease from a tertiary care hospital in south India. PMID:25484534

Rohan, A; Ravishankar, B; Vishwanath, S; Vankalakunti, M; Kishore, B; Ballal, H S

2014-11-01

27

Inflammatory pseudotumors of the kidney due to IgG4-related tubulointerstitial nephritis.  

PubMed

The paper presents the case of a female patient who was admitted to our department because of prolonged febrile syndrome, altered general status and renal tumoral masses revealed by thoracic and abdominal CT. After thorough histological examination, including immunohisto-chemistry and in situ hybridization studies, we reached the diagnosis of renal pseudotumoral masses due to IgG4-related tubulointerstitial nephritis. The kidney is a distinct target organ affected by IgG4-related sclerosing disease, and the most frequent manifestation is tubulo-interstitial nephritis. We described the clinical, imagistic and histopathological features of kidney and urological involvement in IgG4-related sclerosing disease, especially focusing on IgG4-related tubulointerstitial nephritis. This is a rare case of IgG4-related sclerosing disease without extrarenal features, excepting lumboaortic lymphadenopathy. PMID:24969995

Hârza, Mihai; Ismail, Gener; Mitroi, George; Gherghiceanu, Mihaela; Preda, Adrian; Sinescu, Ioanel

2014-01-01

28

Retroperitoneal disorders associated with IgG4-related autoimmune pancreatitis  

PubMed Central

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

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

2014-01-01

29

Retroperitoneal disorders associated with IgG4-related autoimmune pancreatitis.  

PubMed

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

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

2014-11-28

30

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

31

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. PMID:25237380

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

2014-01-01

32

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

PubMed

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

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

2014-08-01

33

IgG4-related prostatitis: a rare cause of steroid-responsive obstructive urinary symptoms.  

PubMed

IgG4-related disease is an idiopathic, systemic fibroinflammatory disease that can affect a wide variety of sites, including several in the genitourinary system. We describe a patient with steroid-responsive urinary symptoms and an abnormal digital rectal exam that were secondary to IgG4-related prostatitis. We discuss the importance of recognizing this condition and differentiating it from prostate cancer, which can present similarly. PMID:23075137

Hart, Phil A; Smyrk, Thomas C; Chari, Suresh T

2013-01-01

34

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

35

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

PubMed Central

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

Frydman, James; Grunner, Shahar; Kluger, Yoram

2014-01-01

36

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

PubMed

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

Frydman, James; Grunner, Shahar; Kluger, Yoram

2014-11-28

37

IgG4-related intracranial hypertrophic pachymeningitis with skull hyperostosis: a case report  

PubMed Central

Background Immunoglobulin G4 (IgG4)-related disease is a systemic syndrome, characterized by sclerosing lesions and usually associated with a raised serum IgG4 level; the pancreas, salivary glands, and lacrimal glands are typically affected. Recently, it has been suggested that IgG4-related sclerosing disease represents a subset of cases previously diagnosed as idiopathic hypertrophic pachymeningitis. This rare inflammatory disorder causes localized or diffused thickening of intracranial dura mater. Headache, cranial nerve palsy, and ataxia are the most common clinical manifestations. Herein, we report the clinical and histopathological features of a rare case of IgG4-related intracranial hypertrophic pachymeningitis involving cranial hyperostosis. Case presentation A 52-year-old man presented with refractory generalized tonic-clonic seizure. Magnetic resonance imaging revealed thickening of the meninges with enhancement near the superior sagittal sinus; skull bone defect was also noted. Extensive excision of affected skull bone and dura was performed, providing the diagnosis of IgG4-related pachymeningitis. After the surgery, the patient’s seizure stopped and he was smoothly tapered off antiepileptic medication. Conclusion To our knowledge, this is the first reported case of IgG4-related pachymeningitis with concomitant skull hyperostosis. PMID:24053604

2013-01-01

38

A Case Report of IgG4-Related Disease Clinically Mimicking Pleural Mesothelioma  

PubMed Central

An immunoglobulin G4 (IgG4)-related disease is a recently emerging entity, and a few cases of IgG4-related disease in lung and pleura have been reported. Herein, we report the case of a 74-year-old man with IgG4-related disease of lung and pleura, clinically suspicious of malignant mesothelioma. Chest computed tomography showed diffuse nodular pleural thickening, and microscopic finding disclosed diffuse thickening of visceral pleura with infiltrations of many lymphoplasma cells with increased number of IgG4-positive plasma cells and a few multinucleated giant cells. It is important for pathologists and clinicians to recognize this rare entity and its histologic finding, because it can be confused with malignant tumors on the radiologic examination although it can be treated with steroid therapy. PMID:24523818

Choi, In Ho; Jang, Si-Hyong; Lee, Seungeun; Kim, Tae-Sung; Chung, Man-Pyo

2014-01-01

39

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

PubMed

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

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

2014-12-01

40

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

PubMed Central

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

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

2014-01-01

41

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

42

A Case of IgG4-Related Disease Presenting as Massive Pleural Effusion and Thrombophlebitis  

PubMed Central

Immunoglobulin (Ig) G4-related disease is a recently recognized systemic fibroinflammatory condition characterized by a lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells with elevated circulating levels of IgG4. The disease can either be localized to one or two organs, or present as diffuse multi-organ disease. Furthermore, lesions in different organs can present simultaneously or metachronously. In the pulmonary manefestations, lesions associated with IgG4-related disease have been described in the lung parenchyma, airways and pleura, as well as the mediastinum. We report a case of IgG4-related disease presenting as massive pleural effusion and thrombophlebitis. PMID:24851132

Choi, Jong Hyun; Sim, Jae Kyeom; Oh, Jee Youn; Lee, Eun Joo; Hur, Gyu Young; Lee, Seung Heon; Lee, Sung Yong; Kim, Je Hyeong; Lee, Sang Yeub; Shin, Chol; Shim, Jae Jeong; In, Kwang Ho; Kang, Kyung Ho

2014-01-01

43

Development of IgG4-related disease in a patient diagnosed with idiopathic membranous nephropathy  

PubMed Central

We report a case of IgG4-related disease (IgG4-RD) diagnosed after 3 years of follow-up for idiopathic membranous nephropathy (MN). MN has been considered as glomerular lesion of IgG4-related kidney diseases in recent years and was diagnosed simultaneously with or after a diagnosis of IgG4-RD in previously reported cases. In the present case, IgG4-RD developed 3 years after the diagnosis of idiopathic MN, indicating a possible relationship between idiopathic MN and IgG4-RD through common underlying mechanisms of development. PMID:24058729

Wada, Yoko; Saeki, Takako; Yoshita, Kazuhiro; Ayalon, Rivka; Kamimura, Kenya; Nakano, Masaaki; Narita, Ichiei

2013-01-01

44

A Case of IgG4-Related Disease Presenting as Massive Pleural Effusion and Thrombophlebitis.  

PubMed

Immunoglobulin (Ig) G4-related disease is a recently recognized systemic fibroinflammatory condition characterized by a lymphoplasmacytic infiltrate rich in IgG4-positive plasma cells with elevated circulating levels of IgG4. The disease can either be localized to one or two organs, or present as diffuse multi-organ disease. Furthermore, lesions in different organs can present simultaneously or metachronously. In the pulmonary manefestations, lesions associated with IgG4-related disease have been described in the lung parenchyma, airways and pleura, as well as the mediastinum. We report a case of IgG4-related disease presenting as massive pleural effusion and thrombophlebitis. PMID:24851132

Choi, Jong Hyun; Sim, Jae Kyeom; Oh, Jee Youn; Lee, Eun Joo; Hur, Gyu Young; Lee, Seung Heon; Lee, Sung Yong; Kim, Je Hyeong; Lee, Sang Yeub; Shin, Chol; Shim, Jae Jeong; In, Kwang Ho; Kang, Kyung Ho; Min, Kyung Hoon

2014-04-01

45

IgG4-related sclerosing disease: an emerging entity frequently misdiagnosed.  

PubMed

IgG4-related sclerosing disease, a multiorgan system disease that has been identified in the last 10 years, is a fibroinflammatory condition with a marked propensity to manifest itself as mass forming lesions characterized by three main histological features (sclerosis, obliterative phlebitis and lymphoplasmacytic infiltrate) and by the presence of abundant IgG4+ plasma cells, frequent elevation of serum IgG4 and a dramatic initial response to steroid therapy. The aim of this mini-review is to increase the capacity to identify the characteristic features of IgG4-related sclerosing disease in specific organs and in two newly proposed entities (urethral caruncle and paratesticular fibrous pseudotumor) using biopsy specimens and methods of counting IgG4. In addition we examine the relationship between IgG4-related sclerosing disease and malignancy. In fact, an increased ability to recognize the characteristic features of IgG4-related sclerosing disease would play an extremely important role in avoiding unnecessary surgery in favor of initiating corticosteroid therapy. PMID:24341121

Mazzucchelli, Roberta; Racchini, Stefano; Barbisan, Francesca; Galosi, Andrea B; Giorgini, Sara

2013-08-01

46

Kimura's disease or IgG4-related disease? A case-based review.  

PubMed

Kimura's disease usually presents with benign painless soft tissue swelling around the head and neck areas with eosinophilia and high immunoglobulin E (IgE) levels. IgG4-related disease is characterized by fibrosis and sclerosis of the involved organs, with infiltration of IgG4-positive plasma cells. There are some similar clinical manifestations of these two diseases, with eosinophilia or high IgE levels often found in patients with IgG4-related disease. However, the relation between these two diseases is not well known. We report a 23-year-old man who had multiple neck lumps for longer than 1 year. He had remarkable eosinophilia and elevated serum IgE levels. Biopsy of his lymph nodes suggested the diagnosis of both Kimura's disease and IgG4-related disease. In this article, we discuss the relationship between Kimura's disease and IgG4-related disease. We also suggest a possible model ("allergen-specific immunotherapy") to illustrate our view that an increase in IgG4-positive plasma cells is an epiphenomenon of Kimura's disease. PMID:24352754

Liu, Lei; Chen, Yong; Fang, Zhi; Kong, Jingping; Wu, Xiudi; Zhang, Zhen

2015-02-01

47

IgG4-related sclerosing disease of the breast successfully treated by steroid therapy.  

PubMed

IgG4-related sclerosing disease was first identified and defined in the twenty-first century. In this pathology, the serum IgG4 level increases and IgG4-positive plasma cells and lymphocytes infiltrate organs such as the pancreas, salivary glands, lacrimal glands, kidneys, and the retroperitoneum. Presented in this report is a case of IgG4-related sclerosing disease that occurred in the breast and was treated successfully with steroid therapy. A 51-year-old woman presented with bilaterally swollen eyelids and an elevated serum IgG4 concentration. Screening CT revealed a lesion in her right breast but no other lesions. Mammography, ultrasonography, and MRI could not rule out malignancy, so a core needle biopsy was performed. Histologically, the lesion was composed of papilloma with fibrosis, adenosis, and severe lymphoplasmacytic infiltration. No malignant features were observed. Many plasma cells within the lesion were immunohistochemically positive for IgG4. IgG4-related sclerosing disease of the breast was diagnosed, and steroid therapy was initiated. During 4 weeks of steroid treatment the lesion became smaller in size, and at 7-months follow-up the lesion showed no new growth. Since steroid therapy is effective for this disease, IgG4-related sclerosing disease should be considered in the differential diagnosis of breast lesions in order to avoid unnecessary surgery. PMID:21042890

Ogiya, Akiko; Tanaka, Kumiko; Tadokoro, Yukiko; Kikutani, Mariko; Uematsu, Takayoshi; Kashiwagi, Hiroya; Kasami, Masako; Takahashi, Kaoru

2014-03-01

48

IgG4-related leptomeningitis: a reversible cause of rapidly progressive cognitive decline.  

PubMed

Immunoglobulin G4-related diseases (IgG4-RD) are a newly recognized category of diseases. CNS involvement in IgG4-RD includes hypophysitis(1) and intracranial or spinal manifestations of hypertrophic pachymeningitis.(2,3) We present a unique case of rapid cognitive decline due to IgG4-related leptomeningitis. PMID:24384648

Mehta, Shyamal H; Switzer, Jeffrey A; Biddinger, Paul; Rojiani, Amyn M

2014-02-11

49

IgG4-related Hashimoto's thyroiditis - A new variant of a well known disease.  

PubMed

Hashimoto's thyroiditis (HT) has been characterized for many years as a well-defined clinicopathologic entity, but is now considered a heterogeneous disease. IgG4-related HT is a new subtype characterized by thyroid inflammation rich in IgG4-positive plasma cells and marked fibrosis. It may be part of the systemic IgG4-related disease. We report a case of a 56-year-old Portuguese man who presented with a one-month history of progressive neck swelling and dysphagia. Laboratory testing revealed increased inflammatory parameters, subclinical hypothyroidism and very high levels of thyroid autoantibodies. Cervical ultrasound (US) demonstrated an enlarged and heterogeneous thyroid gland and two hypoechoic nodules. US-guided fine needle aspiration cytology was consistent with lymphocytic thyroiditis. The patient was submitted to total thyroidectomy and microscopic examination identified typical findings of HT, marked fibrosis limited within the thyroid capsule and lymphoplasmacytic infiltration, with >50 IgG4-positive plasma cells per high-power field and an IgG4/IgG ratio of >40%. After surgery, serum IgG4 concentration was high-normal. Symptoms relief and reduction in laboratory inflammatory parameters were noticed. Thyroid function is controlled with levothyroxine. To our knowledge we report the first case of IgG4-related HT in a non-Asian patient. We also perform a review of the literature regarding IgG4-related disease and IgG4-related HT. Our case highlights this new variant of the well known HT, and helps physicians in recognizing its main clinical features, allowing for proper diagnosis and treatment. PMID:25465611

Luiz, Henrique Vara; Gonçalves, Diogo; Silva, Tiago Nunes da; Nascimento, Isabel; Ribeiro, Ana; Mafra, Manuela; Manita, Isabel; Portugal, Jorge

2014-11-01

50

Orbital immunoglobulin IgG4-related inflammatory fibrosclerosing lesion treated with pentoxifylline and ?-tocopherol: case report.  

PubMed

Immunoglobulin G4 (IgG4)-related disease is a distinct group of disorders that are characterised by intense infiltration of an organ with IgG4(+) cells, subsequent inflammation, fibrosis, and masses. We report a new treatment of orbital IgG4-related disease with pentoxyphylline and ?-tocopherol, both of which are anti-inflammatory and antifibrotic agents. PMID:25467248

Lee, R; MacKinnon, C A; Aburn, N; Tan, S T

2014-11-24

51

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

52

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

PubMed Central

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

Zhou, Jiaxuan; Li, Xian

2014-01-01

53

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

PubMed

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

54

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

55

IgG4-related thyroiditis: a case report and review of literature  

PubMed Central

Summary A 55-year-old male, with a positive medical history for hypothyroidism, treated with stable doses for years was admitted with subacute thyroiditis and a feeling of pain and pressure in the neck. Laboratory tests showed decrease in TSH levels, elevated erythrocyte sedimentation rate, and very high antithyroid antibodies. Owing to enlarging goiter and exacerbation in the patient's complaints, he was operated with excision of a fibrotic and enlarged thyroid lobe. Elevated IgG4 plasma levels and high IgG4/IgG plasma cell ratio on immunohistochemistry led to the diagnosis of IgG4-mediated thyroiditis. We concluded that IgG4-thyroiditis and IgG4-related disease should be considered in all patients with an aggressive form of Hashimoto's thyroiditis. Learning points IgG4-related disease is a systemic disease that includes several syndromes; IgG4-related thyroiditis is one among them.IgG4-thyroiditis should be considered in all patients with an aggressive form of Hashimoto's thyroiditis.Patients with suspected IgG4-thyroiditis should have blood tested for IgG4/IgG ratio and appropriate immunohistochemical staining if possible. PMID:25136446

Abo Salook, Mahmud; Benbassat, Carlos; Strenov, Yulia

2014-01-01

56

Calcifying fibrous tumor: an unrecognized IgG4-related disease?  

PubMed

Calcifying fibrous tumor is a rare benign mass lesion characterized by bland spindle cells embedded in abundant collagenous matrix, interspersed dystrophic or psammomatous calcifications, and lymphoplasmacytic infiltrate. It shares several clinical and morphologic features with IgG4-related disease, a newly recognized fibroinflammatory disorder. Characteristic histologic features of IgG4-related lesions include dense fibrosis and abundant lymphoplasmacytic infiltrate, similar to calcifying fibrous tumor. They contain high numbers of IgG4-positive plasma cells in the tissue. Patients also often have elevated serum IgG4 levels. We report the case of a patient with an ileal calcifying fibrous tumor that contained 69 IgG4-positive plasma cells per high-power field and an IgG4-to-IgG ratio of 56% in lesional plasma cells. The patient's serum IgG4 level was 185 mg/dL, more than double the normal value. Altogether, these features suggest that calcifying fibrous tumor could be an unrecognized lesion of IgG4-related disease. PMID:25244325

Larson, Brent K; Balzer, Bonnie; Goldwasser, Jerome; Dhall, Deepti

2014-09-22

57

Biopsy-proven recurrence of unilateral IgG4-related orbital inflammation after 20 years.  

PubMed

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

58

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

PubMed

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

2014-11-01

59

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

60

Isolated IgG4-related interstitial lung disease: unusual histological and radiological features of a pathologically proven case  

PubMed Central

IgG4-related lung disease is commonly associated with autoimmune pancreatitis. Recently, isolated IgG4-related interstitial lung disease (ILD) without other organ involvement has newly been reported in two cases with clinical features of nonspecific interstitial pneumonitis (NSIP). We report the first case of an isolated IgG4-related ILD in a 78-year-old man with dry cough and dyspnea, whose clinical findings proved to be different from NSIP. Serum IgG4 levels were increased. Chest CT scan revealed bilateral consolidations especially in the lower lobes, enlarged mediastinal and hilar lymph nodes and pleural effusions. Video-assisted thoracoscopic (VATS) lung biopsy revealed a pattern similar to usual interstitial pneumonia (UIP) and an abundant IgG4-positive plasma cell infiltration. He was effectively treated by steroid therapy. Increasing recognition of IgG4 related diseases has led to a growing number of new entities. The novel concept of isolated IgG4-related ILD as a pulmonary manifestation of a systemic IgG4-related disorder should be taken into account as a possible differential diagnosis of ILD and mass-forming lesions, even when no other organ manifestation is clinically apparent at the time of diagnosis. Lung specific diagnostic criteria and algorithms are required to enhance diagnostic accuracy in cases of possible IgG4-related ILD. PMID:23509921

2013-01-01

61

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

62

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

63

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. PMID:25360299

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

2014-01-01

64

Immunoglobulin gene repertoire in ocular adnexal lymphomas: hints on the nature of the antigenic stimulation.  

PubMed

Evidence from certain geographical areas links lymphomas of the ocular adnexa marginal zone B-cell lymphomas (OAMZL) with Chlamydophila psittaci (Cp) infection, suggesting that lymphoma development is dependent upon chronic stimulation by persistent infections. Notwithstanding that, the actual immunopathogenetical mechanisms have not yet been elucidated. As in other B-cell lymphomas, insight into this issue, especially with regard to potential selecting ligands, could be provided by analysis of the immunoglobulin (IG) receptors of the malignant clones. To this end, we studied the molecular features of IGs in 44 patients with OAMZL (40% Cp-positive), identifying features suggestive of a pathogenic mechanism of autoreactivity. Herein, we show that lymphoma cells express a distinctive IG repertoire, with electropositive antigen (Ag)-binding sites, reminiscent of autoantibodies (auto-Abs) recognizing DNA. Additionally, five (11%) cases of OAMZL expressed IGs homologous with autoreactive Abs or IGs of patients with chronic lymphocytic leukemia, a disease known for the expression of autoreactive IGs by neoplastic cells. In contrast, no similarity with known anti-Chlamydophila Abs was found. Taken together, these results strongly indicate that OAMZL may originate from B cells selected for their capability to bind Ags and, in particular, auto-Ags. In OAMZL associated with Cp infection, the pathogen likely acts indirectly on the malignant B cells, promoting the development of an inflammatory milieu, where auto-Ags could be exposed and presented, driving proliferation and expansion of self-reactive B cells. PMID:22024723

Dagklis, A; Ponzoni, M; Govi, S; Cangi, M G; Pasini, E; Charlotte, F; Vino, A; Doglioni, C; Davě, F; Lossos, I S; Ntountas, I; Papadaki, T; Dolcetti, R; Ferreri, A J M; Stamatopoulos, K; Ghia, P

2012-04-01

65

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

PubMed Central

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

66

Perivascular fibrosis and IgG4-related disease: a case report.  

PubMed

Immunoglobulin G4-related disease (IgG4-RD) is a newly recognized fibroinflammatory condition which can potentially involve any organ. Some characteristic histopathologic features with lymphoplasmacytic infiltrate, an increased number of IgG4+ cells, storiform fibrosis and obliterative phlebitis are the mainstay for diagnosis. Serum IgG4 levels often increase. We report the case of a patient with perivascular fibrotic lesions involving the aortic arch and the splenic hilum, with a surgical biopsy-proven diagnosis of IgG4-related disease. The patient is now undergoing a low-dose corticosteroid maintenance therapy without evidence of new localizations of the disease. This case highlights the need for increasing awareness and recognition of this new, emerging clinical condition. PMID:25376960

Monti, S; Crepaldi, G; Peri, A; Pietrabissa, A; Morbini, P; Bobbio-Pallavicini, F; Montecucco, C; Caporali, R

2014-01-01

67

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

PubMed Central

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

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

2014-01-01

68

Clinical review of pulmonary manifestations of IgG4-related disease.  

PubMed

IgG4-related disease (IgG4-RD) is a recently recognized systemic disease characterized by tumefactive lesions in various organ systems. The list of organs that can be involved continues to expand, and recently computed tomography (CT) descriptions of the pulmonary lesions found in the disease have been described. The clinical symptoms are nonspecific and may include cough, dyspnea, chest pain, and fever. The appropriate clinical presentation along with elevated serum IgG4 concentrations and pathologic evidence of lymphoplasmacytic infiltrates with abundant IgG4-positive plasma cells and storiform fibrosis is consistent with the disease. Steroids are used to treat this disease in addition to immunosupressives such as cyclosporine or rituxumab for steroid refractory disease. The pulmonary manifestations and imaging features can often mimic malignancy, and as such knowledge of the diagnostic, clinicopathologic, and radiographic features of the disease is required in order to provide appropriate diagnostic workup and treatment. PMID:25422997

Campbell, Sabrina N; Rubio, Edmundo; Loschner, A Lukas

2014-11-01

69

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

PubMed

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

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

2014-01-01

70

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

PubMed

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

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

2015-01-01

71

Prevalence of atopy, eosinophilia, and IgE elevation in IgG4-related disease.  

PubMed

IgG4-related disease (IgG4-RD) is a fibroinflammatory disorder that can affect virtually every organ system. T-helper type 2 responses have been presumed to be pathogenic in this disease, and a high proportion of patients with IgG4-RD are reported to have longstanding allergies, peripheral blood eosinophilia, and serum IgE elevation. It has therefore been proposed that allergic mechanisms drive IgG4-RD. However, no epidemiological assessment of atopy, peripheral blood eosinophilia, and serum IgE concentrations has ever been undertaken in patients with IgG4-RD. In this study, we evaluated these parameters in a large cohort of patients with IgG4-RD in whom a wide range of organs were affected by disease. Our results demonstrate that the majority of patients with IgG4-RD are nonatopic. Nevertheless, a subset of nonatopic subjects exhibit peripheral blood eosinophilia and elevated IgE, suggesting that processes inherent to IgG4-RD itself rather than atopy per se contribute to the eosinophilia and IgE elevation observed in the absence of atopy. PMID:24266692

Della Torre, E; Mattoo, H; Mahajan, V S; Carruthers, M; Pillai, S; Stone, J H

2014-02-01

72

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

PubMed

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

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

2012-04-01

73

A new conceptualization for Mikulicz's disease as an IgG4-related plasmacytic disease.  

PubMed

Mikulicz's disease (MD) has been included within the diagnosis of primary Sjögren's syndrome (SS), but it represents a unique condition involving persistent enlargement of the lacrimal and salivary glands characterized by few autoimmune reactions and good responsiveness to glucocorticoids, leading to the recovery of gland function. Mikulicz's disease was recently reported to be associated with elevated immunoglobulin G4 (IgG4) concentrations in the serum and prominent infiltration of plasmacytes expressing IgG4 into the lacrimal and salivary glands. The following features were used for diagnosis: (1) visual confirmation of symmetrical and persistent swelling in more than two lacrimal and major salivary glands; (2) prominent mononuclear cell infiltration of lacrimal and salivary glands; and (3) exclusion of other diseases that present with glandular swelling, such as sarcoidosis and lymphoproliferative disease. These features are not observed in most SS cases. The complications of MD include autoimmune pancreatitis, retroperitoneal fibrosis, tubulointerstitial nephritis, autoimmune hypophysitis, and Riedel's thyroiditis, all of which show IgG4 involvement in their pathogenesis. Mikulicz's disease thus differs from SS and may be a systemic IgG4-related plasmacytic disease. PMID:17164992

Yamamoto, Motohisa; Takahashi, Hiroki; Ohara, Mikiko; Suzuki, Chisako; Naishiro, Yasuyoshi; Yamamoto, Hiroyuki; Shinomura, Yasuhisa; Imai, Kohzoh

2006-01-01

74

IgG4- related disease as a rare cause of tubulointerstitial nephritis.  

PubMed

Isolated IgG4 tubulointerstitial nephritis (TIN) is a rare disorder characterized by raised serum IgG4 levels and histological findings of dense lymphoplasmacytic infiltrates rich in IgG4 positive plasma cells. We report a case of isolated IgG4 TIN that presented with acute kidney injury in an 84 year old man with a polyclonal increase in his total IgG and a raised IgE of 381 kUA/L but without evidence of systemic autoimmunity. We draw a parallel with IgG4-related autoimmune pancreatitis and show raised levels of circulating regulatory T cells. Importantly the plasma levels of the T regulatory cell cytokine, IL10, the TH1 cytokines IL12 and IFN?, the proinflammatory TNF ? and immune regulatory IL27 were all highly raised. Furthermore, the level of IL21 that promotes IgG4 production was also very significantly elevated. These results suggest efforts of the immune system to reduce inflammation and suppress an exaggerated Th2 response. A raised serum IgG in the setting of acute kidney injury and in the absence of autoimmunity and chronic infection should encourage an assessment of the IgG subclasses. Prompt steroid treatment of those with a raised IgG4 may reduce ongoing renal damage. PMID:24789687

Lee, Lennard Y W; Yap, Hsiu; Sampson, Steve; Ford, Brian; Hayman, Grant; Marsh, James; Bansal, Amolak S

2014-07-01

75

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

76

Histopathologic Overlap between Fibrosing Mediastinitis and IgG4-Related Disease.  

PubMed

Fibrosing mediastinitis (FM) and IgG4-related disease (IgG4-RD) are two fibroinflammatory disorders with potentially overlapping clinical and radiological features. In this paper, we looked for histopathologic features of IgG4-RD and enumerated infiltrating IgG4-positive plasma cells within mediastinal tissue biopsies from FM patients. We identified 15 consecutive FM surgical mediastinal tissue biopsies between 1985 and 2006. All patients satisfied the clinical and radiological diagnostic criteria for FM. All patients had either serological or radiological evidence of prior histoplasmosis or granulomatous disease, respectively. Formalin-fixed paraffin-embedded tissue sections of all patients were stained for H&E, IgG, and IgG4. Three samples met the predefined diagnostic criteria for IgG4-RD. In addition, characteristic histopathologic changes of IgG4-RD in the absence of diagnostic numbers of tissue infiltrating IgG4-positive plasma cells were seen in a number of additional cases (storiform cell-rich fibrosis in 11 cases, lymphoplasmacytic infiltrate in 7 cases, and obliterative phlebitis/arteritis in 2 cases). We conclude that up to one-third of histoplasmosis or granulomatous-disease-associated FM cases demonstrate histopathological features of IgG4-RD spectrum. Whether these changes occur as the host immune response against Histoplasma or represent a manifestation of IgG4-RD remains to be determined. Studies to prospectively identify these cases and evaluate their therapeutic responses to glucocorticoids and/or other immunosuppressive agents such as rituximab are warranted. PMID:22654916

Peikert, Tobias; Shrestha, Bijayee; Aubry, Marie Christine; Colby, Thomas V; Ryu, Jay H; Sekiguchi, Hiroshi; Smyrk, Thomas C; Specks, Ulrich; Yi, Eunhee S

2012-01-01

77

IgG4-related disease: a systemic condition with characteristic microscopic features.  

PubMed

During the first decade of the 21st century, IgG4-related disease (IgG4-RD), a fibroinflammatory condition occurring at multiple sites of the body, has been newly recognized. As indicated by its name, elevation of IgG4 in the serum and tissue is a common denominator of IgG4-RD. Since the observation that many patients suffering from autoimmune pancreatitis (AIP), a specific type of chronic pancreatitis, had elevated serum levels of IgG4, it was reported that these patients also had increased numbers of IgG4-positive cells in the inflamed pancreatic tissue. In 2003, it was noted that a significant proportion of the AIP patients had a variety of extrapancreatic fibroinflammatory lesions, and that AIP therefore was the pancreatic manifestation of a systemic disease. Among these extrapancreatic manifestations, the extrahepatic bile ducts, salivary glands, thyroid, lymph nodes and retroperitoneum were most frequently reported, and infiltration of the tissue with IgG4-positive cells was also noted at these sites. During the following years, a multitude of other conditions have been added to the spectrum of IgG4-RD. While some of these organ manifestations were once believed to represent diseases on their own, others have been included under the umbrella of "multifocal fibrosclerosis". Biopsies or resection specimens from affected organs in IgG4-RD reveal several common microscopic features irrespective of the site of the lesion. Cellular and storiform fibrosis, lymphoplasmacytic infiltration, increased numbers of IgG4-positive cells and obliterative phlebitis are among the most characteristic histological changes in IgG4-RD. The detailed etiology, pathophysiology, epidemiology and clinical long-term outcome have at present yet to be fully elucidated. This paper focuses on the microscopic features, diagnosis and differential diagnosis of the different organ manifestations of IgG4-RD, and the current concepts of its pathogenesis will also be addressed. PMID:23264201

Detlefsen, Sönke

2013-05-01

78

Clinical features of patients with IgG4-related disease complicated with perivascular lesions.  

PubMed

Abstract Objective. To define the clinical features of IgG4-related disease (IgG4-RD) complicated with perivascular lesions. Methods. The clinical features of seven patients with IgG4-RD and perivascular lesions diagnosed at the University of Tsukuba Hospital between October 2008 and October 2013, were analyzed, including clinical background, results of imaging studies, satisfaction of the 2011 comprehensive diagnostic criteria (CDC) for IgG4-RD, laboratory data, distribution of perivascular lesions, involvement of other organs, and response to steroid therapy. Results. We studied six men and one woman with a mean age of 66.9 ± 6.7 years (± SD). Six of seven patients were diagnosed as definite IgG4-RD, while the seventh was considered possible IgG4-RD, based on the CDC for IgG4-RD. Serum IgG4 levels at diagnosis were higher than 135 mg/dl in all seven patients (mean, 933 ± 527). Serum C-reactive protein (CRP) levels were elevated in two only (mean, 1.42 ± 3.56 mg/dl). The perivascular lesions were located in the pulmonary artery (n = 1), thoracic aorta (n = 2), abdominal aorta (n = 6), coronary (n = 1), celiac (n = 1), superior mesenteric (n = 1), renal (n = 2), inferior mesenteric (n = 5), and iliac (n = 3) arteries. In addition to perivascular lesions, six patients showed involvement of other organs. All seven patients were treated with prednisolone (0.6 mg/kg/day), which rapidly improved the perivascular and other organ lesions in six patients (the other one patient have not yet been evaluated due to the short follow-up). Conclusion. Perivascular lesions show wide distribution in patients with IgG4-RD. Serum CRP levels are not necessarily elevated in these patients. Steroid therapy is effective in IgG4-RD and results in resolution of lesions. PMID:24754274

Ebe, Hiroshi; Tsuboi, Hiroto; Hagiya, Chihiro; Takahashi, Hiroyuki; Yokosawa, Masahiro; Hagiwara, Shinya; Hirota, Tomoya; Kurashima, Yuko; Takai, Chinatsu; Miki, Haruka; Asashima, Hiromitsu; Umeda, Naoto; Kondo, Yuya; Ogishima, Hiroshi; Suzuki, Takeshi; Chino, Yusuke; Matsumoto, Isao; Sumida, Takayuki

2015-01-01

79

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

80

[Three cases of IgG4-related disease associated with urinary tract obstruction].  

PubMed

IgG4-related disease (IgG4RD) is a novel clinical entity characterized by tissue infiltration of IgG4-positive plasma cells. We report here 3 cases of IgG4RD associated with urinary tract obstruction. Patient 1 was a 59-year-old male who complained of difficulty on urination. A CT scan showed bilateral ureteral wall thickness, hydronephrosis, and an enlarged prostate. His serum IgG4 was 817 mg/dl. We made a diagnosis of IgG4RD and performed bilateral ureteral stenting and steroid therapy. A significant reduction in the size of the lesion was detected, and IgG4 was decreased to 272 mg/dl. He was doing well after removal of the ureteral stent. Patient 2 was a 51-year-old female who complained of bilateral swelling of the submaxillary gland. A CT scan showed left ureteral wall thickness and hydronephrosis. Her serum IgG4 was 1,020 mg/dl. We made a diagnosis of IgG4RD and performed left ureteral stenting and steroid therapy. A significant reduction in the size of the lesion was detected, and IgG4 was decreased to 337 mg/dl. She was doing well after removal of the ureteral stent. Patient 3 was a 64-year-old male who underwent evaluation for autoimmune pancreatitis. He complained of back pain and bilateral hydronephrosis was detected. His serum IgG4 level was 649 mg/dl. Bilateral ureteral stenting was performed based on a diagnosis of IgG4RD. He did not receive steroid therapy because of poorly-controlled diabetes mellitus. After insertion of the ureteral stent, hydronephrosis and back pain were relieved. We could only find a few case reports in the literature on IgG4RD associated with urinary tract obstruction. It is important for clinicians to bear in mind that IgG4RD sometimes causes urinary tract obstruction. PMID:23971373

Yazawa, Satoshi; Ohara, Rei; Maeda, Takahiro; Kanao, Kent; Hattori, Seiya; Nakajima, Yosuke; Oya, Mototsugu

2013-07-01

81

A rare case of IgG4-related systemic disease manifesting with pancreatic head mass mimicking borderline resectable cancer  

PubMed Central

INTRODUCTION Autoimmune pancreatitis (AIP) is a rare pancreatic disorder among chronic pancreatitis that can mimick pancreatic cancer (PC). Patients with type 1 AIP usually present obstructive jaundice associated with high level of IgG4 in serum and a pancreatic mass at radiological imaging; these disorders may be associated with other organs lesions presenting the same histopathological features, and in these cases AIP should be considered a pancreatic localization of an IgG4-related systemic disease. PRESENTATION OF CASE We report the case of a young man with initial suspect of PC to be treated with surgery, and final diagnosis of AIP in the context of an IgG4-related systemic disease. DISCUSSION Because of its similar features, several algorithms have been proposed for AIP diagnosis, based on combination of clinical/serological and radiological criteria. However, histology represents the only way to obtain definitive diagnosis, even if sometimes it is difficult to obtain biological samples. CONCLUSION IgG4-related systemic disease must be taken into account among differential diagnosis during the workup for PC, in order to avoid unnecessary surgery. PMID:25460484

Franchello, Alessandro; Gonella, Federica; Campra, Donata; Limerutti, Giorgio; Bruno, Mauro; De Angelis, Claudio; Cassine, Davide; Fronda, Gianruggero; Silvestri, Stefano

2014-01-01

82

IgG4 plasma cell myeloma: new insights into the pathogenesis of IgG4-related disease.  

PubMed

IgG4-related disease is a newly described systemic fibroinflammatory process, characterized by increase in IgG4-positive plasma cells. Its pathogenesis, including the role of IgG4, remains poorly understood. Plasma cell myeloma is typically associated with a large monoclonal serum spike, which is frequently of IgG isotype. We sought to identify and characterize a subset of IgG4-secreting myeloma, as it may provide a biological model of disease with high serum levels of IgG4. Six out of 158 bone marrow biopsies (4%) from patients with IgG myeloma expressed IgG4. Four patients were men and two were women, with a mean age of 64 (range 53-87) years. Imaging showed fullness of pancreatic head (1), small non-metabolic lymphadenopathy (1), and bone lytic lesions (6). Two patients developed necrotizing fasciitis. All had elevated serum M-protein (mean 2.4, range 0.5-4.2?g/dl), and none had definite signs or symptoms of IgG4-related disease. Four myelomas had plasmablastic morphology. Four had kappa and two had lambda light chain expression. Three cases expressed CD56. Two patients had a complex karyotype. In conclusion, the frequency of IgG4 myeloma correlates with the normal distribution of IgG4 isoform. The patients with IgG4 myeloma appear to have a high rate of plasmablastic morphology and could be predisposed to necrotizing fasciitis. Despite high serum levels of IgG4, none had evidence of IgG4-related disease. These findings suggest that the increased number of IgG4-positive plasma cells is not the primary etiologic agent in IgG4-related disease. Elevated serum levels of IgG4 is not sufficient to produce the typical disease presentation and should not be considered diagnostic of IgG4-related disease. PMID:24030741

Geyer, Julia T; Niesvizky, Ruben; Jayabalan, David S; Mathew, Susan; Subramaniyam, Shivakumar; Geyer, Alexander I; Orazi, Attilio; Ely, Scott A

2014-03-01

83

Clinical course after corticosteroid therapy in IgG4-related aortitis/periaortitis and periarteritis: a retrospective multicenter study  

PubMed Central

Introduction Immunoglobulin G4 (IgG4)–related aortitis/periaortitis and periarteritis are vascular manifestations of IgG4-related disease. In this disease, the affected aneurysmal lesion has been suspected to be at risk of rupture. In this study, we aimed to clarify the clinical course after corticosteroid therapy in IgG4-related aortitis/periaortitis and periarteritis. Methods We retrospectively evaluated clinical features, including laboratory data, imaging findings and the course after corticosteroid therapy, in 40 patients diagnosed with IgG4-related aortitis/periaortitis and periarteritis on the basis of periaortic/periarterial radiological findings, satisfaction of the comprehensive diagnostic criteria or each organ-specific diagnostic criteria, and exclusion of other diseases. Results The patients were mainly elderly, with an average age of 66.4 years and with a marked male predominance and extensive other organ involvement. Subjective symptoms were scanty, and only a small proportion had elevated serum C-reactive protein levels. The affected aorta/artery were the abdominal aortas or the iliac arteries in most cases. Thirty-six patients were treated with prednisolone, and the periaortic/periarterial lesions improved in most of them during the follow-up period. Two (50.0%) of four patients with luminal dilatation of the affected lesions before corticosteroid therapy had exacerbations of luminal dilatation after therapy, whereas none of the twenty-six patients without it had a new appearance of luminal dilatation after therapy. Conclusions The results of this retrospective multicenter study highlight three important points: (1) the possibility of latent existence and progression of periaortic/periarterial lesions, (2) the efficacy of corticosteroid therapy in preventing new aneurysm formation in patients without luminal dilatation of periaortic/periarterial lesions and (3) the possibility that a small proportion of patients may actually develop luminal dilatation of periaortic/periarterial lesions in IgG4-related aortitis/periaortitis and periarteritis. A larger-scale prospective study is required to confirm the efficacy and safety of corticosteroid therapy in patients with versus those without luminal dilatation and to devise a more useful and safe treatment strategy, including administration of other immunosuppressants. PMID:25056443

2014-01-01

84

Long-term outcomes of first-line treatment with doxycycline in patients with previously untreated ocular adnexal marginal zone B cell lymphoma.  

PubMed

Ocular adnexal lymphoma (OAL) has been associated with Chlamydophila psittaci infection, for which doxycycline has been suggested as a treatment option. We conducted this study to evaluate the long-term results of first-line doxycycline treatment in patients with OAL. Ninety patients with histologically confirmed OAL with marginal zone B cell lymphoma were enrolled. Each patient received one or two cycles of doxycycline (100 mg bid) for 3 weeks. After a median follow-up period of 40.5 months (8-85), the 5-year progression-free survival (PFS) rate was 60.9 %. All patients were alive at the last follow-up date. Thirty-one patients (34 %) showed local treatment failure without systemic spread. However, PFS rate in these patients was 100 % after salvage chemotherapy and/or radiotherapy. PFS was independently predicted in multivariate analysis by the tumor-node-metastasis (TNM) staging (hazard ratio [HR], 4.35; 95 % confidence interval [CI], 2.03-9.32; P?

Han, Jae Joon; Kim, Tae Min; Jeon, Yoon Kyung; Kim, Mee Kum; Khwarg, Sang In; Kim, Chul-Woo; Kim, Il Han; Heo, Dae Seog

2014-10-24

85

Everyday clinical practice in IgG4-related dacryoadenitis and/or sialadenitis: Results from the SMART database.  

PubMed

Objective. Immunoglobulin (Ig)G4-related disease (IgG4-RD) is a new disease entity that has only been identified this century. Clinical information is thus lacking. We established the Sapporo Medical University and Related Institutes Database for Investigation and Best Treatments of IgG4-related Disease (SMART) to clarify the clinical features of IgG4-RD and provide useful information for clinicians. Methods. Participants comprised 122 patients with IgG4-related dacryoadenitis and/or sialadenitis (IgG4-DS), representing lacrimal and/or salivary lesions of IgG4-RD, followed-up in December 2013. We analyzed the sex ratio, mean age at onset, organ dysfunction, history or complications of malignancy, treatments, rate of clinical remission, and relapse. Results. The sex ratio was roughly equal. Mean age at diagnosis was 59.0 years. Positron emission tomography revealed that the ratio of other organ involvements was 61.4%. Complications of malignancy were observed in 7.4% of cases. Glucocorticoid was used to treat 92.1% of cases, and the mean maintenance dose of prednisolone was 4.8 mg/day. Rituximab was added in three cases, and showed good steroid-sparing effect. The clinical remission rate was 73.8%, and the annual relapse rate was 11.5%. Half of the cases experienced relapses within 7 years of initial treatment. Conclusion. We analyzed the clinical features and treatments of IgG4-DS using SMART, providing useful information for everyday clinical practice. PMID:25159154

Yamamoto, Motohisa; Yajima, Hidetaka; Takahashi, Hiroki; Yokoyama, Yoshihiro; Ishigami, Keisuke; Shimizu, Yui; Tabeya, Tetsuya; Suzuki, Chisako; Naishiro, Yasuyoshi; Takano, Ken-Ichi; Yamashita, Ken; Hashimoto, Masato; Keira, Yoshiko; Honda, Saho; Abe, Takashi; Suzuki, Yasuo; Mukai, Masaya; Himi, Tetsuo; Hasegawa, Tadashi; Imai, Kohzoh; Shinomura, Yasuhisa

2014-08-27

86

A Retrospectively Diagnosed Case of IgG4-Related Tubulointerstitial Nephritis Showing Good Renal Outcome and Pathological Progress.  

PubMed

A 74-year-old man was hospitalized for diabetic nephropathy evaluation and assessment of the effect of treatment on his tubulointerstitial nephritis (TIN). When he was 62 years old, he developed polyarthralgia and had superficial lymph node swelling, mildly increased serum creatinine concentration, hypergammaglobulinemia, hypocomplementemia, high serum IL-2R level, and positive titer of antinuclear antibody. Several tissues were biopsied. Mild chronic sialadenitis and reactive lymphadenitis were identified. Renal specimen showed mild glomerular ischemia, extensive storiform fibrosis, and abundant infiltrating monocytes and plasma cells. He was treated with oral prednisolone and cyclophosphamide. After the treatment, most of his clinical parameters quickly returned to within the reference range. However, he developed diabetes mellitus soon after steroid therapy. At the time of rebiopsy, a high level of serum IgG4 was detected. The second renal biopsy showed diabetic nephropathy without any tubulointerstitial damage. The first biopsied tissues were retrospectively investigated. Large numbers of IgG4-positive plasma cells were detected in the kidneys and lymph nodes. A retrospective diagnosis of IgG4-related TIN with lymph node involvement was made. In conclusion, this paper describes a retrospectively diagnosed case of IgG4-related TIN with lymph node involvement, showing good clinical and pathological prognosis. PMID:24563800

Wu, Qiong; Nakazawa, Raima; Tanaka, Hisae; Endoh, Masayuki; Fukagawa, Masafumi

2013-01-01

87

Chlamydia psittaci-negative ocular adnexal marginal zone B-cell lymphomas have biased VH4-34 immunoglobulin gene expression and proliferate in a distinct inflammatory environment.  

PubMed

Ocular adnexal marginal zone B-cell lymphomas (OAMZLs) arise in the connective tissues of the orbit or in the mucosa-associated lymphoid tissue of the conjunctiva. Here, we present the immunological and genetic analyses of 20 primary Chlamydia psittaci (Cp)-negative OAMZLs. Analysis of the immunoglobulin variable heavy chain (IgV(H)) gene usage demonstrated a significant preference for V(H)4-34. A combined analysis across all previously published OAMZLs confirmed that this is a general feature of OAMZL, in particular of the Cp-negative group. Our series of OAMZLs did not express the characteristic rheumatoid factor V(H)DJ(H) rearrangements that were previously found in salivary gland- and gastric-marginal zone B-cell lymphomas (MZBCLs). We did not detect the MZBCL-specific chromosomal translocations, t(11;18) API2-MALT1 (mucosa-associated lymphoid tissue1) and t(14;18) IgH/MALT1. Two cases contained a premature stop codon in the A20 gene (TNFAIP3) and one case harbored the activating MYD88 hotspot mutation L265P. Variable nuclear expression of BCL10, NF?B1 (p50) and NF?B2 (p52) suggests that other additional genetic abnormalities affecting the NF?B pathway exist within this group of lymphomas. OAMZL showed variable expression of the chemokine receptor CXCR3 and integrin ?4?7 by the tumor B cells, and low interferon-? and interlukin-4 mRNA levels in the tissue, indicative of an inflammatory environment with features in between those previously found in cutaneous and other extranodal MZBCL. The strongly biased usage of V(H)4-34 in Cp-negative OAMZLs suggests involvement of a particular stimulatory (auto-) antigen in their development. PMID:22382892

van Maldegem, F; Wormhoudt, T A M; Mulder, M M S; Oud, M E C M; Schilder-Tol, E; Musler, A R; Aten, J; Saeed, P; Kersten, M J; Pals, S T; van Noesel, C J M; Bende, R J

2012-07-01

88

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

89

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

90

Recent Advances in the Concept and Pathogenesis of IgG4-Related Disease in the Hepato-Bilio-Pancreatic System  

PubMed Central

Recent studies have proposed nomenclatures of type 1 autoimmune pancreatitis (AIP) (IgG4-related pancreatitis), IgG4-related sclerosing cholangitis (IgG4-SC), IgG4-related cholecystitis, and IgG4-related hepatopathy as IgG4-related disease (IgG4-RD) in the hepato-bilio-pancreatic system. In IgG4-related hepatopathy, a novel concept of IgG4-related autoimmune hepatitis (AIH) with the same histopathological features as AIH has been proposed. Among organs involved in IgG4-RD, associations with pancreatic and biliary lesions are most frequently observed, supporting the novel concept of “biliary diseases with pancreatic counterparts.” Targets of type 1 AIP and IgG4-SC may be periductal glands around the bile and pancreatic ducts. Based on genetic backgrounds, innate and acquired immunity, Th2-dominant immune status, regulatory T (Treg) or B cells, and complement activation via a classical pathway may be involved in the development of IgG4-RD. Although the role of IgG4 remains unclear in IgG4-RD, IgG4-production is upregulated by interleukin 10 from Treg cells and by B cell activating factor from monocytes/basophils with stimulation of toll-like receptors/nucleotide-binding oligomerization domain-like receptors. Based on these findings, we have proposed a hypothesis for the development of IgG4-RD in the hepato-bilio-pancreatic system. Further studies are necessary to clarify the pathogenic mechanism of IgG4-RD. PMID:25228969

Okazaki, Kazuichi; Yanagawa, Masahito; Mitsuyama, Toshiyuki; Uchida, Kazushige

2014-01-01

91

Recent advances in the concept and pathogenesis of IgG4-related disease in the hepato-bilio-pancreatic system.  

PubMed

Recent studies have proposed nomenclatures of type 1 autoimmune pancreatitis (AIP) (IgG4-related pancreatitis), IgG4-related sclerosing cholangitis (IgG4-SC), IgG4-related cholecystitis, and IgG4-related hepatopathy as IgG4-related disease (IgG4-RD) in the hepato-bilio-pancreatic system. In IgG4-related hepatopathy, a novel concept of IgG4-related autoimmune hepatitis (AIH) with the same histopathological features as AIH has been proposed. Among organs involved in IgG4-RD, associations with pancreatic and biliary lesions are most frequently observed, supporting the novel concept of "biliary diseases with pancreatic counterparts." Targets of type 1 AIP and IgG4-SC may be periductal glands around the bile and pancreatic ducts. Based on genetic backgrounds, innate and acquired immunity, Th2-dominant immune status, regulatory T (Treg) or B cells, and complement activation via a classical pathway may be involved in the development of IgG4-RD. Although the role of IgG4 remains unclear in IgG4-RD, IgG4-production is upregulated by interleukin 10 from Treg cells and by B cell activating factor from monocytes/basophils with stimulation of toll-like receptors/nucleotide-binding oligomerization domain-like receptors. Based on these findings, we have proposed a hypothesis for the development of IgG4-RD in the hepato-bilio-pancreatic system. Further studies are necessary to clarify the pathogenic mechanism of IgG4-RD. PMID:25228969

Okazaki, Kazuichi; Yanagawa, Masahito; Mitsuyama, Toshiyuki; Uchida, Kazushige

2014-09-01

92

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

93

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

94

Multifocal lesions with pancreatic atrophy in IgG4-related autoimmune pancreatitis: report of a case.  

PubMed

We herein report a case of IgG4-related autoimmune pancreatitis (AIP). A 72-year-old male with jaundice visited our hospital complaining of epigastralgia. A blood chemistry analysis revealed elevated serum levels of total bilirubin and DUPAN-II. Computed tomography (CT) revealed irregularly shaped pancreatic masses with a stricture of the main pancreatic duct (MPD) in the head and tail that were interposed by marked atrophy with MPD dilation in the body. F-18 fluorodeoxyglucose (FDG)-positron emission tomography/CT revealed abnormally intense FDG uptake only at the masses. During surgery, another small tumor was also found in the atrophied body; therefore, a total pancreatectomy was performed under the diagnosis of multiple pancreatic cancers. The histological analysis revealed fibrosis with dense and diffuse infiltrations of lymphocytes and IgG4-positive plasma cells. The pancreatic parenchyma of the body was firmly replaced by fibrosis. AIP can lead to the formation of multiple pancreatic lesions, and thus the correct diagnosis is occasionally difficult to establish in atypical cases. PMID:23549930

Kimura, Akifumi; Yamamoto, Junji; Hatsuse, Kazuo; Aosasa, Suefumi; Nishiyama, Kiyoshi; Maejima, Tadashi; Ogata, Sho; Shimazaki, Hideyuki; Kawaguchi, Atsushi; Hase, Kazuo

2014-06-01

95

Intraduct papillary mucinous neoplasm of the pancreas: a tumour linked with IgG4-related disease?  

PubMed Central

Objectives Intraduct papillary mucinous neoplasm (IPMN) is a pancreatic tumour that is often associated with chronic pancreatitis (CP) in the surrounding pancreas. Type 1 autoimmune pancreatitis (AIP) is a fibro-inflammatory condition with characteristic histological features and prominent IgG4+ plasma cells and is part of the spectrum of IgG4-related disease (IgG4-RD). The aim of this study was to determine whether CP associated with pancreatic IPMN commonly represents AIP. Methods We identified two consecutive ‘index’ cases of pancreatic IPMN during routine reporting in which the adjacent pancreas showed morphological features suggestive of AIP. These cases were investigated using the Boston criteria for the histopathological diagnosis of IgG4-RD and the HISORt criteria for the clinical and histopathological diagnosis of AIP. Using the same criteria, we proceeded to a clinical review of 12 extra cases of IPMN in which the tumour or the surrounding pancreas showed significant lymphoplasmacytic inflammation and/or fibrosis. Results Both of the ‘index’ cases fulfilled the HISORt criteria for AIP and both had morphological features characteristic of IgG4-RD using the Boston criteria, although only one possessed features ‘highly suggestive of IgG4-RD’ after immunohistochemistry. Additionally, both ‘index’ cases had radiological features that could represent extrapancreatic manifestations. Review of the 12 additional cases of IPMN revealed no further examples showing co-existent AIP. Conclusion While pancreatic IPMN and AIP may co-exist, most CP associated with IPMN does not represent AIP. PMID:23596150

Bateman, Adrian C; Culver, Emma L; Sommerlad, Matthew; Chetty, Runjan

2013-01-01

96

Lymphoplasmacytic sclerosing pancreatitis without IgG4 tissue infiltration or serum IgG4 elevation: IgG4-related disease without IgG4.  

PubMed

Type 1 autoimmune pancreatitis can be diagnosed by and is synonymous with its pathognomonic histopathologic appearance called lymphoplasmacytic sclerosing pancreatitis. Type 1 autoimmune pancreatitis, also called IgG4-related pancreatitis, is the pancreatic manifestation of IgG4-related disease. However, the role of IgG4 in the pathogenesis of IgG4-related disease is unclear. We describe patients with LPSP without serum or tissue IgG4 abnormalities. From the Mayo Clinic database of autoimmune pancreatitis patients, we identified three patients with histologically confirmed type 1 autoimmune pancreatitis (lymphoplasmacytic sclerosing pancreatitis) who had normal serum IgG4 and no increase in IgG4-positive plasma cells in tissue. We reviewed original clinical records and pathologic specimens, and describe the clinical and histologic features of these three patients. All patients (age/gender: 63/F, 70/M and 68/M) had normal serum IgG and IgG4 levels, and multiple sections of pancreatic histology did not show increased IgG4-positive plasma cells. Two patients were diagnosed retrospectively following pancreatic surgery, one relapsed in another organ and one has remained relapse free. Another patient was diagnosed by pancreatic core biopsy and has suffered multiple relapses that have been controlled by rituximab. These cases highlight the fact that although the currently agreed upon name for type 1 autoimmune pancreatitis is IgG4-related pancreatitis, serum and tissue IgG4 abnormalities are best considered characteristic, but not essential for the diagnosis of this enigmatic condition.Modern Pathology advance online publication, 1 August 2014; doi:10.1038/modpathol.2014.91. PMID:25081756

Hart, Phil A; Smyrk, Thomas C; Chari, Suresh T

2014-08-01

97

Multimodality imaging in adnexal torsion.  

PubMed

Adnexal torsions are one among the causes of acute pelvic pain in females. Commonly occurring adnexal torsions are ovarian either involving the normal ovary with functional cysts or an associated mass. Fallopian tube torsions, torsions involving paraovarian, fimbrial cysts and subserosal fibroids are rare. Here we discuss the multimodality imaging approach for the diagnosis of adnexal torsion, its limitations and mimics. PMID:25528961

Patil, Aruna R; Nandikoor, Shrivalli; Rao, Anuradha; M Janardan, Govindarajan; Kheda, AmithaVikrama; Hari, Mahesh; Basappa, Sharana

2015-02-01

98

Increased numbers of IgG4-positive plasma cells may rarely be seen in lymph nodes of patients without IgG4-related sclerosing disease.  

PubMed

IgG4-related sclerosing disease (IRSD) is a steroid-responsive fibroinflammatory disorder characterized by increased IgG4+ cells. Nodal involvement usually lacks the dense sclerosis seen in extranodal sites, with histologic patterns overlapping with other reactive processes. Twenty-six lymph nodes showing IRSD-related histologic patterns were evaluated for IgG and IgG4 positive cells by immunohistochemistry and correlated with the clinical features. Cases included 7 Castleman disease-like cases (type I pattern), 10 follicular hyperplasia (type II), and 9 plasmacytosis (type III). The mean numbers of IgG4+ cells per high-power field (HPF) were 4.8 (I), 8.4 (II), and 26.6(III), and the mean IgG4/IgG ratios were 0.05 (I), 0.04 (II), and 0.08 (III). Using >50 IgG4+cells/HPF and IgG4/IgG ratio of >0.4 for absolute and relative increases, only 1 case fulfilled both criteria for increased IgG4+ cells, a patient with Hashimoto's thyroiditis without clinical evidence of IRSD. The results suggest that increased IgG4+ cells may rarely be seen in non-IRSD lymph nodes. PMID:21911432

Rollins-Raval, Marian A; Felgar, Raymond E; Krasinskas, Alyssa M; Roth, Christine G

2012-02-01

99

Circulating Th2 memory cells in IgG4-related disease are restricted to a defined subset of subjects with atopy.  

PubMed

IgG4-related disease (IgG4-RD) is characterized by a lymphoplasmacytic infiltrate composed of IgG4(+) plasma cells, tumefactive lesions, obliterative phlebitis, and mild to moderate eosinophilia. It has been suggested that IgG4-RD is characterized by allergic manifestations and is potentially driven by enhanced T-helper type 2 (Th2) responses. We aimed to investigate the potential contribution of atopy to enhanced Th2 responses in IgG4-RD. Peripheral blood mononuclear cells from 39 patients were isolated and subjected to in vitro mitogenic stimulation with PMA and ionomycin. Following stimulation, gated CD3(+) CD4(+) T cells were analyzed for production of the Th2 cytokines IL-4, IL-5, and IL-13. Among the 39 patients analyzed, only the 18 patients who had a history of atopy showed increases in circulating Th2 memory cells. Our results indicate that Th2 responses that have been reported in IgG4-RD may result from concomitant atopic manifestations in disease subjects. PMID:24382311

Mattoo, H; Della-Torre, E; Mahajan, V S; Stone, J H; Pillai, S

2014-03-01

100

CCAAT/enhancer binding protein ? (C/EBP?)(+) M2 macrophages contribute to fibrosis in IgG4-related disease?  

PubMed

IgG4-related disease (IgG4-RD) is a new disease entity characterized by type 2 helper T (Th2)-dominant inflammation and progressive fibrosis. We found the infiltration of strange cell populations in the fibrotic lesions of submandibular gland specimens obtained from 15 patients with IgG4-RD. These cells expressed CCAAT/enhancer binding protein a (C/EBP?). Many of the cell populations were identified with M2 macrophages. The degrees of infiltration of C/EBP?(+)M2 macrophages and the ratio of fibrotic lesions in the specimens were correlated (r(2) = 0.83, p < 0.01). We also analyzed the expression of C/EBP? in other chronic inflammatory disorders: synovium in rheumatoid arthritis (RA), liver tissue in chronic viral hepatitis, and mucosa in ulcerative colitis. The specimens from RA and chronic viral hepatitis showed infiltration of C/EBP?(+) cells, but there were few C/EBP?-positive cells in ulcerative colitis. Fibrosis is not a major issue in ulcerative colitis. In conclusion, we found the remarkable infiltration of C/EBP?(+)M2 macrophages in cases of chronic inflammation with fibrosis, including IgG4-RD. This primitive study also disclosed that most of C/EBP?(+)M2 macrophages localized in fibrotic lesions, and the degree of the infiltration and the ratio of fibrotic area were correlated. PMID:25180614

Yamamoto, Motohisa; Shimizu, Yui; Takahashi, Hiroki; Yajima, Hidetaka; Yokoyama, Yoshihiro; Ishigami, Keisuke; Tabeya, Tetsuya; Suzuki, Chisako; Matsui, Mikiko; Naishiro, Yasuyoshi; Imai, Kohzon; Shinomura, Yasuhisa

2014-09-01

101

Serious eye and adnexal injuries from fireworks in Northern Ireland before and after lifting of the firework ban- an ophthalmology unit’s experience  

Microsoft Academic Search

Background\\/Aims: To report serious fireworks-related eye and adnexal injuries presenting to the Department of Ophthalmology in the Royal Victoria Hospital, Belfast. To assess the effect of lifting of the legislative ban on fireworks in Northern Ireland in 1996. Method: Twelve year retrospective review from 1990 to 2001 inclusive of all ocular and adnexal injuries from fireworks requiring hospitalisation to the

W. C. Chan; F. A. Knox; F. G. McGinnity; J. A. Sharkey

2004-01-01

102

A condition closely mimicking IgG4-related disease despite the absence of serum IgG4 elevation and IgG4-positive plasma cell infiltration.  

PubMed

We describe a 74-year-old Japanese man with systemic fibroinflammatory conditions closely resembling those of immunoglobulin G4-related disease (IgG4-RD). Radiology and histology showed characteristics of IgG4-related tubulointerstitial nephritis, despite normal serum IgG4 value and scanty IgG4-positive plasma cell infiltration in each organ. This case suggests that a condition closely mimicking IgG4-RD may develop without IgG4-positive plasma cells and those exceptional cases should also be taken into account in the differential diagnosis of IgG4-RD. PMID:24884481

Hara, Satoshi; Kawano, Mitsuhiro; Mizushima, Ichiro; Yamada, Kazunori; Fujita, Kentaro; Harada, Kenichi; Matsumura, Masami; Yamagishi, Masakazu; Sato, Yasuharu; Yamaguchi, Yutaka; Nakanuma, Yasuni; Nagata, Michio

2014-06-01

103

The successful treatment of IgG4-positive colitis with adalimumab in a patient with IgG4-related sclerosing disease--a new subtype of aggressive colitis?  

PubMed

We present the case of a 16 year old girl who developed an aggressive colitis in the context of a prior biopsy proven autoimmune pancreatitis, which presented with obstructive jaundice at the age of 13 year. This history prompted prospective investigation and the discovery of compelling evidence to make a diagnosis of IgG4-related sclerosing disease with extra-pancreatic colonic involvement on the basis of raised serum IgG4 levels and a florid colonic IgG4 plasma cell infiltrate with over 20 IgG4 positive plasma cells/hpf. The colitis was resistant to conventional therapy but responded dramatically to treatment with the anti-TNF? monoclonal antibody, adalimumab. This is the first case to report both the effectiveness of adalimumab in treating IgG4 positive colitis in a patient with IgG4-related sclerosing disease, and to prospectively record resolution of an IgG4 positive colonic infiltrate with immunosuppression. PMID:22647639

Naghibi, Mani; Ahmed, Adil; al Badri, Adnan M; Bateman, Adrian C; Shepherd, Hugh A; Gordon, John N

2013-04-01

104

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

105

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

PubMed Central

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

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

2013-01-01

106

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

PubMed

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

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

2014-04-01

107

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

PubMed

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

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

2013-01-01

108

Antibiotic therapy for ocular infection.  

PubMed Central

Infections of the eye can rapidly damage important functional structures and lead to permanent vision loss or blindness. Broad-spectrum antibiotics should be administered to the appropriate site of infection as soon as a diagnosis is made. Topical drops are preferred for corneal and conjunctival infections. Intravitreal antibiotics, and possibly subconjunctival and parenteral antibiotics, are preferred for endophthalmitis. Parenteral antibiotics are recommended for infection in deep adnexal structures. We review specific aspects of antibiotic therapy for ocular and periocular infection. PMID:7856158

Snyder, R W; Glasser, D B

1994-01-01

109

Adnexal torsion -- a multimodality imaging review.  

PubMed

Adnexal torsion is a gynaecological surgical emergency as prompt restoration of ovarian blood flow may prevent permanent irreversible damage. Patients frequently present with non-specific symptoms and signs and therefore adnexal torsion is often an unexpected radiological diagnosis. Although ultrasound is the initial imaging technique of choice in suspected adnexal torsion, many patients undergo computed tomography (CT) or magnetic resonance imaging (MRI) either as a first-line test following non-specific presentation, or as a confirmatory test following equivocal ultrasound findings. Using multiple techniques, this review illustrates the wide variety of imaging features observed in adnexal torsion enabling a confident diagnosis that may result in a more favourable surgical outcome. PMID:22137723

Wilkinson, C; Sanderson, A

2012-05-01

110

Microcystic adnexal carcinoma: a distinct clinicopathologic entity.  

PubMed

Microcystic adnexal carcinoma is an unusual locally aggressive neoplasm that is important to recognize since it may be confused with benign adnexal neoplasms, particularly desmoplastic trichoepithelioma, trichoadenoma, and syringoma. Six cases are described all of which displayed benign histological features on initial biopsy. Most often these neoplasms presented as solitary flesh-colored indurated plaques on the upper lip. All patients were white, five were women, and the average age was 44-years-old. Islands of basaloid keratinocytes, some of which contained horn cysts and abortive follicles, were embedded in a desmoplastic stroma. In other foci, ducts and gland-like structures lined by a two-cell layer predominated. In deep components individual and thin strands of cells dissected collagen bundles and skeletal muscle and invaded perineural spaces. Despite this, cytologic atypia and mitotic figures were rare. The cell of origin is considered to be a pluripotential adnexal keratinocyte which is capable of both follicular and sweat gland differentiation. PMID:7093897

Goldstein, D J; Barr, R J; Santa Cruz, D J

1982-08-01

111

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. PMID:25285023

Smorgick, Noam; Maymon, Ron

2014-01-01

112

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

113

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

114

Application of robotics in adnexal surgery.  

PubMed

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

115

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

116

21 CFR 866.6050 - Ovarian adnexal mass assessment score test system.  

Code of Federal Regulations, 2011 CFR

...2011-04-01 false Ovarian adnexal mass assessment score test system. 866...Systems § 866.6050 Ovarian adnexal mass assessment score test system. (a) Identification. An ovarian/adnexal mass assessment test system is a device...

2011-04-01

117

[Clinical presentation of cutaneous adnexal tumors].  

PubMed

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

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

2014-09-01

118

Isolated intrapancreatic IgG4-related sclerosing cholangitis  

PubMed Central

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

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

2015-01-01

119

Autoimmune pancreatitis and IgG4-related sclerosing disease  

Microsoft Academic Search

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

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

2010-01-01

120

Isolated intrapancreatic IgG4-related sclerosing cholangitis.  

PubMed

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

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

2015-01-28

121

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

122

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

Federal Register 2010, 2011, 2012, 2013

...Devices; Immunology and Microbiology Devices; Classification of Ovarian Adnexal Mass Assessment Score Test System; Correction AGENCY...76 FR 16292). The document announced the classifying of ovarian adnexal mass assessment score test system into class II...

2011-04-21

123

Microcystic adnexal carcinoma: a report of three cases.  

PubMed

Microcystic adnexal carcinoma is an uncommon adnexal neoplasm. It is highly aggressive locally and its importance lies in the fact that it can be easily confused with benign adnexal tumours, particularly desmoplastic trichoepithelioma, trichoadenoma and syringoma. We report three cases of microcystic adnexal carcinoma of the skin, all three being on the face: two on the lips and one on the left eyebrow. Clinically, the neoplasms were slow growing indurated nodules or plaques. Two of the cases displayed benign features on initial biopsy and their malignant potential could not be established at that stage. On subsequent review, the three neoplasms showed all the characteristic features of microcystic adnexal carcinoma as described by Goldstein et al. and the University of Virginia study. All three patients were treated by surgery in the form of wide excision. They behaved in a highly locally malignant manner with excisions being incomplete in two of the lesions, in spite of taking an adequate margin around the clinically assessable margins. The other recurred after three years in spite of a histologically proven complete excision. Two of the tumours showed infiltration into the underlying muscle with perineural spread. Wider excision in the next stage with frozen section control achieved good clearance and after a five year follow-up period all are symptom free. None of these tumours showed any evidence of distant spread. PMID:9990792

Kumar, K; McGregor, J C; Watson, J D

1998-12-01

124

Five Year Retrospective Case Series of Adnexal Torsion  

PubMed Central

Aims and Objectives: Adnexal torsion is a rare gynaecological emergency that requires an early surgical intervention to save the adnexa from irreversible damage .Our study is about clinical presentation and management approach of adnexal torsion in a tertiary care centre. Study Design: Retrospective study. Materials and Methods: Review of case records during the five years of 2008 November -2013 November in Amrita Institute of Medical Sciences, Kochi, India. Results: Adnexal torsion was found mainly in the reproductive age. Ultrasound was the most commonly used imaging modality. Benign tumours predispose to torsion. Torsion occurred during postovulatory period in many cases. Polycystic ovaries were a risk factor for unexplained torsion in younger age groups. Diagnosis of adnexal torsion was mostly intra operative by direct visualisation of the rotated adnexa. Laparoscopy was the preferred method of surgical intervention. Ovarian conservation was tried in majority of the child bearing age groups. Conclusion: Adnexal torsion is a rare emergency which requires a high index of clinical suspicion for diagnosis as the symptoms are non specific. Imaging helps in diagnosis but most of them are diagnosed intra operatively. Laparoscopic conservative surgery is the preferred surgical approach especially in younger age groups. An early surgical intervention helps in salvaging the adnexa and prevents further complications.

Joy, Smitha; Nayar, Jayashree

2014-01-01

125

Pregnancies complicated by adnexal masses: a case series  

Microsoft Academic Search

Introduction  Adnexal masses ?5 cm in diameter are rare during pregnancy.\\u000a \\u000a \\u000a \\u000a Materials and methods  We present our experience on six pregnant women with adnexal masses diagnosed and operated during pregnancy and\\/or at the\\u000a time of cesarean section.\\u000a \\u000a \\u000a \\u000a Results  Carefully selected cases with a unilateral mass and a solid component with normal tumor marker result can be followed until\\u000a term and adnexectomy can be

N. Cenk Sayin; Hasan A. Inal; Füsun G. Varol

2008-01-01

126

Diagnosis and Management of Adnexal Masses in Pregnancy  

PubMed Central

Widespread use of ultrasound in early pregnancy has led to the detection of incidental adnexal masses more frequently. This article reviews the diagnosis and management options for adnexal masses in pregnancy. The availability of high-resolution ultrasound has made observation to be a viable option in some cases. However, for those masses suspicious of malignancy, at risk of torsion, rupture, or clinically symptomatic, surgical treatment is warranted. Laparoscopy has been successfully used in pregnancy and is safe in experienced and trained hands in properly equipped units. PMID:23741580

Yakasai, Ibrahim Adamu; Bappa, Lawal Abdullahi

2012-01-01

127

Laparoscopic management of pedicle torsion of adnexal cysts.  

PubMed

Pedicle torsion of adnexal cysts results from the increased weight of cysts, longer length of the ovarian and suspensory ligaments or ovarian teratoma. Color doppler ultrasonography is particularly important for detecting suspected cyst torsion. Laparoscopy is becoming more important in the early diagnosis and treatment of adnexal cyst torsion due to its advantages, such as its minimally invasive nature, reduced acute stress reaction and facilitation of direct observation of intra-abdominal lesions. The present study analyzed 28 cases of laparoscopic torsion surgery. The laparoscopic conservative surgery rate was 75% and loss of endocrine function and fertility was avoided. Since the torsion duration is the only variable factor for avoiding oophorectomy, laparoscopic exploration should be performed as soon as possible when pedicle torsion of an adnexal cyst is suspected. Detorsion while retaining ovarian function did not increase the risk of thromboembolism and laparoscopic surgery was minimally invasive with faster recovery times and minimal impact on fertility. Furthermore, the study showed that the laparoscopic management of pedicle torsion of adnexal cysts is safe and reliable with the retention of ovarian endocrine and reproductive function. PMID:23761838

Wang, Yuxia; Xie, Yuanyuan; Wu, Xiaoqing; Li, Lu; Ma, Yifei; Wang, Xiaoyuan

2013-05-01

128

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

129

Ocular sarcoidosis.  

PubMed

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

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

2012-06-01

130

Ocular leprosy.  

PubMed

Ocular involvement in leprosy is estimated to be 70-75%, about 10-50% of leprosy patients suffer from severe ocular symptoms, and blindness occurs in about 5% of patients. The disease leads to many ophthalmologic symptoms and signs in the range of the eyeball itself, as well as of the bulb adnexa, ie, eyebrows, eyelids with eyelashes, and lacrimal drainage system. Especially dangerous are complications of lagophthalmos and corneal hypoanesthesia, neurotrophic or infectious keratitis, and iridocyclitis and cataract formation, which may lead to significant decrease of visual acuity or even blindness. Multidrug treatment rapidly interrupts transmission of Mycobacterium leprae by infectious patients, but even after being completed, it does not guarantee the withholding of ocular complications. PMID:25432813

Grzybowski, Andrzej; Nita, Ma?gorzata; Virmond, Marcos

2015-01-01

131

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

132

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

133

Ocular phototherapy.  

PubMed

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

2013-02-01

134

Large mucinous neoplasm of the appendix mimicking adnexal mass in a postmenopausal woman  

PubMed Central

INTRODUCTION Appendiceal tumors are rare, late-diagnosed neoplasms that may not be differentiated from adnexal masses even by advanced imaging methods and other diagnostic procedures. They may be asymptomatic and remain undiagnosed until surgery. PRESENTATION OF CASE We report a case of 81-year-old postmenopausal woman presented with abdominal pain. A magnetic resonance imaging revealed right adnexal mass. Laparotomy was performed and detected a 12 cm × 9 cm mucinous tumoral mass arising in the appendix. An appendectomy and a right hemicolectomy with ileo-transverse anastomosis were performed. Histopathological examination was revealed appendiceal mucinous neoplasm with low malignancy potential. DISCUSSION Gastrointestinal tumors such as appendiceal tumors can mimicking adnexal mass. Therefore, appendiceal tumor kept in mind in a patient with diagnosed adnexal mass, especially patient had non-specific clinical symptoms, laboratory and radiologic findings. CONCLUSION Gastrointestinal tumors such as appendiceal tumors kept in mind in a patient with diagnosed adnexal mass. PMID:25498566

Akman, Levent; Hursitoglu, Behiye Seda; Hortu, ?smet; Sezer, Taylan; Oztekin, Kemal; Avsargil, Basak Dogan

2014-01-01

135

Ocular onchocerciasis  

PubMed Central

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

Thylefors, B.

1978-01-01

136

Ocular dispersion  

NASA Astrophysics Data System (ADS)

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

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

1999-06-01

137

Ocular neuromyotonia.  

PubMed Central

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

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

1996-01-01

138

Ocular Myasthenia Gravis  

MedlinePLUS

What is ocular myasthenia gravis? Ocular myasthenia gravis is a form of myasthenia gravis (MG) in which the muscles that move the eyes and ... weakened. What are the common symptoms of ocular myasthenia gravis? People with ocular MG have trouble with sight ...

139

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, Mihály; Rózsa, Lajos; Bodó, Imre

2014-01-01

140

21 CFR 866.6050 - Ovarian adnexal mass assessment score test system.  

Code of Federal Regulations, 2013 CFR

... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Tumor Associated Antigen immunological Test Systems § 866.6050 Ovarian adnexal mass...

2013-04-01

141

21 CFR 866.6050 - Ovarian adnexal mass assessment score test system.  

Code of Federal Regulations, 2012 CFR

... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES IMMUNOLOGY AND MICROBIOLOGY DEVICES Tumor Associated Antigen immunological Test Systems § 866.6050 Ovarian adnexal mass...

2012-04-01

142

Microcystic adnexal carcinoma: review of a potential diagnostic pitfall and management.  

PubMed

Microcystic adnexal carcinoma (MAC) is an uncommon, locally aggressive cutaneous neoplasm that usually presents as a slow-growing, asymptomatic lesion on the head or neck. Microcystic adnexal carcinoma frequently is misdiagnosed due to its histologic appearance on superficial biopsy specimens mimicking other follicular neoplasms. Herein, we highlight a case in which a slow-growing lesion was initially diagnosed as a trichoadenoma following superficial biopsy; however, after surgical excision the pathology revealed a locally aggressive MAC. PMID:24738099

McKinley, Lana H; Seastrom, Stacey; Hanly, Andrew J; Miller, Richard A

2014-03-01

143

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

PubMed

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

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

2012-01-01

144

Ocular neovascularization.  

PubMed

Retinal and choroidal vascular diseases constitute the most common causes of moderate and severe vision loss in developed countries. They can be divided into retinal vascular diseases, in which there is leakage and/or neovascularization (NV) from retinal vessels, and subretinal NV, in which new vessels grow into the normally avascular outer retina and subretinal space. The first category of diseases includes diabetic retinopathy, retinal vein occlusions, and retinopathy of prematurity, and the second category includes neovascular age-related macular degeneration (AMD), ocular histoplasmosis, pathologic myopia, and other related diseases. Retinal hypoxia is a key feature of the first category of diseases resulting in elevated levels of hypoxia-inducible factor-1 (HIF-1) which stimulates expression of vascular endothelial growth factor (VEGF), platelet-derived growth factor-B (PDGF-B), placental growth factor, stromal-derived growth factor-1 and their receptors, as well as other hypoxia-regulated gene products such as angiopoietin-2. Although hypoxia has not been demonstrated as part of the second category of diseases, HIF-1 is elevated and thus the same group of hypoxia-regulated gene products plays a role. Clinical trials have shown that VEGF antagonists provide major benefits for patients with subretinal NV due to AMD and even greater benefits are seen by combining antagonists of VEGF and PDGF-B. It is likely that addition of antagonists of other agents listed above will be tested in the future. Other appealing strategies are to directly target HIF-1 or to use gene transfer to express endogenous or engineered anti-angiogenic proteins. While substantial progress has been made, the future looks even brighter for patients with retinal and choroidal vascular diseases. PMID:23329331

Campochiaro, Peter A

2013-03-01

145

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 ...

146

Role of sonography in the diagnostic workup of ovarian and adnexal masses except in pregnancy and during ovarian stimulation.  

PubMed

The main role of imaging is to provide a description of the appearance, size, and location of adnexal lesions and associated abnormalities. In some circumstances, the aggressive potential of an adnexal lesion may be suggested on the basis of the imaging findings, the age of the patient, and the clinical data. PMID:22729945

Loubeyre, Pierre; Patel, Seema; Copercini, Michele; Petignat, Patrick; Dallenbach, Patrick; Dubuisson, Jean Bernard

2012-09-01

147

Laparoscopic management of adnexal torsion in a twin, in vitro fertilization pregnancy at 23 weeks  

PubMed Central

Maternal adnexal torsion in pregnancy, with a reported incidence of 1–10 per 10,000 spontaneous pregnancies, is very uncommon. Since it has been described as a severe complication after controlled ovarian hyper-stimulation for in vitro fertilization (IVF), it is more common in IVF pregnancies. This condition mainly occurs in the first trimester; it is rare during the late second trimester. Conservative management of adnexal torsion by laparoscopy is extended for the management of such conditions during pregnancy. An enlarged uterus could cause operational difficulties in the second trimester. In this paper, we report a case of adnexal torsion in a twin, 23 weeks with IVF pregnancy, that was successfully untwisted by laparoscopy.

Aydin, Turgut

2014-01-01

148

Laparoscopic management of adnexal torsion in a twin, in vitro fertilization pregnancy at 23 weeks.  

PubMed

Maternal adnexal torsion in pregnancy, with a reported incidence of 1-10 per 10,000 spontaneous pregnancies, is very uncommon. Since it has been described as a severe complication after controlled ovarian hyper-stimulation for in vitro fertilization (IVF), it is more common in IVF pregnancies. This condition mainly occurs in the first trimester; it is rare during the late second trimester. Conservative management of adnexal torsion by laparoscopy is extended for the management of such conditions during pregnancy. An enlarged uterus could cause operational difficulties in the second trimester. In this paper, we report a case of adnexal torsion in a twin, 23 weeks with IVF pregnancy, that was successfully untwisted by laparoscopy. PMID:25562010

Aydin, Turgut; Yucel, Burak

2014-12-01

149

Resident lymphocytes in the epidermis and adnexal epithelia of normal dorsolateral thorax of alpacas  

PubMed Central

A small population of resident T-lymphocytes is present in the normal epidermis of skin from humans, mice, sheep, and cattle. The objective of this study was to determine the prevalence of lymphocytes, CD3+ cells (T-lymphocytes) and CD79a+ cells (B-lymphocytes and plasma cells), in the epidermis and adnexal epithelia of alpacas. Skin-biopsy specimens from the normal skin of the dorsolateral thorax of 31 alpacas were examined histologically and immunohistochemically for the presence of CD3+ cells and CD79a+ cells in the epidermis and adnexal epithelia. CD3+ T-lymphocytes, but not CD79a+ cells, were present in the epidermis and adnexal epithelia. Therefore, in the absence of other signs of inflammation, the presence of lymphocytes in these structures in skin-biopsy specimens should be considered normal. PMID:23814357

Clark, Mitzi D.; Peters-Kennedy, Jeanine; Scott, Danny W.

2013-01-01

150

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

PubMed Central

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

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

2007-01-01

151

Intraoperative laparoscopic sonography for improved preoperative sonographic pathologic characterization of adnexal masses.  

PubMed

This study compares the diagnostic accuracy of laparoscopic sonography and transvaginal sonography in the evaluation of adnexal masses. Fifty-eight women underwent transvaginal sonography, which showed 69 adnexal masses, and laparoscopic ultrasonography, which showed 68 adnexal lesions. Conventional gray-scale ultrasonography (using transvaginal sonography and laparoscopic ultrasonography) was performed with morphologic characterization of internal architecture, followed by color Doppler imaging with spectral Doppler analysis where possible. A specific diagnosis was obtained with transvaginal sonography and laparoscopic ultrasonography based on a combination of imaging features. The specific diagnosis obtained with each imaging modality was compared with the final histologic diagnosis as the gold standard in 57 patients with 68 adnexal masses who underwent cystectomy or oophorectomy. The ability of laparoscopic sonography to detect the contralateral ovary and any residual ovarian tissue in the presence of a mass was also compared with transvaginal sonography. The accuracy of laparoscopic ultrasonography in the characterization of adnexal masses was 83.8% and that of transvaginal sonography was 73.5% (P < 0.05). Laparoscopic sonography showed greater morphologic detail than that obtained with transvaginal sonography, allowed more precise and specific characterization of adnexal masses, and detected additional adnexal lesions not evident on preoperative transvaginal sonography. Laparoscopic ultrasonography showed the contralateral ovary in 86.2% of patients, compared with 81.0% using transvaginal sonography (P = 0.51). In addition, laparoscopic ultrasonography was able to demonstrate the presence of residual ovarian tissue in the side affected pathologically in 76.5% of patients compared with 59.4% using transvaginal sonography (P < 0.005). Laparoscopic sonography allows more precise morphologic characterization of internal architecture and histologic diagnosis of adnexal lesions, but it is as yet unable to increase the diagnostic accuracy of borderline or malignant lesions, possibly due to the small sample size. Laparoscopic sonography is superior to transvaginal sonography in the evaluation of residual ovarian tissue in the side affected pathologically, which may help in surgical planning between cystectomy and oophorectomy, and also in the identification of the contralateral ovary, which may potentially increase the detection of bilateral pathologic conditions. PMID:9440109

Yang, W T; Yuen, P M; Ho, S S; Leung, T N; Metreweli, C

1998-01-01

152

Unidirectional ocular flutter  

Microsoft Academic Search

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

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

2007-01-01

153

Thermography in ocular inflammation  

PubMed Central

Background and Objectives: The purpose of this study was to evaluate ocular inflammatory and non-inflammatory conditions using commercially available thermal camera. Materials and Methods: A non-contact thermographic camera (FLIR P 620) was used to take thermal pictures of seven cases of ocular inflammation, two cases of non-inflammatory ocular pathology, and one healthy subject with mild refractive error only. Ocular inflammatory cases included five cases of scleritis, one case of postoperative anterior uveitis, and a case of meibomian gland dysfunction with keratitis (MGD-keratitis). Non-inflammatory conditions included a case of conjunctival benign reactive lymphoid hyperplasia (BRLH) and a case of central serous chorio-retinopathy. Thermal and non-thermal photographs were taken, and using analyzing software, the ocular surface temperature was calculated. Results: Patient with fresh episode of scleritis revealed high temperature. Eyes with MGD-keratitis depicted lower temperature in clinically more affected eye. Conjunctival BRLH showed a cold lesion on thermography at the site of involvement, in contrast to cases of scleritis with similar clinical presentation. Conclusion: Ocular thermal imaging is an underutilized diagnostic tool which can be used to distinguish inflammatory ocular conditions from non-inflammatory conditions. It can also be utilized in the evaluation of tear film in dry eye syndrome. Its applications should be further explored in uveitis and other ocular disorders. Dedicated “ocular thermographic” camera is today's need of the hour. PMID:24347863

Kawali, Ankush A

2013-01-01

154

21 CFR 866.6050 - Ovarian adnexal mass assessment score test system.  

...is a device that measures one or more proteins in serum or plasma. It yields a single result for the likelihood that an adnexal pelvic mass in a woman, for whom surgery is planned, is malignant. The test is for adjunctive use, in the context of a...

2014-04-01

155

Microcystic adnexal carcinoma of the cheek—a case report with dermatoscopy and dermatopathology  

PubMed Central

We present a case report of a microcystic adnexal carcinoma on the cheek of a 67-year-old man. Clinical, dermatoscopic and dermatopathologic images are presented. A search of the literature has not discovered any previously published dermatoscopy images of microcystic adenexal carcinoma.

Inskip, Mike; Magee, Jill

2015-01-01

156

Histopathological Study of Skin Adnexal Tumours—Institutional Study in South India  

PubMed Central

Objective. The aim of this study was correlation of skin adnexal tumors with age, sex, and location and determining its incidence in the Department of Pathology at Dr. D. Y. Patil Medical College and Hospital, Kolhapur, Maharashtra. Material and Methods. 56 cases were included in this study from Jan 2004 to June 2010 with respect to incidence of adnexal tumors, age, and sex distribution. All slides were stained with haematoxylin and eosin and then findings were corroborated with special stains like PAS and reticulin wherever required. Results. 80.36% (45/56) were benign and 19.64% (11/56) were malignant adnexal tumors. The sweat gland tumors constituted the largest group (42.86% 24/56) cases followed by the hair follicle tumors (35.71%, 20/56) of cases and sebaceous gland tumors (21.43%, 12/56) cases. Overall male?:?female ratio was 1.07?:?1. The commonest age group was 51–60 years and the commonest affected body part was head and neck region (64.28%, 36/56) followed by trunk (14.28%, 8/56). Clear cell hidradenoma and pilomatricoma were commonest benign tumors and sebaceous carcinoma was the only malignant tumor seen. Conclusion. The incidence of benign skin adnexal tumors was more as compared to the malignant tumors. Malignant tumors were seen in older age group, usually over 50 years of age. PMID:24649367

Sharma, Ankit; Paricharak, Deepak G.; Nigam, Jitendra Singh; Rewri, Shivani; Soni, Priyanka Bhatia; Omhare, Anita; Sekar, Preethi

2014-01-01

157

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

158

Azithromycin for ocular toxoplasmosis  

PubMed Central

AIMS—To investigate the efficacy of azithromycin in patients with ocular toxoplasmosis.?METHODS—11 immunocompetent patients with ocular toxoplasmosis were treated with azithromycin (500 mg the first day, followed by 250 mg/day for 5 weeks). Ocular and systemic examinations were performed during active retinitis episodes and all patients were followed for at least 1 year.?RESULTS—The intraocular inflammation disappeared within 4 weeks in seven patients, including two cases with progressive retinitis despite previous treatment with pyrimethamine, sulphadiazine, and folinic acid. Recurrence of retinitis occurred in three patients (27%) within the first year of follow up. No systemic side effects of azithromycin were encountered.?CONCLUSION—These results indicate that although azithromycin cannot prevent recurrent disease it may be an effective alternative for patients with ocular toxoplasmosis who cannot tolerate standard therapies.?? Keywords: azithromycin; ocular toxoplasmosis PMID:9924338

Rothova, A.; Bosch-Driessen, L.; van Loon, N. H; Treffers, W

1998-01-01

159

IgG4-related disease: a novel, important but easily missed condition.  

PubMed

Immunoglobulin G4-related disease (IgG4-RD) is a multisystem, fibroinflammatory condition unrecognised in medical science until the last decade. It is characterised by progressive scarring and dysfunction of affected organs and tissues including the pancreas, hepatobiliary tree, kidneys, salivary glands, retroperitoneum and lungs. The diagnosis is made with the presence of numerous IgG4 positive plasma cells within a histologically-distinct chronic inflammatory process; most patients also have elevated serum IgG4. Though early cases were all identified in Japan, subsequent reports clearly demonstrate that IgG4-RD exists worldwide. There are no data confirming the prevalence of IgG4-RD in the West but it is thought to be very rare. Limited awareness of the condition and its heterogeneous presentation frequently results in misdiagnosis. Prompt and correct diagnosis is critical, as a rapid reversal of even advanced disease is often seen with corticosteroid therapy. We present three cases that illustrate some of the typical features of this condition. PMID:23734354

Lees, J S; Church, N; Langdale-Brown, B; Bellamy, C; Gibson, P; Watson, S

2013-01-01

160

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

161

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

PubMed

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

Pieringer, Herwig; Parzer, Ilse; Wöhrer, Adelheid; Reis, Petra; Oppl, Bastian; Zwerina, Jochen

2014-01-01

162

First case of IgG4-related sclerosing cholangitis associated with autoimmune hemolytic anemia.  

PubMed

To our knowledge, patients with immunoglobulin G4-related sclerosing cholangitis (IgG4-SC) associated with autoimmune hemolytic anemia (AIHA) have not been reported previously. Many patients with IgG4-SC have autoimmune pancreatitis (AIP) and respond to steroid treatment. However, isolated cases of IgG4-SC are difficult to diagnose. We describe our experience with a patient who had IgG4-SC without AIP in whom the presence of AIHA led to diagnosis. The patient was a 73-year-old man who was being treated for dementia. Liver dysfunction was diagnosed on blood tests at another hospital. Imaging studies suggested the presence of carcinoma of the hepatic hilus and primary sclerosing cholangitis, but a rapidly progressing anemia developed simultaneously. After the diagnosis of AIHA, steroid treatment was begun, and the biliary stricture improved. IgG4-SC without AIP was thus diagnosed. PMID:25024635

Masutani, Hironori; Okuwaki, Kosuke; Kida, Mitsuhiro; Yamauchi, Hiroshi; Imaizumi, Hiroshi; Miyazawa, Shiro; Iwai, Tomohisa; Takezawa, Miyoko; Koizumi, Wasaburo

2014-07-14

163

Critical evaluation of the specificity of MRI and TVUS for differentiation of malignant from benign adnexal lesions  

Microsoft Academic Search

.   The aim of our work was to study the specificity of MRI in comparison with transvaginal US for differentiation of malignant\\u000a from benign adnexal lesions. A total of 67 patients with clinically suspicious adnexal lesions were evaluated by MRI. Transaxial\\u000a and coronal images were acquired using T1-weighted sequences before and following IV contrast and T2-weighted sequences. In\\u000a all patients

M. Reuter; J.-C. Steffens; U. Schüppler; J. Lüttges; C. Muhle; G. Brinkmann; A. Maschek; D. Weisner; R.-P. Spielmann; M. Heller

1998-01-01

164

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

165

Hyperreactio luteinalis presenting with marked hyperglycemia and bilateral multicystic adnexal masses at 21 weeks gestation.  

PubMed

We present an unusual case in which a 23-year-old nulliparous patient was noted to have bilateral multicystic adnexal masses at 21 weeks gestation. Subsequent severe nausea, vomiting, and hyperglycemia with a serum glucose level of 450 mg/dL led to the diagnosis of gestational diabetes. Gradual development of marked maternal virilization ensued and was associated with a serum testosterone level of 4030 ng/mL (free testosterone level of 224 pg/mL), with normal serum dehydroepiandrostendione, estriol, and cortisol levels, leading to the diagnosis of hyperreactio luteinalis. Following vaginal delivery at 38 weeks gestation, gradual and complete spontaneous resolution of signs, symptoms, adnexal masses, diabetes, and testosterone levels were documented. PMID:16506113

Sherer, David M; Dalloul, Mudar; Khoury-Collado, Fady; Hellman, Mira; Osho, Joseph A; Gupta, Roopa S P; Abulafia, Ovadia

2006-02-01

166

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

PubMed Central

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

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

2010-01-01

167

Ocular immune privilege.  

PubMed

It has been over 60 years since the phrase immune privilege was used by Sir Peter Medawar to describe the lack of an immune response against allografts placed into the ocular microenvironment. Since then, we have come to understand that the mechanisms of ocular immune privilege include unique anatomical features of a blood barrier and a lack of direct lymphatic drainage. Also, we know that the ocular microenvironment is rich with immunosuppressive molecules that influence the activity of immune cells. Moreover, the placement of foreign antigen into the ocular microenvironment can induce a systemic form of tolerance to the foreign antigen called anterior chamber-associated immune deviation (ACAID). Many soluble immunomodulators are found in aqueous humour, and are a mixture of growth factors, cytokines, neuropeptides, and soluble receptors. This is a continuously growing list. The mechanisms of ocular immune privilege induce apoptosis, promote the production of anti-inflammatory cytokines, and mediate the activation of antigen-specific regulatory immunity. These mechanisms of immune privilege also attempt to impose themselves upon immunity within the uveitic eye. The adaptation of several anatomical and biochemical mechanisms to establish an immune privileged microenvironment within the eye makes the eye immunologically unique. It is a tissue site where we may learn how immunity is regulated in inflammation and at rest. Success in translating the lessons of ocular immune privilege to other tissues has the potential to drastically change the therapy and clinical outcomes of autoimmune diseases and allograft survival. PMID:19136922

Taylor, A W

2009-10-01

168

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

169

Epidemiology of Patients Hospitalized for Ocular Trauma in the Chaoshan Region of China, 2001–2010  

PubMed Central

Background The burden and pattern of ocular trauma in China are poorly known and not well studied. We aimed at studying the epidemiological characteristics of patients hospitalized for ocular trauma at major ophthalmology departments in the largest industrial base of plastic toys in China. Methods A retrospective study of ocular trauma cases admitted to 3 tertiary hospitals in China from 1st January 2001 to 31st December 2010 was performed. Results The study included a total of 3,644 injured eyes from 3,559 patients over the 10-year period: 2,008 (55.1%) open-globe injuries, 1,580 (43.4%) closed-globe injuries, 41 (1.1%) chemical injuries, 15 (0.4%) thermal injuries and 678 (18.6%) ocular adnexal injuries. The mean age of the patients was 29.0±16.8 years with a male-to-female ratio of 5.2?1 (P?=?0.007). The most frequent types of injury were work-related injuries (1,656, 46.5%) and home-related injuries (715, 20.1%). The majority of injuries in males (56.2%) and females (36.0%) occurred in the 15–44 age group and 0–14 age group, respectively. The final visual acuity correlated with the initial visual acuity (Spearman’s correlation coefficient?=?0.659; P<0.001). The Ocular Trauma Score also correlated with the final visual acuity (Spearman’s correlation coefficient?=?0.655; P<0.001). Conclusions This analysis provides an epidemiological study of patients who were hospitalized for ocular trauma. Preventive efforts are important for both work-related and home-related eye injuries. PMID:23118997

Cao, He; Li, Liping; Zhang, Mingzhi

2012-01-01

170

MR imaging compared with intraoperative frozen-section examination for the diagnosis of adnexal tumors; correlation with final histology.  

PubMed

The aim was to compare the accuracy of magnetic resonance imaging (MRI) and intraoperative consultation (IC) for the diagnosis of adnexal masses, with reference to final histology. MRI was performed in 136 women with sonographically indeterminate adnexal masses. IC included macroscopic and frozen-section examination. Macroscopic examination and MRI determined size, nature, and presence of vegetations or solid portions within masses. All masses were characterized as benign or malignant according to previously published MR imaging and histopathologic criteria. Sensitivities, specificities, and predictive values for the diagnosis of malignancy of MRI and IC were assessed. Histology revealed 168 adnexal masses (99 benign, 23 borderline and 46 invasive). Frozen sections were examined in 151 cases. Among the 151 adnexal masses studied by both MRI and IC, respective sensitivities, specificities, positive and predictive values of both methods for the diagnosis of malignancy were 89.7% and 84.5%, 91.4% and 100%, 86.7% and 100%, and 93.4% and 91.3%. Sensitivities of MR imaging and frozen section for the diagnosis of serous versus mucinous borderline tumors were 33.3% and 93.3%, and 62.5% and 12.5%, respectively. MRI is less accurate than IC for characterizing adnexal masses. However, MRI may increase the relevance of IC for borderline mucinous tumors. PMID:16547708

Bazot, Marc; Nassar-Slaba, Jinane; Thomassin-Naggara, Isabelle; Cortez, Annie; Uzan, Serge; Daraď, Emile

2006-12-01

171

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

172

Therapy of ocular toxoplasmosis  

Microsoft Academic Search

We performed a prospective multicentre study to evaluate the efficacy of therapeutic strategies currently used for ocular toxoplasmosis in a large number of patients (n=106). Treatment was given for at least four weeks and consisted of three triple drug combinations: group 1, pyrimethamine, sulphadiazine and corticosteroids (n=29); group 2. clindamycin, sulphadiazine and corticosteroids (n=37); and group 3. cotrimoxazole (trimethoprim and

A. Rothova; H. J. Buitenhuis; C. Meenken; G. S. Baarsma; T. N. Boen-Tan; P. T. V. M. de Jong; C. M. C. Schweitzer; Z. Timmerman; J. de Vries; M. J. W. Zaal; A. Kijlstra

1989-01-01

173

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

174

Accuracy of 64-multidetector computed tomography in diagnosis of adnexal tumors  

PubMed Central

Background Adnexal cancers are in fifth place among the tumors with the highest mortality in the female population. The aim of the present study was to evaluate the accuracy of Multi-detector computed tomography (MDCT) on a 64-multislice CT scanner in the detection and differentiation of adnexal masses stages. Methods During the present prospective study, 95 women with a primary diagnosis of ovarian mass in base of clinical examination and ultrasonographic findings underwent preoperative evaluation by a 64-slice MDCT with a section thickness of 0.6 mm, 50% overlap and reconstructed images. Afterward, results of MDCT were compared with surgical and histopathological findings, and the sensitivity, specificity, positive and negative predictive value and accuracy were determined. Results The mean age of patients was 48.63 ± 13.93 years. MDCT diagnosed 25 (26.3%) masses to be benign and 70 (73.7%) to be malignant (sensitivity, specificity, positive and negative predictive value and accuracy were 92.8%, 88.0%, 95.5%, 81.4% and 91.5% respectively). The sensitivity and specificity of MDCT in determining local extension was 72.2% and 93.4% respectively. And the sensitivity and specificity of MDCT in determining peritoneal seeding and liver extension was 81.8% and 93% respectively. Estimated stage was significantly agreed with the surgical (Cohen's Kappa (?) = 0.891) and histopathological findings (? = 0.858). Conclusion MDCT is a highly sensitive and specific diagnostic method in evaluation of adnexal masses and successfully stage the tumor in consistent with surgery and histopathology. PMID:21846406

2011-01-01

175

Complex adnexal mass in pregnancy: predictive value of color Doppler sonography.  

PubMed

We sought to establish color Doppler sonographic criteria specific to benign and malignant neoplasms in pregnant patients for parameters already reported for complex adnexal masses in nongravid patients. Thirty-four patients with complex adnexal masses were evaluated during the second trimester with transabdominal sonography and transvaginal color Doppler sonography. The lowest pulsatility index obtained was chosen to be indicative of histologic type. A pulsatility index of less than 1.0 in a morphologically suspect area was taken to be suggestive of malignancy. Prospective diagnoses made by color Doppler sonography were compared with actual histologic diagnosis. Three malignant ovarian lesions and five tumors of low malignant potential were identified correctly, with a sensitivity of 0.89 and a mean pulsatility index of 0.71 (range, 0.44 to 1.3). The mean pulsatility index for benign masses was 1.21 (range, 0.4 to 2.8) (P = 0.03). The negative predictive value of a pulsatility index greater than 1.0 was 0.93. The positive predictive value and false-positive rate for a pulsatility index less than 1.0, however, were 0.42 and 0.48, respectively. Low impedance was associated with malignant ovarian masses detected during pregnancy. A considerable overlap in blood flow patterns, however, may cause incorrect assignment of malignant potential to some benign lesions. PMID:9315188

Wheeler, T C; Fleischer, A C

1997-06-01

176

Ocular Proton Therapy Centers  

NASA Astrophysics Data System (ADS)

This chapter describes a review of proton therapy (PT) centers and the techniques used for the treatment of ocular lesions. The role of ion beam therapy (IBT) for eye treatments, principally choroidal melanomas, has become well established among the competing treatment modalities. More national centers now offer PT for these lesions, but not necessarily in a hospital environment. Significant improvements in eye treatment planning, patient positioning, and QA dosimetry have been realized, to the benefit of treatment efficiency and accuracy of dose delivery.

Kacperek, Andrzej

177

Laser ocular flash effects  

NASA Astrophysics Data System (ADS)

During this decade, lasers on the modern battlefield will become a directed energy threat to the eyes of ground force military personnel (1, 2, 3). One needs only to reflect on the enormous increase in electro-optical battlefield devices presently being developed to both train and equip troops for combat to suspect that a dramatic increase in accidental and intentional exposure incidence may well occur. Laser rangefinders (single pulse) and designators (multiple pulse) are anticipated to be commonplace in the modern electronic battlefield. While the future may hold to the concept of a laser injury as radiation that 'vaporizes' its target, now we need only to be concerned with those devices that disrupt the complex man-machine interface by ocular injury. Such interfaces are critical to a modern equipped Army, and ocular injury will severely affect this complexity. Laser devices that inflict such ocular damage are easily available and will be prolific in ground battlefield scenarios. The present investigation was designed to incorporate several key features of the military scenario in order to address the question of a low level laser threat to the eye and acute vision.

Zwick, H.; Bloom, K. R.; Lund, D. J.; Beatrice, E. S.

1982-06-01

178

Vestibular-Ocular Reflex  

NSDL National Science Digital Library

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

Marlene Y. Macleish, Ed D.; Bernice R. Mclean, M. E.

2013-01-30

179

[Ocular ischemic syndrome.  

PubMed

A 76-year-old patient presented with a reduced visual acuity of 0.8. The clinical examination revealed rubeosis iridis and dilated retinal veins. In fluorescein angiography peripheral retinal ischemia could be observed and panretinal laser coagulation was immediately started. A comprehensive internistic counselling on the risk factors particularly for ocular ischemic syndrome was refused by the patient. Over time there was a progression of loss of visual acuity to complete visual loss. Magnetic resonance angiography revealed a profound stenosis of the internal carotid artery with complete closure of the left ophthalmic artery and percutaneous transluminal angioplasty was performed in vascular surgery. PMID:25480566

Abraham, S; Feucht, N; Lohmann, C P; Maier, M

2014-12-01

180

Effects of ocular decongestants.  

PubMed

Eight widely used commercially available ocular decongestants were compared on the basis of vasoconstrictive effectiveness. The ability of these preparations to counteract histamine-induced erythema and to block its recurrence when rechallenged after one hour was evaluated in six human subjects in seven sessions. All vasoconstrictors tested were effective. No preparation was statistically different from 0.02% naphazoline hydrochloride in vasoconstrictive effect. In fact, this intermediate concentration of naphazoline (0.02%) was found to be significantly better that the other nonprescription decongestant preparations tested as a group and not significantly different from a group of higher concentrations of naphazoline. PMID:7378008

Abelson, M B; Yamamoto, G K; Allansmith, M R

1980-05-01

181

Ocular injuries caused by fireworks  

Microsoft Academic Search

What are the consequences of suddenly legalizing fireworks sales in a largely rural society? Would the spectrum of ocular injuries caused by fireworks differ from those found in the Western world? This is the first study on ocular injuries caused by fireworks conducted in the Republic of South Africa. We analyzed the presenting features and prospectively followed up all patients

Lewis Mark Levitz; Joanne Karen Miller; Matthias Uwe Harald Drüsedau

1999-01-01

182

Receiver operating characteristic curves of transvaginal Doppler blood flow measurements in benign and malignant adnexal tumors.  

PubMed

The role of receiver operating characteristic curves of transvaginal Doppler velocimetry in predicting malignancy was evaluated in 80 patients with benign and 40 patients with malignant adnexal tumors. The mean values of peak systolic velocity did not differ significantly. Malignant tumors had a significantly higher end diastolic velocity and mean flow velocity than benign tumors. Benign tumors had a significantly higher ratio of peak systolic to end diastolic velocity, pulsatility index, and resistive index than malignant tumors. The diagnostic accuracies in predicting malignancy were as follows: peak systolic velocity, 62%; end diastolic velocity, 79%; ratio of peak systolic to end diastolic velocity, 63%; mean flow velocity, 73%; pulsatility index, 91%; resistive index, RI 92%. Doppler velocimetry analysis allows us to predict the presence of malignancy with limited reliability. PMID:9771608

Takac, I

1998-10-01

183

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

184

Value of positron emission tomography/computed tomography in diagnosis and staging of primary ocular and orbital tumors  

PubMed Central

Accurate and reliable staging methods are crucial for optimal care of patients with ocular and orbital malignancies. Positron emission tomography/computed tomography (PET/CT) has recently emerged as a staging tool in the field of ophthalmic oncology. For detecting primary ocular or orbital lesions, PET/CT does not seem to provide an advantage over clinical ophthalmologic examination or conventional imaging studies such as CT or magnetic resonance imaging of the orbit. However, PET/CT may detect distant metastatic lesions that conventional imaging studies miss. For orbital and ocular adnexal lymphoma, use of PET/CT has been proven to be feasible and is now accepted both as a standard part of the initial staging work-up and for the assessment of response to therapy. For other ophthalmic tumors, PET/CT seems most appropriate for advanced metastatic tumors of the orbit, eyelid, and eye, for which the detection of distant metastasis with 1 comprehensive study may be preferable to performing multiple CT scans with contrast. PMID:23961021

Hui, Ka-Hoi; Pfeiffer, Margaret L.; Esmaeli, Bita

2012-01-01

185

Ocular complications of diabetes mellitus  

PubMed Central

Diabetes mellitus (DM) is a important health problem that induces ernestful complications and it causes significant morbidity owing to specific microvascular complications such as, retinopathy, nephropathy and neuropathy, and macrovascular complications such as, ischaemic heart disease, and peripheral vasculopathy. It can affect children, young people and adults and is becoming more common. Ocular complications associated with DM are progressive and rapidly becoming the world’s most significant cause of morbidity and are preventable with early detection and timely treatment. This review provides an overview of five main ocular complications associated with DM, diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases.

Sayin, Nihat; Kara, Necip; Pekel, Gökhan

2015-01-01

186

Ocular myasthenia gravis: A review  

PubMed Central

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

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

2014-01-01

187

Ocular complications of diabetes mellitus.  

PubMed

Diabetes mellitus (DM) is a important health problem that induces ernestful complications and it causes significant morbidity owing to specific microvascular complications such as, retinopathy, nephropathy and neuropathy, and macrovascular complications such as, ischaemic heart disease, and peripheral vasculopathy. It can affect children, young people and adults and is becoming more common. Ocular complications associated with DM are progressive and rapidly becoming the world's most significant cause of morbidity and are preventable with early detection and timely treatment. This review provides an overview of five main ocular complications associated with DM, diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases. PMID:25685281

Sayin, Nihat; Kara, Necip; Pekel, Gökhan

2015-02-15

188

Corticosteroids for ocular toxoplasmosis  

PubMed Central

Background Ocular infestation with Toxoplasma gondii, a parasite, may result in inflammation in the retina, choroid, and uvea and consequently lead to complications such as glaucoma, cataract, and posterior synechiae. Objectives The objective of this systematic review was to assess the effects of adjunctive use of corticosteroids for ocular toxoplasmosis. Search methods We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 9), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE, (January 1950 to October 2012), EMBASE (January 1980 to October 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to October 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We searched the reference lists of included studies for any additional studies not identified by the electronic searches. We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 11 October 2012. Selection criteria We planned to include randomized and quasi-randomized controlled trials. Eligible trials would have enrolled participants of any age who were immunocompetent and were diagnosed with active ocular toxoplasmosis. Included trials would have compared anti-parasitic therapy plus corticosteroids versus anti-parasitic therapy alone, or different doses or times of initiation of corticosteroids. Data collection and analysis Two authors independently screened titles and abstracts retrieved from the electronic searches. We retrieved full-text articles of studies categorized as ‘unsure’ or ‘include’ after review of the abstracts. Two authors independently reviewed each full-text article. Discrepancies were resolved through discussion. Main results The electronic searches retrieved 368 titles and abstracts. We reviewed 20 full-text articles. We identified no trials eligible for inclusion in this systematic review. Authors' conclusions Although research has identified wide variation in practices regarding use of corticosteroids, our systematic review did not identify evidence from randomized controlled trials for the role of corticosteroids in the management of ocular toxoplasmosis. Several questions remain unanswered by well-conducted randomized trials in this context, including whether use of corticosteroids is more effective than use of anti-parasitic therapy alone, when corticosteroids should be initiated in the treatment regimen (early versus late course of treatment), and which dosage and duration of steroid use is best. These questions are easily amenable to research using a randomized controlled design and they are ethical due to the absence of evidence to support or discourage use of corticosteroids for this condition. The question of foremost importance, however, is whether they should be used as adjunct therapy (that is, additional) to anti-parasitic agents. PMID:23633342

Jasper, Smitha; Vedula, Satyanarayana S; John, Sheeja S; Horo, Saban; Sepah, Yasir J; Nguyen, Quan Dong

2014-01-01

189

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

190

Ocular Screening System  

NASA Technical Reports Server (NTRS)

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

1987-01-01

191

Photorefractor ocular screening system  

NASA Technical Reports Server (NTRS)

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

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

1987-01-01

192

Ocular Tropism of Respiratory Viruses  

PubMed Central

SUMMARY Respiratory viruses (including adenovirus, influenza virus, respiratory syncytial virus, coronavirus, and rhinovirus) cause a broad spectrum of disease in humans, ranging from mild influenza-like symptoms to acute respiratory failure. While species D adenoviruses and subtype H7 influenza viruses are known to possess an ocular tropism, documented human ocular disease has been reported following infection with all principal respiratory viruses. In this review, we describe the anatomical proximity and cellular receptor distribution between ocular and respiratory tissues. All major respiratory viruses and their association with human ocular disease are discussed. Research utilizing in vitro and in vivo models to study the ability of respiratory viruses to use the eye as a portal of entry as well as a primary site of virus replication is highlighted. Identification of shared receptor-binding preferences, host responses, and laboratory modeling protocols among these viruses provides a needed bridge between clinical and laboratory studies of virus tropism. PMID:23471620

Rota, Paul A.; Tumpey, Terrence M.

2013-01-01

193

Movilidad de prótesis ocular Movilidad de prótesis ocular Movilidad de prótesis ocular Movilidad de prótesis ocular Movilidad de prótesis oculares individuales  

Microsoft Academic Search

A clinical investigation was carried out in the Service of Maxillofacial Prosthesis of the Estomatology School of the Superior Institute of Medical Sciences of the Havana City, to determine the mobility of the individual ocular prosthesis applied to 10 patients remitted from the ophthalmology services of different hospitals of this capital, after receiving an ocular enucleating treatment with insertion of

Coralina HAP; Moreno Granados; Alfredo Álvarez Rivero; Nereyda Martínez Suárez

194

Rosai-Dorfman Disease: Report of a Case Associated with IgG4-Related Sclerotic Lesions  

PubMed Central

We describe a rare case of sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) associated with a six-year history of autoimmune pancreatitis, which was controlled by steroid treatment. The patient presented with multiple, cervical and thoracic lymphadenopathy and abnormal, nodular opacities in the lung. Histologically, Rosai-Dorfman disease with numerous IgG4-positive cells was identified in a subcutaneous lymph node in the patient's left forearm. The patient recovered uneventfully with steroid treatment. PMID:23323110

Park, Bong-Hee; Son, Da Hye; Kim, Myung-Hwan; Shim, Tae Sun; Lee, Hee Jin

2012-01-01

195

Rosai-Dorfman Disease: Report of a Case Associated with IgG4-Related Sclerotic Lesions.  

PubMed

We describe a rare case of sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) associated with a six-year history of autoimmune pancreatitis, which was controlled by steroid treatment. The patient presented with multiple, cervical and thoracic lymphadenopathy and abnormal, nodular opacities in the lung. Histologically, Rosai-Dorfman disease with numerous IgG4-positive cells was identified in a subcutaneous lymph node in the patient's left forearm. The patient recovered uneventfully with steroid treatment. PMID:23323110

Park, Bong-Hee; Son, Da Hye; Kim, Myung-Hwan; Shim, Tae Sun; Lee, Hee Jin; Huh, Jooryung

2012-12-01

196

Human ocular biometry?  

PubMed Central

The aim of this study was to examine growth of the human eye globe and cornea from early in gestation to late in adult life. Globe antero-posterior length, horizontal and vertical diameters, corneal horizontal and vertical (white to white) diameters and posterior pole to limbus distances were measured using digital calipers (±0.01 mm) in 541 postmortem eyes. Additional pre- and postnatal data for some of the dimensions were obtained from the literature. All dimensions examined increase rapidly during prenatal development but postnatal growth differs. Growth of globe antero-posterior length, vertical and horizontal diameters as well as corneal vertical and horizontal diameters stops within 1 year after birth. Logistic analysis is consistent with an asymptotic prenatal growth mode and no further growth after its completion around 1 year after birth. Horizontal and vertical globe diameters are the same at all ages but the corneal horizontal diameter is always larger than the vertical diameter. No differences could be detected between males and females in any of the ocular dimensions. Globe and corneal growth take place primarily during the prenatal growth mode and dimensions reach their maxima, shortly after birth. It is suggested that cessation of a growth stimulating signal at birth marks the end of the prenatal growth mode and that the small increases over the next year are due to cells already stimulated. Male and female eyes of the same age have the same globe and cornea dimensions. PMID:22819768

Augusteyn, Robert C.; Nankivil, Derek; Mohamed, Ashik; Maceo, Bianca; Pierre, Faradia; Parel, Jean-Marie

2012-01-01

197

Rabies: ocular pathology.  

PubMed

Ocular pathology in the first European case of human bat-borne rabies is described. The patient was a 30-year-old bat scientist who seven weeks after bat bite developed neurological symptoms and died 23 days later. Rabies virus antigens were detected in brain smears. After extensive virological studies the virus turned out to be a rabies-related virus, closely resembling the Duvenhage virus isolated from bats in South Africa in 1980. By light microscopy focal chronic inflammatory infiltration of the ciliary body and of the choroid was found. PAS-positive exudate was seen in the subretinal and in the outer plexiform layers of the retina, and retinal veins showed endothelial damage and perivascular inflammation. Many of the retinal ganglion cells were destroyed. The presence of rabies-related viral antigen in the retinal ganglion cells was shown by positive cytoplasmic immunofluorescence, though electron microscopy failed to identify definite viral structures in the retina. By immunohistochemistry glial fibrillary acidic protein was observed in the Müller's cells, which are normally negative for this antigen but express it as a reactive change when the retina is damaged. Synaptophysin, a constituent of presynaptic vesicles of normal retinal neurons, was not detected in the retina. PMID:2920157

Haltia, M; Tarkkanen, A; Kivelä, T

1989-01-01

198

A20 deletion is associated with copy number gain at the TNFA/B/C locus and occurs preferentially in translocation-negative MALT lymphoma of the ocular adnexa and salivary glands.  

PubMed

The genetic basis of MALT lymphoma is largely unknown. Characteristic chromosomal translocations are frequently associated with gastric and pulmonary cases, but are rare at other sites. We compared the genetic profiles of 33 ocular adnexal and 25 pulmonary MALT lymphomas by 1 Mb array-comparative genomic hybridization (CGH) and revealed recurrent 6q23 losses and 6p21.2-6p22.1 gains exclusive to ocular cases. High-resolution chromosome 6 tile-path array-CGH identified NF-kappaB inhibitor A20 as the target of 6q23.3 deletion and TNFA/B/C locus as a putative target of 6p21.2-22.1 gain. Interphase fluorescence in situ hybridization showed that A20 deletion occurred in MALT lymphoma of the ocular adnexa (8/42=19%), salivary gland (2/24=8%), thyroid (1/9=11%) and liver (1/2), but not in the lung (26), stomach (45) and skin (13). Homozygous deletion was observed in three cases. A20 deletion and TNFA/B/C gain were significantly associated (p<0.001) and exclusively found in cases without characteristic translocation. In ocular cases, A20 deletion was associated with concurrent involvement of different adnexal tissues or extraocular sites at diagnosis (p=0.007), a higher proportion of relapse (67% versus 37%) and a shorter relapse-free survival (p=0.033). A20 deletion and gain at TNFA/B/C locus may thus play an important role in the development of translocation-negative MALT lymphoma. PMID:19006194

Chanudet, E; Ye, H; Ferry, J; Bacon, C M; Adam, P; Müller-Hermelink, H K; Radford, J; Pileri, S A; Ichimura, K; Collins, V P; Hamoudi, R A; Nicholson, A G; Wotherspoon, A C; Isaacson, P G; Du, M Q

2009-02-01

199

Radiotherapy for ocular tumours  

PubMed Central

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

2013-01-01

200

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

201

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

202

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

203

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.

204

Polymer Hydrogels as Ocular Bandages  

E-print Network

Polymer Hydrogels as Ocular Bandages Matthew Menyo, Bob Scogna, Professor Register #12;An Eye contact lenses, collagen corneal shields #12;What's a Hydrogel? Network of cross linked polymer chains(mPa) Strain (%) Expected Modulus: 30 MPa Average Experimental Modulus: 7.98 MPa #12;Gravimetric Swelling Trial

Petta, Jason

205

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

206

Neuromuscular model of ocular microtremor  

Microsoft Academic Search

This paper investigates two implementations of the neuro-muscular model of the fine tremor of the eye known as ocular microtremor (OMT). The neurological model assumes that the spectrum of tremor reflects the distribution of firing frequencies among oculomotor neurones. The neuro-mechanical model assumes that the OMT spectral peak reflects the mechanical resonance of the eye. The results indicate that: (i)

Noirin F. Sheahan; Davis Coakley; James F. Malone

1992-01-01

207

The Contribution of Qualitative CEUS to the Determination of Malignancy in Adnexal Masses, Indeterminate on Conventional US – A Multicenter Study  

PubMed Central

The aim of this study is to evaluate the efficacy of qualitative analysis of contrast-enhanced ultrasound (CEUS) in discrimination of adnexal masses which were undetermined by conventional ultrasound (US). A total of 120 patients underwent transabdominal CEUS. The initial enhancement time and intensity compared with the uterine myometrium, contrast agent distribution patterns and dynamic changes of enhancement were assessed. The sensitivity (Sen), specificity (Spe), positive predictive value (PPV), negative predictive value (NPV), accuracy (ACC) and Youden’s index were calculated for contrast variables. The gold standard was the histological diagnosis. There were 48 malignant tumors and 72 benign tumors. The enhancement features of malignant masses were different from benign ones. Earlier or simultaneous enhancement with inhomogeneous enhancement yielded the highest capability in differential diagnosis, and Sen, Spe, PPV, NPV, ACC, Youden’s index was 89.6%, 97.2%, 93.2%, 95.6%, 93.3%, and 0.88, respectively. The qualitative evaluation of CEUS is useful in the differential diagnosis of adnexal masses where conventional US is indeterminate. PMID:24736589

Zhang, Xinling; Mao, Yongjiang; Zheng, Rongqin; Zheng, Zhijuan; Huang, Zeping; Huang, Dongmei; Zhang, Jing; Dai, Qing; Zhou, Xiaodong; Wen, Yanling

2014-01-01

208

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

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

2014-07-01

209

Oculoplastic aspects of ocular oncology  

PubMed Central

It is estimated that 5–10% of all cutaneous malignancies involve the periocular region and management of periocular skin cancers account for a significant proportion of the oculoplastic surgeon's workload. Epithelial tumours are most frequently encountered, including basal cell carcinoma, squamous cell carcinoma, and sebaceous gland carcinoma, in decreasing order of frequency. Non-epithelial tumours, such as cutaneous melanoma and Merkel cell carcinoma, rarely involve the ocular adnexae. Although non-surgical treatments for periocular malignancies are gaining in popularity, surgery remains the main treatment modality and has as its main aims tumour clearance, restoration of the eyelid function, protection of the ocular surface, and achieving a good cosmetic outcome. The purpose of this article is to review the management of malignant periocular tumours, with particular emphasis on surgical management. PMID:23196649

Rene, C

2013-01-01

210

Ocular microtremor laser speckle metrology  

Microsoft Academic Search

Ocular Microtremor (OMT) is a continual, high frequency physiological tremor of the eye present in all subjects even when the eye is apparently at rest. OMT causes a peak to peak displacement of around 150nm-2500nm with a broadband frequency spectrum between 30Hz to 120Hz; with a peak at about 83Hz. OMT carries useful clinical information on depth of consciousness and

Mohammed Al-Kalbani; Emilia Mihaylova; Niamh Collins; V. Toal; D. Coakley; G. Boyle

2009-01-01

211

Understanding ocular torticollis in children.  

PubMed

Ocular abnormal head posture (AHP) or torticollis is a frequent sign in pediatric pathology The incidence is 5.6% in ophthalmological practice and 3.19% in pediatric ophthalmological practice. The abnormal head posture is adopted to improve visual acuity maintain binocular single vision, center residual visual field with the body or for cosmetic reasons. Face turn is the most frequent abnormal head posture in pediatric ophthalmology. The more common diseases causing face turn are Duane syndrome, congenital fibrosis of extraocular muscles, nystagmus, refractive errors, visual field defects. The most frequent ocular causes of head tilt in children are congenital nystagmus, superior oblique paresis, dissociated vertical deviation, Brown syndrome, refractive errors. Chin-up or chin-down abnormal head postures are most commonly caused by "A" and "V"-pattern strabismus, palpebral ptosis, nystagmus, refractive errors. Torticollis is not a diagnosis, but it is a sign of an underlying disease. There are ocular diseases which diagnosis is straightforward for general practitioner, pediatricians or pediatric surgeons (horizontal nystagmus, lateral rectus paralysis, ptosis, esotropia), but others less obvious (superior oblique paralysis, Duane syndrome, A and V-pattern strabismus, torsional nystagmus) because of the compensatory head posture, and these last disorders are predisposed to confusion with congenital AHP Interdisciplinary collaboration between ophthalmologist, pediatrician, pediatric surgeon, ENT specialist and neurologist is mandatory in establishing the etiology of AHP Every child with AHP must be examined by an ophthalmologist. PMID:21774381

Boricean, Ioana-Daniela; B?rar, A

2011-01-01

212

[Principles of treatment in ocular burns regarding the ocular surface and limbal stem cells].  

PubMed

The term ocular surface emphasizes the functional interdependence of the nonkeratinizing epithelium of cornea and conjunctiva. The limbal stem cells are responsible for replacement of corneal epithelium following ocular surface injuries. Over the past decades important advances in the management of chemical injury have occurred based on the application of theories on ocular surface and limbal stem cells. PMID:16245740

Potop, V; Dumitrache, Marieta

2005-01-01

213

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

214

21 CFR 886.4360 - Ocular surgery irrigation device.  

Code of Federal Regulations, 2012 CFR

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

2012-04-01

215

21 CFR 886.4360 - Ocular surgery irrigation device.  

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

2014-04-01

216

21 CFR 886.4360 - Ocular surgery irrigation device.  

Code of Federal Regulations, 2010 CFR

...2010-04-01 2010-04-01 false Ocular surgery irrigation device. 886.4360 Section...Surgical Devices § 886.4360 Ocular surgery irrigation device. (a) Identification. An ocular surgery irrigation device is a device...

2010-04-01

217

21 CFR 886.4360 - Ocular surgery irrigation device.  

Code of Federal Regulations, 2011 CFR

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

2011-04-01

218

21 CFR 886.4360 - Ocular surgery irrigation device.  

Code of Federal Regulations, 2013 CFR

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

2013-04-01

219

Benign subclinical syringomatous proliferations adjacent to a microcystic adnexal carcinoma: a tumor mimic with significant patient implications.  

PubMed

Microcystic adnexal carcinoma (MAC) is an uncommon, locally aggressive, malignant cutaneous tumor with pilar and eccrine differentiation. Mohs micrographic surgery is the treatment of choice for this condition, but specific histological findings can complicate MAC removal and leave doubt as to whether the tumor has been completely removed. Here we describe the clinical and pathological characteristics of a case in which a patient with an MAC underwent multiple reexcisions because of the presence of benign subclinical syringomatous proliferations adjacent to the primary lesion. Our case raises awareness of syringomatous proliferation, a benign process histologically similar but behaviorally distinct from a primary MAC. This experience highlights the importance of continued communication between dermatopathologists and dermatologic surgeons in providing quality patient care. PMID:24061399

Boos, Markus D; Elenitsas, Rosalie; Seykora, John; Lehrer, Michael S; Miller, Christopher J; Sobanko, Joseph

2014-02-01

220

Ocular drug delivery systems: An overview  

PubMed Central

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

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

2014-01-01

221

Two-port laparoscopic adnexal surgery with a multichannel port using a wound retractor: is it safe and minimally scarring?  

PubMed

This study aimed to explore and evaluate the feasibility and safety of laparoscopic adnexal surgery using a two-port technique with a multichannel port, using a wound retractor, as previously reported. A series of patients undergoing two-port laparoscopy for a benign pelvic mass were enrolled in this study. To perform two-port laparoscopic surgery, the ancillary 5-mm trocar was inserted at the left iliac fossa under laparoscopic view after umbilical trocar insertion. The inserted umbilical trocar was removed and the skin incision was extended about 1.5 cm with index-finger-passable width. An Alexis wound retractor XS (Applied Medical, Santa Rancha Margarita, CA) was inserted through the umbilical wound. Two trocars were inserted into two fingers of a no. 6 surgical rubber glove and ligated with rubber bands. The wrist portion of the rubber glove covered the wound retractor, and the edge of the wound retractor was clamped with three Babcock clamps to prevent carbon-dioxide gas leakage. Both a 10-mm laparoscope and atraumatic forceps were inserted through the umbilical multichannel port. Laparoscopic adnexal surgery was performed in the usual manner. A total of 19 patients were enrolled. The operative procedures were adnexectomy (n = 8), myomectomy (n = 1), and ovarian cystectomy and/or salpingectomy (n = 10). There were no operative complications, conversion to laparotomy, or additional trocar insertions. The mean operation time was 81.3 +/- 28.7 min. The pathologic diagnosis were mature cystic teratoma (n = 6), benign cyst (n = 4), endometrial cyst (n = 3), serous cystadenoma (n = 3), mucinous cystadenoma (n = 1), leiomyoma (n = 1), and tubo-ovarian abscess (n = 1). The mean postoperative hospital stay was 4.0 +/- 1.3 days. This two-port method seems to be safe and needs no additional cost from the use of the conventional laparoscopic instruments. It is also cosmetically effective and highly appreciated by patients, leaving minimal abdominal scarring. PMID:19694570

Yi, Sang-Wook

2009-12-01

222

Ocular perfusion pressure and ocular blood flow in glaucoma  

PubMed Central

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

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

2013-01-01

223

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

224

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

225

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

226

Interferometry for ocular microtremor measurement.  

PubMed

The eyes of all normal subjects undergo a continuous, low-amplitude, high-frequency tremor called ocular microtremor (OMT). A number of potential clinical applications of OMT have been identified, including the prediction of outcome in coma. To date, OMT has been investigated primarily with an eye-contacting piezoelectric probe. We describe a laser-based, noncontacting, interferometric technique for the measurement of OMT. The technique employs an in-plane-sensitive, phase-modulating speckle interferometer to detect the movement of the sclera, or white of the eye. PMID:18356988

Boyle, G; Coakley, D; Malone, J F

2001-01-01

227

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

228

[Ocular injuries due to allergic mechanism].  

PubMed

The paper presents the main ocular injuries due to allergic mechanism and it point out the actual data about etiopathogenesis of type 1 hypersensitivity and immunologic mechanism involved in allergic keratoconjunctivitis. Then are exposed the classification of ocular allergy, the main signs and symptoms, the paraclinical methods of diagnosis and the actual agents of therapy. PMID:12474434

Nenciu, A; Stefan, C

2002-01-01

229

Ocular manifestations in fetal alcohol syndrome  

Microsoft Academic Search

Eight children with the fetal alcohol syndrome are described with ocular anomalies. They all had a strong history of maternal alcohol abuse throughout pregnancy, especially in the first trimester. All the children had eye abnormalities. These included external eye lesions, Peters' anomaly, lens opacification, ocular motility disorders, and optic nerve hypoplasia.

T Chan; R Bowell; M OKeefe; B Lanigan

1991-01-01

230

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

231

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

232

Custom Ocular Prosthesis: A Palliative Approach  

PubMed Central

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

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

2012-01-01

233

Ocular ischemic syndrome - a systematic review.  

PubMed

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

2012-08-01

234

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

235

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. PMID:25264529

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

2014-01-01

236

Evisceration for the management of ocular trauma.  

PubMed

Despite the eye being surrounded by orbital bones and protective mechanisms such as the blink reflex, it is vulnerable to trauma. The two key issues to consider when presented with a case of ocular trauma are the visual potential of the eye and the risk of sympathetic ophthalmia. The Ocular Trauma Score can be used to assess the visual potential of the injured eye. Surgical management may be either repair or removal of the eye (evisceration or enucleation). Herein we describe a case of ocular trauma and the decision-making process in the management of the injury. PMID:24172777

McAlinden, Colm; Saldanha, Mario; Laws, David

2013-01-01

237

Gender disparities in ocular inflammatory disorders*.  

PubMed

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

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

2015-02-01

238

Gender Disparities in Ocular Inflammatory Disorders*  

PubMed Central

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

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

2014-01-01

239

Human ocular Thelaziasis in Karnataka  

PubMed Central

Thelaziasis is an Arthropod-born disease of the eye and adnexa caused by Thelazia callipaeda, a nematode parasite transmitted by drosophilid flies to carnivores and humans. Because of its distribution mainly confined to South Asian countries and Russia, it is commonly known as Oriental Eye worm. It is often under-reported and not been given its due clinical importance. We report first case of human Thelaziasis from Hassan District, Karnataka. Five creamy-white, translucent worms were removed from the conjunctival sac of a 74-year-old male patient. Based on morphological characters, the worms were identified as nematodes belonging to the genus Thelazia and speciation was confirmed by CDC, Atlanta as callipaeda. Rarity of the disease and its ability to cause both extra and intraocular manifestations leading to ocular morbidity is the reason for presenting this case. From the available data, this is the first case report from Karnataka, India. PMID:25116781

Krishnachary, Prabhakar S; Shankarappa, Vijaykumar G; Rajarathnam, Rajendra; Shanthappa, Mahesh

2014-01-01

240

Ocular lesions in free-living raptors.  

PubMed

In a retrospective study, records of 931 raptors admitted to the Avian Clinic at the New York State College of Veterinary Medicine and to the Owl Rehabilitation Research Foundation were evaluated to determine the prevalence, cause, and distribution of ocular lesions. Some form of ocular lesion was identified in 135 (14.5%) birds. Of these, 90% were the result of physical injury. Collisions accounted for 33% of ocular lesions; gunshot wounds accounted for 11%. Unilateral lesions were more common than bilateral lesions, with the anterior segment being most frequently involved. Hyphema was the most common clinical finding. In a prospective study involving raptors admitted to the Avian Clinic from 1980-1982, it was found that 17 of 61 birds (28%) had some form of ocular lesion. The higher prevalence in this study was attributed to a lower proportion of juvenile cases and to increased detection of subtle lesions, especially those involving the posterior segment. PMID:7174449

Murphy, C J; Kern, T J; McKeever, K; McKeever, L; MacCoy, D

1982-12-01

241

The origin of ocular microtremor in man.  

PubMed

A novel technique for the study of human eye movements was used to investigate the frequency components of ocular drift and microtremor in both eyes simultaneously. The tangential components of horizontal eye accelerations were recorded in seven healthy subjects using light-weight accelerometers mounted on scleral contact lenses during smooth pursuit movements, vestibulo-ocular reflexes and eccentric gaze with and without fixation. Spectral peaks were observed at low (up to 25 Hz) and high (60-90 Hz) frequencies. A multivariate analysis based on partial coherence analysis was used to correct for head movement. After correction, the signals were found to be coherent between the eyes over both low- and high-frequency ranges, irrespective of task, convergence or fixation. It is concluded that the frequency content of ocular drift and microtremor reflects the patterning of low-level drives to the extra-ocular muscle motor units. PMID:10422719

Spauschus, A; Marsden, J; Halliday, D M; Rosenberg, J R; Brown, P

1999-06-01

242

21 CFR 886.1040 - Ocular esthesiometer.  

Code of Federal Regulations, 2010 CFR

...Identification. An ocular esthesiometer is a device, such as a single-hair brush, intended to touch the cornea to assess corneal sensitivity. (b) Classification. Class I (general controls). The device is exempt from the premarket...

2010-04-01

243

21 CFR 886.1040 - Ocular esthesiometer.  

Code of Federal Regulations, 2011 CFR

...Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OPHTHALMIC DEVICES... An ocular esthesiometer is a device, such as a single-hair brush, intended to touch the cornea to assess corneal...

2011-04-01

244

Ocular and visual complications of head injury  

Microsoft Academic Search

PurposeTo evaluate the pattern of ocular and visual complications of head injury.MethodA prospective study of 225 head-injured patients managed at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. For the purpose of extracting vaisual complications, a Neurosurgeon and an Ophthalmologist examined each patient and appropriate investigations were carried out. Patients with ocular morbidity were analysed for age, sex, cause of

T O Odebode; D S Ademola-Popoola; T A Ojo; A A Ayanniyi

2005-01-01

245

Reconsidering the pathogenesis of ocular toxoplasmosis  

Microsoft Academic Search

PURPOSE:To review recent observations regarding the sources of Toxoplasma gondii infection and rates of ocular involvement in cases of infection acquired after birth, and to reconcile them with older observations and widely held beliefs about the pathogenesis of ocular toxoplasmosis.METHOD:A review of pertinent reports from the medical literature.RESULTS:There are several potential sources and routes of infection, including inhalation of spores

Gary N. Holland

1999-01-01

246

The origin of ocular microtremor in man  

Microsoft Academic Search

A novel technique for the study of human eye movements was used to investigate the frequency components of ocular drift and\\u000a microtremor in both eyes simultaneously. The tangential components of horizontal eye accelerations were recorded in seven\\u000a healthy subjects using light-weight accelerometers mounted on scleral contact lenses during smooth pursuit movements, vestibulo-ocular\\u000a reflexes and eccentric gaze with and without fixation.

Alexander Spauschus; J. Marsden; David M. Halliday; Jay R. Rosenberg; P. Brown

1999-01-01

247

Application site dependent ocular absorption of timolol.  

PubMed

Ocular absorption of timolol in rabbits was studied after topical ocular administration of 3H-timolol in an eyedrop or in silicone cylindrical devices that released timolol at 7.2 micrograms/h. The devices were applied in either the inferior or superior conjunctival sac. Timolol concentrations were nearly equal in the inferior and superior portions of ocular tissues when the drug was administered in an eyedrop. Administration in the devices resulted in unequal timolol distribution in the cornea, conjunctiva, sclera, and iris-ciliary body. Timolol concentrations were higher in the part of each tissue that was closer to the site of the device application. Unequal concentrations of timolol in the superior and inferior part of the eye and very low timolol concentrations in the aqueous humor indicated that timolol was absorbed mainly via a noncorneal route from the device placed in the inferior conjunctival sac. Induced blinking at one minute intervals did not change ocular absorption of timolol. Compared with inferior conjunctival sac applications, placement of the devices in the superior conjunctival sac resulted in increased corneal and total ocular absorption of timolol as indicated by higher timolol concentrations in the aqueous humor and by a smaller difference between concentrations in the superior and inferior portions of the examined tissues. The application site dependent ocular absorption indicated that controlled release of timolol in the tear fluid did not result in a uniform timolol distribution in the preocular tear fluid of rabbit eyes. PMID:3246568

Urtti, A; Sendo, T; Pipkin, J D; Rork, G; Repta, A J

1988-01-01

248

Gender differences in ocular blood flow.  

PubMed

Abstract Gender medicine has been a major focus of research in recent years. The present review focuses on gender differences in the epidemiology of the most frequent ocular diseases that have been found to be associated with impaired ocular blood flow, such as age-related macular degeneration, glaucoma and diabetic retinopathy. Data have accumulated indicating that hormones have an important role in these diseases, since there are major differences in the prevalence and incidence between men and pre- and post-menopausal women. Whether this is related to vascular factors is, however, not entirely clear. Interestingly, the current knowledge about differences in ocular vascular parameters between men and women is sparse. Although little data is available, estrogen, progesterone and testosterone are most likely important regulators of blood flow in the retina and choroid, because they are key regulators of vascular tone in other organs. Estrogen seems to play a protective role since it decreases vascular resistance in large ocular vessels. Some studies indicate that hormone therapy is beneficial for ocular vascular disease in post-menopausal women. This evidence is, however, not sufficient to give any recommendation. Generally, remarkably few data are available on the role of sex hormones on ocular blood flow regulation, a topic that requires more attention in the future. PMID:24892919

Schmidl, Doreen; Schmetterer, Leopold; Garhöfer, Gerhard; Popa-Cherecheanu, Alina

2015-02-01

249

Unusual ocular motor findings in multiple sclerosis.  

PubMed

In multiple sclerosis (MS), nystagmus or internuclear ophthalmoplegia (INO) are the usual ocular motor dysfunctions. However, in patients with focal brainstem lesions, other rare manifestations may be observed, such as an isolated ocular motor nerve palsy or complex ocular motor disturbances. We report five MS patients with unusual ocular motor disturbances (bilateral third nerve palsy [n = 2], opsoclonus, Horner's syndrome and one-and-a-half syndrome). We discuss possible correlations between clinical disturbances and MRI abnormalities. Patients were seen in two MS centres. They had a confirmed diagnosis of MS and underwent a brain MRI and a complete neuro-ophthalmological work-up. In one case (opsoclonus), ocular motor manifestations were the first manifestation of MS. In the other four cases they occurred 3 months (Horner syndrome), 6 years and 12 years (bilateral third nerve palsy) and 2 years (one-and-a-half syndrome) after the disease onset, respectively. Four out of five patients were still in a relapsing-remitting form of MS. In the opsoclonus case, there was no evidence of a brainstem lesion. A gadolinium-enhanced lesion (2 cases) or a new T2-weighted lesion located in the brainstem correlated with the clinical presentation. All patients completely or partially recovered after corticosteroid infusions. Our study shows some rare or previously undescribed complex ocular motor symptoms in MS. PMID:16466746

de Seze, J; Vukusic, S; Viallet-Marcel, M; Tilikete, C; Zéphir, H; Delalande, S; Stojkovic, T; Defoort-Dhellemmes, S; Confavreux, C; Vermersch, P

2006-04-15

250

Ocular microtremor laser speckle metrology  

NASA Astrophysics Data System (ADS)

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

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

2009-02-01

251

Crash & Burn: Ocular Injuries due to Fireworks.  

PubMed

Abstract Purpose: To identify the patterns of ocular injury and to determine ocular morbidity resulting from the use of firecrackers. Methods: A prospective observational study of all patients presenting with ocular trauma consequent to fireworks usage in a tertiary eye care center in South India over a one-month period around the autumn festival of Diwali. We also reviewed the published literature from around the world reporting ocular injuries due to firecrackers. Result: 49 patients were included in the study, out of which the vast majority (40/81%) were males. The mean age was 17 years. Almost an equal number of bystanders (24/48.9%) was affected as compared to people handling the fireworks (25/51%). 13 (26.53%) patients had open-globe injury whereas 33 (67.34%) patients had closed-globe injury. Twenty-two (44.8%) patients underwent surgical intervention. Eighteen (36.7%) patients had final vision less then 20/40 (range?=?20/50 to No Perception of Light) with eight patients having no perception of light in the affected eye. Conclusion: Unregulated use of firecrackers can lead to significant ocular morbidity, mainly involving children, young males, and even innocent bystanders. A combination of public awareness and appropriate legislative laws should be formulated regarding the use of fireworks to decrease the load of needless blindness on society. PMID:25310140

Patel, Ravija; Mukherjee, Bipasha

2014-10-13

252

Ocular Findings in Volcanic Fog Induced Conjunctivitis  

PubMed Central

Objective To describe the ocular signs and symptoms of patients complaining of eye irritation due to volcanic fog (vog). Methods The study utilized a non-comparative, retrospective chart review of 30 patients who had a chief complaint of eye irritation, which the subjects attributed to vog. Ocular signs and symptoms are described and related to the ambient concentration of sulfur dioxide (SO2), particulate matter sized 2.5 microns (PM2.5), and vog visibility in O‘ahu during the period of the study. Results Ocular signs noted were conjunctival injection (100%), clear mucous discharge (100%), papillary reaction (100%), punctal edema (80%), eyelid swelling (73.3%) and chemosis (63.3%). Ocular symptoms were itchiness (100%), foreign body sensation (100%), tearing (96.6%) and burning sensation (90%). All patients had concurrent respiratory symptoms. During the period of study, the highest 24-hour average concentration of particulate matter sized 2.5 microns (PM2.5) was 49.04 µg/m3 and vog was visually present. Conclusions Patients complaining of eye irritation due to vog have observable ocular signs and symptoms. PMID:22187513

Lagunzad, John Kenneth D

2011-01-01

253

Neuroretinitis in ocular bartonellosis: a case series  

PubMed Central

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

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

2014-01-01

254

The role of complement in ocular pathology  

PubMed Central

Functionally active complement system and complement regulatory proteins are present in the normal human and rodent eye. Complement activation and its regulation by ocular complement regulatory proteins contribute to the pathology of various ocular diseases including keratitis, uveitis and age-related macular degeneration. Furthermore, a strong relationship between age-related macular degeneration and polymorphism in the genes of certain complement components/complement regulatory proteins is now well established. Recombinant forms of the naturally occurring complement regulatory proteins have been exploited in the animal models for treatment of these ocular diseases. It is hoped that in the future recombinant complement regulatory proteins will be used as novel therapeutic agents in the clinic for the treatment of keratitis, uveitis, and age-related macular degeneration. PMID:18299835

Jha, Purushottam; Bora, Puran S.

2008-01-01

255

Autologous serum for ocular surface diseases.  

PubMed

Autologous serum has been used to treat dry eye syndrome for many years. It contains several growth factors, vitamins, fibronectin and other components that have been considered important for corneal and conjunctival integrity. Serum eye drops are usually prepared as an unpreserved blood solution. The serum is by nature well tolerated and its biochemical properties are somewhat similar to natural tears. Autologous serum eye drops have been reported to be effective for the treatment of severe dry eye-related ocular surface disorders (Sjögren's syndrome), and also other entities such as superior limbic keratoconjunctivitis, graft-versus-host disease, Stevens-Johnson syndrome, ocular cicatricial pemphigoid, recurrent or persistent corneal erosions, neurotrophic keratopathy, Mooren's ulcer, aniridic keratopathy, filtering blebs after trabeculectomy, and post-keratorefractive surgery. The purpose of this study is to review the recently published literature on ocular surface diseases treated with human autologous serum eye drops. PMID:19274411

Quinto, Guilherme Goulart; Campos, Mauro; Behrens, Ashley

2008-01-01

256

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

257

Pinwheel stabilization by ocular dominance segregation.  

PubMed

We present an analytical approach for studying the coupled development of ocular dominance and orientation preference columns. Using this approach we demonstrate that ocular dominance segregation can induce the stabilization and even the production of pinwheels by their crystallization in two types of periodic lattices. Pinwheel crystallization depends on the overall dominance of one eye over the other, a condition that is fulfilled during early cortical development. Increasing the strength of intermap coupling induces a transition from pinwheel-free stripe solutions to intermediate and high pinwheel density states. PMID:19519077

Reichl, Lars; Löwel, Siegrid; Wolf, Fred

2009-05-22

258

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. PMID:25279127

Hessen, Michelle; Akpek, Esen Karamursel

2014-01-01

259

Evolution of the vestibulo-ocular system  

NASA Technical Reports Server (NTRS)

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

Fritzsch, B.

1998-01-01

260

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

261

Ocular immune privilege and CTL tolerance.  

PubMed

The introduction of antigens into the anterior chamber (AC) of the eye, an immune-privileged site, induces immune responses that effectively eliminate ocular pathogens while minimizing tissue damage that can cause blindness. This specialized immune response, termed AC associated immune deviation (ACAID) is thought to be an evolutionary compromise to preserve the delicate microanatomy of the eye while maintaining ocular immune responses. The injection of soluble antigen in the AC of mice results in systemic tolerance characterized by reduced priming for antigen-specific delayed-type hypersensitivity (DTH) and cytotoxic T lymphocyte (CTL) responses. Similarly, the injection of histo incompatible tumors into the AC of mice reduces priming for DTH responses specific to minor antigens. However, robust tumor-specific CTL responses are induced systemically following this treatment that are capable of eliminating a subsequent injection of the same tumors in the skin or the opposite eye. Interestingly, CTL responses induced by administration of tumors in the AC fail to eliminate the primary ocular tumor. In this review, we compare and contrast CTL responses generated by the injection of soluble or tumor-associated antigens in the AC and discuss mechanisms employed to induce ocular CTL tolerance. PMID:15181274

McKenna, Kyle C; Kapp, Judith A

2004-01-01

262

Impression cytology of the ocular surface  

PubMed Central

Impression cytology refers to the application of a cellulose acetate filter to the ocular surface to remove the superficial layers of the ocular surface epithelium. These cells can then be subjected to histological, immunohistological, or molecular analysis. Proper technique is essential as the number of cells sampled can vary considerably. Generally two to three layers of cells are removed in one application but deeper cells can be accessed by repeat application over the same site. Applications for impression cytology include diagnosing a wide range of ocular surface disorders, documenting sequential changes in the conjunctival and corneal surface over time, staging conjunctival squamous metaplasia, and monitoring effects of treatment. It is also a useful investigational tool for analysing ocular surface disease with immunostaining and DNA analysis. It is non-invasive, relatively easy to perform, and yields reliable information about the area sampled with minimal discomfort to the patient. Major ophthalmic centres should develop and introduce this technique into routine clinical practice. This is best achieved with a team approach including the ophthalmologist, pathologist, microbiologist, and the immunologist. PMID:16299150

Singh, R; Joseph, A; Umapathy, T; Tint, N L; Dua, H S

2005-01-01

263

Recent advances in ocular drug delivery.  

PubMed

Amongst the various routes of drug delivery, the field of ocular drug delivery is one of the most interesting and challenging endeavors facing the pharmaceutical scientist. Recent research has focused on the characteristic advantages and limitations of the various drug delivery systems, and further research will be required before the ideal system can be developed. Administration of drugs to the ocular region with conventional delivery systems leads to short contact time of the formulations on the epithelium and fast elimination of drugs. This transient residence time involves poor bioavailability of drugs which can be explained by the tear production, non-productive absorption and impermeability of corneal epithelium. Anatomy of the eye is shortly presented and is connected with ophthalmic delivery and bioavailability of drugs. In the present update on ocular dosage forms, chemical delivery systems such as prodrugs, the use of cyclodextrins to increase solubility of various drugs, the concept of penetration enhancers and other ocular drug delivery systems such as polymeric gels, bioadhesive hydrogels, in-situ forming gels with temperature-, pH-, or osmotically induced gelation, combination of polymers and colloidal systems such as liposomes, niosomes, cubosomes, microemulsions, nanoemulsions and nanoparticles are discussed. Novel ophthalmic delivery systems propose the use of many excipients to increase the viscosity or the bioadhesion of the product. New formulations like gels or colloidal systems have been tested with numerous active substances by in vitro and in vivo studies. Sustained drug release and increase in drug bioavailability have been obtained, offering the promise of innovation in drug delivery systems for ocular administration. Combining different properties of pharmaceutical formulations appears to offer a genuine synergy in bioavailability and sustained release. Promising results are obtained with colloidal systems which present very comfortable conditions of use and prolonged action. PMID:23153114

Achouri, Djamila; Alhanout, Kamel; Piccerelle, Philippe; Andrieu, Véronique

2013-11-01

264

Quemaduras oculares en un centro de referencia oftalmológica de Santiago de Cali, Colombia  

Microsoft Academic Search

Palabras clave: Quemadura ocular; Trauma; Agudeza visual. Ocular burns in an ophthalmology referral center in Santiago de Cali, Colombia SUMMARY Introduction: Ocular burns are a public health problem due to the little conscience about ocular protection, the morbility and the severity of the sequelae that present. The objective is to characterize intentional and no intentional ocular burns of patients that

HUGO HERNÁN OCAMPO; JUAN C AMILO CONTRERAS; ALEXANDER M ARTÍNEZ; CÉSAR AUGUSTO AMAYA; F RANCISCO J AVIER

265

Ocular hypotensive effects of topically administered agmatine in a chronic ocular hypertensive rat model.  

PubMed

Agmatine, a primary polyamine and potential neuromodulator, exhibits a high affinity to the alpha2-adrenergic receptor as well as imidazoline receptors. As alpha2-adrenergic receptor agonists display positive ocular hypotensive effects, we assessed whether agmatine effectively lowers intraocular pressure (IOP) using a chronic ocular hypertensive rat model. We raised IOP in unilateral eyes of Sprague-Dawley rats by cauterizing three episcleral veins per eye. Four weeks later, we topically administered 10(-3) M agmatine solution 4 times a day for 6 consecutive weeks. After confirming the recovery of IOP to pretreatment level at 13 weeks after cauterization, the retinal ganglion cells (RGCs) were retrogradely labeled and counted. Eyes subjected to episcleral vein cauterization (EVC) demonstrated significant increases in IOP (48.39% increase over baseline IOP), and the elevated IOP was well maintained until 12 weeks. Topically administered agmatine powerfully lowered IOP to 30.29% of its pretreatment level, and the associated washout period was about two weeks. EVC was associated with a 55.44% loss of RGCs in the control group, but agmatine appeared to attenuate this RGC loss to 18.65%. Overall, topically administered agmatine appeared to effectively lower IOP and rescue RGCs in a chronic ocular hypertensive rat model. Although the mechanism underlying these effects is not yet established, it is possible that agmatine offers a powerful new ocular hypotensive agent for eyes with chronic ocular hypertension and/or glaucoma. PMID:19782071

Hong, Samin; Kim, Chan Yun; Lee, Won Seok; Shim, Jongwoo; Yeom, Ho Yeop; Seong, Gong Je

2010-01-01

266

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

267

Ocular manifestations of hepatitis C virus infection.  

PubMed

Approximately 3.6 million persons in the United States are infected with the hepatitis C virus (HCV), a condition with both hepatic and extrahepatic sequelae. Although no pathognomonic manifestation of HCV infection in the eye has been demonstrated, associations between HCV infection and various ocular syndromes have been reported in small case series and individual patients. At this time, the ocular manifestations of HCV infections best supported by the literature include a dry eye syndrome similar to Sjögren syndrome, and ischemic retinopathy caused by either an HCV-induced vasculitis or treatment with interferon. Patients with diabetes seem to be more susceptible to interferon retinopathy and to subsequent permanent visual loss. There have been no cases of HCV transmission via corneal transplantation, suggesting that current cadaveric screening protocols are effective in preventing this route of transmission. Screening for HCV should be considered in patients with risk factors for HCV infection who suffer from unexplained ischemic retinopathy or dry eyes. PMID:12441848

Zegans, Michael E; Anninger, William; Chapman, Christopher; Gordon, Stuart R

2002-12-01

268

Ocular problems in military free fall parachutists.  

PubMed

Military free fall parachutists may be unaware of the risk of corneal freezing and desiccation keratitis should their goggles come off during free fall in subfreezing temperatures. We determine the incidence of ocular difficulties in military free fall parachutists and the role freezing temperatures may play in causing these problems. We found that 79% of those who responded to the survey had lost their goggles at least once during free fall and 69% experienced ocular symptoms after goggle loss. Analysis shows a 30-fold increase in the duration of symptoms in subfreezing vs. above-freezing temperatures, with the odds of the ground mission being affected at 7.3 per 100 jumps in the subfreezing group. The rate of goggles coming off per jump is 3.3 times less with >75 jumps. Contact lenses are not protective and photorefractive keratectomy was not detrimental. PMID:12392242

Gruppo, Leonard; Mader, Thomas H; Wedmore, Ian

2002-10-01

269

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

270

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

271

Ocular injuries from improvised explosive devices  

PubMed Central

Purpose To document the characteristics, treatments, and anatomical and functional outcomes of patients with ocular trauma from improvised explosive devices (IEDs). Methods Retrospective review of ocular injuries caused by IEDs, admitted to our tertiary referral centre. Results In total, sixty-one eyes of the 39 patients with an average age of 24 years (range, 20–42 years) were included in the study. In total, 49 (80%) eyes of the patients had open-globe and 12 (20%) had closed-globe injury. In eyes with open-globe injury, intraocular foreign body (IOFB) injury was the most frequently encountered type of injury, observed in 76% of eyes. Evisceration or enucleation was required as a primary surgical intervention in 17 (28%) of the eyes. Twenty-two (36%) eyes had no light perception at presentation. Patients were followed up for an average of 6 months (range, 4–34 months). At the last follow-up, 26 (43%) of 61 eyes had no light perception. Postoperative proliferative vitreoretinopathy (PVR) developed in 12 (50%) of the 24 eyes that underwent vitreoretinal surgery, and four of these eyes became phthisical. There were no cases of endophthalmitis. The presence of open-globe injury and presenting visual acuity worse than 5/200 were significantly associated with poor visual outcome (<5/200, P<0.05). In eyes with open-globe injury, the presence of an IOFB was not associated with poor visual outcome (P>0.05). Conclusion Ocular injuries from IEDs are highly associated with severe ocular damage requiring extensive surgical repair or evisceration/enucleation. Postoperative PVR is a common cause of poor anatomical and visual outcome. PMID:21852806

Erdurman, F C; Hurmeric, V; Gokce, G; Durukan, A H; Sobaci, G; Altinsoy, H I

2011-01-01

272

Ocular quinine toxicity in a sleepwalker.  

PubMed

A 55-year-old woman presented to the emergency department following an episode of severe visual impairment, headache, dizziness and confusion. The patient had been taking quinine sulfate as long-term medication for leg cramps. During an episode of sleepwalking, the patient had taken an overdose of quinine sulfate. Following a thorough investigation and assessment, a diagnosis of ocular quinine toxicity was made. We present this case and highlight the risks of quinine prescription. PMID:24287479

Sinha, Amit; Al Husainy, Sahar

2013-01-01

273

Gender specific issues in hereditary ocular disorders.  

PubMed

Abstract This review is intended to summarize the current knowledge from basic science and clinical medical literature cited within PubMed that pertain to gender-related factors and affect those individuals with hereditary ocular disorders. We consider gender-related biological factors that (a) affect disease onset and progression, (b) gender differences for major X-linked ocular disorders, (c) gender-specific conditions, (d) medications that may influence genetic eye disorders, and finally, (e) gender-related issues that influence the management and quality of life of these patients. Several studies have demonstrated the manner in which sex-related hormones in animal models are capable of influencing cell pathway and survival that are likely to affect hereditary eye disorders. There are very few clinical studies that provide compelling evidence for gender differences in human ocular conditions, other than for a number of X-linked disorders. Disease expression for X-linked disorders may be impacted by genetic mechanisms such as lyonization or uniparental disomy. Clinical evidence regarding the impact of gender-related medical conditions and therapies on eye conditions is extremely limited and primarily based on anecdotal evidence. Gender-specific factors may play a major role in the underlying biological pathways that influence the onset, rate of progression, and clinical findings associated with ocular genetic conditions. Clinicians need to be aware of the variable phenotypes observed in female carriers of X-linked disorders of gender specific issues, many of which are inadequately addressed in the current literature. Clinicians need to be sensitive to gender differences in social, cultural, and religious systems and they should also be aware of how their own gender biases may influence how they counsel patients. Finally, it is clear that the lack of effective clinical studies in this area creates an opportunity for future research that will have real benefits for these patients. PMID:25019185

Iragavarapu, Saradha; Gorin, Michael B

2015-02-01

274

Ocular Surface Parameters in Older Male Veterans  

PubMed Central

Purpose. To characterize ocular surface discomfort and tear film parameters in a veteran population. Methods. Male patients seen in the Miami Veterans Affairs eye clinic aged 50 years or older were recruited to participate in the study. All patients had normal eyelid, corneal, and conjunctival anatomy. Patients filled out the Dry Eye Questionnaire 5 (DEQ5) and underwent measurement of tear film parameters. The main outcome measures were the frequency of ocular surface symptoms and the correlation between symptoms and global, aqueous, and meibomian gland parameters. Results. A total of 263 men participated in the study; 48% had DES based on the presence of severe symptoms. Many men had objective abnormalities in tear function measurements. Using Schirmer information, lid plugging, and meibomian quality to define objective DES, 176 patients (68%) had one or more abnormalities. Of these, 22 (8%) had aqueous tear deficiency, 124 (47%) lipid tear deficiency, and 30 (11%) a mixed pattern. When examining associations between individual clinical parameters and DEQ5 score, the only significant, but weak, correlations were with the global parameters conjunctival and corneal staining (r = 0.16) and TBUT (r = ?0.15). Neither specific aqueous nor meibomian gland measurements were significantly correlated with the presence of symptoms. When considering all measured parameters in a regression model, 8% of the variability in symptoms was explained by the tear parameters. Conclusions. We found that ocular surface symptoms were prevalent in our population. Measurement of standard tear film parameters could not explain the degree of symptoms. This study highlights the need for future research regarding the mechanisms behind ocular surface discomfort in patients with tear film disturbances. PMID:23385801

Galor, Anat; Feuer, William; Lee, David J.; Florez, Hermes; Venincasa, Vincent D.; Perez, Victor L.

2013-01-01

275

Ocular microtremor measurement system: Design and performance  

Microsoft Academic Search

The frequency of ocular microtremor (OMT) is related to the functional status of the brain stem, and thus OMT may be useful\\u000a in the diagnosis and management of brain stem disorders. The paper discusses the design of an OMT measurement system and reports\\u000a quantitative specifications for three portable systems. All systems use a piezo-electric element as the transducer, which\\u000a measures

N. F. Sheahan; D. Coakley; F. Hegarty; C. Bolger; J. Malone

1993-01-01

276

Sources of variance in ocular microtremor  

Microsoft Academic Search

Presents a preliminary investigation of the sources of variance in the measurement of ocular microtremor frequency in a normal population. When the results from both experienced and relatively inexperienced operators are pooled, factors that contribute significantly to the total variance include the measurement procedure (p<0.001), day-to-day variations within subjects (p<0.001), and inter-subject differences (p<0.01). Operator experience plays a role in

N F Sheahan; D Coakley; C Bolger; D ONeill; G Fry; J Phillips; J F Malone

1994-01-01

277

Speckle interferometric system to measure ocular microtremor  

Microsoft Academic Search

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

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

2008-01-01

278

Ocular pathology in trisomy 18 (Edwards' syndrome).  

PubMed

A case of a full-term female with confirmed trisomy 18 who died a few hours after her delivery is presented. In addition to many severe systemic malformations, some ocular findings are described. They include cataract and hypoplasia of optic nerves in both eyes, and juxtapapillary coloboma, retinal dysplasia and Bergmeister's papilla in the left eye. The last finding is a new one in trisomy 18. PMID:3725316

Pe'er, J; Braun, J T

1986-01-01

279

Ocular prosthetic obturator: an innovative medical device.  

PubMed

The following article describes the methods, materials and techniques used in the long-term management of an anophthalmic patient. Following aggressive surgery to remove a squamous cell carcinoma, the patient had no orbital implant inserted at the time of surgery and remains reticent in regard to further surgery. She presented with a large orbital socket requiring imaginative and innovative ocular rehabilitation. This paper describes the materials and methods of fabricating this new and innovative medical device. PMID:24505037

Worrell, Emma

2014-07-01

280

Ocular pathology in congenital heart disease  

Microsoft Academic Search

PurposeTo describe the ocular findings in subjects with congenital heart disease (CHD).Methods In a prospective study, the same observer examined 240 consecutive patients with CHD admitted to the medical centre. Two independent geneticists performed identification of syndromes.ResultsThe commonest anatomic cardiac anomalies were ventricular or atrial septal defects (62), tetralogy of Fallot (39), pulmonary stenosis (25), and transposition of the great

A M Mansour; F F Bitar; E I Traboulsi; K M Kassak; M Y Obeid; A Megarbane; H I Salti

2005-01-01

281

Ocular fluid ferning test and fractals.  

PubMed

The ferning test can be regarded as a crystallization process obtained by simple water subtraction. Such a process is feasible for every kind of ocular fluid (i.e. tears and aqueous, vitreous and subretinal fluids). The ferning test can be described in terms of fractal geometry, as the image characteristics related to this test are consistent with three of the main properties of fractals: self-similarity, fractal dimension and lacunarity. PMID:8259264

Battaglia Parodi, M; Giusto, D D

1993-01-01

282

Resolution, the Grail for Healthy Ocular Inflammation  

PubMed Central

Acute inflammation is a frequent, essential and beneficial response to maintain normal tissue function. PMN are the primary effector cells of acute inflammatory responses and their timely resolution by macrophages from an injured, stressed or infected tissues are required for the successful execution of this routine tissue response. Dysregulation of this fundamental program is a major factor in the global disease burden and contributes to many ocular diseases. Counter-regulatory signals are critical to the controlled activation of innate and adaptive immune responses in the eye and recent studies have identified two circuits in the cornea, uvea and/or retina, namely 15-lipoxygenase and heme-oxygenase, which control inflammation, promote resolution of PMN and afford neuroprotection. The role of these counter-regulator and pro-resolution circuits may provide insight into ocular inflammatory diseases and opportunities to restore stressed ocular tissue to a pre-inflammatory state, namely homeostasis, rather than limiting therapeutic options to palliative inhibition of pro-inflammatory circuits. PMID:20637194

Gronert, Karsten

2010-01-01

283

Mean Platelet Volume in Ocular Behçet's Disease  

PubMed Central

Objective. To determine whether mean platelet volume (MPV) is an indicator of disease severity in ocular Behçet's Disease (BD). Materials and Methods. The study population was 30 newly diagnosed ocular BD patients who presented with active uveitis. These patients had no past history of smoking, drug use, or systemic diseases including diabetes mellitus, hypertension, cardiovascular disease, and renal disease. A control group consisting of 34 healthy individuals was included for comparison. MPV measurements were performed serially upon presentation with active uveitis and at one and three month thereafter in BD group whereas only at presentation in the controls. Results. Upon presentation with active uveitis, the mean MPV levels were 7.88 ± 1.14 femtoliters (fL) for BD group. During the posttreatment follow-up period at first and third months, BD patients demonstrated a mean MPV level of 7.71 ± 1.12?fL and 7.65 ± 1.04?fL, respectively. The mean MPV value of control group, was 8.39 ± 0.66?fL at presentation. Fluctuations in MPV values were not significant in the BD group, while there was a significant difference between the initial measurements of the BD and control groups. Conclusion. MPV measurement in ocular BD is not a predictive laboratory test to determine the clinical improvement in early stages following classical immunosuppressive treatment. PMID:24250258

Türkcü, Fatih Mehmet; Cingü, Abdullah Kür?at; Yüksel, Harun; Ç?nar, Yasin; Akkurt, Meltem; ?ahin, Muhammed; Özkurt, Zeynep; ?ahin, Alparslan; Çaça, ?hsan

2013-01-01

284

Ocular alterations in patients of alopecia areata.  

PubMed

There is paucity of published work on ocular alterations in patients of alopecia areata (AA), especially from the Asian continent. We studied the clinical profile of 83 patients of AA and 80 sex- and age-matched controls to assess and compare the ocular changes, namely punctate opacities, cataract, intraocular tension and retinal changes. The outcome was analyzed with respect to prevalence of atopy, concomitant personal or family history of autoimmune diseases and nail changes in both the groups. The prevalence of atopy and family history of autoimmune diseases was significantly higher in the patient group. Lenticular changes were observed in 40.9% patients (including cataract in 16.9%) and 11.2% controls (P < 0.005). Within the patient group, lenticular involvement occurred with increased frequency in atopics (P = 0.034) and in the presence of family history of autoimmune diseases (P < 0.05). Retinal changes in the form of degenerative changes, pigmentary clumping and abnormal vascular changes were more prevalent (P < 0.001) in the study group. As the ocular changes were not found to correlate with the age, severity or extent of the disease, an initial ophthalmological screening of all patients is suggested. PMID:19382996

Pandhi, Deepika; Singal, Archana; Gupta, Ritika; Das, Gopal

2009-05-01

285

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

286

Influence of Immune Privilege on Ocular Tumor Development  

PubMed Central

Mechanisms that maintain ocular immune privilege may contribute to ocular tumor progression by inhibiting tumoricidal immune responses. Consistent with that notion are observations from transplantable tumor models in mice demonstrating that the tumoricidal activity of CD8+ cytolytic T lymphocytes (CTL) may be inhibited directly by interfering with CTL effector function in the eye or indirectly by abrogating the effector function of CD8+ T cell-activated intratumoral macrophages that are critical for ocular tumor rejection. In addition, epigenetic gene regulation by factors within the ocular tumor environment favors the generation of tumor variants that are resistant to CD8+ CTL. Intratumoral macrophages may be essential for eliminating these variants because, unlike CTL, their tumoricidal activity is nonspecific. Hence, the inhibition of macrophage effector function within the eye, presumably to preserve immune privilege by minimizing ocular immunopathology, may hasten the outgrowth of tumor escape variants which contributes to ocular tumor progression. PMID:20370332

McKenna, Kyle C.; Chen, Peter W.

2011-01-01

287

Inter-observer agreement in describing the ultrasound appearance of adnexal masses and in calculating the risk of malignancy using logistic regression models.  

PubMed

Purpose: To estimate inter-observer agreement with regard to describing adnexal masses using the International Ovarian Tumor Analysis (IOTA) terminology and the risk of malignancy calculated using IOTA logistic regression models LR1 and LR2, and to elucidate what explained the largest inter-observer differences in calculated risk of malignancy. Experimental Design: 117 women with adnexal masses were examined with transvaginal gray scale and power Doppler ultrasound by two independent experienced sonologists who described the masses using IOTA terminology. The risk of malignancy was calculated using LR1 and LR2. A predetermined risk of malignancy cutoff of 10% indicated malignancy. Results: There were 94 benign, four borderline and 19 invasively malignant tumors. There was substantial variability between the two sonologists in measurement results and some variability in assessment of categorical variables (agreement 40-98%, Kappa 0.30-0.91). Inter-observer agreement when classifying tumors as benign or malignant was 84% (98/117), Kappa 0.68 for LR1, and for LR2 85% (99/117), Kappa 0.68. When using LR1 and LR2 the inter-observer difference in calculated risk was >25 percentage units in 9% (11/117) and 12% (14/117) of tumors, respectively. Differences in assessment of wall irregularity, acoustic shadowing, color score and color flow in papillary projections explained most of these largest differences. Conclusions: Inter-observer agreement in classifying tumors as benign or malignant using the risk of malignancy cut off of 10% for LR1 and LR2 was good. However, because risks estimates may differ substantially between sonologists one should be cautious with using the risk value for counseling patients about their individual risk. PMID:25424853

Sladkevicius, Povilas; Valentin, Lil

2014-11-25

288

Sitting at the window to the world--ocular parasites.  

PubMed

Parasitic infections cause significant ophthalmic disease, both in developing countries and in the Western world. The parasitic infections Acanthamoeba keratitis, ocular toxoplasmosis, and ocular toxocariasis are responsible for a significant proportion of ocular pathology. Especially in light of the recent increase of immunocompromised (i.e. using immunosuppressants or HIV) and aged populations, parasitic infections of the eye are rising in number. This reviews aims to describe the pathogenesis, symptoms, diagnosis and management of infection, as well as preventative measures for these three parasitic ocular diseases. PMID:25358598

Barisani-Asenbauer, Talin

2014-10-01

289

Albinism: particular attention to the ocular motor system.  

PubMed

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

290

Ocular manifestations of the potentially lethal rheumatologic and vasculitic disorders.  

PubMed

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

Foster, C Stephen

2013-06-01

291

Ocular shell structures in some Cretaceous trachyleberid Ostracoda  

USGS Publications Warehouse

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

Kontrovitz, M.; Puckett, T.M.

1998-01-01

292

Bioadhesive hyaluronan–chitosan nanoparticles can transport genes across the ocular mucosa and transfect ocular tissue  

Microsoft Academic Search

Gene transfer is considered to be a promising alternative for the treatment of several chronic diseases that affect the ocular surface. The goal of the present work was to investigate the efficacy and mechanism of action of a novel DNA nanocarrier made of hyaluronan (HA) and chitosan (CS), specifically designed for topical ophthalmic gene therapy. With this goal in mind,

M de la Fuente; B Seijo; M J Alonso

2008-01-01

293

Amniotic membrane transplantation for ocular surface reconstruction  

PubMed Central

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

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

1999-01-01

294

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

295

Ocular Dominance and Visual Function Testing  

PubMed Central

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

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

2013-01-01

296

Fabrication of a Custom Ocular Prosthesis  

PubMed Central

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

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

2014-01-01

297

Sources of variance in ocular microtremor.  

PubMed

This study presents a preliminary investigation of the sources of variance in the measurement of ocular microtremor frequency in a normal population. When the results from both experienced and relatively inexperienced operators are pooled, factors that contribute significantly to the total variance include the measurement procedure (p < 0.001), day-to-day variations within subjects (p < 0.001), and inter-subject differences (p < 0.01). Operator experience plays a role in determining the measurement precision: the intra-subject coefficient of variation is about 5% for a very experienced operator, and about 14% for a relatively inexperienced operator. PMID:8161957

Sheahan, N F; Coakley, D; Bolger, C; O'Neill, D; Fry, G; Phillips, J; Malone, J F

1994-02-01

298

Sebaceous carcinoma of the ocular adnexa.  

PubMed

Sebaceous carcinoma accounts for 1-5.5% of all eyelid malignancies. This lesion, traditionally considered among the most lethal of all tumors of the ocular adnexa, occurs more commonly in women and in the elderly and has a predilection for the upper lid. Both clinically and histologically, sebaceous carcinoma may masquerade as benign or less invasive conditions such as chalazion, blepharitis, conjunctivitis, meibomitis, superior limbic keratoconjunctivitis, basal cell carcinoma and carcinoma in situ, resulting in delayed diagnosis and treatment. In this review the incidence, clinical presentation, and prognostic factors (both clinical and histopathologic), and treatment modalities are discussed. PMID:2658172

Kass, L G; Hornblass, A

1989-01-01

299

A Rare Case of Ocular Myositis  

PubMed Central

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

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

2014-01-01

300

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

301

The Association Between Cigarette Smoking and Ocular Diseases  

Microsoft Academic Search

Tobacco smoke is composed of as many as 4,000 active compounds, most of them toxic on either acute or long-term exposure. Many of them are also poisonous to ocular tissues, affecting the eye mainly through ischemic or oxidative mechanisms. The list of ophthalmologic disorders associated with cigarette smoking continues to grow. Most chronic ocular diseases, with the possible exception of

Yoram Solberg; Mordechai Rosner; Michael Belkin

1998-01-01

302

Ocular toxoplasmosis in the United States: recent and remote infections.  

PubMed

We tested all samples from patients with ocular toxoplasmosis sent to the Palo Alto Medical Foundation Toxoplasma Reference Laboratory from June 2004 through August 2010 for serologic evidence of recent Toxoplasma gondii infection. Of 205 patients aged 10-96 years, 11.7% had recent infection. Many people develop ocular disease soon after T. gondii infection. PMID:25301214

Jones, Jeffrey L; Bonetti, Valerie; Holland, Gary N; Press, Cindy; Sanislo, Steven R; Khurana, Rahul N; Montoya, Jose G

2015-01-15

303

Effects of an erbium:YAG laser on ocular structures  

Microsoft Academic Search

We evaluated the effects of the erbium:YAG laser (2.9 µm wavelength) on ocular structures. Energy was successfully transmitted through a fiberoptic bundle for intraocular and extraocular applications. The wavelength was strongly absorbed by ocular tissues, producing ablations with minimal thermal damage. Our results indicated that the erbium: YAG laser may have potential uses as a photoablative tool to reshape the

Gholam A. Peyman; Naoko Katoh

1987-01-01

304

Dominant frequency content of ocular microtremor from normal subjects  

Microsoft Academic Search

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

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

1999-01-01

305

Ocular flutter in suspected multiple sclerosis: a presenting paroxysmal manifestation  

Microsoft Academic Search

A patient with suspected multiple sclerosis is described who presented with attacks of blurring of vision and ocular flutter. This has not previously been reported as an isolated paroxysmal manifestation of brain stem demyelination. As with other paroxysmal disturbances ocular flutter may present as the first sign of the disease.

D. A. Francis; J. R. Heron

1985-01-01

306

Ocular melanoma: Detection using iodine-123-iodoamphetamine and SPECT imaging  

SciTech Connect

Uptake of iodine-123-iodoamphetamine has been demonstrated in malignant melanoma using planar imaging techniques and has been used to detect an ocular melanoma at 12 hr postinjection. Using SPECT technique, an ocular melanoma is identified in a 64-yr-old male at 1 hr postinjection.

Dewey, S.H.; Leonard, J.C. (Department of Veterans Affairs Medical Center, Oklahoma City, OK (USA))

1990-03-01

307

Resolution of chronic ocular sarcoidosis with antimycobacterial therapy  

PubMed Central

Ocular and cutaneous sarcoidosis is a chronic manifestation of sarcoidosis that remains difficult to treat. Recent investigations demonstrating efficacy with antimicrobial therapy in pulmonary and cutaneous sarcoidosis have been reported. Here, we report dual clinical improvement in cutaneous and ocular sarcoidosis following administration of oral antimycobacterial therapy.

Richmond, Bradley W.; Richter, Kyra; King, Lloyd E.; Drake, Wonder P.

2014-01-01

308

[A case of thymic cyst & thymolipoma with ocular myasthenia gravis].  

PubMed

A 65-year-old woman with ocular myasthenia gravis (MG) and thymic tumor underwent expanded thymectomy. Histologically the tumor was thymic cyst and thymolipoma. To our knowledge, there has been no case reported in medical literatures, which is thymic cyst & thymolipoma with ocular MG. This case suggests some effect of steroid therapy. PMID:8478577

Yamamura, M; Shimizu, Y; Suehiro, S; Miyamoto, T; Nakamura, K

1993-03-01

309

[The morphological substrate and histogenesis of systemic and ocular atherosclerosis].  

PubMed

The atherosclerosis is an complex pathologic process with thrombosis and vessels obstructions. At the cerebral level, atherosclerosis determines lesions especially at the Willis circle vessels, and his peripheral ramifications (ophthalmic artery). The authors presents the atherosclerotic lesions at the level of ocular vessels, and their consequence at the central retinal artery, and other ocular vessels. PMID:7766572

Dumitrache, M; Ani?escu, M; Gheorghe, L

1995-01-01

310

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

311

Efficacy of Topical Immunoglobulins against Experimental Adenoviral Ocular Infection  

PubMed Central

Purpose Presently, there is no U.S. Federal Drug Administration (FDA)–approved antiviral therapy for the treatment of adenoviral (Ad) ocular infections. The goal of the present study was to determine the antiviral efficacy of human immunoglobulin (Ig), a preparation of highly purified and concentrated immunoglobulin (IgG) antibodies isolated from a large pool of human plasma donors, in vitro and on acute Ad replication in the Ad5 New Zealand White (NZW) rabbit ocular model. Methods The antiviral activity of human Ig against multiple wild-type and human ocular isolates of adenovirus serotypes was investigated in vitro by using neutralizing assays in different human epithelial cell lines. In vivo bilateral topical ocular toxicity and antiviral efficacy were evaluated with established Ad5/NZW rabbit ocular models. In vivo Ig antiviral results were compared with those obtained with topical 0.5% cidofovir and saline. Results In three different epithelial cell lines, ?6.25 mg/mL of the Ig neutralized several wild-type adenoviral serotypes that cause ocular infections. A dose of ?10 mg/mL neutralized 88% of ocular isolates of the adenovirus serotypes. After treatment of infected animals, adenovirus-positive cultures per total cultures (days 1–14; P = 0.021), the duration of Ad5 shedding, (P = 0.008), and the mean combined ocular viral titer during the early (days 1–5; P = 0.0001) and the late (days 7–14; P = 0.013) phases of infection were significantly lower in Ig-treated animals than in saline-treated animals and were similar to those in cidofovir-treated animals. Conclusions Ig demonstrated antiviral properties against multiple adenoviral serotypes in vitro and in the Ad5/NZW rabbit ocular model. Further studies are needed to advance topical immunoglobulin for treatment and prophylaxis of ocular infections. PMID:17724203

Nwanegbo, Edward C.; Romanowski, Eric G.; Gordon, Y. Jerold; Gambotto, Andrea

2007-01-01

312

Ocular toxoplasmosis in immunosuppressed nonhuman primates  

SciTech Connect

To investigate the role of cellular immunodeficiency in recurrent toxoplasmic retinochoroiditis, six Cynomolgus monkeys (Macaca fascicularis) with healed toxoplasmic lesions of the retina were immunosuppressed by total lymphoid irradiation. Three months prior to irradiation 30,000 Toxoplasma gondii organisms of the Beverley strain had been inoculated onto the macula of eye in each monkey via a pars plana approach. Toxoplasmic retinochoroiditis developed in each animal, and lesions were allowed to heal without treatment. During total lymphoid irradiation animals received 2000 centigrays (cGy) over a 7-week period. Irradiation resulted in an immediate drop in total lymphocyte counts and decreased ability to stimulate lymphocytes by phytohemagglutinin. Weekly ophthalmoscopic examinations following irradiation failed to show evidence of recurrent ocular disease despite persistent immunodeficiency. Four months after irradiation live organisms were reinoculated onto the nasal retina of the same eye in each animal. Retinochoroidal lesions identical to those seen in primary disease developed in five of six animals. Toxoplasma organisms therefore were able to proliferate in ocular tissue following the administration of immunosuppressive therapy. This study fails to support the hypothesis that cellular immunodeficiency alone will initiate recurrent toxoplasmic retinochoroiditis. Results suggest that reactivation of disease from encysted organisms involves factors other than suppression of Toxoplasma proliferation. If reactivation occurs by other mechanisms, however, cellular immunodeficiency then may allow development of extensive disease.

Holland, G.N.; O'Connor, G.R.; Diaz, R.F.; Minasi, P.; Wara, W.M.

1988-06-01

313

Fluid Transport Phenomena in Ocular Epithelia  

PubMed Central

This article discusses three largely unrecognized aspects related to fluid movement in ocular tissues; namely, a) the dynamic changes in water permeability observed in corneal and conjunctival epithelia under anisotonic conditions; b) the indications that the fluid transport rate exhibited by the ciliary epithelium is insufficient to explain aqueous humor production; and c) the evidence for fluid movement into and out of the lens during accommodation. We have studied each of these subjects in recent years and present an evaluation of our data within the context of the results of others who have also worked on electrolyte and fluid transport in ocular tissues. We propose that 1) the corneal and conjunctival epithelia, with apical aspects naturally exposed to variable tonicities, are capable of regulating their water permeabilities as part of the cell-volume regulatory process, 2) fluid may directly enter the anterior chamber of the eye across the anterior surface of the iris, thereby representing an additional entry pathway for aqueous humor production, and 3) changes in lens volume occur during accommodation, and such changes are best explained by a net influx and efflux of fluid. PMID:18289913

Candia, Oscar A.; Alvarez, Lawrence J.

2008-01-01

314

Ocular Metastatic Renal Carcinoma Presenting With Proptosis.  

PubMed

Metastatic renal carcinoma is the third most common source of ocular and second most common source of orbital metastases. This is the first published case of von Hippel-Lindau (vHL) disease that developed renal cell carcinoma metastatic to an eye with a retinal hemangioblastoma. A 73-year-old woman had a history of vHL disease that included prior retinal hemangioblastomas, 2 cerebellar hemangioblastomas, and bilateral renal cell carcinomas with sacral metastasis. After presenting with progressive, painful proptosis secondary to a large mass observable by ocular CT, an enucleation-orbitotomy was performed, and the surgical specimen was sent for histopathological analysis. The ophthalmic renal metastatic tumor, like the primary tumor, was a clear cell variant that involved both the eyeball and orbit in continuity. The intraocular component was larger than the extraocular portion, which was interpreted as an outward extension of an initial retinal metastasis that probably first settled within a hemangioblastoma. Clusters of ectatic ghost vessels with thickened walls produced by periodic acid Schiff-positive, redundant basement membrane material were partially infiltrated by tumor cells at their periphery, thereby lending some support for this hypothesis. Immunohistochemical positivity for the biomarkers cytokeratin 18, vimentin, carbonic anhydrase IX, PAX2, and PAX 8 confirmed the diagnosis. The patient has refused further treatment. Her anophthalmic socket has comfortably retained a porous polyethylene implant without clinical evidence of local recurrence during 5 months of follow up. PMID:24828963

Rai, Ruju; Jakobiec, Frederick A; Fay, Aaron

2014-05-13

315

Ocular Immune Privilege in the Year 2010: Ocular Immune Privilege and Uveitis  

PubMed Central

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.

2012-01-01

316

Colloidal drug delivery system: amplify the ocular delivery.  

PubMed

Abstract Context: The ocular perceivers are the most voluntarily accessible organs in terms of location in the body, yet drug distribution to these tissues is one of the most intriguing and challenging endeavors and problematic to the pharmaceutical scientist. The most of ocular diseases are treated with topical application of conventional formulation, i.e. solutions, suspensions and ointment. Typically on installation of these conventional formulations, only <5% of the applied dose penetrates the cornea and reaches intraocular tissues, while a major fraction of the instilled dose is wastage due to the presence of many ocular barriers like external barriers, rapid loss of the instilled solution from the precorneal area and nasolacrimal drainage system. Systemic absorption caused systemic side effects varying from mild to life-threatening events. Objective: The main objective of this review is to explore the role of colloidal delivery of drug to minimize the drawbacks associated with them. Methods: This review provides an insight into the various constraints associated with ocular drug delivery, summarizes recent findings and applications of colloidal delivery systems, i.e. nanoparticles, nanosuspensions, liposomes, niosomes, dendrimers and contact lenses containing nanoparticles have the capacity to distribute ocular drugs to categorical target sites and hold promise to revolutionize the therapy of many ocular perceiver diseases and minimized the circumscription of conventional delivery. Conclusion: Form the basis of literature review, it has been found that the novel delivery system have greater impact to maximize ocular drug absorption, and minimize systemic absorption and side effects. PMID:24892625

Ali, Javed; Fazil, Mohd; Qumbar, Mohd; Khan, Nazia; Ali, Asgar

2014-06-01

317

ELECTRICAL SIGNALING IN CONTROL OF OCULAR CELL BEHAVIORS  

PubMed Central

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; Viera, Ana C.; Mannis, Mark; Reid, Brian

2011-01-01

318

Normal Ocular Development in Young Rhesus Monkeys (Macaca mulatta)  

PubMed Central

Purpose The purpose of this study was to characterize normal ocular development in infant monkeys and to establish both qualitative and quantitative relationships between human and monkey refractive development. Methods The subjects were 214 normal rhesus monkeys. Cross-sectional data were obtained from 204 monkeys at about 3 weeks of age and longitudinal data were obtained from 10 representative animals beginning at about 3 weeks of age for a period of up to 5 years. Ocular development was characterized via refractive status, corneal power, crystalline lens parameters, and the eye’s axial dimensions, which were determined by retinoscopy, keratometry, phakometry and A-scan ultrasonography, respectively. Results From birth to about 5 years of age, the growth curves for refractive error and most ocular components (excluding lens thickness and equivalent lens index) followed exponential trajectories and were highly coordinated between the two eyes. However, overall ocular growth was not a simple process of increasing the scale of each ocular component in a proportional manner. Instead the rates and relative amounts of change varied within and between ocular structures. Conclusion The configuration and contribution of the major ocular components in infant and adolescent monkey eyes are qualitatively and quantitatively very comparable to those in human eyes and their development proceeds in a similar manner in both species. As a consequence, in both species the adolescent eye is not simply a scaled version of the infant eye. PMID:17416396

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

2007-01-01

319

Mine blast injuries: ocular and social aspects  

PubMed Central

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

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

2000-01-01

320

Age-Dependent Ocular Dominance Plasticity in Adult Mice  

PubMed Central

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

Lehmann, Konrad; Löwel, Siegrid

2008-01-01

321

Using neural nets to measure ocular refractive errors: a proposal  

NASA Astrophysics Data System (ADS)

We propose the development of a functional system for diagnosing and measuring ocular refractive errors in the human eye (astigmatism, hypermetropia and myopia) by automatically analyzing images of the human ocular globe acquired with the Hartmann-Schack (HS) technique. HS images are to be input into a system capable of recognizing the presence of a refractive error and outputting a measure of such an error. The system should pre-process and image supplied by the acquisition technique and then use artificial neural networks combined with fuzzy logic to extract the necessary information and output an automated diagnosis of the refractive errors that may be present in the ocular globe under exam.

Netto, Antonio V.; Ferreira de Oliveira, Maria C.

2002-12-01

322

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

323

Definite Ocular Sarcoidosis Using Endobronchial Ultrasonography with Transbronchial Needle Aspiration  

PubMed Central

Purpose. To introduce a minimally invasive procedure, endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), to obtain a pathologic evidence of a definite ocular sarcoidosis in a patient who initially presented with presumed ocular sarcoidosis with pulmonary involvement. Methods. An EBUS-TBNA procedure was performed at perihilar lymph nodes, subcarina, and right paratrachea of the patient and specimen obtained was sent for histocytopathological studies. Result. Histocytopathological findings revealed aggregates of epithelioid histiocytes forming a noncaseous granuloma, a hallmark of sarcoidosis. Conclusion. EBUS-TBNA should be considered an alternative procedure to provide cytohistopathology proven diagnosis of definite ocular sarcoidosis. PMID:25197595

Warrasak, Sukhuma; Euswas, Ataya; Methasiri, Santa; Nirapathpongporn, Supranee

2014-01-01

324

Ocular cicatricial pemphigoid masquerading as chronic conjunctivitis: a case report  

PubMed Central

Conjunctivitis is often considered an innocuous condition which is self-limiting. This report describes misdiagnosis of ocular cicatricial pemphigoid as chronic conjunctivitis. Ocular cicatricial pemphigoid is a rare autoimmune condition. The clinical features which are useful to distinguish this condition from infective conjunctivitis are discussed. The investigation and treatment of ocular cicatricial pemphigoid is discussed. It is important to recognize nonocular symptoms and signs that may indicate the presence of a more serious underlying pathological condition necessitating specialized ophthalmic referral and subsequent investigation and treatment. PMID:23269857

DaCosta, Joanna

2012-01-01

325

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

326

Nanotechnology approaches for ocular drug delivery.  

PubMed

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

327

Cultured corneal epithelia for ocular surface disease.  

PubMed Central

PURPOSE: To evaluate the potential efficacy for autologous and allogeneic expanded corneal epithelial cell transplants derived from harvested limbal corneal epithelial stem cells cultured in vitro for the management of ocular surface disease. METHODS: Human Subjects. Of the 19 human subjects included, 18 (20 procedures) underwent in vitro cultured corneal epithelial cell transplants using various carriers for the epithelial cells to determine the most efficacious approach. Sixteen patients (18 procedures on 17 eyes) received autologous transplants, and 2 patients (1 procedure each) received allogeneic sibling grafts. The presumed corneal epithelial stem cells from 1 patient did not grow in vitro. The carriers for the expanded corneal epithelial cells included corneal stroma, type 1 collagen (Vitrogen), soft contact lenses, collagen shields, and amniotic membrane for the autologous grafts and only amniotic membrane for the allogeneic sibling grafts. Histologic confirmation was reviewed on selected donor grafts. Amniotic membrane as carrier. Further studies were made to determine whether amniotic membrane might be the best carrier for the expanding corneal epithelial cells. Seventeen different combinations of tryspinization, sonication, scraping, and washing were studied to find the simplest, most effective method for removing the amniotic epithelium while still preserving the histologic appearance of the basement membrane of the amnion. Presumed corneal epithelial stem cells were harvested and expanded in vitro and applied to the amniotic membrane to create a composite graft. Thus, the composite graft consisted of the amniotic membrane from which the original epithelium had been removed without significant histologic damage to the basement membrane, and the expanded corneal epithelial stem cells, which had been applied to and had successfully adhered to the denuded amniotic membrane. Animal model. Twelve rabbits had the ocular surface of 1 eye damaged in a standard manner with direct removal of the presumed limbal stem cells, corneal epithelium, and related epithelium, followed by the application of n-heptanol for 60 seconds. After 6 weeks, all damaged eyes were epithelialized and vascularized. Two such treated eyes were harvested without further treatment, to be used for histologic study as damaged controls. The remaining 10 rabbits received composite grafts (consisting of amniotic membrane with expanded allogeneic rabbit corneal epithelial cell transplants) applied to the ocular surface in a standard manner followed by the application of a contact lens. At 16 days following transplantation, 5 of the rabbits were sacrificed and the corneal rims were removed for histologic study. At 28 days, the remaining rabbits were sacrificed and the previously damaged eyes were harvested for histologic and immunohistochemical study. RESULTS: Human subjects. Of the 19 total patients admitted to the study, the presumed corneal epithelial stem cells of 1 patient did not grow in vitro. Of the remaining 18 patients (20 procedures, 19 eyes), 3 patients had unsuccessful results (3 autologous procedures), 1 patient had a partially successful procedure (allogeneic procedure), and 1 patient had a procedure with an undetermined result at present (allogeneic procedure). One unsuccessful patient had entropion/trichiasis and mechanically removed the graft and eventually went into phthisis. The other 2 unsuccessful patients suffered presumed loss of autologous donor epithelium and recurrence of the ocular surface disease (pterygium). The partially successful patient receiving an allogeneic transplant had infectious keratitis delay of his re-epithelialization; he has only minimal visual improvement but has re-epithelialized. The patient receiving the second allogeneic graft lost his donor epithelium at day 4. Additional donor epithelium was reapplied, but the result is undetermined at present. Amniotic membrane as carrier. The in vitro preparation of the amniotic membrane with corneal epithelial stem cell graft overlay was successful.Histology docume

Schwab, I R

1999-01-01

328

Ocular microtremor measurement system: design and performance.  

PubMed

The frequency of ocular microtremor (OMT) is related to the functional status of the brain stem, and thus OMT may be useful in the diagnosis and management of brain stem disorders. The paper discusses the design of an OMT measurement system and reports quantitative specifications for three portable systems. All systems use a piezo-electric element as the transducer, which measures the displacement of the sclera during eye rotations. The systems differ in the manner in which the signal is recorded. All systems can detect eye movements corresponding to displacements of the sclera ranging from 12 to over 3000 nm. The frequency responses of all systems are flat (< 2 dB deviation from peak response) between 20 and 150 Hz. The phase response shows deviations (< pi) at the extremes of this range, but qualitative comparison of input and measured signals demonstrates that phase distortion is not excessive. Thus all systems are acceptable for clinical studies involving OMT. PMID:8412372

Sheahan, N F; Coakley, D; Hegarty, F; Bolger, C; Malone, J

1993-05-01

329

Some methodological problems in ocular fluorophotometry.  

PubMed

Facing conflicting results from centers working with vitreous fluorophotometry, we performed a series of methodological studies of the technique preceding clinical studies. A major problem is the resolution power of the system. This is predicted to be dependent on the size of the fiberoptic probe, the slit width and angle between incident and detecting light beam, which is shown to be true in experiments with glass cuvettes and in studies of the eyes of 10 healthy volunteers. In the in vivo studies, variations of slit height could also influence readings. The selection of appropriate filters is important to reduce reflexes and autofluorescence of the ocular media, which otherwise must be accounted for. PMID:6678845

Kjaergaard, J J; Fabrin, K

1983-01-01

330

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

331

Complimentary imaging technologies in blunt ocular trauma  

PubMed Central

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.

2013-01-01

332

Updates in the treatment of ocular allergies  

PubMed Central

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

Kari, Osmo; Saari, K Matti

2010-01-01

333

Autoimmunity at the ocular surface: pathogenesis and regulation  

PubMed Central

A healthy ocular surface environment is essential to preserve visual function, and as such the eye has evolved a complex network of mechanisms to maintain homeostasis. Fundamental to the health of the ocular surface is the immune system, designed to respond rapidly to environmental and microbial insults, whereas maintaining tolerance to self-antigens and commensal microbes. To this end, activation of the innate and adaptive immune response is tightly regulated to limit bystander tissue damage. However, aberrant activation of the immune system can result in autoimmunity to self-antigens localized to the ocular surface and associated tissues. Environmental, microbial and endogenous stress, antigen localization, and genetic factors provide the triggers underlying the immunological events that shape the outcome of the diverse spectrum of autoimmune-based ocular surface disorders. PMID:20485329

Stern, ME; Schaumburg, CS; Dana, R; Calonge, M; Niederkorn, JY; Pflufelder, SC

2013-01-01

334

Glaucoma Drainage Implant Surgery and Ocular Surface Transplant Graft Preservation.  

PubMed

Abstract Glaucoma may develop or worsen after ocular surface transplantation and often requires surgical management for adequate intraocular pressure control. Traditional glaucoma filtering procedures in patients with prior ocular surface transplant may be problematic for several reasons, which include mechanical disruption of the pre-existing graft, epithelial and stem cell toxicity induced by antifibrotic agents, and increased risk of future corneal transplantation failure. We describe the implantation of a glaucoma drainage implant via a limbal-based conjunctival incision with tube placement in the ciliary sulcus in three eyes of two patients with prior ocular surface transplantation. At a follow-up interval of 3-7 months, all three eyes have excellent postoperative control of intraocular pressure, stable vision, and healthy ocular surface grafts. PMID:24116393

Aref, Ahmad A; Sivaraman, Kavitha R; Djalilian, Ali R

2013-10-11

335

Study of normal ocular thermogram using textural parameters  

NASA Astrophysics Data System (ADS)

Ocular surface temperature (OST) has been studied with numerous approach and Infrared (IR) thermography has proved to be the best way to capture temperature distribution over some surfaces. It is applied to a number of biomedical applications including studies in the field of ophthalmology. However, the analysis of an ocular thermogram is largely in nascent stage, and is usually achieved by first-order texture analysis. This current study conducted second-order texture analysis on ocular thermal images, mainly by cross co-occurrence matrix together with first-order texture analysis, moments and difference histogram. It was found that, for subjects aged above 35 years old their interocular difference in median, textural contrast, moment 2 and moment 3 (in absolute value) were significantly higher than younger peers. Several significant linear correlations among investigated features were observed. The features extracted from cross co-occurrence matrix may play an important role in the diagnosis of ocular diseases.

Tan, Jen-Hong; Ng, E. Y. K.; Rajendra Acharya, U.; Chee, C.

2010-03-01

336

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

337

The visual motion detectors underlying ocular following responses in monkeys  

Microsoft Academic Search

Psychophysical evidence indicates that visual motion can be sensed by low-level (energy-based) and high-level (feature-based) mechanisms. The present experiments were undertaken to determine which of these mechanisms mediates the initial ocular following response (OFR) that can be elicited at ultra-short latencies by sudden motion of large-field images. We used the methodology of Sheliga, Chen, Fitzgibbon, and Miles (Initial ocular following

Kenichiro Miura; Kiyoto Matsuura; Masakatsu Taki; Hiromitsu Tabata; Naoko Inaba; Kenji Kawano; Frederick A. Miles

2006-01-01

338

Laser irradiation and IR spectroscopy in ocular tumors  

NASA Astrophysics Data System (ADS)

Infrared spectra were obtained from ocular malignant melanoma in phosphate buffered saline and bovine ocular extract (BOE). The spectra of BOE differed from those obtained from patients with either cancer or dysplasia. The spectra of controls, standards and samples were studied by IR spectroscopy before and after irradiation and were obtained differences between normal and pathological states. The spectroscopy changes appear to progress in tandem with the morphological changes that lead normal tissue to cancer through the premalignant stage of dysplasia.

Necsoiu, Dana; Radu, Mihaela; Stroila, A.; Ciotaru, D.; Caralicea, Mariana; Antihi, Mihaela; Tarnavschi, Ruxandra; Carstocea, Benone D.

1995-03-01

339

Disturbances of ocular movements and blinking in schizophrenia.  

PubMed Central

Neurological examination and electroencephalograms and electro-oculograms, recorded by telemetry, from unmedicated patients with acute and chronic schizophrenia demonstrate a number of abnormalities of extraocular movement including staring, abnormal blink rate, absent glabellar reflex, and increase in horizontal eye movements. As potential clues to the pathophysiology of schizophrenia, these disturbances are analysed in relation to anatomical substrate and dopamine modulation of ocular movement, rapid eye movement sleep, and the neurological disorders in which similar disturbances of ocular movement occur. PMID:712370

Stevens, J R

1978-01-01

340

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

341

Validating and Troubleshooting Ocular In Vitro Toxicology Tests  

PubMed Central

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 function 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, improvement 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

342

Novel Strategies for Anterior Segment Ocular Drug Delivery  

PubMed Central

Abstract Research advancements in pharmaceutical sciences have led to the development of new strategies in drug delivery to anterior segment. Designing a new delivery system that can efficiently target the diseased anterior ocular tissue, generate high drug levels, and maintain prolonged and effective concentrations with no or minimal side effects is the major focus of current research. Drug delivery by traditional method of administration via topical dosing is impeded by ocular static and dynamic barriers. Various products have been introduced into the market that prolong drug retention in the precorneal pocket and to improve bioavailability. However, there is a need of a delivery system that can provide controlled release to treat chronic ocular diseases with a reduced dosing frequency without causing any visual disturbances. This review provides an overview of anterior ocular barriers along with strategies to overcome these ocular barriers and deliver therapeutic agents to the affected anterior ocular tissue with a special emphasis on nanotechnology-based drug delivery approaches. PMID:23215539

Cholkar, Kishore; Patel, Sulabh P.; Vadlapudi, Aswani Dutt

2013-01-01

343

Characterization of ocular gland morphology and tear composition of pinnipeds  

PubMed Central

Objective The importance of tear film integrity to ocular health in terrestrial mammals is well established, however, in marine mammals, the role of the tear film in protection of the ocular surface is not known. In an effort to better understand the function of tears in maintaining health of the marine mammal eye surface, we examined ocular glands of the California sea lion, and began to characterize the biochemical nature of the tear film of pinnipeds. Procedures Glands dissected from California sea lion eyelids and adnexa were examined for gross morphology, sectioned for microscopic analysis, and stained with haematoxylin and eosin. The tear film was examined using interferometry. Tears were collected from humans and pinnipeds for analysis of protein and carbohydrate content. Results The sea lion has sebaceous glands in the lid, but these glands are different in size and orientation compared to typical meibomian glands of terrestrial mammals. Two other accessory ocular glands located dorsotemporally and medially appeared to be identical in morphology, with tubulo-acinar morphology. An outer lipid layer on the ocular surface of the sea lion was not detected using interferometry, consistent with the absence of typical meibomian glands. Similar to human tears, the tears of pinnipeds contain several proteins but the ratio of carbohydrate to protein was greater than that in human tears. Conclusions Our findings indicate that the ocular gland architecture and biochemical nature of the tear film of pinnipeds have evolved to adapt to the challenges of an aquatic environment. PMID:23067374

Davis, Robin Kelleher; Doane, Marshall G.; Knop, Erich; Knop, Nadja; Dubielzig, Richard R.; Colitz, Carmen M. H.; Argüeso, Pablo; Sullivan, David A.

2012-01-01

344

Speckle interferometric system to measure ocular microtremor  

NASA Astrophysics Data System (ADS)

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

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

2008-04-01

345

The Role of Lumican in Ocular Disease  

PubMed Central

Lumican is keratan sulfate proteoglycan of the small leucine rich proteoglycan family. Through studies in animal models lumican has been found to be critical in maintaining corneal clarity. It maintains ordered collagen fibrils which are vital in keeping the cornea transparent. It may also be important in primary open angle glaucoma influencing aqueous outflow. Lumican deficiency in mice results in increased axial length with fibromodulin deficiency and thinner sclerae. There is evidence suggesting that this characteristic may be pertinent in humans and lumican gene polymorphisms could be related to high myopia. Lumican plays a fundamental role in inflammation and wound healing. It localises macrophages to the site of corneal injury and recruits neutrophils in lipopolysaccharide-induced keratitis in mice. It has also been shown to bind lipopolysaccharide which may be critical in inflammatory diseases such as uveitis. Lumican is also important in wound healing revealing decreased synthesis in scar tissue and mediating Fas-Fas ligand interactions. It is present in human placenta and amniotic membrane suggesting that it may ensure viable amniotic membrane grafts. Lumican may also be involved in the formation of posterior capsular opacification following cataract surgery. Research into the pivotal role of lumican in the pathogenesis of ocular disease has resulted in greater understanding of the key role which proteoglycans play in human disease. PMID:24558602

McCluskey, Peter; Wakefield, Denis

2013-01-01

346

Role of Heparan Sulfate in Ocular Diseases  

PubMed Central

Heparan sulfate (HS), a ubiquitous and structurally diverse cell surface polysaccharide and extracellular matrix component, is a factor common to several major eye pathologies. Its multitude of functions and variable distribution among the different ocular tissues makes it an important contributor to a variety of disease states. Although HS facilitates the pathogenesis of many disorders, its role in each varies. Unique functions of HS have been particularly noted in viral and bacterial keratitis and age-related macular degeneration. Combined, these pathologies comprise a large portion of conditions leading to visual impairment worldwide. Given this prevalence of diseases facilitated by HS, it is prudent to take an in-depth look at this compound in the context of these pathologic states. While the initial part of the review will discuss the pathogenic aspects of HS, it is also important to consider the wider implications of such roles for HS. The remainder of the article will specifically address one such implication, the possibility for future use of novel HS-based therapeutics to combat these eye pathologies. PMID:23410824

Park, Paul J; Shukla, Deepak

2013-01-01

347

Endothelial Tip Cells in Ocular Angiogenesis  

PubMed Central

Endothelial tip cells are leading cells at the tips of vascular sprouts coordinating multiple processes during angiogenesis. In the developing retina, tip cells play a tightly controlled, timely role in angiogenesis. In contrast, excessive numbers of tip cells are a characteristic of the chaotic pathological blood vessels in proliferative retinopathies. Tip cells control adjacent endothelial cells in a hierarchical manner to form the stalk of the sprouting vessel, using, among others, the VEGF-DLL-Notch signaling pathway, and recruit pericytes. Tip cells are guided toward avascular areas by signals from the local extracellular matrix that are released by cells from the neuroretina such as astrocytes. Recently, tip cells were identified in endothelial cell cultures, enabling identification of novel molecular markers and mechanisms involved in tip cell biology. These mechanisms are relevant for understanding proliferative retinopathies. Agents that primarily target tip cells can block pathological angiogenesis in the retina efficiently and safely without adverse effects. A striking example is platelet-derived growth factor, which was recently shown to be an efficacious additional target in the treatment of retinal neovascularization. Here we discuss these and other tip cell-based strategies with respect to their potential to treat patients with ocular diseases dominated by neovascularization. PMID:23092791

Siemerink, Martin J.; Klaassen, Ingeborg; Van Noorden, Cornelis J.F.

2013-01-01

348

Retinitis pigmentosa and ocular blood flow.  

PubMed

Is the concept of integrative, preventive and personalised medicine applicable to the relationship between retinitis pigmentosa (RP) and ocular blood flow (OBF)? RP encompasses a group of hereditary diseases of the posterior segment of the eye characterised by degeneration, atrophy and finally loss of photoreceptors and retinal pigment epithelium, leading to progressive visual loss. Many different mutations affecting different genes can lead to the clinical picture of RP. Even though the disease has a clear genetic background, there are obviously other factors influencing the manifestation and progression of RP. In this review, we focus on the role of OBF. There is evidence that, in PR patients, OBF is more reduced than one would expect secondary to the retinal atrophy. The main cause of this additional component seems to be primary vascular dysregulation (PVD) syndrome. As PVD syndrome is partly treatable, a vascular evaluation of RP patients is meaningful. Based on the outcome, a targeted individualised, preventive or supportive treatment might be introduced in selected RP patients. PMID:23199279

Konieczka, Katarzyna; Flammer, Andreas J; Todorova, Margarita; Meyer, Peter; Flammer, Josef

2012-01-01

349

Detection system for ocular refractive error measurement.  

PubMed

An automatic and objective system for measuring ocular refractive errors (myopia, hyperopia and astigmatism) was developed. The system consists of projecting a light target (a ring), using a diode laser (lambda = 850 nm), at the fundus of the patient's eye. The light beams scattered from the retina are submitted to an optical system and are analysed with regard to their vergence by a CCD detector (matrix). This system uses the same basic principle for the projection of beams into the tested eye as some commercial refractors, but it is innovative regarding the ring-shaped measuring target for the projection system and the detection system where a matrix detector provides a wider range of measurement and a less complex system for the optical alignment. Also a dedicated electronic circuit was not necessary for treating the electronic signals from the detector (as the usual refractors do); instead a commercial frame grabber was used and software based on the heuristic search technique was developed. All the guiding equations that describe the system as well as the image processing procedure are presented in detail. Measurements in model eyes and in human eyes are in good agreement with retinoscopic measurements and they are also as precise as these kinds of measurements require (0.125D and 5 degrees). PMID:9623657

Ventura, L; de Faria e Sousa, S J; de Castro, J C

1998-05-01

350

Tolerance of ocular iontophoresis in healthy volunteers.  

PubMed

To evaluate ocular tolerance, healthy volunteers were iontophoresed transclerally using novel OcuPhor trade mark hydrogel drug delivery applicators filled with balanced salt solution. In this three-period crossover study in 24 male and female subjects, 16 subjects received 0 mA and two of the following DC currents: 0.1, 0.5., 1.0, 2.0, 3.0, or 4.0 mA for 20 min; 6 subjects received 3 mA for 20 min and 1.5 mA for 40 min (both equivalent to 60 mAmin total charge). Safety and tolerance were determined by subjective VAS and objective ophthalmic assessments. Subjects were evaluated before and up to 22 hr after dosing. The applicators were well-tolerated and no clinically significant changes in symptomology or in ophthalmic assessments were seen following exposure to 0-3.0 mA for 20 min or 1.5 mA for 40 min. At 4.0 mA 2 of 4 subjects reported a burning sensation under the applicator during dosing which resolved by 22 hr post-dose; superficial changes in fluorescein staining were observed at 1 hr, but not at 22 hr. The OcuPhor trade mark system has promise for noninvasive drug delivery to the eye. PMID:12804059

Parkinson, Thomas M; Ferguson, Elizabeth; Febbraro, Salvatore; Bakhtyari, Arash; King, Martin; Mundasad, Mohan

2003-04-01

351

Microindentation of the young porcine ocular lens.  

PubMed

Debate regarding the mechanisms of how the eye changes focus (accommodation) and why this ability is lost with age (presbyopia) has recently been rejoined due to the advent of surgical procedures for the correction of presbyopia. Due to inherent confounding factors in both in vivo and in vitro measurement techniques, mechanical modeling of the behavior of the ocular lens in accommodation has been attempted to settle the debate. However, a paucity of reliable mechanical property measurements has proven problematic in the development of a successful mechanical model of accommodation. Instrumented microindentation was utilized to directly measure the local elastic modulus and dynamic response at various locations in the lens. The young porcine lens exhibits a large modulus gradient with the highest modulus appearing at the center of the nucleus and exponentially decreasing with distance. The loss tangent was significantly higher in the decapsulated lens and the force waveform amplitude decreased significantly upon removal of the lens capsule. The findings indicate that localized measurements of the lens' mechanical properties are necessary to achieve accurate quantitative parameters suitable for mechanical modeling efforts. The results also indicate that the lens behaves as a crosslinked gel rather than as a collection of individual arched fiber cells. PMID:19275444

Reilly, Matthew; Ravi, Nathan

2009-04-01

352

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

353

Decreased percentages of regulatory T cells in peripheral blood of patients with Behcet's disease before ocular attack: a possible predictive marker of ocular attack.  

PubMed

The current study investigates the role of regulatory T (Treg) cells in the pathogenesis of ocular attack in patients with Behcet's disease (BD). Nineteen BD patients with ocular complications (BDo), including 11 BD patients with ocular attack (BDa) and eight BD patients with inactive ocular complications (BDi), were studied. Four BD patients without ocular complications (BDwo) were also evaluated as controls. All patients were prospectively followed by our outpatient clinic between autumn 2004 and spring 2005. CD4+ CD25+bright T cells (Treg cells) from peripheral blood were measured by flow cytometry. The percentages of Treg cells in CD4+ T cells from BDo were significantly decreased before ocular attack compared with those after ocular attack. Moreover, surprisingly, these levels before attack were significantly lower than normal level, whereas the percentages of Treg cells in both BDi and BDwo patients were normal. Treg cells were significantly decreased in BDa before active ocular attack. These findings suggest that Treg cells play an important role in ocular attack in BD patients. In addition, decreased percentages of Treg cells may be a predictive marker of ocular attack in BD patients allowing treatment of BD patients before an ocular attack. PMID:18427720

Nanke, Yuki; Kotake, Shigeru; Goto, Mari; Ujihara, Hiroshi; Matsubara, Masao; Kamatani, Naoyuki

2008-01-01

354

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

NASA Technical Reports Server (NTRS)

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

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

2015-01-01

355

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

356

Ocular surface temperature in age-related macular degeneration.  

PubMed

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. PMID:25436140

Sodi, Andrea; Matteoli, Sara; Giacomelli, Giovanni; Finocchio, Lucia; Corvi, Andrea; Menchini, Ugo

2014-01-01

357

Structural and Mechanical Mechanisms of Ocular Tissues Probed by AFM  

NASA Astrophysics Data System (ADS)

In recent years, the atomic force microscope (AFM) has become an important tool in ophthalmic research. It has gained popularity largely because AFM is not restricted by the diffraction limits of light microscopy and can be applied to resolve images with molecular resolution. AFM is a minimally invasive technique and can be used to visualize molecular structures under near-physiological conditions. In addition, the AFM can be employed as a force apparatus to characterize the viscoelastic properties of biomaterials on the micron level and at the level of individual proteins. In this article, we summarize recent AFM studies of ocular tissues, while highlighting the great potential of AFM technology in ophthalmic research. Previous research demonstrates the versatility of the AFM as high resolution imaging technique and as a sensitive force apparatus for probing the mechanical properties of ocular tissues. The structural and mechanical properties of ocular tissues are of major importance to the understanding of the optomechanical functions of the human eye. In addition, AFM has played an important role in the development and characterization of ocular biomaterials, such as contact lenses and intraocular lenses. Studying ocular tissues using Atomic Force Microscopy has enabled several advances in ophthalmic research.

Ziebarth, Noël M.; Rico, Felix; Moy, Vincent T.

358

The role of SIRT1 in ocular aging.  

PubMed

The sirtuins are a highly conserved family of nicotinamide adenine dinucleotide (NAD+)-dependent histone deacetylases that helps regulate the lifespan of diverse organisms. The human genome encodes seven different sirtuins (SIRT1-7), which share a common catalytic core domain but possess distinct N- and C-terminal extensions. Dysfunction of some sirtuins have been associated with age-related diseases, such as cancer, type II diabetes, obesity-associated metabolic diseases, neurodegeneration, and cardiac aging, as well as the response to environmental stress. SIRT1 is one of the targets of resveratrol, a polyphenolic SIRT1 activator that has been shown to increase the lifespan and to protect various organs against aging. A number of animal studies have been conducted to examine the role of sirtuins in ocular aging. Here we review current knowledge about SIRT1 and ocular aging. The available data indicate that SIRT1 is localized in the nucleus and cytoplasm of cells forming all normal ocular structures, including the cornea, lens, iris, ciliary body, and retina. Upregulation of SIRT1 has been shown to have an important protective effect against various ocular diseases, such as cataract, retinal degeneration, optic neuritis, and uveitis, in animal models. These results suggest that SIRT1 may provide protection against diseases related to oxidative stress-induced ocular damage, including cataract, age-related macular degeneration, and optic nerve degeneration in glaucoma patients. PMID:23892278

Mimura, Tatsuya; Kaji, Yuichi; Noma, Hidetaka; Funatsu, Hideharu; Okamoto, Shinseiro

2013-11-01

359

Ocular biometry using computed tomography: a study in Benin, Nigeria.  

PubMed

AIMS AND OBJECTIVES The aim was to determine CT measured ocular biometry in Mid-Western Nigeria which may be employed on other Nigerians and Black Africans. PATIENTS AND METHODS The ocular images of 200 patients that had normal cranial CT scans without ocular abnormality or complaints were retrospectively retrieved and analysed. The CT scans were done at the University of Benin Teaching Hospital. The axial length and width were obtained at the maximum mid-axial images and analysed using SPSS version 17 for measures of central tendency and correlations between variables (level of significance set at 0.05). RESULTS The mean axial length was 21.4mm (right) and 21.6mm (left) while the width was 21.6mm (for right and left). The ocular biometry was larger in the left eye than the right, and also in males than females. The axial length and width increased with advancing age. CONCLUSION CT ocular biometry can be performed on previous cranial CT scans done for other reasons. The dimensions in this study may be used as a local normogram. PMID:25331243

Igbinedion, B O; Ogbeide, O U

2014-09-01

360

Pathophysiology of ocular surface squamous neoplasia.  

PubMed

The incidence of ocular surface squamous neoplasia (OSSN) is strongly associated with solar ultraviolet (UV) radiation, HIV and human papilloma virus (HPV). Africa has the highest incidence rates in the world. Most lesions occur at the limbus within the interpalpebral fissure particularly the nasal sector. The nasal limbus receives the highest intensity of sunlight. Limbal epithelial crypts are concentrated nasally and contain niches of limbal epithelial stem cells in the basal layer. It is possible that these are the progenitor cells in OSSN. OSSN arises in the basal epithelial cells spreading towards the surface which resembles the movement of corneo-limbal stem cell progeny before it later invades through the basement membrane below. UV radiation damages DNA producing pyrimidine dimers in the DNA chain. Specific CC ? TT base pair dimer transformations of the p53 tumour-suppressor gene occur in OSSN allowing cells with damaged DNA past the G1-S cell cycle checkpoint. UV radiation also causes local and systemic photoimmunosuppression and reactivates latent viruses such as HPV. The E7 proteins of HPV promote proliferation of infected epithelial cells via the retinoblastoma gene while E6 proteins prevent the p53 tumour suppressor gene from effecting cell-cycle arrest of DNA-damaged and infected cells. Immunosuppression from UV radiation, HIV and vitamin A deficiency impairs tumour immune surveillance allowing survival of aberrant cells. Tumour growth and metastases are enhanced by; telomerase reactivation which increases the number of cell divisions a cell can undergo; vascular endothelial growth factor for angiogenesis and matrix metalloproteinases (MMPs) that destroy the intercellular matrix between cells. Despite these potential triggers, the disease is usually unilateral. It is unclear how HPV reaches the conjunctiva. PMID:25447808

Gichuhi, Stephen; Ohnuma, Shin-ichi; Sagoo, Mandeep S; Burton, Matthew J

2014-12-01

361

Ocular microtremor in brain stem death  

PubMed

OBJECTIVE: This study was undertaken to establish whether measurement of ocular microtremor (OMT) activity could be used as a method to establish brain stem death. Presently, the diagnosis of brain stem death can be made using clinical criteria alone. OMT is a high-frequency, low-amplitude physiological tremor of the eye caused by impulses emanating from the brain stem. There have been a number of reports indicating that the recording of OMT may be useful in the assessment of comatose states and in establishing brain stem viability or death. METHODS: We obtained the OMT recordings of 32 patients suspected of having brain stem death using the piezoelectric strain gauge technique. This method involves mounting the piezoelectric probe in a headset and lowering the rubber-tipped end piece onto the anesthetized scleral surface of the subject. The signal produced is recorded on audiomagnetic tape and later played back and analyzed on an electrocardiographic tape analyzer. RESULTS: In 28 patients, initial clinical assessment confirmed the diagnosis of brain stem death and no OMT activity was recorded from these subjects. In three patients in whom initial clinical assessment demonstrated brain stem function, OMT activity was present; when brain stem death was subsequently diagnosed in these three patients, no OMT activity could be demonstrated. In the remaining patient, two of three OMT recordings demonstrated activity in spite of the absence of clinical evidence of brain stem function. A post mortem revealed bacterial cerebritis in this subject. CONCLUSION: The results suggest that OMT is a sensitive method of detecting brain stem life and that it could play an important role in the assessment of brain stem death. PMID:10371619

Bolger; Bojanic; Phillips; Sheahan; Coakley; Malone

1999-06-01

362

Ocular side effects of selected systemic drugs.  

PubMed

Numerous systemic drugs produce adverse effects that involve the eye. Pigmentary inclusions of the lids or conjunctivae or both may be caused by a variety of drugs, including amiodarone, chlorpromazine, and gold salts, while conjunctivitis and blepharoconjunctivitis have been associated with isotretinoin, sulfonamides, salicylates, and antineoplastic agents. Dry eye complaints may be caused by antihistamines, beta-receptor blocking agents prescribed for cardiovascular problems, antianxiety agents, and tricyclic antidepressants. Several drugs have been well documented as causes of keratopathies and/or lenticular deposits, including chloroquine and hydroxychloroquine, chlorpromazine, gold salts, systemic corticosteroids, nonsteroidal antiinflammatory drugs, and the antiarrhythmic agent amiodarone. Visual acuity may be decreased by transient changes in refractive error caused by sulfonamides, the antifungal agent metronidazole, thiazide diuretics, and carbonic anhydrase inhibitors. Dilation of the pupil may be caused by anticholinergic drugs, antihistamines, antidepressant agents, and central nervous system stimulants such as cocaine, methylphenidate, and amphetamines. Nystagmus, diplopia, and extraocular muscle palsies have been associated with central nervous system depressants, antihistamines, barbiturates, and elevated blood ethanol concentrations. Intraocular pressure can be elevated in susceptible individuals by long-term use of topical or systemic corticosteroids. Numerous drugs have been associated with retinal toxicity, including chloroquine and hydroxychloroquine, thioridazine, tamoxifen, and talc, which may embolize to the retinal circulation when administered by long-term drug abusers. The antituberculosis agents ethambutol and isoniazid have been implicated as causes of reduced acuity, visual field defects, and disturbances of color vision. Optic neuritis and retrobulbar neuritis may result from the use of chloramphenicol. This paper describes these and other adverse ocular effects that may be encountered when examining patients who are taking systemic drugs. PMID:1363080

Jaanus, S D

1992-01-01

363

Exon-level Expression Profiling of Ocular Tissues  

PubMed Central

The normal gene expression profiles of the tissues in the eye are a valuable resource for considering genes likely to be involved with disease processes. We profiled gene expression in ten ocular tissues from human donor eyes using Affymetrix Human Exon 1.0 ST arrays. Ten different tissues were obtained from six different individuals and RNA was pooled. The tissues included: retina, optic nerve head (ONH), optic nerve (ON), ciliary body (CB), trabecular meshwork (TM), sclera, lens, cornea, choroid/retinal pigment epithelium (RPE) and iris. Expression values were compared with publically available Expressed Sequence Tag (EST) and RNA-sequencing resources. Known tissue-specific genes were examined and they demonstrated correspondence of expression with the representative ocular tissues. The estimated gene and exon level abundances are available online at the Ocular Tissue Database. PMID:23500522

Wagner, Alex H.; Anand, Nikhil; Wang, Wan-Heng; Chatterton, Jon E.; Sun, Duo; Shepard, Allan; Jacobson, Nasreen; Pang, Iok-Hou; DeLuca, Adam; Casavant, Thomas L.; Scheetz, Todd E.; Mullins, Robert; Braun, Terry A.; Clark, Abbot F.

2013-01-01

364

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

365

A case of ocular cardiac reflex in a child with blunt ocular trauma.  

PubMed

An 11-year-old boy re-presented with refractory vomiting 18?h after blunt facial and head trauma. Initial CT of the brain performed at his first visit was normal. He was found to have a heart rate of 56?bpm (age appropriate 65-100?bpm) with a blood pressure 90/60?mm?Hg. Physical examination revealed an injected sclera and limited vertical movement of the left eye. Neurological examination revealed no focal deficits, but a Glasgow Coma Scale of 14, with mild confusion, depressed mental status and diplopia on upward gaze. Performing upward gaze extra ocular movements exacerbated the patient's bradycardia and confirmed the presence of the oculocardiac reflex. High-resolution CT of orbits demonstrated a left orbital floor fracture with entrapment of the left inferior rectus muscle. Surgical correction resolved his bradycardia. PMID:25422334

Reddy, Soma Sekhara; Landry, Jonathan P; Douglass, Kate; Venugopalan, Poovathum Parambil

2014-01-01

366

Ocular side effects of anti-rheumatic medications: what a rheumatologist should know  

PubMed Central

Nearly every drug may cause changes to ocular tissues through a variety of mechanisms. Medication overdoses, drug–drug interactions but also chronic administration of medications at the recommended doses may lead to ocular toxicity. The ocular side effects, screening for eye toxicity and treatment guidelines for anti-inflammatory and immunosuppressive drugs commonly used by rheumatologists are reviewed herein. PMID:20144965

Peponis, V; Kyttaris, VC; Chalkiadakis, SE; Bonovas, S; Sitaras, NM

2010-01-01

367

Visualization of ocular melanoma with N-isopropyl-p-(/sup 123/I)-iodoamphetamine  

SciTech Connect

In a patient with ocular melanoma, scintigraphy with N-isopropyl-p-(/sup 123/I)-iodoamphetamine (( /sup 123/I)IMP) clearly delineated the histologically proven ocular lesion. In a tissue distribution study, using the resected specimen, a significantly high accumulation of the radioactivity was confirmed in tumor tissue. Thus, (/sup 123/I)IMP scintigraphy provided specific localization of an ocular melanoma.

Ono, S.; Fukunaga, M.; Otsuka, N.; Nagai, K.; Morita, K.; Furukawa, T.; Muranaka, A.; Yanagimoto, S.; Tomomitsu, T.; Tabuchi, A.

1988-08-01

368

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

369

Dominant frequency content of ocular microtremor from normal subjects.  

PubMed

Ocular microtremor (OMT) is a high frequency tremor of the eyes present during fixation and probably related to brainstem activity (Coakley, D. (1983). Minute eye movement and brain stem function. CRC Press, FL.). Published observations on the frequency of OMT have varied widely. Ocular microtremor was recorded in 105 normal healthy subjects using the Piezoelectric strain gauge technique. The dominant frequency content of a signal was determined using the peak counting method. Values recorded ranged from 70 to 103 Hz, the mean frequency being 83.68 Hz (S.D. +/- 5.78 Hz). PMID:10343779

Bolger, C; Bojanic, S; Sheahan, N F; Coakley, D; Malone, J F

1999-06-01

370

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

371

Infrared thermography on ocular surface temperature: A review  

NASA Astrophysics Data System (ADS)

Body temperature is a good indicator of human health. Thermal imaging system (thermography) is a non-invasive imaging procedure used to record the thermal patterns using Infrared (IR) camera. It provides visual and qualitative documentation of temperature changes in the vascular tissues, and is beginning to play an important role in the field of ophthalmology. This paper deals with the working principle, use and advantages of IR thermography in the field of ophthalmology. Different algorithms to acquire the ocular surface temperature (OST), that can be used for the diagnosis of ocular diseases are discussed.

Tan, Jen-Hong; Ng, E. Y. K.; Rajendra Acharya, U.; Chee, C.

2009-07-01

372

Topical Ocular Hypotensive Medication and Lens Opacification: Evidence from the Ocular Hypertension Treatment Study (OHTS)  

PubMed Central

Purpose To determine whether topical ocular hypotensive medication is associated with refractive changes, visual symptoms, decreased visual function, or increased lens opacification. Design Multicenter clinical trial Methods We compared the medication and observation groups of OHTS during 6.3 years of follow-up with regard to the rate of cataract and combined cataract/filtering surgery, and change from baseline in visual function, refraction and visual symptoms. A one-time assessment of lens opacification was done using the Lens Opacities Classification System III (LOCS III) grading system. Results An increased rate of cataract extraction and cataract/filtering surgery was found in the medication group (7.6%) compared to the observation group (5.6%) (HR 1.56; 95% CI 1.05–2.29). The medication and observation groups did not differ with regard to changes from baseline to June 2002 in Humphrey visual field mean deviation, Humphrey visual field foveal sensitivity, Early Treatment of Diabetic Retinopathy Study (ETDRS) visual acuity, refraction and visual symptoms. For the medication and observation groups, LOCS III readings were similar for nuclear color, nuclear opalescence and cortical opacification. There was a borderline higher mean grade for posterior subcapsular opacity in the medication group (0.43 ± 0.6 SD) compared to the observation group (0.36 ± 0.6 SD) (p=0.07). Conclusion We noted an increased rate of cataract extraction and cataract/filtering surgery in the medication group as well as a borderline higher grade of posterior subcapsular opacification in the medication group on LOCS III readings. We found no evidence for a general effect of topical ocular hypotensive medication on lens opacification or visual function. PMID:17056362

Herman, David C.; Gordon, Mae O.; Beiser, Julia A.; Chylack, Leo T.; Lamping, Kathleen A.; Schein, Oliver D.; Soltau, Joern B.; Kass MD, Michael A.

2007-01-01

373

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. PMID:25180112

Jenkins, Timothy C.

2014-01-01

374

Competition and Arbors in Ocular Dominance Peter Dayan  

E-print Network

Competition and Arbors in Ocular Dominance Peter Dayan Gatsby Computational Neuroscience Unit, UCL 17 Queen Square, London, England, WC1N 3AR. dayan@gatsby.ucl.ac.uk Abstract Hebbian and competitive) for the development of 1d stripe­like patterns, which places competitive and interactive cortical influences, and free

Dayan, Peter

375

Ocular findings in sickle cell-haemoglobin O Arab disease.  

PubMed Central

The ocular findings in 2 patients with sickle cell-haemoglobin O Arab disease are described. One patient had proliferative sickle cell retinopathy with extensive autoinfarction of lesions. Sickle cell-haemoglobin O Arab disease must be added to the list of conditions that may be associated with proliferative sickle cell retinopathy. Images PMID:526465

Condon, P. I.; Serjeant, G. R.

1979-01-01

376

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

Microsoft Academic Search

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

THEODORE E. KEATS

377

Characterization of Ocular Tissues Using Micro-Indentation and  

E-print Network

strongly on the connective tissue content. Conclusions: Relaxation testing by micro orbital connective tissue,14, 15 and extraocular muscle (EOM).16-18 However, idiosyncratic techniques usedCharacterization of Ocular Tissues Using Micro-Indentation and Hertzian Viscoelastic Models Running

Gimzewski, James

378

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

379

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

380

Brain (1998), 121, 11171131 Ocular search during line bisection  

E-print Network

Brain (1998), 121, 1117­1131 Ocular search during line bisection The effects of hemi-neglect, two patients with right hemianopia, nine patients with left hemi-neglect and nine normal control with hemi- neglect. The fixation with the longest duration and the bisection point were also shifted

Behrmann, Marlene

381

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

382

Recovering the Ocular Microtremor Signal using Wavelet Denoising Technique  

Microsoft Academic Search

Ocular Microtremor (OMT) is a continual very low amplitude involuntary tremor of the eye which has known potential in the diagnosis of a number of clinical conditions. Rapid involuntary flicks of the eye called microsaccades and slow drifting eye movements contaminate the OMT record. Current methods used to extract OMT from recorded eye movement traces result in some information loss

M. Al-Kalbani; N. Collins; G. Boyle; T. Foran; F. Hegarty; N. Sheahan; D. Coakley

2007-01-01

383

Non-contact measurement of ocular microtremor using laser speckle  

Microsoft Academic Search

The human eye moves continuously even while it appears to be at rest. The involuntary eye movements causing this motion are called fixational eye movements. Ocular Microtremor (OMT) is the smallest (150 - 2500nm amplitude) and fastest (~ 80Hz) of these eye movements. OMT has been proven to provide useful clinical information regarding depth of consciousness and neurological disorders. Most

E. Kenny; D. Coakley; G. Boyle

2010-01-01

384

Ocular microtremor (OMT): a new neurophysiological approach to multiple sclerosis  

Microsoft Academic Search

Using a piezoelectric transducer, the frequency and pattern of ocular microtremor (OMT) between 50 normal subjects and 50 patients with multiple sclerosis were compared. Controls were age matched. All records were analysed blindly. The frequency of OMT in the normal group was 86 (SD 6) Hz, which was significantly different from that of the multiple sclerosis group (71 (SD) 10

Ciaran Bolger; Stana Bojanic; Noirin Sheahan; James Malone; Michael Hutchinson; Davis Coakley

2000-01-01

385

Temporal dynamics of ocular aberrations: monocular vs binocular vision  

Microsoft Academic Search

The temporal dynamics of ocular aberrations are important for the evaluation of, e.g. the accuracy of aberration estimates, the correlation to visual performance, and the requirements for real-time correction with adaptive optics. Traditionally, studies on the eyes dynamic behavior have been performed monocularly, which might have affected the results. In this study we measured aberrations and their temporal dynamics both

A. Mira-Agudelo; L. Lundström; P. Artal

2009-01-01

386

Role of Protease-Inhibitors in Ocular Diseases.  

PubMed

It has been demonstrated that the balance between proteases and protease-inhibitors system plays a key role in maintaining cellular and tissue homeostasis. Indeed, its alteration has been involved in many ocular and systemic diseases. In particular, research has focused on keratoconus, corneal wounds and ulcers, keratitis, endophthalmitis, age-related macular degeneration, Sorsby fundus dystrophy, loss of nerve cells and photoreceptors during optic neuritis both in vivo and in vitro models. Protease-inhibitors have been extensively studied, rather than proteases, because they may represent a therapeutic approach for some ocular diseases. The protease-inhibitors mainly involved in the onset of the above-mentioned ocular pathologies are: ?2-macroglobulin, ?1-proteinase inhibitor (?1-PI), metalloproteinase inhibitor (TIMP), maspin, SERPINA3K, SERPINB13, secretory leukocyte protease inhibitor (SLPI), and calpeptin. This review is focused on the several characteristics of dysregulation of this system and, particularly, on a possible role of proteases and protease-inhibitors in molecular remodeling that may lead to some ocular diseases. Recently, researchers have even hypothesized a possible therapeutic effect of the protease-inhibitors in the treatment of injured eye in animal models. PMID:25493637

Pescosolido, Nicola; Barbato, Andrea; Pascarella, Antonia; Giannotti, Rossella; Genzano, Martina; Nebbioso, Marcella

2014-01-01

387

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

2014-10-01

388

Ocular Firework Injuries at New Year’s Eve  

Microsoft Academic Search

Purpose: To prospectively study mechanisms and injury characteristics of ocular firework burns. Methods: A prospective analysis of all patients with firework injuries attending the Department of Ophthalmology, University of Vienna, between 1994 and 2001. We looked for classes of fireworks and mechanisms of injuries. The number of diagnoses was established and their severity classified. Results: During this period (8 years)

Stefan Sacu; Nikolaus Ségur-Eltz; Karin Stenng; Martin Zehetmayer

2002-01-01

389

In Vitro Activity of Thimerosal against Ocular Pathogenic Fungi  

Microsoft Academic Search

The in vitro activity of thimerosal versus those of amphotericin B and natamycin was assessed against 244 ocular fungal isolates. The activity of thimerosal against Fusarium spp., Aspergillus spp., and Alternaria alternata was 256 times, 512 times, and 128 times, respectively, greater than that of natamycin and 64 times, 32 times, and 32 times, respectively, greater than that of amphotericin

Yan Xu; Guangren Pang; Dongqing Zhao; Chuanwen Gao; Lutan Zhou; Shengtao Sun; Bingliang Wang

2010-01-01

390

Ocular Fungal Isolates and Antifungal Susceptibility in Northern China  

Microsoft Academic Search

? PURPOSE: To analyze the distribution characteristics of ocular fungal isolates and antifungal susceptibility in vitro. ? DESIGN: A retrospective case-series descriptive study. ? METHODS: Two thousand one hundred and seventy- nine specimens collected from Tongren Hospital during 2001 to 2004 were identified at the Beijing Institute of Ophthalmology. Fungal culture-positive rate, antifungal susceptibility in vitro, and genus distribution of

SUN XUGUANG; WANG ZHIXIN; WANG ZHIQUN; LUO SHIYUN

391

Ocular Manifestations of Acquired Immunodeficiency Syndrome in Korea  

PubMed Central

The clinical features of HIV/AIDS-related ocular manifestations in Korean patients were investigated in this study. Data on 200 consecutive Korean patients diagnosed with AIDS who visited the Seoul National University Hospital from January 2003 to June 2008 were reviewed. Fifty-seven patients (28.5%) had ocular manifestations, and they showed significantly lower CD4+ T cell count than patients without ocular manifestations. Among them, 23 (40.3%) patients showed retinal microvasculopathy, and 22 (38.5%) patients showed cytomegalovirus (CMV) retinitis. Other manifestations included retinal vein occlusion (n = 4), herpes zoster ophthalmicus (n = 4), syphilitic uveitis (n = 2), acute retinal necrosis (n = 1), and progressive outer retinal necrosis (n = 1). The mean CD4+ lymphocyte counts of the patients with retinal microvasculopathy and cytomegalovirus retinitis were 108.5 cells/µL and 69.4 cells/µL, respectively. In conclusion, ocular manifestations including CMV retinitis are common complications in Korean patients with AIDS even in the era of highly active anti-retroviral therapy. Compared to previous reports in western countries, prevalence of CMV retinitis is relatively low and CD4+ lymphocytes count at the time of diagnosis is relatively high. PMID:22563221

Kim, Sang Jin; Park, Sang Jun; Kim, Nam Joong; Jang, Hee-Chang; Oh, Myoung-don

2012-01-01

392

Ocular myasthenia gravis after D-penicillamine administration.  

PubMed Central

A 68-year-old black woman who was put on D-penicillamine therapy (250-500 mg per day, total dose 15 g) for rheumatoid arthritis developed ocular myasthenia gravis. Two weeks after she discontinued D-penicillamine her signs and symptoms cleared with no other treatment. Review of previous cases and possible immunological mechanisms are discussed. PMID:2692700

Katz, L J; Lesser, R L; Merikangas, J R; Silverman, J P

1989-01-01

393

Ocular findings in the inmates of a leprosy rehabilitation centre.  

PubMed

This study is aimed at presenting the profile of ocular lesions observed in the inmates of a leprosy rehabilitation centre. Corneal involvement was found to be the highest (52.7%), followed by lesions of the eyebrows (47.3%) and eyelids (30.9%), uveal tract involvement (18.1%) and chronic conjunctivitis (1.8%). PMID:2583793

Sanjiv, D; Rajiv, D; Desai, N C; Shoba, L; Kumar, K

1989-01-01

394

Blink-related microtrauma: when the ocular surface harms itself.  

PubMed

Superior limbic keratoconjunctivitis results mechanically from blinking under prolonged unphysiological conditions. The pathogenic process is known as blink-related microtrauma. This review aimed to explore the validity of a general theory that besides superior limbic keratoconjunctivitis, there may be other diseases of the ocular surface arising from mechanical microtrauma. A review of relevant clinical and microscopic lesions in a range of ocular surface disorders with possible mechanical aetiology was conducted. New terms were selected to facilitate understanding of such new aetiology. Besides superior limbic keratoconjunctivitis, other ocular surface disorders regarded as primarily derived from blink microtrauma are: other filamentary keratitides; blepharospasm and severe ptosis; canthal/palpebral froth; affections from disordered eyelid lining; and contact lens related damage. A group of secondarily microtraumatic disorders was identified, including the example of microtrauma impacting upon interpalpebral bulbar prominences. Superior limbic keratoconjunctivitis is the archetype of diseases affecting a unique combination; namely, the ocular surface conjoined with its lacrimal fluid. It is only one among many diseases actively generated within the confines of 'a self-harming surface'. PMID:12786767

Cher, Ivan

2003-06-01

395

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

396

Laser-Induced Mouse Model of Chronic Ocular Hypertension  

E-print Network

) is considered a primary risk factor for the initiation and progression of glaucomatous neuropathy.2 However human diseases could provide an opportunity to identify possible risk factors that may predispose to andLaser-Induced Mouse Model of Chronic Ocular Hypertension Sinisa D. Grozdanic,1,2 Daniel M. Betts,1

Sakaguchi, Donald S.

397

Defensins and Other Antimicrobial Peptides at the Ocular Surface  

PubMed Central

Although constantly exposed to the environment and “foreign bodies” such as contact lenses and unwashed fingertips, the ocular surface succumbs to infection relatively infrequently. This is, in large part, due to a very active and robust innate immune response mounted at the ocular surface. Studies over the past 20 years have revealed that small peptides with antimicrobial activity are a major component of the human innate immune response system. The ocular surface is no exception, with peptides of the defensin and cathelicidin families being detected in the tear film and secreted by corneal and conjunctival epithelial cells. There is also much evidence to suggest that the role of some antimicrobial peptides is not restricted to direct killing of pathogens, but, rather, that they function in various aspects of the immune response, including recruitment of immune cells, and through actions on dendritic cells provide a link to adaptive immunity. A role in wound healing is also supported. In this article, the properties, mechanisms of actions and functional roles of antimicrobial peptides are reviewed, with particular emphasis on the potential multifunctional roles of defensins and LL-37 (the only known human cathelicidin) at the ocular surface. PMID:17216098

McDermott, Alison M.

2006-01-01

398

Monochromatic ocular wavefront aberrations in the awake-behaving cat  

E-print Network

Monochromatic ocular wavefront aberrations in the awake-behaving cat Krystel R. Huxlin a,b,*,1 manipulations. Wavefront measures have also been performed in several other species, but never in cats aberrations reliably in live, awake-behaving cats in a manner that is directly comparable to that used

Yoon, Geunyoung

399

Human ocular vergence movements induced by changing size and disparity.  

PubMed Central

Human subjects viewed an electronically generated bright square. Horizontal movements of the two eyes were recorded with the scleral coil method. The dynamic properties of vergence movements induced by movement of the bright square were investigated for the following three kinds of stimulus motion: (a) both the size and the binocular disparity of the square changed together, in such a way as to exactly mimic the retinal image changes produced by a real object's motion in depth; (b) the changing-size component in (a) was present with no disparity component; (c) the changing-disparity component in (a) was present with no size component. The gain and phase of the ocular vergence responses to these three stimuli were computed. Ocular vergence movements were induced by changing size in all five subjects. Responses during binocular viewing were higher and less variable than responses during monocular viewing. Size oscillations induced ocular vergence oscillations with a phase lead of up to 65 deg relative to target size for frequencies of stimulation below 1.0 Hz. Vergence oscillation amplitudes were of the order of 10 min of arc and maximal for frequencies of 0.4-0.7 Hz. Ocular vergence movements were not induced by changes in target size in one dimension nor by flickering a stationary square. Ocular vergence movements induced by size changes were entirely transient with no sustained component: vergence responses to disparity were sustained. When the stimulus combined size change with disparity change in the ratio characteristic of a real moving object, vergence tracking was more accurate and less noisy than when the eyes were stimulated with the disparity component alone. The ocular vergence response induced by the combination of size change with disparity change was accurately predicted by linearly adding the vergence response produced by the size change alone to the vergence response produced by the disparity change alone: combined stimulation produced no evidence of non-linear interaction between responses to size change and to disparity change. The properties of vergence responses induced by changing size and by changing disparity showed several close correlations with the corresponding data on psychophysical sensitivity for motion-in-depth sensation. We suggest that responses to changing size contribute to the accuracy with which ocular vergence tracks real objects moving in depth. PMID:3559991

Erkelens, C J; Regan, D

1986-01-01

400

Ocular myasthenia gravis: response to long-term immunosuppressive treatment.  

PubMed Central

OBJECTIVE: Ocular myasthenia gravis is a subtype of myasthenia gravis that causes relatively mild disability, but may convert into severe generalised muscle weakness. A universal management plan for ocular myasthenia gravis has not been established. This study was performed to determine the outcome of ocular myasthenia gravis with the currently available therapeutic options. METHODS: Retrospective analysis of 78 patients with ocular myasthenia gravis with a mean disease duration of 8.3 (range 0.5-58.3) years. RESULTS: In 54 patients (69%) symptoms and signs remained confined to the extraocular muscles during the observation period. The remaining 24 patients (31%) developed symptoms of generalised myasthenia gravis; 50% of them within two years, 75% within four years after onset. A somewhat reduced risk of generalisation was found in those with mild symptoms, normal repetitive nerve stimulation test, and low or absent antiacetylcholine receptor (AChR) antibodies at the time of diagnosis. Patients receiving immunosuppressive treatment (corticosteroids and/or azathioprine) rarely developed generalised myasthenia gravis (six of 50, 12%). Those without such treatment, usually due to uncertain diagnosis and late referral, converted into generalised myasthenia gravis significantly more often (18 of 28, 64%). CONCLUSIONS: The prognosis of ocular myasthenia gravis is good. A conventional scheme with short-term corticosteroids and long-term azathioprine seems adequate to achieve remission in most patients. The proportion of patients developing generalised myasthenia gravis was smaller in this population compared with previously published groups (usually 50%-70%). Early immunosuppressive treatment is at least partially responsible for this finding. Thymectomy (performed here in 12 patients with an abnormal chest CT) also correlated with a good outcome, but had no apparent advantage over medical treatment alone. PMID:9048716

Sommer, N; Sigg, B; Melms, A; Weller, M; Schepelmann, K; Herzau, V; Dichgans, J

1997-01-01

401

Non-cytomegalovirus ocular opportunistic infections in patients with AIDS  

PubMed Central

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

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

2014-01-01

402

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

403

Evidence suggesting individual ocular motor control of each eye (muscle).  

PubMed

Current models of the ocular motor system are usually presented in their most reduced form, are unilateral in architecture, and precise yoking is presumed. Although this simplifies the models, it does not accurately simulate the actual neuroanatomy and limits the models to simple, stereotyped responses. Studies of normal humans and monkeys have demonstrated striking disconjugacies in normal responses. Normal saccades may be disconjugate, or 1 eye may exhibit a dynamic overshoot. Asymmetric vergence can result in disconjugate saccades, unequal magnification spectacles cause differential saccadic gain adjustment, and saccades to unequal disparities also cause unequal saccades in the 2 eyes. In strabismus, deviated eyes typically do not mimic the movements of the fixating eye nor do their latent or congenital nystagmus waveforms duplicate those of the fixating eye. In spasmus nutans, each eye oscillates independently of the other. In achiasmatic dogs, uni-ocular saccades and uni-ocular nystagmus waveforms are seen; the same may be true in human achiasma. These data from both normals and those with abnormalities suggest that current models for ocular motor control are inadequate representations of the actual system. The inability of unilateral, yoked control (or even bilateral, yoked control) system models to duplicate the ocular motor responses of binocular mammals suggests that their ocular motor systems evolved from the bilateral, independent control systems seen in chameleons. One need only postulate a yoking overlay superimposed on two independent control systems to achieve conjugacy (bilateral, yoked, independent control) of the eyes. Abnormalities producing grossly disconjugate eye movements may then be simulated using the independent control of each eye released by a deficiency in the yoking overlay. Independent control of each eye coupled with the essential bilateral brain stem architecture implies that each individual muscle is driven by independent populations of neurons (burst cells, neural integrator cells, etc.). The agonist muscles of each eye are usually coordinated (yoked) but may function independently if the task dictates or if binocularity did not develop. Models based on the above architecture would be robust and could duplicate the many responses (both normal and abnormal) possible from the neurophysiological system. PMID:7994479

Dell'Osso, L F

1994-01-01

404

Novel Nanomicellar Formulation Approaches for Anterior and Posterior Segment Ocular Drug Delivery  

PubMed Central

One of the most challenging areas of pharmaceutical research is ocular drug delivery. The unique anatomy and physiology of the eye impedes drug permeation to deeper ocular tissues. Nanosized carrier systems such as nanoparticles, liposomes, suspensions, dendrimers, and nanomicelles are being explored for ocular drug delivery. In this review, we have focused on application of emerging nanomicellar carrier systems in ocular drug delivery. Nanomicelles are nanosized vesicular carriers formed from amphiphilic monomer units. Surfactant and polymeric micellar nanocarriers provide an amenable means to improve drug solubilization, develop clear aqueous formulations and deliver drugs to anterior and posterior ocular tissues. Nanomicelles due to their amphiphilic nature encapsulate hydrophobic drugs and aid in drug delivery. Various methods are employed to develop nanosized micellar formulations depending upon the physicochemical properties of the drug. Nanomicellar carriers appear to be promising vehicles with potential applications in ocular drug delivery. In this review, we attempted to discuss about the progress in ocular drug delivery research using nanomicelles as carriers from the published literature and issued patents. Also, with regards to ocular static and dynamic barriers which prevent drug permeation, a brief discussion about nanomicelles, types of nanomicelles, their methods of preparation and micellar strategy to overcome ocular barriers, delivering therapeutic levels of drugs to anterior and posterior ocular tissues are discussed. PMID:25400717

Cholkar, Kishore; Patel, Ashaben; Vadlapudi, Aswani Dutt; Mitra, Ashim K

2014-01-01

405

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

406

Ocular tolerability and safety of ketotifen fumarate ophthalmic solution.  

PubMed

Ketotifen fumarate, formulated for the treatment of allergic conjunctivitis, is a histamine H1-receptor antagonist, mast cell stabilizer, and eosinophil inhibitor (decreases chemotaxis and activation of eosinophils). In this study, healthy volunteers 3 years of age or older received ketotifen fumarate .025% ophthalmic solution (n = 330) or placebo (n = 165) four times daily for 6 weeks. Ketotifen was safe and well tolerated in the adult and pediatric populations, with an incidence of ocular adverse events of 18.2%, compared with 15.2% with placebo. No ocular rebound vasodilation or itching was observed within 48 hours after treatment. Ketotifen has a favorable safety and tolerability profile, which may have a positive impact on compliance, an important aspect of effective symptomatic control of allergic conjunctivitis. PMID:12431041

Abelson, Mark B; Chapin, Matthew J; Kapik, Barry M; Shams, Naveed B K

2002-01-01

407

An Imaging Review of Intra-ocular Calcifications.  

PubMed

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

Kachewar, Sushil G; Kulkarni, Devidas S

2014-01-01

408

Ocular pharmacokinetic study of a corticosteroid by 19F MR  

PubMed Central

Traditional ocular pharmacokinetic studies are invasive and cannot be easily applied to humans in vivo. To acquire in vivo ocular pharmacokinetic data noninvasively, 19F MR on a 3T clinical scanner was used to follow the real time dynamics of a corticosteroid in the eye. 1H MR was also performed to locate the site of administration. Triamcinolone acetonide phosphate (TAP) was the model drug, administered by intravitreal and subconjunctival injections. TAP pharmacokinetics were monitored by changes in the 19F spectrum of the intraocular drug in real time. The elimination half-lives of TAP in the eye after intravitreal and subconjunctival injections were 8 and 0.5 h in vivo and 17 and 6.0 h postmortem, respectively. The half-lives associated with clearance were 14 h for intravitreal injection and 0.5 h for subconjunctival injection. PMID:20537996

Liu, Xin; Li, S. Kevin; Jeong, Eun-Kee

2010-01-01

409

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

410

Superior limbic keratoconjunctivitis causing chronic ocular irritation in a child.  

PubMed

Superior limbic keratoconjunctivitis (SLK) is an uncommon, painful inflammation of the ocular surface localized to the superior sectors of the cornea, limbus, and conjunctiva. The clinical course tends to be chronic, with alternating periods of remission and exacerbation. Many patients experience severe ocular discomfort for long periods. Corneal involvement may induce scarring, astigmatism, and ultimately decreased vision. SLK typically occurs in woman between 20 and 60 years of age. Little is known about the features of SLK in young children because the earliest age described in the literature is adolescence. We report the clinical presentation and management of SLK in a 7-year-old boy who responded well to topical steroids and lubricants. PMID:23158547

Gupta, Amit; Morini, Chiara; Sachdeva, Virender; Kekunnaya, Ramesh

2012-12-01

411

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

412

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

413

Safety of negative-pressure wound therapy over ocular structures.  

PubMed

This is a report of the use, efficacy, and theoretic safety of negative-pressure wound therapy over ocular structures as a part of surgical treatment for necrotizing fasciitis. We treated a 65-year-old man with facial necrotizing fasciitis requiring serial debridement and closure of extensive periorbital and nasal wounds with skin grafts. Negative-pressure wound therapy was first used as a bridge to allow temporary closure and to encourage granulation tissue development. It was then used as a bolster dressing to stabilize skin grafts in the complex wound, not amenable to tie-over dressings. Excellent functional and cosmetic reconstruction of the periorbital and nasal regions was achieved. After treatment, the patient's corrected vision was 20/20. To our knowledge, the use of negative-pressure wound therapy directly over ocular structures has not been previously documented. In this case, it was safely used over the eyes with no sequelae to the patient's vision. PMID:22186986

Semlacher, Roy A; Taylor, Elise J; Golas, Liliya; Snyder, Kiersten R; Semlacher, Berlin M; Martel, Joseph R; Martel, James B

2012-01-01

414

Anti-acetylcholinesterase antibodies associate with ocular myasthenia gravis.  

PubMed

In MG, anti-AChR or anti-MuSK abs impair neuromuscular transmission. Partial inhibition of AChE can ameliorate symptoms, while a complete block causes a cholinergic blockade. We found anti-AChE abs in 115/240 MG patients, with no correlation with sex, age at onset, thymus pathology, presence of anti-AChR or anti-MuSK antibodies. We found a correlation with the ocular form of the disease, and with milder forms of MG not requiring immunosuppressants; moreover, when we considered only those patients who were off AChEI therapy, we found that ocular patients were positive for anti-AChE abs, while generalized patients were negative. According to an experimental model, we hypothesize that anti-AChE abs could contribute to ptosis through an inhibition of the sympathetic innervation of the tarsal muscle. PMID:19942297

Provenzano, Carlo; Marino, Mariapaola; Scuderi, Flavia; Evoli, Amelia; Bartoccioni, Emanuela

2010-01-25

415

Risk Factors for Fluoroquinolone Resistance in Ocular Cultures  

PubMed Central

Purpose To identify the risk factors associated with fluoroquinolone resistance in patients undergoing cataract surgery. Methods A total of 1,125 patients (1,125 eyes) who underwent cataract surgery at Veterans Health Service Medical Center from May 2011 to July 2012 were enrolled in this study. Conjunctival cultures were obtained from the patients on the day of surgery before instillation of any ophthalmic solutions. The medical records of patients with positive coagulase negative staphylococcus (CNS) and Staphylococcus aureus (S. aureus) cultures were reviewed to determine factors associated with fluoroquinolone resistance. Results Of 734 CNS and S. aureus cultures, 175 (23.8%) were resistant to ciprofloxacin, levofloxacin, gatifloxacin, or moxifloxacin. Use of fluoroquinolone within 3 months and within 1 year before surgery, topical antibiotic use other than fluoroquinolone, systemic antibiotic use, recent hospitalization, ocular surgery, intravitreal injection and use of eyedrops containing benzalkonium chloride were significantly more frequent in resistant isolates than in susceptible isolates. In multivariable logistic regression analysis, ocular surgery (odds ratio [OR], 8.457), recent hospitalization (OR, 6.646) and use of fluoroquinolone within 3 months before surgery (OR, 4.918) were significant predictors of fluoroquinolone resistance, along with intravitreal injection (OR, 2.976), systemic antibiotic use (OR, 2.665), use of eyedrops containing benzalkonium chloride (OR, 2.323), use of fluoroquinolone within 1 year before surgery (OR, 1.943) and topical antibiotic use other than fluoroquinolone (OR, 1.673). Conclusions Recent topical fluoroquinolone use, hospitalization and ocular surgery were significantly associated with fluoroquinolone resistance in CNS and S. aureus isolates from ocular culture. PMID:25646055

Lee, Junsung

2015-01-01

416

Fabry disease: a survey of visual and ocular symptoms  

PubMed Central

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

Davey, Pinakin Gunvant

2014-01-01

417

Ocular Manifestations of Late-Onset Behçet Disease  

Microsoft Academic Search

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

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

2011-01-01

418

Ocular adverse effects associated with systemic medications : recognition and management.  

PubMed

This article reviews several retrospective case series and reported adverse events regarding common ocular adverse effects related to systemic therapy. It is not intended as a comprehensive summary of these well described adverse drug reactions, nor is it intended to cover the complete spectrum of all ocular adverse effects of systemic therapy. Many systemic drugs may produce ocular toxicity, including bisphosphonates, topiramate, vigabatrin, isotretinoin and other retinoids, amiodarone, ethambutol, chloroquine and hydroxychloroquine, tamoxifen, quetiapine, cyclo-oxygenase (COX)-2 inhibitors, erectile dysfunction agents and some herbal medications. For this review, the certainty of the adverse effect profile of each medication was evaluated according to the WHO Causality Assessment Guide.A certain relationship has been established for pamidronate and alendronate as causes of scleritis, uveitis, conjunctivitis and blurred vision. Topiramate has been established as adversely causing symptoms consistent with acute angle-closure glaucoma, typically bilateral. Vigabatrin has been shown to cause bilateral irreversible visual field defects attributed to underlying medication-induced retinal pathology. Isotretinoin should be considered in the differential diagnosis of any patient with pseudotumour cerebri. Patients taking amiodarone and hydroxychloroquine should be monitored and screened regularly for development of optic neuropathy and maculopathy, respectively. Sildenafil has been reported to cause several changes in visual perception and is a possible, not yet certain, cause of anterior ischaemic optic neuropathy. Patients taking tamoxifen should also be monitored for development of dose-dependent maculopathy and decreased colour vision. COX-2 inhibitors should be included in the differential diagnosis of reversible conjunctivitis. Several herbal medications including canthaxanthine, chamomile, datura, Echinacea purpurea, Ginkgo biloba and liquorice have also been associated with several ocular adverse effects. It is the role of all healthcare professionals to detect, treat and educate the public about adverse reactions to medications as they are an important health problem. PMID:17209665

Santaella, Ricardo M; Fraunfelder, Frederick W

2007-01-01

419

Ocular Disease, Knowledge, and Technology Applications in Patients with Diabetes  

PubMed Central

An estimated 25.8 million children and adults in the United States, approximately 8.3% of the population, have diabetes. Diabetes prevalence varies by race and ethnicity. African Americans have the highest prevalence (12.6%), followed closely by Hispanics (11.8%), Asian Americans (8.4%), and Whites (7.1%). The purpose of this article is to discuss the ocular complications of diabetes, the cultural and racial differences in diabetes knowledge, and the role of telemedicine as a means to reach the undeserved who are at risk of complications. Information on the pathophysiology of ocular disease in patients with diabetes and the role of telemedicine in diabetes care was derived from a literature review. National Institutes of Health (NIH) on-line resources were queried to present data on the racial and cultural understandings of diabetes and diabetes-related complications. The microvascular ocular complications of diabetes are discussed for retinopathy, cataracts, glaucoma and ocular surface disease. Racial and cultural differences in knowledge of recommended self-care practices are presented. These differences in part, may explain health disparities and the increased risk of diabetes and its complications in rural minority communities. Finally, advances in telemedicine technology are discussed that show improvements in metabolic control and cardiovascular risk in adults with type 2 diabetes. Improving provider and patient understanding of diabetes complications may improve management and self care practices that are important for diabetes control. Telemedicine may improve access to diabetes specialists and may improve self-management education and diabetes control particularly in rural and underserved communities. PMID:23531956

Threatt, Jennifer; Williamson, Jennifer Faye; Huynh, Kyle; Davis, Richard M.

2013-01-01

420

Ocular dominance, cognitive strategy, and sex differences in spatial ability.  

PubMed

Ocular dominance, handedness, and cognitive strategy were assessed in relation to performance by 146 undergraduates on the Vandenberg Mental Rotation Test. Higher spatial scores were found for right-eyed subjects, right-handed subjects, and males. These higher scoring groups reported using similar cognitive strategies. The counted blocks less, used their hands less, and pictured in their minds more than the left-eyed, left-handed and female subjects. Results confirm previous findings. PMID:7255075

Freedman, R J; Rovegno, L

1981-04-01

421

Range of ocular deformities in calves due to hypovitaminosis A.  

PubMed

Hypovitaminosis A responsible for ocular deformities in suckler calves A review of type D clostridial enterotoxaemia in cattle Nitrate/nitrite poisoning in kale fed lambs Louping ill in sheep in mid-winter Rhodococcus equi abscessation identified at meat inspection of fattening pigs These are among matters discussed in the disease surveillance report for December 2013 from SAC Consulting: Veterinary Services (SAC C VS). PMID:24736821

2014-03-01

422

Association of Ocular Disease and Mortality in a Diabetic Population  

Microsoft Academic Search

for age and sex, retinopathy severity, macular edema, cata- ract, history of cataract surgery, and history of glau- coma at baseline were associated with all-cause and is- chemic heart disease mortality. In the older-onset group, after controlling for age and sex, retinopathy and visual impairment were related to all-cause, ischemic heart dis- ease, and stroke mortality. No ocular variable under

Ronald Klein; Barbara E. K. Klein; Scot E. Moss; Karen J. Cruickshanks

1999-01-01

423

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

424

Unusual panuveitis in a child: toxocariasis associated with ocular myiasis.  

PubMed

Most panuveitis in children are caused by infectious agents. A detailed clinical history and clinical examination are helpful in the diagnosis, but specific techniques are sometimes required to identify the causing specimen. We report the first published case of panuveitis in a child caused by simultaneous ocular infection by Toxocara canis and a fly larva and the innovative use of immunodiffusion technique in the vitreous for the diagnosis. PMID:24916981

Marques, André; Rodrigues, António; Belo, Silvana; Guedes, Marta Esteves

2014-01-01

425

Influence of gravity on cat vertical vestibulo-ocular reflex  

Microsoft Academic Search

The vertical vestibulo-ocular reflex (VOR) was recorded in cats using electro-oculography during sinusoidal angular pitch. Peak stimulus velocity was 50°\\/s over a frequency range from 0.01 to 4.0 Hz. To test the effect of gravity on the vertical VOR, the animal was pitched while sitting upright or lying on its side. Upright pitch changed the cat's orientation relative to gravity,

D. L. Tomko; C. Wall; F. R. Robinson; J. P. Staab

1988-01-01

426

[A complication of inferior dental nerve block: temporary ocular palsy].  

PubMed

An interesting case of temporary ocular palsy, a complication of inferior dental nerve block was reported. Symptom, sign and proper management were described. Several updated literatures on this topic were reviewed and concluded that this complication might be explained by accidental intra-arterial injection of anesthetic solution. To prevent this serious complication, aspirating before each injection by an aspirated syringe was strongly recommended. PMID:2635191

Hotrabhavanond, P; Meksupa, L

1989-01-01

427

Ocular myositis: insights into recurrence and semiological presentation.  

PubMed

Ocular myositis (OM) is a rare clinical entity characterized by idiopathic, nonspecific inflammation of primarily or exclusively extraocular muscles (EOM). Presentation usually encompasses painful diplopia, exacerbated by eye movement. We report two cases of idiopathic OM with unique characteristics. The first presented with pseudo-sixth nerve palsy due to medial nucleus inflammation and the second presented with recurrent OM, subsequently affecting both eyes. Knowledge of different patterns of presentation and recurrence are important to manage this rare inflammatory syndrome. PMID:25364881

Martins, William Alves; Marrone, Luiz Carlos Porcello; Saute, Ricardo; Becker, Jefferson; Vargas, José Amadeu Almeida; da Costa Vargas, Juliana Ferreira; Marrone, Antonio Carlos Huf

2014-11-26

428

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

429

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

430

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

431

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-Méničre'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 Méničre'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 Méničre'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

432

Current treatment of vestibular, ocular motor disorders and nystagmus.  

PubMed

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 Meničre'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 Meničre's disease, bilateral vestibular failure, vestibular paroxysmia, vestibular migraine, and many forms of central eye movement disorders. PMID:21179531

Strupp, Michael; Brandt, Thomas

2009-07-01

433

Nonionic surfactant vesicles in ocular delivery: innovative approaches and perspectives.  

PubMed

With the recent advancement in the field of ocular therapy, drug delivery approaches have been elevated to a new concept in terms of nonionic surfactant vesicles (NSVs), that is, the ability to deliver the therapeutic agent to a patient in a staggered profile. However the major drawbacks of the conventional drug delivery system like lacking of permeability through ocular barrier and poor bioavailability of water soluble drugs have been overcome by the emergence of NSVs. The drug loaded NSVs (DNSVs) can be fabricated by simple and cost-effective techniques with improved physical stability and enhance bioavailability without blurring the vision. The increasing research interest surrounding this delivery system has widened the areas of pharmaceutics in particular with many more subdisciplines expected to coexist in the near future. This review gives a comprehensive emphasis on NSVs considerations, formulation approaches, physicochemical properties, fabrication techniques, and therapeutic significances of NSVs in the field of ocular delivery and also addresses the future development of modified NSVs. PMID:24995280

Sahoo, Ranjan Ku; Biswas, Nikhil; Guha, Arijit; Sahoo, Nityananda; Kuotsu, Ketousetuo

2014-01-01

434

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

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