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Sample records for bullous keratopathy corneas

  1. Extracellular matrix alterations in human corneas with bullous keratopathy

    DEFF Research Database (Denmark)

    Ljubimov, A V; Burgeson, R E; Butkowski, R J

    1996-01-01

    . RESULTS. Fibrillar deposits of an antiadhesive glycoprotein tenascin in the anterior and posterior stroma, epithelial basement membrane (BM), bullae and subepithelial fibrosis (SEF) areas, and posterior collagenous layer (PCL) were revealed in disease corneas. Tenascin in midstroma, which was observed......; accumulation of fibronectin and alpha 1-alpha 2 type IV collagen on the endothelial face of the Descemet's membrane; and abnormal deposition of stromal ECM (tenascin, fibronectin, decorin, types I, III, V, VI, VIII, XII, XIV collagen) and BM components (type IV, collagen, perlecan, bamacan, laminin-1, entactin...

  2. Bullous Keratopathy

    Science.gov (United States)

    ... cloudy cornea with blisters on the surface. Treatment Salty eye drops Drugs to lower pressure in the ... and treatment—surgical and nonsurgical—of eye disorders). Salty eye drops (hypertonic saline) and salty ointments are ...

  3. Histological evaluation of corneal scar formation in pseudophakic bullous keratopathy.

    Directory of Open Access Journals (Sweden)

    Ting Liu

    Full Text Available PURPOSE: To evaluate histological changes in the corneal stroma in pseudophakic bullous keratopathy. METHODS: Twenty-eight patients (28 eyes with pseudophakic bullous keratopathy underwent therapeutic penetrating keratoplasty at Shandong Eye Institute between January 2006 and November 2011. The patients were divided into two groups according to the duration of bullous keratopathy (1.0 year group, and three buttons from enucleated eyes with choroidal melanoma served as a control. In vivo confocal microscopy examination, hematoxylin-eosin, Masson's trichrome stain and Van Gieson staining were used for microscopic examination. The histological evaluation and scoring of the buttons for morphological changes, including the degree of stromal scars, neovascularization and inflammatory cells within the corneal buttons, were compared. To study the underlying mechanism, connective tissue growth factor (CTGF and TGF-β immunohistochemistry were performed. RESULTS: Confocal microscopy examination and histological evaluation and scoring of the buttons showed that compared with the 1.0 year group (P1.0 year group. CONCLUSIONS: During the progression of pseudophakic bullous keratopathy, stromal scars occurred more often in the patients that had a longer duration of disease. Cytokines such as CTGF and TGF-β1 may play a role in this pathological process and deserve further investigation.

  4. The results descemet-stripping automated endothelial keratoplasty at bullous keratopathy

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    S. V. Trufanov

    2012-01-01

    Full Text Available Purpose: to evaluate outcomes of the descemet-stripping automated endothelial keratoplasty using eye drops Kombinil-Duo dur- ing postoperative period.Methods: 26 patients suffered from bullous keratopathy underwent descemet-stripping automated endothelial keratoplasty using our own technique. We applied eye drops Kombinil-Duo during postoperative period.Results: 25 patients had clear corneas whole period of observation. Graft rejection occurred in 1 eye. Mean BSCVA was 0.47±0.21.Conclusion: Kombinil-Duo has been allowed to avoid infectious complication and to increase efficiency of the operative interven-tion during postoperative period.

  5. Descemet-stripping automated endothelial keratoplasty for vitrectomized cases with traumatic aniridia and aphakic bullous keratopathy

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    Eguchi H

    2012-09-01

    Full Text Available Hiroshi Eguchi, Tatsuro Miyamoto, Fumika Hotta, Machiko Tomida, Masayuki Inoue, Yoshinori MitamuraDepartment of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, JapanAbstract: The surgical indication for Descemet-stripping automated endothelial keratoplasty (DSAEK is largely limited to phakic or pseudophakic cases of endothelial dysfunction with normal pupils, because the endothelial lenticule is generally attached to the recipient cornea by use of gas tamponade into the anterior chamber. Although it may be desirable for vitrectomized cases with aniridia and aphakic bullous keratopathy without capsule support to undergo DSAEK, one of the major problems is lenticule detachment during surgery or in the postoperative period. To perform DSAEK in such cases, special surgical techniques are needed in order to facilitate adhesion of the lenticule. Herein, we describe a suture technique for attaching the endothelial lenticule in DSAEK for aniridic and aphakic cases that have undergone vitrectomy for traumatic vitreoretinal disease.Keywords: traumatic aniridia, aphakic bullous keratopathy, Descemet-stripping automated endothelial keratoplasty, vitrectomy

  6. Non-Descemet’s stripping automated endothelial keratoplasty for bullous keratopathy secondary to iridoschisis

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    Minezaki T

    2013-07-01

    Full Text Available Teruumi Minezaki, Takaaki Hattori, Hayate Nakagawa, Shigeto Kumakura, Hiroshi GotoDepartment of Ophthalmology, Tokyo Medical University, Shinjukuku, Tokyo, JapanPurpose: To report a case of bullous keratopathy secondary to iridoschisis treated by non-Descemet's stripping automated endothelial keratoplasty (nDSAEK.Case report: A 79-year-old woman was referred to our hospital with loss of vision in the left eye. Slit lamp examination of her left eye showed a shallow anterior chamber with cataract and schisis in the inferior quadrant of iris stroma. Bullous keratopathy secondary to iridoschisis was diagnosed. Cataract surgery with iridectomy succeeded to deepen the anterior chamber and remove the floating iris leaf, although corneal edema remained. Four days later, nDSAEK was performed, which resolved corneal edema and restored visual acuity.Conclusion: The two-step surgery of cataract surgery plus iridectomy followed by nDSAEK may be an effective strategy for treating bullous keratopathy secondary to iridoschisis.Keywords: iridoschisis, bullous keratopathy, non-Descemet's stripping automated endothelial keratoplasty

  7. Recurrent rates and risk factors associated with recurrent painful bullous keratopathy after primary phototherapeutic keratectomy

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    Kasetsuwan N

    2015-09-01

    Full Text Available Ngamjit Kasetsuwan, Kanokorn Sakpisuttivanit, Usanee Reinprayoon, Vilavun Puangsricharern Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand Objective: To assess the recurrent rate, mean survival time, and risk factors associated with recurrent painful bullous keratopathy (BK after primary treatment with phototherapeutic keratectomy.Methods: Medical records from 72 patients (72 eyes who had phototherapeutic keratectomy for painful BK were evaluated. Data for sex, age, duration of BK, associated ocular and systemic diseases (hypertension, diabetes mellitus, ischemic heart disease, asthma, dyslipidemia, and rheumatoid arthritis, frequency and degree of pain (grade 1–3, visual acuity, corneal thickness, intraocular pressure, and laser setting were extracted and analyzed.Results: The mean age of the patients was 64.2±11.4 years. The mean preoperative duration of BK was 15.0±11.0 months. Most patients had pseudophakic BK (69.40%. Majority of the cases had grade 3 degree of pain (48.60%. Glaucoma and hypertension were markedly found among these patients (51.40% and 19.40%, respectively. Preoperative mean intraocular pressure and corneal thickness were 13.70±4.95 mmHg and 734.1±83.80 µm, respectively. The mean laser diameter and depth were 8.36±1.22 mm and 38.89±8.81 µm, respectively. Systemic disease was significantly associated with the risk for developing recurrent painful BK (P=0.022, hazard ratio [HR] 1.673, 95% confidence interval [CI] 1.08–2.58. The overall recurrent rate was 51%. The average duration time of recurrent painful BK was 17.3±12.9 months (range 1–50 months. The median survival time before recurrence was 29.0±6.6 months.Conclusion: Systemic disease was found to be the only risk factor significantly associated with the development of recurrent painful BK. Low recurrent rate and long mean survival time showed that phototherapeutic

  8. Descemet stripping automated endothelial keratoplasty in Fuchs′ endothelial dystrophy versus pseudophakic bullous keratopathy

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    Mohammad Ali Javadi

    2016-01-01

    Full Text Available Purpose: To compare clinical and confocal scan outcomes after Descemet stripping automated endothelial keratoplasty (DSAEK performed for Fuchs′ endothelial dystrophy (FED versus pseudophakic bullous keratopathy (PBK. Methods: This retrospective comparative study included 47 consecutive eyes of 39 patients with the diagnosis of FED (n = 29, group 1 or PBK (n = 18, group 2 that underwent DSAEK. Clinical outcomes were compared between the study groups. At the final follow-up examination, confocal microscopy was used to measure and compare central corneal and graft thickness as well as endothelial cell density and morphology between the two groups. Results: Mean age at the time of surgery was 65.2 ± 11.8 and 69.4 ± 12.5 years in groups 1 and 2, respectively (P = 0.27. Follow-up period was 23.6 ± 14.0 months in group 1 and 25.6 ± 15.7 months in group 2 (P = 0.79. Postoperative best spectacle-corrected visual acuity was significantly better in group 1 than in group 2 until postoperative month 6. Afterwards, the two study groups were comparable in this regard. At the final follow-up examination, spherical equivalent refractive error was + 0.39 ± 1.46 diopters (D in group 1 and + 0.80 ± 1.47 D in group 2 (P = 0.45. Postoperative keratometric astigmatism was 1.02 ± 0.83 D and 2.36 ± 0.67 D, respectively (P < 0.001. Mean central graft thickness was 98.0 ± 33.3 μm in group 1 and 107.6 ± 28.0 μm in group 2 (P = 0.45. No statistically significant difference was observed between the two groups in terms of the postoperative endothelial cell density. Conclusion: The outcomes of DSAEK surgery were comparable between FED and PBK. All grafts were clear despite the lower than normal endothelial cell counts.

  9. Descemet Stripping Automated Endothelial Keratoplasty in Fuchs’ Endothelial Dystrophy versus Pseudophakic Bullous Keratopathy

    Science.gov (United States)

    Javadi, Mohammad Ali; Feizi, Sepehr; Jafari, Roya; Mirbabaee, Firooz; Ownagh, Vahid

    2016-01-01

    Purpose: To compare clinical and confocal scan outcomes after Descemet stripping automated endothelial keratoplasty (DSAEK) performed for Fuchs’ endothelial dystrophy (FED) versus pseudophakic bullous keratopathy (PBK). Methods: This retrospective comparative study included 47 consecutive eyes of 39 patients with the diagnosis of FED (n = 29, group 1) or PBK (n = 18, group 2) that underwent DSAEK. Clinical outcomes were compared between the study groups. At the final follow-up examination, confocal microscopy was used to measure and compare central corneal and graft thickness as well as endothelial cell density and morphology between the two groups. Results: Mean age at the time of surgery was 65.2 ± 11.8 and 69.4 ± 12.5 years in groups 1 and 2, respectively (P = 0.27). Follow-up period was 23.6 ± 14.0 months in group 1 and 25.6 ± 15.7 months in group 2 (P = 0.79). Postoperative best spectacle-corrected visual acuity was significantly better in group 1 than in group 2 until postoperative month 6. Afterwards, the two study groups were comparable in this regard. At the final follow-up examination, spherical equivalent refractive error was + 0.39 ± 1.46 diopters (D) in group 1 and + 0.80 ± 1.47 D in group 2 (P = 0.45). Postoperative keratometric astigmatism was 1.02 ± 0.83 D and 2.36 ± 0.67 D, respectively (P < 0.001). Mean central graft thickness was 98.0 ± 33.3 μm in group 1 and 107.6 ± 28.0 μm in group 2 (P = 0.45). No statistically significant difference was observed between the two groups in terms of the postoperative endothelial cell density. Conclusion: The outcomes of DSAEK surgery were comparable between FED and PBK. All grafts were clear despite the lower than normal endothelial cell counts. PMID:27994806

  10. Effectiveness and safety of endothelial keratoplasty for pseudophakic and aphakic bullous keratopathy: a systematic review of randomized controlled trials and cohort studies

    Directory of Open Access Journals (Sweden)

    Bruno Harfuch

    2016-06-01

    Full Text Available ABSTRACT Objective: For nearly a century, penetrating keratoplasty has been the surgical technique of choice in the management of corneal changes. However, in recent years, several lamellar keratoplasty techniques have been developed, modified or improved, especially techniques for replacing the posterior portion, for the correction of bullous keratopathy. The aim of this study was to evaluate the effectiveness and safety of endothelial keratoplasty versus penetrating keratoplasty for pseudophakic and aphakic bullous keratopathy. Methods: A systematic review of the literature was carried out, and the main electronic databases were searched. The date of the most recent search was from the inception of the electronic databases to December 11, 2015. Two authors independently selected relevant clinical trials, assessed their methodological quality and extracted data. Results: The electronic search yielded a total of 893 published papers from the electronic databases. Forty-four full-text articles were retrieved for further consideration. Of these 44 full-text articles, 33 were excluded because they were all case series studies; therefore, ten studies (with one further publication met the inclusion criteria: one randomized clinical trial with two publications; three controlled studies; and six cohort studies. The clinical and methodological diversity found in the included studies meant that it was not possible to combine studies in a metaanalysis. Conclusions: There is no robust evidence that endothelial keratoplasty is more effective and safe than penetrating keratoplasty for improving visual acuity and decreasing corneal rejection for pseudophakic and aphakic bullous keratopathy. There is a need for further randomized controlled trials.

  11. Bee sting keratopathy with retained stinger

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    Lott Pooi Wah

    2016-01-01

    Full Text Available This case report aims to report an uncommon case of bee sting keratopathy with retained stinger. A 55-year-old man presented with left cornea bee sting while gardening two days prior to first visit. He complained of severe eye pain with redness, tearing and blurring of vision. On examination, his right eye visual acuity was 6/6 and in left eye was hand movement. There was generalized conjunctival hyperemia and cornea showing significant descemet striae. A bee stinger with surrounding infiltration noted at 2 o'clock was associated with striate keratitis. It was deeply seated at the posterior third of cornea stroma near to paracentral area. Pupil was mid-dilated with absence of relative afferent pupillary defect. There was neither hypopyon nor cataract. The posterior segment could not be visualized due to severe corneal edema. However, B-scan ultrasound was normal. Bee stinger was removed under local anaesthesia on the day of presentation. Post-operatively, patient was administered with topical moxifloxacin and topical non steroidal anti-inflammatory drugs. Three weeks later, there was resolution of cornea infiltrate with improvement of striate keratitis and his vision was improved to 1/60. However, cornea edema did not regress but ended up with bullous keratopathy. The patient has undergone descemet-stripping automated endothelial keratoplasty and his vision was improved to 6/9. We recommend early stinger removal to reduce the possible sequelae of bee sting toxicity for better visual outcome.

  12. Bee sting keratopathy with retained stinger

    Institute of Scientific and Technical Information of China (English)

    Lott Pooi Wah; Syed Shoeb Ahmad; Yew Yih Voon; Shuaibah Abdul Ghani; Visvaraja AL Subrayan

    2016-01-01

    This case report aims to report an uncommon case of bee sting keratopathy with retained stinger. A 55-year-old man presented with left cornea bee sting while gardening two days prior to first visit. He complained of severe eye pain with redness, tearing and blurring of vision. On examination, his right eye visual acuity was 6/6 and in left eye was hand movement. There was generalized conjunctival hyperemia and cornea showing significant descemet striae. A bee stinger with surrounding infiltration noted at 2 o'clock was associated with striate keratitis. It was deeply seated at the posterior third of cornea stroma near to paracentral area. Pupil was mid-dilated with absence of relative afferent pupillary defect. There was neither hypopyon nor cataract. The posterior segment could not be visualized due to severe corneal edema. However, B-scan ultrasound was normal. Bee stinger was removed under local anaesthesia on the day of presentation. Post-operatively, patient was administered with topical moxifloxacin and topical non steroidal anti-inflammatory drugs. Three weeks later, there was resolution of cornea infiltrate with improvement of striate keratitis and his vision was improved to 1/60. However, cornea edema did not regress but ended up with bullous keratopathy. The patient has undergone descemet-stripping automated endothelial keratoplasty and his vision was improved to 6/9. We recommend early stinger removal to reduce the possible sequelae of bee sting toxicity for better visual outcome.

  13. Clinical efficacy of phototherapeutic keratectomy for bullous keratopathy%PTK治疗大泡性角膜病变的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    段嘉欢; 郭秀瑾; 马月磊; 李向品; 刘超敏

    2016-01-01

    Objective To observe the efficacy of excimer laser phototherapeutic keratectomy (PTK) for bullous keratopathy,and to discuss the safety and effectiveness of PTK.Methods Nineteen patients (19 eyes) with bullous keratopathy who had undergone PTK in the Second Hospital of Hebei Medical University's Excimer Laser Treatment Center from January 2010 to December 2014 were chosen.All of them had recurrent symptom for pain,photophobia and watering.The outcomes of drugs were poor.Slit-lamp examination showed comeal edema,erosion and bullae.Preoperative examination included visual acuity,IOP,slit-lamp examination and CCT.Laser treatment information:target fluence 160rnJ/cm2,laser pulse rate 10.0 Hz,ablation area was lesion-centered,6.5mm diameter,2.0mm TZ,ablation depth ranged 80-160 (mean 106.32±18.92)μm.Follow-up was done at 1 day,1 week,1 month,3 months,6 months,and 5 years postoperatively,including visual acuity,ocular stimulus symptom,slit-lamp examination,postoperative complications and recurrence.Results After operation,visual acuity had no increase or only slight improvement,ocular stimulus symptoms was obviously relieved.The average time of epithelial healing was 6.42± 1.50 days.The average time of bullae fading was 21.74±21.79 days.Three cases needed further therapy because of persistent corneal bullae,and obtained satisfactory effects.One case had a corneal ulcer after PTK.No other complications were found during the follow-up period.There was no recurrence during 6 months to 5 years' follow-up.Conclusions PTK is a simple and economical surgery with less suffering for bullous keratopathy,and it has high safety,effectiveness and repeatability.PTK provides a new choice for patients with terminal bullous keratopathy and poor visual potential.%目的 观察PTK治疗大泡性角膜病变的临床疗效,探讨手术的安全性及有效性.方法 选择2010年1月至2014年12月在河北医科大学第二医院眼科准分子激光治疗中心接受PTK手术治疗

  14. Adenoviral Gene Therapy for Diabetic Keratopathy: Effects on Wound Healing and Stem Cell Marker Expression in Human Organ-cultured Corneas and Limbal Epithelial Cells.

    Science.gov (United States)

    Kramerov, Andrei A; Saghizadeh, Mehrnoosh; Ljubimov, Alexander V

    2016-04-07

    The goal of this protocol is to describe molecular alterations in human diabetic corneas and demonstrate how they can be alleviated by adenoviral gene therapy in organ-cultured corneas. The diabetic corneal disease is a complication of diabetes with frequent abnormalities of corneal nerves and epithelial wound healing. We have also documented significantly altered expression of several putative epithelial stem cell markers in human diabetic corneas. To alleviate these changes, adenoviral gene therapy was successfully implemented using the upregulation of c-met proto-oncogene expression and/or the downregulation of proteinases matrix metalloproteinase-10 (MMP-10) and cathepsin F. This therapy accelerated wound healing in diabetic corneas even when only the limbal stem cell compartment was transduced. The best results were obtained with combined treatment. For possible patient transplantation of normalized stem cells, an example is also presented of the optimization of gene transduction in stem cell-enriched cultures using polycationic enhancers. This approach may be useful not only for the selected genes but also for the other mediators of corneal epithelial wound healing and stem cell function.

  15. Quantitative & qualitative analysis of endothelial cells of donor cornea before & after penetrating keratoplasty in different pathological conditions

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    Aruna K.R. Gupta

    2016-01-01

    Full Text Available Background & objectives: Endothelial cells of the donor cornea are known to be affected quantitatively and qualitatively in different pathological conditions after penetrating keratoplasty (PK and this has direct effect on the clarity of vision obtained after PK. This study was undertaken to analyze the qualitative and quantitative changes in donor endothelial cells before and after PK in different pathological conditions. Methods: A prospective investigational analysis of 100 consecutive donor corneas used for penetrating keratoplasty between June 2006 and June 2008, was conducted. The patients were evaluated on the first day, at the end of first week, first month, third and six months and one year. Results: A decrease was observed in endothelial cell count in all pathological conditions. After one year of follow up the loss was 33.1 per cent in corneal opacity, 45.9 per cent in acute infective keratitis (AIK, 58.5 per cent in regrafts, 28.5 per cent in pseudophakic bullous keratopathy (PBK, 37 per cent in descemetocele, 27 per cent in keratoconus and 35.5 per cent in aphakic bullous keratopathy (ABK cases. Interpretation & conclusions: The endothelial cell loss was highest in regraft cases which was significant (P<0.05, while the least endothelial cell loss was seen in keratoconus cases. The cell loss was associated with increase in coefficient of variation (CV, i.e. polymegathism and pleomorphism. Inspite of this polymegathism and pleomorphism, the clarity of the graft was maintained.

  16. Familial band-shaped nodular keratopathy.

    Science.gov (United States)

    Meisler, D M; Tabbara, K F; Wood, I S; Alvarado, J A; Biswell, R

    1985-02-01

    A family is reported in which two brothers have a bilateral, symmetrical corneal disorder characterized by small yellowish to amber-colored globules arranged in a band-shaped configuration in the central superficial layers of the cornea. The globules have a similar clinical appearance to those found in Bietti's "band-shaped nodular dystrophy," a keratopathy that is nonfamilial, has an onset later in life, and initially involves the peripheral cornea. Light and electron microscopic studies of corneal tissue obtained from the proband showed that the globular deposits autofluoresce, that they stain black with Verhoeff's elastic stain, and that they correspond to an electron-dense material found within corneal epithelial cells and keratocytes and within the extracellular tissues of the anterior cornea. A third, younger brother appears to have the early corneal signs of the condition. Unlike the condition described by Bietti, the keratopathy we report is unique in its familial nature, early onset in life, and initial, marked central corneal involvement.

  17. Bullous pemphigoid

    Science.gov (United States)

    Bernard P, Borradori L. Pemphigoid group. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 30. Scott M, Werth VP. Bullous pemphigoid. In: ...

  18. Climatic droplet keratopathy: an old disease in new clothes.

    Science.gov (United States)

    Serra, Horacio M; Holopainen, Juha M; Beuerman, Roger; Kaarniranta, Kai; Suárez, María F; Urrets-Zavalía, Julio A

    2015-09-01

    Climatic droplet keratopathy (CDK) is an acquired and potentially handicapping cornea degenerative disease that is highly prevalent in certain rural communities around the world. It predominantly affects males over their forties. It has many other names such as Bietti's band-shaped nodular dystrophy, Labrador keratopathy, spheroidal degeneration, chronic actinic keratopathy, oil droplet degeneration, elastoid degeneration and keratinoid corneal degeneration. CDK is characterized by the haziness and opalescence of the cornea's most anterior layers which go through three stages with increasing severity. Globular deposits of different sizes may be histopathologically observed under the corneal epithelium by means of light and electron microscopy. The coalescence and increased volume of these spherules may cause the disruption of Bowman's membrane and the elevation and thinning of the corneal epithelium. The exact aetiology and pathogenesis of CDK are unknown, but they are possibly multifactorial. The only treatment in CDK advanced cases is a corneal transplantation, which in different impoverished regions of the world is not an available option. Many years ago, the clinical and histological aspects of this disease were described in several articles. This review highlights new scientific evidence of the expanding knowledge on CDK's pathogenesis which will open the prospect for new therapeutic interventions.

  19. Cornea Transplant

    Science.gov (United States)

    ... died from an unknown cause. During your cornea transplant On the day of your cornea transplant, you' ... when you see your eye doctor. Procedures to transplant a portion of the cornea With some types ...

  20. Familial band-shaped keratopathy.

    Science.gov (United States)

    Ticho, U; Lahav, M; Ivry, M

    1979-01-01

    A brother and sister out of a consanguinous family of four siblings are presented as prototypes of primary band-shaped keratopathy. The disease manifested sever progressive changes of secondary nature over two years of follow-up. Histology and treatment are described.

  1. Cloudy cornea

    Science.gov (United States)

    ... of lid tissue Computer mapping of the cornea (corneal topography) Schirmer's test for eye dryness Special photographs to measure the cells of the cornea Standard eye exam Ultrasound to measure corneal thickness ...

  2. Anesthetic keratopathy presenting as bilateral Mooren-like ulcers

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    Khakshoor H

    2012-10-01

    Full Text Available Hamid Khakshoor,1 Majid Moshirfar,2 Rachel G Simpson,3 Hamid Gharaee,1 Amir H Vejdani,1 Steven M Christiansen,2 Jason N Edmonds,2 Nicholas L Behunin21Mashhad University of Medical Sciences, Department of Ophthalmology, Mashad, Iran; 2John A Moran Eye Center, University of Utah, Salt Lake City, UT, 3The University of Arizona College of Medicine, Phoenix, AZ, USAAbstract: This observational case report describes the development of bilateral Mooren-like ulcers in a patient with anesthetic keratopathy. A 42-year-old man with a recent history of minor eye trauma and pain self-treated with tetracaine eye drops presented with complaints of acutely worsening vision and severe pain bilaterally. His visual acuity at presentation was limited to hand motion. Slit-lamp examination revealed bilateral epithelial defects at the center of the cornea, and an area of stromal infiltration and thinning with an undermining leading edge resembling a Mooren's ulcer in both eyes. Corneal haze and hypopyon were visible. Anesthetic use was halted immediately and the patient was started on prednisolone and mycophenolate mofetil (Cellcept®, after which visual acuity gradually improved and pain decreased. Despite improvement of symptoms, residual epithelial defects remained, and the patient was ultimately treated with keratoplasty for recovery of vision. We suggest that anesthetic keratopathy should be included in the differential diagnosis for any patient presenting with ring-shaped stromal infiltrates or nonhealing epithelial defects.Keywords: anesthetic abuse, corneal damage, corneal ulceration

  3. Infectious crystalline keratopathy caused by Cladosporium sp. after penetrating keratoplasty: a case report

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    Stock RA

    2016-08-01

    Full Text Available Ricardo Alexandre Stock,1 Elcio Luiz Bonamigo,2 Emeline Cadore,3 Rafael Allan Oechsler4 1Corneal Transplant Section, Santa Terezinha University Hospital, 2Department of Ophthalmology and Bioethics, 3University of Western Santa Catarina, Joaçaba, 4Cornea Department, Oftalmo Center Blumenau, Blumenau, Santa Catarina, Brazil Background: Infectious crystalline keratopathy is a rare, progressive infection characterized by the insidious progression of branches and crystalline corneal opacities with minimal or no inflammation. This case report describes the evolution of an infectious crystalline keratopathy caused by Cladosporium sp., which developed after tectonic keratoplasty in a patient with a history of ocular trauma.Case presentation: A 40-year-old Brazilian male was the victim of firework-induced trauma to the left eye, which resulted in a corneal laceration that could not be sutured as well as a severe traumatic cataract. The patient underwent penetrating keratoplasty and phacoemulsification. During postoperative follow-up, another therapeutic keratoplasty was required because unresponsive infectious keratitis was observed. The infiltrate’s characteristics were suggestive of infectious crystalline keratopathy; in particular, the infiltrate was insidious and progressive, and grayish-white branches appeared in the anterior corneal stroma. As different therapies were administered, inflammatory reactions ranging from mild to severe were observed. The infection was unresponsive to typical antifungal drugs. This lack of response most likely occurred due to steroid treatment and the diffuse corneal spread of an atypical microorganism, which was subsequently identified in culture as Cladosporium sp. After the second therapeutic keratoplasty, the patient’s eye integrity was successfully reestablished.Conclusion: This study likely provides the first report describing a case of infectious crystalline keratopathy caused by Cladosporium sp. This case

  4. [The cornea: stasis and dynamics].

    Science.gov (United States)

    Nishida, Teruo

    2008-03-01

    of the cornea. However, the possibility of blood-borne infections has interfered with the development of serum-derived fibronectin as a drug. An automated machine for the preparation of autologous fibronectin eyedrops has therefore recently been developed. Furthermore, in seeking an alternative to fibronectin eyedrops, we are investigating the effects of a peptide corresponding to the second cell-binding domain of fibronectin on corneal epithelial wound healing. Considering that urokinase-type plasminogen activator may be expressed at the site of corneal epithelial defects and facilitates epithelial migration, the potential clinical application of annexin V, which stimulates the secretion of urokinase-type plasminogen activator for the treatment of persistent corneal epithelial defects is also now under investigation in Japan. 2. Development of eyedrops for treatment of neurotrophic keratopathy. Substance P, a neurotransmitter, stimulates corneal epithelial migration in a synergistic manner with insulin-like growth factor (IGF)--1. We have shown that eyedrops containing both the substance P-derived peptide FGLM-amide and the IGF-1--derived peptide SSSR are effective for the treatment of persistent corneal epithelial defects in individuals with diabetic keratopathy or neurotrophic keratopathy, both of which are associated with a reduction in corneal sensation. 3. Development of drugs for corneal ulcer. Treatment of corneal infection with antibiotics does not necessarily halt the process of corneal ulceration, which is characterized by excessive degradation of stromal collagen, or resolve persistent corneal epithelial defects. In addition to eyedrops for the treatment of persistent corneal epithelial defects, we have therefore also been working on the development of new drugs for the treatment of corneal ulcer. To this end, we have established an experimental system in which corneal fibroblasts are cultured in a three-dimensional collagen gel. With this system, we have

  5. Neuronal Changes in the Diabetic Cornea: Perspectives for Neuroprotection

    Science.gov (United States)

    Yamamoto, Shuichi

    2016-01-01

    Diabetic neuropathy is associated with neurotrophic ulcerations of the skin and cornea. Decreased corneal sensitivity and impaired innervation lead to weakened epithelial wound healing predisposing patients to ocular complications such as corneal infections, stromal opacification, and surface irregularity. This review presents recent findings on impaired corneal innervation in diabetic individuals, and the findings suggest that corneal neuropathy might be an early indicator of diabetic neuropathy. Additionally, the recent findings for neuroprotective and regenerative therapy for diabetic keratopathy are presented. PMID:28044131

  6. [Simple keratectomy in band-shaped degeneration of the cornea (author's transl)].

    Science.gov (United States)

    Kenyeres, P

    1980-01-01

    In a case of band-shaped keratopathy chemical solution of the opacity failed but it proved easy to remove Bowman's membrane by grasping it with a forceps and pulling it off. As a result the cornea became clear and vision improved up to 6/7ths.

  7. Perfil epidemiológico dos pacientes na lista de espera para transplante de córnea no Estado de Sergipe Epidemiological profile of the patients on the waiting list for cornea transplantation in the State of Sergipe , Brazil

    Directory of Open Access Journals (Sweden)

    Ângelo Augusto Araújo

    2004-08-01

    analyzed data were: corneal disease, age, sex, visual acuity and the time spent on the waiting list until the transplantation was performed. RESULTS: Pseudophakic and aphakic bullous keratopathy was the most common disease (39.1%, followed by leukoma (22.5%, keratoconus (14.1%, "other diseases" (10.6%, regraft (7.8% and ulcerative conditions (5.6%. Mean age was 52.16 years and there was no significant difference between the sexes. "Hand motion" and "light perception" were the most common visual acuities. The 110 patients who had their cornea transplanted waited, on average, six months. The ones who were indicated for transplant due to ulcerative conditions and regraft had priority and waited less time. Those who had bullous keratopathy were 68.5 years old on average whereas the ones with keratoconus were 23.6 years old. CONCLUSIONS: It is possible to conclude that bullous keratopathy is the main indication for corneal transplant in our state. There is no difference in the frequency concerning sex; the mean age of the most common disease is in agreement with the time of its development. Visual acuity is as expected and the time spent on the waiting list is long and inappropriate.

  8. Epidemiology of Autoimmune Bullous Diseases

    Directory of Open Access Journals (Sweden)

    Erkan Alpsoy

    2011-06-01

    Full Text Available We have very limited knowledge about aotuimmune bullous disesases which are important causes of morbidity and mortality. They are generally rare disases in population. The yearly over all incidences of pemphigus and bullous pemhigoid are between 0.5 to 16.1/million and 2.5 to 42.8/million, respectively. Pemphigus vulgaris is the major type of pemphigus and it is most prevalent between ages of 40 and 50. Bullous pemphigoid is tpypically most prevalent in ages of over 70. In this review the results obtained from the studies which are especially about epidemiology of pemphigus and bullous pemphigoid were analised according to geographic regions.

  9. [Retarded bullous dermographism].

    Science.gov (United States)

    Franco, N; Scaletzky, A; Cabo, H; Lutzky, F; Calb, I

    1982-01-01

    A case of what we denominate Bullous Delayed Dermographism in a woman who had neither allergic nor urticarial antecedents is registered. We comment the features of the lesions which appeared after a period of 4 to 12 hs. This lesions appeared by friction or percussion. We describe the existence of an endocrine and psychological predisposition mechanism and the non specificity of the histopathological characters. The nonexistence of bibliographical antecedents of the illness is noted. Also its difference with bullous and pressure urticaria. This differentiation is based on clinical features, and the nonexistence of allergic antecedents and urticarial lesions. Also on the existence of friction mechanism different to the simple pressure and the nonexistence of immunoglobulins in the subepidermal blister.

  10. [Cornea in diabetus mellitus].

    Science.gov (United States)

    Simion, Maria; Selaru, Daniela

    2011-01-01

    Diabetus mellitus is associated with numerous ocular complications. Diabetic keratopathy occurs in response to a neuropathy of the ophthalmic division of the trigeminal nerve, but also as a result of epithelial subclinical abnormalities, limbal vasculopathy and decrease in tear production. It comprises several symptomatic corneal conditions inducing superficial punctate keratopathy and persistent corneal epithelial erosions; the latter can progress to corneal ulceration and is often resistant to routine clinical management.

  11. Two percent ethylenediaminetetraacetic acid chelation treatment for band-shaped keratopathy, without blunt scratching after removal of the corneal epithelium

    Directory of Open Access Journals (Sweden)

    Kobayashi W

    2015-02-01

    Full Text Available Wataru Kobayashi,1 Shunji Yokokura,1 Takehiro Hariya,1 Toru Nakazawa1–3 1Department of Ophthalmology, 2Department of Retinal Disease Control, Ophthalmology, 3Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan Background: The purpose of this study was to assess the effectiveness of 2% ethylenediaminetetraacetic acid (EDTA for the treatment of band-shaped keratopathy.Methods: We studied 24 eyes of 16 patients with band-shaped keratopathy who underwent EDTA chelation treatment from April 1, 2011 to December 31, 2012. We compared preoperative and 1 month postoperative logarithm of the minimum angle of resolution (logMAR best corrected visual acuity, intraocular pressure, and corneal curvature radius (K1, horizontal meridian; K2, vertical meridian; Km, average of K1 and K2. The Mann-Whitney U-test was used to determine the significance of differences.Results: There was a significant difference in preoperative and postoperative logMAR best corrected visual acuity (P=0.01. There were no significant differences in preoperative and postoperative intraocular pressure (P=0.24 or corneal curvature radius (K1, P=0.54; K2, P=0.49; Km, P=0.45.Conclusion: After 2% EDTA chelation treatment, post-operative logMAR best corrected visual acuity improved significantly. Moreover, since there was no significant difference in corneal curvature radius, there was little influence on corneal surface form. We believe that the results of our 2% EDTA chelation treatment were comparable with results obtained with 3.75% EDTA chelation treatment in previous reports. Two percent EDTA chelation is an effective treatment for band-shaped keratopathy and a useful method for any institution. Keywords: ethylenediaminetetraacetic acid, band-shaped keratopathy, phototherapeutic keratectomy, cornea

  12. Tibolone induced Bullous pemphigoid.

    Directory of Open Access Journals (Sweden)

    Vishal. R. Tandon, Annil Mahajan* & Sudhaa Sharma**

    2008-01-01

    Full Text Available We present first ever report of Bullous pemphigoid induced by Tibolone, a STEAR (Selective tissueestrogenic activity regulator that has progestogenic, some androgenic as well as estrogenic effects prescribedas an alternative to estrogen replacement therapy for treatment of climacteric symptoms in one ofthe 51 year old postmenopausal women with one and half year duration since menopause with previoushistory of use of estrogen progesterone pills during her active sexual life. The mechanism for this ADR isnot well understood. But possible explanation could be progesterone activity of the drug leading to autoimmunityas reported previously. The present patient was managed by dechallenge of drug, local, oral corticosteroidsand injectable, methotrexate, along with folic acid and antibiotic coverage fearing anemia andsecondary infections.

  13. Enucleaton of the right eye due to large choroidal melanoma with simultaneous penetrating cornea transplantation from OD to OS (Case report.

    Directory of Open Access Journals (Sweden)

    E. A. Korchuganova

    2014-07-01

    Full Text Available There is presentation case report of 75‑year old woman with choroidal melanoma (T3N0M0 on the right eye and failed graft on the left pseudophakic eye with far advanced glaucoma and ARMD. No treatment was given to the leading eye with VA 0,2. VA of OS = 1 / ∞ pr.l.certa; PKP OS in 2008 for pseudophakic bullous keratopathy on the eye with far advanced glaucoma. IOP was normal after previous filtering surgery. After PKP VA = 0,04; clear graft during 2 years; then gradually opacification and vascularization occurred. VA dropped to light perception. Echography OD — tumor h 8,29 mm, d 21,77 mm. No ingrowth of tumor into anterior segment of the eye; VA OD = 0 (no light perception. Concerning the need to enucleate the right eye with large choroidal melanoma, the advantage of using corneal autograft from OD to OS, location of tumor in the posterior pole with no ingrowth in anterior segment, the decision was made to perform the following operation — to enucleate the right eye and transplant simultaneously corneal graft from OD on OS. Patient was discharged from the Ophthalmology Hospital with VA OS = 0,01, during next week VA improved to 0,02. 8,0 mm graft isclear, fixed with 8 interruptured and continious suture 10 / 0‑nylon. Anterior chamber — normal depth, atrophic iris, stable position of PC IOL. Optic nerve head is pale with subtotal deep glaucomatous excavation. Conclusion: presented case report demonstrates the rarepossibility to use cornea after enucleation the eye with large malignant tumor (located in the posterior pole for grafting in the only eye with failed vascularised graft. It was the only possibility for this patient to restore some vision.

  14. [Neurotrophic keratopathy--studies on substance P and the clinical significance of corneal sensation].

    Science.gov (United States)

    Nishida, T; Nakamura, M; Konma, T; Ofuji, K; Nagano, K; Tanaka, T; Enoki, M; Reid, T W; Brown, S M; Murphy, C J; Mannis, M J

    1997-12-01

    Neurotrophic keratopathy, which often follows damage to the trigeminal nerve, is clinically characterized by various types of epithelial disorders and melting of corneal stroma. To understand both the pathology of neurotrophic keratopathy and the physiological significance of corneal sensation, we investigated both the cellular and molecular functions of a sensory neurotransmitter, substance P, in corneal epithelial cells. Our findings prompted us to try a new mode of treatment for neurotrophic keratopathy. Substance P, a member of the tachykinin family, is an 11-amino-acid peptide. In an organ culture system using rabbit corneas, substance P alone had no effect on corneal epithelial migration. In the presence of insulin-like growth factor-1 (IGF-1), however, substance P synergistically facilitated corneal epithelial migration in proportion to the concentration of substance P or of IGF-1. Other neurotransmitters (acetylcholine, norepinephrine, serotonin etc.) or tachykinins (neurokinin A, eledoisin etc.) did not show this synergistic effect with IGF-1. Among receptors for the tachykinin family (NK-1, NK-2, or NK-3) only the NK-1 receptor system was involved in the synergistic effect of substance P and IGF-1 on corneal epithelial migration. IGF-1 affected neither the binding constant nor the number of sites of substance P receptors in corneal epithelial cells, suggesting that the synergistic effect was not regulated at the receptor level. Various extracellular signals activate the intracellular signal transduction system, thus amplifying specific biological functions. We found that the addition of inhibitors of protein kinase C or tyrosine kinase clearly inhibited the synergistic effect of substance P and IGF-1 on corneal epithelial migration, demonstrating that protein kinase C and tyrosine kinase are involved in the synergistic effect. During corneal epithelial wound healing, epithelial cells must attach to a provisional, extracellular fibronectin matrix. We

  15. PROSE treatment for lagophthalmos and exposure keratopathy.

    Science.gov (United States)

    Gire, Anisa; Kwok, Alan; Marx, Douglas P

    2013-01-01

    Prosthetic replacement of the ocular surface ecosystem is a treatment developed by the Boston Foundation for Sight that uses a Food and Drug Administration-approved prosthetic device for the treatment of severe ocular surface disease to improve vision and discomfort in addition to supporting the ocular surface. Facial nerve paralysis has multiple causes including trauma, surgery, tumor, stroke, and congenital lagophthalmos. Subsequent lagophthalmos leading to exposure keratitis has been treated with copious lubrication, tarsorrhapy, eyelid weights, chemodenervation to yield protective ptosis, and palpebral spring insertion. Each of these treatments, however, has limitations and potential complications. The prosthetic replacement of the ocular surface ecosystem device provides a liquid bandage to protect the cornea from eyelid interaction and dessication in addition to improving vision. This report describes 4 patients with exposure keratitis who were successfully treated with prosthetic replacement of the ocular surface ecosystem devices at 2 clinical sites.

  16. The Etiopathogenesis of Autoimmune Bullous Diseases

    OpenAIRE

    2011-01-01

    Autoimmune bullous diseases are rare disorders affecting skin and mucous membranes which are mediated by pathogenic autoantibodies against target antigens whose function is adhesion within the epidermis or adhesion of epidermis to dermis. The pathogenesis of these disorders has been extensively investigated with advanced techniques in recent years. This review focuses on the etiopathogenesis of main autoimmune bullous disorders including pemphigus, bullous pemphigoid, anti-p200 pemphigoid, ci...

  17. The Etiopathogenesis of Autoimmune Bullous Diseases

    Directory of Open Access Journals (Sweden)

    Şebnem Aktan

    2011-06-01

    Full Text Available Autoimmune bullous diseases are rare disorders affecting skin and mucous membranes which are mediated by pathogenic autoantibodies against target antigens whose function is adhesion within the epidermis or adhesion of epidermis to dermis. The pathogenesis of these disorders has been extensively investigated with advanced techniques in recent years. This review focuses on the etiopathogenesis of main autoimmune bullous disorders including pemphigus, bullous pemphigoid, anti-p200 pemphigoid, cicatricial pemphigoid, pemphigoid gestationis, dermatitis herpetiformis, linear IgA bullous dermatosis and epidermolysis bullosa acquisita.

  18. Diagnosis and management of bullous disease.

    Science.gov (United States)

    Hurley, Maria Yadira; Mattox, Adam R

    2013-05-01

    As the population ages, the prevalence of bullous skin diseases will escalate. Efficient management depends on timely recognition by the physician and reduces the morbidity associated with the disease course. This article outlines the common bullous dermatoses affecting older adults and provides tips for a streamlined approach to workup and treatment.

  19. A typical band-shaped calcific keratopathy with keratocyte changes.

    Science.gov (United States)

    Dark, A J; Proctor, J

    1982-05-01

    The clinical features of a patient with atypical band keratopathy are described. Histochemical and electron probe analyses indicate that the granular deposits in Bowman's layer contain calcium and phosphate. An unusual feature in this patient was the presence of severe keratocyte degeneration; its possible role in the pathogenesis of this condition is discussed. Exfoliation of the calcified Bowman's layer appears to have been the basis for severe attacks of recurrent ocular pain.

  20. Recurrence of climatic droplet keratopathy. Two case reports.

    Science.gov (United States)

    al-Rajhi, A A; Cameron, J A

    1996-12-01

    Climatic droplet keratopathy (CDK) is characterized by a band-shaped pattern of subepithelial opacities and golden-yellow spherules. Recurrence of this disease in corneal grafts has not been reported. We report two cases that developed recurrence of this disease in corneal grafts done for CDK, 3 1/2 years following lamellar penetrating keratoplasty and 6 years following penetrating keratoplasty. This illustrates the possibility of this degenerative disease to recur in a few years if aetiological factors are persistently present.

  1. Bullous leukemia cutis mimicking facial cellulitis*

    Science.gov (United States)

    Caldato, Luciana de Sales; Britto, Juliana de Sousa; Niero-Melo, Ligia; Miot, Hélio Amante

    2016-01-01

    Bullous leukemia cutis is an uncommon clinical manifestation of cutaneous infiltration by leukemic cells, from B-cell chronic lymphocytic leukemia. We present the case of a 67-year-old, female, chronic lymphocytic leukemia patient. She was taking chlorambucil and developed facial edema with erythema and warmth, misjudged as facial cellulitis. Two days later, she developed bullous lesions in the arms, legs, neck and face. The histopathology of facial and bullous lesions confirmed leukemia cutis. All lesions disappeared following the administration of rituximab combined with cycles of fludarabine and cyclophosphamide. Although soft tissue infections are common complications in patients undergoing chemotherapy, leukemia cutis can also resemble cellulitis. PMID:27192532

  2. [Linear IgA bullous dermatosis].

    Science.gov (United States)

    Lorette, Gérard; Georgesco, Gabriella

    2010-10-01

    The linear IgA bullous dermatosis can have various aspects involving erythema and bullous lesions. It is a rare disease. Two peaks of frequency are noticed in children before puberty and in adults around 60 years of age. The histological and immunological characterisation is infraepidermal bullous lesions and linear deposits of IgA along the dermoepidermal basement membrane. There are some targets antigens. There is often a medical condition that seems to trigger. The link with drugs in particular with vancomycin was established. The mainstay of treatment is dapsone generally associated with steroids.

  3. Photodynamic therapy (ALA-PDT) in the treatment of pathological states of the cornea

    Science.gov (United States)

    Switka-Wieclawska, Iwona; Kecik, Tadeusz; Kwasny, Miroslaw; Graczyk, Alfreda

    2003-10-01

    Each year an increasing amount of research is published on the use of photodynamic therapy in medicine. The most recent research has focused mostly on the use of photosensitizer called vertoporphyrin (Visudyne) is the treatment of subretinal neovascularization in age-related macular degeneration (AMD) or myopia, following a substantial amount of ophthalmology research mostly experimental on the application of the method in diagnosis and treatment of some eye tumors. In the Department of Ophthalmology of Polish Medical University in Warsaw, PDT was used as supplementary method in a selected group of patients with chronic virus ulcer of the cornea and keratopathies. During the treatment 5-aminolevulinic acid (5-ALA) was applied in ointment form as a photosensitizer activated with light wave of 633 nm. It appears, on the basis of the results obtained, that photodynamic therapy (ALA-PDT) may become in the future a valuable supplement to the methods being used at the present treating pathological states of the cornea.

  4. Molecular biological aspects of acquired bullous diseases

    DEFF Research Database (Denmark)

    Dabelsteen, Erik

    1998-01-01

    Bullous diseases of the oral mucosa and skin were originally classified on the basis of clinical and histological criteria. The discovery of autoantibodies in some of these patients and the introduction of molecular biology have resulted in a new understanding of the pathological mechanisms of many...... of the bullous lesions. In this article, updated topics of the immune-mediated bullous lesions which involve oral mucosa and skin are reviewed. Pemphigus antigens, which are desmosomal-associated proteins and belong to the cadherin superfamily of cell adhesion proteins, have been isolated, and their genes have...... to be the target for mutations seen in patients with the inherited type of epidermolysis bullosa in which bullous lesions are a prominent clinical feature....

  5. The cornea in measles

    NARCIS (Netherlands)

    N.W.H.M. Dekkers (Nico)

    1981-01-01

    textabstractThe involvement of the cornea in the acute stage of measles is the subject of the present study. The best study on the measles-keratitis now available is still the one by Trantas in 1903. It seems wo.:thwhile therefore to study this self-limiting keratitis with the investigative tools no

  6. [Evaluation of corneal biomechanics before and after up-to-date keratoplasty in patients with bullous keratopathy].

    Science.gov (United States)

    Trufanov, S V; Antonov, A A; Malozhen, S A; Siplivyi, V I

    2015-01-01

    Цель — изучить биомеханические особенности роговицы у пациентов с буллезной кератопатией до и после кератопластики. Материал и методы. На основании данных пневмотонометрии с динамической двунаправленной апланацией роговицы изучили биомеханические свойства роговой оболочки глаза до и после кератопластики у 37 больных (37 глаз) буллезной кератопатией. В 17 случаях провели эндотелиальную кератопластику с удалением десцеметовой мембраны в модификации UTDSAEK (Ultrathin Descemet Stripping Automated Endothelial Keratoplasty), в 13 случаях — автоматизированную эндотелиальную кератопластику с фиксацией трансплантата под поверхностным лоскутом роговицы реципиента (ЭК-Л), в 7 случаях — мануальную частичную обратную грибовидную кератопластику (ЧОГКП). Исследование проводили до операции, через 1, 2, 6 мес и 1, 2, 3, 5 лет после кератопластики. Результаты. Показатели роговичного гистерезиса (Corneal Hysteresis, СН) и фактора резистентности роговицы (Corneal Resistance Factor, CRF) были достоверно снижены на глазах с буллезной кератопатией по сравнению со здоровыми глазами (p<0,05). После ЭК-Л, UTDSAEK и ЧОГКП биомеханические свойства роговицы к 6 мес частично восстанавливались и стабилизировались, но оставались достоверно ниже нормы (p<0,05). Разница этих показателей при разных видах кератопластики и в различные сроки после операции оказалась статистически недостоверна. На глазах с буллезной кератопатией средние значения компенсированного давления (Corneal-Compensated Intraocular Pressure, IOPcc) превышали средние значения внутриглазного давления, измеренного по Гольдману (Goldmann-Correlated Intraocular Pressure, IOPg), на 2,4 мм рт.ст. Через 1 мес после кератопластики разница этих показателей составляла 2,7; 4,3; 3,6 мм рт.ст., к 6 мес — 2,6; 2,4 и 3,6 мм рт.ст. при ЭК-Л, UTDSAEK и ЧОГКП соответственно (p<0,05). На парных глазах с клинически здоровой роговицей эти показатели не имели статистически достоверных различий. Заключение. Хронический отек роговицы ведет к нарушению ее вязкоэластических свойств. Значения СН и CRF достоверно снижены по сравнению со здоровым глазом. После изученных видов кератопластики биомеханические свойства роговицы частично восстанавливаются, но остаются ниже нормы на протяжении всего срока наблюдения (до 5 лет). Толщина роговицы на фоне ее хронического отека, а также после кератопластики не коррелирует с ее биомеханическими свойствами. Снижение жесткости роговицы на глазах с буллезной кератопатией и после кератопластики ведет к недооценке истинного уровня внутриглазного давления и может являться причиной несвоевременной диагностики сопутствующей глаукомы.

  7. [Acquired bullous diseases of the oral mucosa].

    Science.gov (United States)

    Vaillant, L; Hüttenberger, B

    2005-11-01

    Bullous diseases of the oral cavity cause painful erosion. They must be distinguished from aphthae and vesicles which may have a similar presentation. Acute, chronic and congenital conditions are recognized. Acute lesions may involve a polymorphous oral erhythema which has an polymorphous erythematous presentation or toxidermia (Stevens-Johnson syndrome, Lyell syndrome, fixed pigmented erythema). Examination of the skin and history taking are the keys to diagnosis. Patients with chronic bullous diseases may have a congenital condition (bullous epidermolysis or lymphangioma) suggested by the age at onset and the clinical presentation. Acquired chronic bullous diseases include lichen planus and autoimmune bullous diseases. Careful examination is essential to identify mucosal or cutaneous involvement and to obtain a biopsy for histological examination. Search for antibodies deposited in the perilesional mucosa is necessary. Chronic erosive gingivitis is a frequent presentation. Most of the patients have cicatricial pemphigoid, lichen planus, and more rarely pemphigus. The pinch sign is highly discriminative to differentiate the cause of this syndrome. Symptomatic treatment of bullous lesions of the oral cavity include adapted diet and correct and early use of antalgesics.

  8. Linear immunoglobulin A bullous dermatosis.

    Science.gov (United States)

    Fortuna, Giulio; Marinkovich, M Peter

    2012-01-01

    Linear immunoglobulin A (IgA) bullous dermatosis, also known as linear IgA disease, is an autoimmune mucocutaneous disorder characterized by subepithelial bullae, with IgA autoantibodies directed against several different antigens in the basement membrane zone. Its immunopathologic characteristic resides in the presence of a continuous linear IgA deposit along the basement membrane zone, which is clearly visible on direct immunofluorescence. This disorder shows different clinical features and distribution when adult-onset of linear IgA disease is compared with childhood-onset. Diagnosis is achieved via clinical, histopathologic, and immunopathologic examinations. Two common therapies are dapsone and sulfapyridine, which reduce the inflammatory response and achieve disease remission in a variable period of time.

  9. In vivo confocal microscopy in chloroquine-induced keratopathy

    Directory of Open Access Journals (Sweden)

    Iacopo Paladini

    2013-01-01

    Full Text Available In vivo confocal microscopy is becoming a mandatory examination to study corneal abnormalities such as drug deposits in systemic disease. A female diagnosed with fibromyalgia on systemic chloroquine for 9 months presented for an ophthalmic examination. Confocal microscopy was performed using the Confoscan 4 (Nidek Co. Ltd., Gamagori, Japan and multiple highly reflective deposits in the epithelial basal cells were found, that were consistent with choloquine. Deposits were also present in the wing cell layer. In the anterior stroma these deposits were rare. Atypically shaped and branched nerves were also present in the anterior stroma. Corneal deposits of chloroquine can be evaluated by confocal microscopy. Confocal microscopy provides information on corneal metabolism and physiology. Chloroquine keratopathy can affect the anterior stroma in addition to the epithelium.

  10. Bullous Systemic Lupus Erythematosus: Case report

    Directory of Open Access Journals (Sweden)

    Miziara, Ivan Dieb

    2014-01-01

    Full Text Available Introduction: Bullous systemic lupus erythematosus (BSLE is an autoantibody-mediated disease with subepidermal blisters. It is a rare form of presentation of SLE that occurs in less than 5% of cases of lupus. Case Report: A 27-year-old, female, FRS patient reported the appearance of painful bullous lesions in the left nasal wing and left buccal mucosa that displayed sudden and rapid growth. She sought advice from emergency dermatology staff 15 days after onset and was hospitalized with suspected bullous disease. Intravenous antibiotics and steroids were administered initially, but the patient showed no improvement during hospitalization. She displayed further extensive injuries to the trunk, axillae, and vulva as well as disruption of the bullous lesions, which remained as hyperemic scars. Incisional biopsy of a lesion in the left buccal mucosa was performed, and pathological results indicated mucositis with extensive erosion and the presence of a predominantly neutrophilic infiltrate with degeneration of basal cells and apoptotic keratinocytes. Under direct immunofluorescence, the skin showed anti-IgA, anti-IgM, and anti-IgG linear fluorescence on the continuous dermal side of the cleavage. Indirect immunofluorescence of the skin showed conjugated anti-IgA, was anti-IgM negative, and displayed pemphigus in conjunction with anti-IgG fluorescence in the nucleus of keratinocytes, consistent with a diagnosis of bullous lupus erythematosus. Discussion: BSLE is an acquired autoimmune bullous disease caused by autoantibodies against type VII collagen or other components of the junctional zone, epidermis, and dermis. It must be differentiated from the secondary bubbles and vacuolar degeneration of the basement membrane that may occur in acute and subacute cutaneous lupus erythematosus.

  11. Bullous Systemic Lupus Erythematosus: Case report

    Science.gov (United States)

    Miziara, Ivan Dieb; Mahmoud, Ali; Chagury, Azis Arruda; Alves, Ricardo Dourado

    2013-01-01

    Summary Introduction: Bullous systemic lupus erythematosus (BSLE) is an autoantibody-mediated disease with subepidermal blisters. It is a rare form of presentation of SLE that occurs in less than 5% of cases of lupus. Case Report: A 27-year-old, female, FRS patient reported the appearance of painful bullous lesions in the left nasal wing and left buccal mucosa that displayed sudden and rapid growth. She sought advice from emergency dermatology staff 15 days after onset and was hospitalized with suspected bullous disease. Intravenous antibiotics and steroids were administered initially, but the patient showed no improvement during hospitalization. She displayed further extensive injuries to the trunk, axillae, and vulva as well as disruption of the bullous lesions, which remained as hyperemic scars. Incisional biopsy of a lesion in the left buccal mucosa was performed, and pathological results indicated mucositis with extensive erosion and the presence of a predominantly neutrophilic infiltrate with degeneration of basal cells and apoptotic keratinocytes. Under direct immunofluorescence, the skin showed anti-IgA, anti-IgM, and anti-IgG linear fluorescence on the continuous dermal side of the cleavage. Indirect immunofluorescence of the skin showed conjugated anti-IgA, was anti-IgM negative, and displayed pemphigus in conjunction with anti-IgG fluorescence in the nucleus of keratinocytes, consistent with a diagnosis of bullous lupus erythematosus. Discussion: BSLE is an acquired autoimmune bullous disease caused by autoantibodies against type VII collagen or other components of the junctional zone, epidermis, and dermis. It must be differentiated from the secondary bubbles and vacuolar degeneration of the basement membrane that may occur in acute and subacute cutaneous lupus erythematosus. PMID:25992032

  12. Acute band keratopathy formation after penetrating keratoplasty:A case report

    Institute of Scientific and Technical Information of China (English)

    Wee-Min Teh; Mohtar Ibrahim

    2015-01-01

    A 53-year-old male was referred from another eye hospital for right eye corneal perforation secondary to infective keratitis. A penetrating keratoplasty was performed for tectonic purposes. Forty eight hours after penetrating keratoplasty, he developed a band keratopathy located at the interpalpebral area of the corneal button. Despite stopping topical and systemic ciprofloxacin which could have contributed to this, the band keratopathy became more severe. Surgical debridement of the band keratopathy was done and there was no recurrence after that. This case of acute band keratopathy is an uncommon condition that develops within days to weeks of a particular insult to the eye. Various offending medications have been implicated, and treatment options include chelation therapy, surgical debridement and penetrating keratoplasty. Recurrence is common despite treatment and the cessation of possible offending medications. As such, it is prudent to be aware of and recognise the early symptoms and signs of this potentially sight-threatening condition.

  13. Treatment of Subepidermal Autoimmune Bullous Diseases

    Directory of Open Access Journals (Sweden)

    Ekin Şavk

    2011-06-01

    Full Text Available The common therapeutic goal for all subepidermal bullous diseases is to prevent inflammation and production of pathogenic autoantibodies and/or to facilitate the elimination of these antibodies. Diseases included in this group are the pemphigoids, linear IgA dermatosis, epidermolysis bullosa acquisita, dermatitis herpetiformis and bullous systemic erythematosus. Corticosteroids are the most commonly used systemic medication. Other alternatives include dapsone, various antibiotics and nicotinamide, azathioprine, cyclophosphamide, methotrexate, cycloporine, mycophenolate mofetil, IV immunoglobulins and plasmapheresis. Rapid reepithelialization and prevention of secondary infections are provided by local hygenic measures including antiseptic baths and wound care.

  14. Childhood-onset bullous systemic lupus erythematosus.

    Science.gov (United States)

    Lourenço, D M R; Gomes, R Cunha; Aikawa, N E; Campos, L M A; Romiti, R; Silva, C A

    2014-11-01

    Bullous systemic lupus erythematosus has rarely been described in pediatric lupus population and the real prevalence of childhood-onset bullous systemic lupus erythematosus has not been reported. From January 1983 to November 2013, 303 childhood-onset SLE (c-SLE) patients were followed at the Pediatric Rheumatology Unit of the Childreńs Institute of Hospital das Clínicas da Faculdade de Medicina Universidade da Universidade de São Paulo, three of them (1%) diagnosed as childhood-onset bullous systemic lupus erythematosus. All three cases presented tense vesiculobullous lesions unassociated with lupus erythematosus lesions, with the median duration of 60 days (30-60). All patients fulfilled bullous systemic lupus erythematosus criteria. Two had nephritis and serositis and presented specific autoantibodies. The histological pattern demonstrated subepidermal blisters with neutrophils-predominant infiltrates within the upper dermis. Direct immunofluorescence (DIF) showed deposits of IgG and complement along the epidermal basement membrane, in the presence or absence of IgA and/or IgM. A positive indirect immunofluorescence on salt-split skin demonstrating dermal binding was observed in two cases. All of them had moderate/severe disease activity at diagnosis with median Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) of 18 (14-24). Two patients received dapsone and one with severe nephritis received immunosuppressive drugs. In conclusion, in the last 30 years the prevalence of bullous lupus in childhood-onset lupus population was low (1%) in our tertiary University Hospital. A diagnosis of SLE should always be considered in children with recurrent tense vesiculobullous lesions with or without systemic manifestations.

  15. Clinical Relevance of Autoantibodies in Patients with Autoimmune Bullous Dermatosis

    OpenAIRE

    Lilla Mihályi; Mária Kiss; Attila Dobozy; Lajos Kemény; Sándor Husz

    2012-01-01

    The authors present their experience related to the diagnosis, treatment, and followup of 431 patients with bullous pemphigoid, 14 patients with juvenile bullous pemphigoid, and 273 patients with pemphigus. The detection of autoantibodies plays an outstanding role in the diagnosis and differential diagnosis. Paraneoplastic pemphigoid is suggested to be a distinct entity from the group of bullous pemphigoid in view of the linear C3 deposits along the basement membrane of the perilesional skin ...

  16. IgE-mediated mechanisms in bullous pemphigoid and other autoimmune bullous diseases.

    Science.gov (United States)

    van Beek, Nina; Schulze, Franziska S; Zillikens, Detlef; Schmidt, Enno

    2016-01-01

    Autoimmune bullous diseases (AIBDs) are characterized by autoantibodies against structural proteins of the dermal-epidermal junction (in pemphigoid diseases) and the epidermal/ epithelial desmosomes (in pemphigus diseases). By far, the most common AIBD is bullous pemphigoid, which is immunopathologically characterized by autoantibodies against BP180 (type XVII collagen) and BP230. IgG and, to a lesser extent, IgA autoantibodies are the major autoantibody isotypes in these disorders. IgE autoantibodies are increasingly reported in particular in bullous pemphigoid. The development of specific and sensitive anti-BP180 IgE ELISA systems, the report of two experimental murine models employing IgE autoantibodies against BP180, and the successful treatment of bullous pemphigoid with the anti-IgE antibody omalizumab have raised interest in the role of IgE autoantibodies and the modulation of their production in AIBDs. Here, the relevance of IgE autoantibodies in the diagnosis, pathophysiology, and treatment decisions of AIBDs, with a focus on bullous pemphigoid, is reviewed.

  17. Rapid progression of band-shaped keratopathy with early central localisation in a patient on chronic dialytic treatment.

    Science.gov (United States)

    Klaassen-Broekema, N; Van Bijsterveld, O P

    1994-01-01

    This clinical study reports on an unusual start of a band-shaped keratopathy in a patient with diabetic nephropathy on dialytic treatment. The earliest corneal manifestations were centrally located small greyish-white disc-shaped lesions evenly distributed in the interpalpebral area in the left eye. Later a typical peripheral band-shaped keratopathy developed. In the course of the observation period the peripheral keratopathy rapidly spread towards the centre, finally resulting in a complete band-shaped keratopathy in which only the most central original disc-shaped lesions could be identified. Serum calcium and phosphorus concentrations were markedly elevated at the time of the progression of the band-shaped keratopathy but no tertiary hyperparathyroidism was present.

  18. Analysis of corneal morphologic and pathologic changes in early-stage congenital aniridic keratopathy

    Science.gov (United States)

    Du, Juan; Liu, Rong-Qiang; Ye, Lei; Li, Zhi-Hui; Zhao, Feng-Tu; Jiang, Nan; Ye, Lin-Hong; Shao, Yi

    2017-01-01

    AIM To determine typical corneal changes of congenital aniridic keratopathy (CAK) using corneal topography and confocal systems, and to identify characteristics that might assist in early diagnosis. METHODS Patients with CAK and healthy control subjects underwent detailed ophthalmic examinations including axial length, corneal thickness, tear film condition, corneal topography, and laser-scanning in vivo confocal microscopy (IVCM). RESULTS In early stage aniridic keratopathy, Schirmer I test (SIT), break-up time (BUT), mean keratometry (mean K) and simulated keratometry (sim K) were reduced relative to controls (Pcorneal astigmatism (sim A) and corneal thickness were increased (Pcorneal morphology in borderline situations can be useful to confirm the diagnosis of CAK. PMID:28393028

  19. Familial band--shaped keratopathy and spheroidal degeneration. Clinical and electron microscopic study.

    Science.gov (United States)

    Kloucek, F

    1977-12-31

    Presumptive primary band-shaped keratopathy was described in a 35-year-old man and his 62-year-old paternal uncle. Lamellar keratoplasty was performed in one eye in each of these patients. The light and electron microscopic studies were carried out on both corneal specimens. Histologic stains for calcium were negative. Noncalcific band-shaped keratopathy was confirmed by electron microscopic findings too. Electron-dense globular deposits were found in the region of Bowman's membrane and superficial stroma. These may be characterized as a secondary form of spheroidal degeneration.

  20. A newborn with bullous pemphigoid associated with linear IgA bullous dermatosis.

    Science.gov (United States)

    Akin, M A; Gunes, T; Akýn, L; Ohyama, B; Kontas, O; Hashimoto, T

    2009-06-01

    A 16-day-old boy was admitted to our clinic with localized blisters on the neck, cheeks, earlobes, and oral cavity and with erythema on the toes, in addition to poor weight gain and respiratory distress. A physical examination revealed several erythematous plaques with tense bullae, multiple vesicles, and erosions on the left toes, neck, earlobes, and face as well as erosive lesions on the anterior part of the oral cavity, lips, and buccal mucosae. A bronchoscopic examination revealed bullous lesions in the upper respiratory tract and on the epiglottis. A skin biopsy suggested a diagnosis of bullous pemphigoid (BP). Because of the severe mucosal involvement, further investigations including various immunological techniques were performed. The case was diagnosed as BP associated with linear IgA bullous disease (LAD). Complete remission without any scarring was achieved after three weeks of oral methyl prednisolone treatment. A correct differential diagnosis of bullous diseases is important for determining the prognosis and expected response to treatment. To our knowledge, this is the first case of BP associated with LAD reported in literature.

  1. Infectious crystalline keratopathy caused by Cladosporium sp. after penetrating keratoplasty: a case report

    Science.gov (United States)

    Stock, Ricardo Alexandre; Bonamigo, Elcio Luiz; Cadore, Emeline; Oechsler, Rafael Allan

    2016-01-01

    Background Infectious crystalline keratopathy is a rare, progressive infection characterized by the insidious progression of branches and crystalline corneal opacities with minimal or no inflammation. This case report describes the evolution of an infectious crystalline keratopathy caused by Cladosporium sp., which developed after tectonic keratoplasty in a patient with a history of ocular trauma. Case presentation A 40-year-old Brazilian male was the victim of firework-induced trauma to the left eye, which resulted in a corneal laceration that could not be sutured as well as a severe traumatic cataract. The patient underwent penetrating keratoplasty and phacoemulsification. During postoperative follow-up, another therapeutic keratoplasty was required because unresponsive infectious keratitis was observed. The infiltrate’s characteristics were suggestive of infectious crystalline keratopathy; in particular, the infiltrate was insidious and progressive, and grayish-white branches appeared in the anterior corneal stroma. As different therapies were administered, inflammatory reactions ranging from mild to severe were observed. The infection was unresponsive to typical antifungal drugs. This lack of response most likely occurred due to steroid treatment and the diffuse corneal spread of an atypical microorganism, which was subsequently identified in culture as Cladosporium sp. After the second therapeutic keratoplasty, the patient’s eye integrity was successfully reestablished. Conclusion This study likely provides the first report describing a case of infectious crystalline keratopathy caused by Cladosporium sp. This case emphasizes the clinical characteristics and outcome of this type of keratitis. PMID:27621671

  2. 10-Year Observation of Bullous Pemphigoid Patients

    Directory of Open Access Journals (Sweden)

    Bengu Nisa Akay

    2010-06-01

    Full Text Available Background and Design: Bullous pemphigoid (BP is an autoimmune skin disorder characterized by large, tense blisters of the skin. It occurs mainly in the elderly. The one year mortality associated with bullous pemphigoid ranges from 19% to 41%. We aim to analyse the etiologic factors, demographic features, clinical course and response to treatment in patients with BP. Material and Method: Between January 1999 and January 2008, 31 patients with BP were evaluated retrospectively. We assessed duration of the disease, presence of associated symptoms, clinical findings, drug intake, response to treatment, recurrence rates and also extensive laboratory testing and radiologic evaluations on each patient to clarify a possible underlying malignancy. Results: In a 10-year period, 31 patients with BP, female male ratio was 19/12, ranging in age from 59 to 96 (mean 78.8±8.67 years were evaluated. Duration of the disease was 16.58±18.48 months. Direct immunoflourescence of the perilesional skin showed linear deposition of IgG and C3 along the dermoepidermal junction in 24 patients (77.4%. There was no significant relationship between drug usage and bullous pemphigoid. No malignancy was detected. Medium dosage of prednisolone (50-60 mg/day was the first choice of treatment in 8 patients with a complete response rate in all but two patients died during therapy. Four patients died during hospitalization with unknown reasons before any treatment was started. In 16 cases the initial treatment was prednisolone and azathioprine. The mean follow-up period was 12 months and 11 (35% cases had relapsed. The longest remission was achieved with prednisolone and azathioprine combination. Conclusion: In conclusion, no association was found between BP and drug usage or malignancy. All patients responded well to treatment. Therapy with prednisone maintained with azathiopyrine significantly reduced the recurrences. However, disease-specific mortality is found to be high and

  3. Staphylococcal bullous impetigo in a neonate

    Science.gov (United States)

    Duggal, Shalini Dewan; Bharara, Tanisha; Jena, Pragnya Paramita; Kumar, Avinash; Sharma, Abha; Gur, Renu; Chaudhary, Sanjay

    2016-01-01

    An otherwise healthy, full-term neonate presented at day 15 of life to the pediatric emergency with generalized papulo-pustular rash for 2 d. This was finally diagnosed as bullous impetigo caused by Staphylococcus aureus (S. aureus). The skin lesions decreased significantly after starting antibiotic therapy and drainage of blister fluid. There was no recurrence of the lesions on follow-up. This case of generalized pustular eruption due to S. aureus in a neonate is reported, as it poses a diagnostic dilemma and can have serious consequences if left untreated. PMID:27458596

  4. Bullous Mastocytosis Mimicking Congenital Epidermolysis Bullosa

    Directory of Open Access Journals (Sweden)

    Julio Cesar Salas-Alanis

    2014-05-01

    Full Text Available A 2-month-old female infant was referred to DebRA Mexico from the Regional Children's Hospital because of a generalized dermatosis from birth characterized by multiple blisters and erosions on the trunk, face and limbs, associated with minor trauma. A skin biopsy showing subepidermal blisters associated with a dermal infiltrate of Giemsa-positive cells and CD117-positive antibody was consistent with the diagnosis of bullous mastocytosis. Treatment with oral antihistamines, topical steroids, and antibiotics was initiated, leading to a remission of the lesions.

  5. Bullous Skin Diseases: Classical Types of Autoimmune Diseases

    Directory of Open Access Journals (Sweden)

    Jan Damoiseaux

    2013-01-01

    Full Text Available The prototypic bullous skin diseases, pemphigus vulgaris, pemphigus foliaceus, and bullous pemphigoid, are characterized by the blister formation in the skin and/or oral mucosa in combination with circulating and deposited autoantibodies reactive with (hemidesmosomes. Koch’s postulates, adapted for autoimmune diseases, were applied on these skin diseases. It appears that all adapted Koch’s postulates are fulfilled, and, therefore, these bullous skin diseases are to be considered classical autoimmune diseases within the wide and expanding spectrum of autoimmune diseases.

  6. [Linear IgA bullous dermatosis of childhood: case report].

    Science.gov (United States)

    Reyes-Baraona, Francisco; Andino, Romina; Carrasco, Juan Eduardo; Arriagada, Camila; Guerrero, Silvia

    2014-04-01

    Linear IgA bullous dermatosis is a rare acquired autoinmune vesiculobullous disease characterized by linear IgA deposit on the dermo-epidermal basement membrane observed with direct inmunofluorescence. The characteristic lesions are vesicles and tense serous bullae, which most often are grouped giving a "cluster of jewels" appearance. Differential diagnosis must be established with other autoimmune dermatosis, such as dermatitis herpetiformis and bullous pemphigoid. Dapsone is the first line therapy, with excellent response in a short period. This is a benign disease that tends to wax and wane in severity until it disappears spontaneously. We report the case of a 5-year-old girl presenting with bullous lesions, being diagnosed a linear IgA bullous dermatosis, with excellent response to dapsone in less than 2 weeks.

  7. Tzanck Cytology in Diagnosis of Autoimmune Bullous Diseases

    Directory of Open Access Journals (Sweden)

    Murat Durdu

    2011-06-01

    Full Text Available Tzanck smear test is a simple, rapid, repeatable, and inexpensive diagnostic method based on the investigation of characteristics of individual cells. For diagnosis of cutaneous diseases, cytology was first used by Arnault Tzanck in 1947. After this date, Tzanck cytology has been used in the diagnosis of various erosive-vesiculobullous, nodular, and tumoral skin lesions. In daily dermatology practice, the most common use areas of cytology are diagnosis of herpetic infections, cutaneous leishmaniasis, leprosy, and autoimmune bullous diseases. The purpose of cytology in autoimmune bullous diseases is to rapidly distinguish pemphigus from subepidermal bullous disease. In this review article, taking and staining methods of cytologic specimen for the diagnosis of autoimmune bullous diseases, and the cytologic findings have been reviewed.

  8. Bullous oral lichen planus: report of two cases

    Institute of Scientific and Technical Information of China (English)

    Berrin (U)NSAL; S. Elif G(U)LTEKIN; Erol BAL; Benay TOKMAN

    2003-01-01

    @@ Lichen planus is a common chronic mucocutaneous disease of unknown cause. Several types of lichen planus (reticular, atrophic, erosive and bullous) within the oral cavity have been described, among which the reticular and erosive types are the most common types,1,2 while the bullous type is rarely observed.1,3 Bullous lichen planus (BLP) lesions are commonly seen on the buccal mucosa, most frequently at the posterior areas adjacent to the second and third molar teeth. Less common localizations are gingiva and inner aspect of the lips.4 Bullae are generally short lived and leave ulcerated lesions on rupturing.1 The clinical diagnosis of bullous lichen planus is extremely difficult, and pathological examinations may be necessary to establish a definitive diagnosis.5

  9. Spheroidal Degeneration of the Cornea

    Directory of Open Access Journals (Sweden)

    Erdem Dinç

    2011-08-01

    Full Text Available A thirty-one-year-old male patient presented with bilateral epiphora and stinging sensation in the cornea. Detailed history revealed that a bilateral corneal scraping had been made regarding the initial diagnosis of fungal keratitis. His bestcorrected visual acuities were 20/20 and 20/30 in right and left eyes, respectively. Biomicroscopy showed bilateral amber colored spherules in the anterior stroma of the central cornea. The diagnosis of spheroidal corneal degeneration was established and symptomatic therapy with artificial tear drops was prescribed. Ultraviolet light is widely accepted to be the main etiological factor in the pathogenesis of spheroidal degeneration. Because of difficulties in the early stages of the diagnostic process of the disease, incorrect diagnoses can be made with inappropriate interventions. (Turk J Ophthalmol 2011; 41: 264-6

  10. Bee sting of the cornea.

    Science.gov (United States)

    Singh, G

    1984-04-01

    Irreversible heterochromia-iridis, internal ophthalmoplegia, and punctate subcapsular lenticular opacities developed in a 9-year-old girl after she received a bee sting in her right cornea. These complications persisted even after an 11-month follow-up period. To the author's knowledge, this presentation is the first of its nature. The pathogenesis of these changes is discussed and the literature is reviewed.

  11. Cornea and ocular surface treatment.

    Science.gov (United States)

    De Miguel, Maria P; Alio, Jorge L; Arnalich-Montiel, Francisco; Fuentes-Julian, Sherezade; de Benito-Llopis, Laura; Amparo, Francisco; Bataille, Laurent

    2010-06-01

    In addition to being a protective shield, the cornea represents two thirds of the eye's refractive power. Corneal pathology can affect one or all of the corneal layers, producing corneal opacity. Although full corneal thickness keratoplasty has been the standard procedure, the ideal strategy would be to replace only the damaged layer. Current difficulties in corneal transplantation, mainly immune rejection and shortage of organ supply, place more emphasis on the development of artificial corneas. Bioengineered corneas range from prosthetic devices that solely address the replacement of the corneal function, to tissue-engineered hydrogels that allow regeneration of the tissue. Recently, major advances in the biology of corneal stem cells have been achieved. However, the therapeutic use of these stem cell types has the disadvantage of needing an intact stem cell compartment, which is usually damaged. In addition, long ex vivo culture is needed to generate enough cell numbers for transplantation. In the near future, combination of advanced biomaterials with cells from abundant outer sources will allow advances in the field. For the former, magnetically aligned collagen is one of the most promising ones. For the latter, different cell types will be optimal: 1) for epithelial replacement: oral mucosal epithelium, ear epidermis, or bone marrow- mesenchymal stem cells, 2) for stromal regeneration: adipose-derived stem cells and 3) for endothelial replacement, the possibility of in vitro directed differentiation of adipose-derived stem cells towards endothelial cells provides an exciting new approach.

  12. A Case of Oropharyngeal Bullous Pemphigoid Presenting with Haemoptysis

    Directory of Open Access Journals (Sweden)

    C. M. Lee

    2015-01-01

    Full Text Available Objective. Bullous pemphigoid is well known for its cutaneous features; however in rare cases it may present with mucosal involvement. We report a case of bullous pemphigoid presenting with haemoptysis, initially presenting to the Ear, Nose and Throat Department for investigation. Methods. An 87-year-old lady was admitted with haemoptysis. She also complained of a spreading, pruritic, bullous rash, which first began three weeks previously. Initial investigations, which included nasendoscopy, revealed a normal nasal mucosa and a normal postnasal space. A large deroofed blister was observed on the soft palate. The presenting symptoms and signs raised the suspicion of an immunobullous disease including bullous pemphigoid. Conclusion. Bullous pemphigoid (BP is a subepidermal immunobullous disease that typically manifests in elderly patient populations. Although rare, BP can present in a mucocutaneous fashion akin to its more aggressive variant, mucous membrane pemphigoid (MMP. Differentiation of the two is based on clinical grounds, with the prevailing feature for the latter being the predominance of mucosal involvement, which may be extensive. The mainstay of treatment for bullous pemphigoid is steroid therapy, which may be administered both topically and systemically. A deeper understanding into the pathophysiology of the various immunobullous diseases may assist in our understanding of how the various disease entities manifest themselves.

  13. Extensive bullous lichen sclerosus et atrophicus*

    Science.gov (United States)

    Vukicevic, Jelica

    2016-01-01

    Lichen sclerosus et atrophicus is a chronic disease of unknown etiology characterized by atrophic and sclerotic plaques in both genital and extragenital regions. Extensive bullous lichen sclerosus et atrophicus (BLSA) is a severe variant of the disease with no widely accepted treatment. We present a 63-year-old woman with extensive extragenital, ivory-colored, atrophic plaques on her trunk and extremities and disseminated hemorrhagic bullae. The patient was unsuccessfully treated with standard topical corticosteroid therapy, doxycycline and chloroquine. According to the literature, there is little evidence of the efficacy of doxycycline and hydroxychloroquine in the treatment of BLSA. We report a rare case of extensive BLSA that is unresponsive to these drugs.

  14. Occurrence of hereditary bullous epidermolyses in Croatia.

    Science.gov (United States)

    Pavicić, Z; Kmet-Vizintin, P; Kansky, A; Dobrić, I

    1990-06-01

    To determine the occurrence of hereditary bullous epidermolyses (EB) in Croatia, Yugoslavia, from 1960 to 1987, cases were gathered from the hospital files of dermatologic and pediatric clinics and departments throughout the area. The diagnosis of EB type was made on the basis of clinical features, patients' histories, and light microscopy and electron microscopy findings. Fifty families with 58 patients were registered; 44 patients were examined personally by one of the authors. The most frequent type of EB in Croatia was recessive dystrophic EB Hallopeau-Siemens, occurring in 35 of the 58 individuals. Regional accumulation of cases within the Varazdin area was noted (13 patients). Prevalence of EB in Croatia is 0.956 cases per 100,000 inhabitants. One case of recessive dystrophic EB Hallopeau-Siemens occurred in about every 52,000 live births.

  15. The treatment of bullous rhegmatogenous retinal detachment.

    Science.gov (United States)

    Wong, D; Chignell, A H; Inglesby, D V; Little, B C; Franks, W

    1992-01-01

    We describe the results of a consecutive series of 97 cases of bullous superior retinal detachment treated by conventional surgery. The retinal detachments were characterized by either a single retinal break or multiple retinal breaks confined within 1 clock hour and no proliferative vitreoretinopathy. The surgery involved sequential drainage of subretinal fluid, injection of air, cryotherapy and the application of local explant. All cases would otherwise be suitable for pneumatic retinopexy. The anatomical success rate was 85.5% with a single operation and 97% with further procedures. We report on the complications encountered and appraise the advantages and disadvantages of this operation. Forty-five of the 97 cases had detachment of the macula for less than 2 weeks, and 35 of the 45 (80%) achieved a visual acuity of 6/18 or better. These visual results challenge the assertion that better visual outcome might be attained with pneumatic retinopexy.

  16. Familial calcific band-shaped keratopathy: report of two new cases with early recurrence.

    Science.gov (United States)

    Arora, Ritu; Shroff, Daraius; Kapoor, Seema; Nigam, Sonu; Narula, Ritesh; Chauhan, Deepender; Jain, Priyanka

    2007-01-01

    We report two siblings with the rare entity of familial calcific band-shaped keratopathy (BSK). Detailed ophthalmic and systemic investigations failed to reveal any underlying causative pathology. Topical disodium ethylenediamine-tetraacetate (EDTA) was applied for 30 min to all four eyes. In addition the right eye of the younger sibling required a superficial keratectomy. An improvement in corneal clarity was seen in the immediate postoperative period in both siblings. Histopathology of the keratectomy specimen revealed linear extracellular sub-epithelial granular calcium deposits. However, an early recurrence was noted in all four eyes at four weeks postoperatively. We report the second instance in the English literature of this entity. Band-shaped keratopathy presenting without an obvious etiology merits a complete systemic and ophthalmic workup. Patients with familial idiopathic BSK could be cases with poor prognosis for treatment with EDTA due to an early recurrence of the disease.

  17. Familial calcific band-shaped keratopathy: Report of two new cases with early recurrence

    Directory of Open Access Journals (Sweden)

    Arora Ritu

    2007-01-01

    Full Text Available We report two siblings with the rare entity of familial calcific band-shaped keratopathy (BSK. Detailed ophthalmic and systemic investigations failed to reveal any underlying causative pathology. Topical disodium ethylenediamine-tetraacetate (EDTA was applied for 30 min to all four eyes. In addition the right eye of the younger sibling required a superficial keratectomy. An improvement in corneal clarity was seen in the immediate postoperative period in both siblings. Histopathology of the keratectomy specimen revealed linear extracellular sub-epithelial granular calcium deposits. However, an early recurrence was noted in all four eyes at four weeks postoperatively. We report the second instance in the English literature of this entity. Band-shaped keratopathy presenting without an obvious etiology merits a complete systemic and ophthalmic workup. Patients with familial idiopathic BSK could be cases with poor prognosis for treatment with EDTA due to an early recurrence of the disease.

  18. Keratopathy and pachymetric changes after photorefractive keratectomy and vitrectomy with silicone oil injection

    DEFF Research Database (Denmark)

    Buch, H; Vesti Nielsen, N

    2000-01-01

    We present a man who, after bilateral excimer laser photorefractive keratectomy (PRK) for high myopia in the right eye, had repeated retinal detachment surgery with lensectomy and injection of silicone oil. Visual acuity fluctuated in accordance with significant central corneal thickness diurnal...... variation. The case illustrates the possibility of PRK as a predisposing factor for keratopathy after retinal detachment surgery with silicone injection in an aphakic eye....

  19. Architectural and Biochemical Expressions of Mustard Gas Keratopathy: Preclinical Indicators and Pathogenic Mechanisms

    Science.gov (United States)

    2012-08-10

    Nanoscale topography of the basement membrane underlying the corneal epithelium of the rhesus macaque. Cell Tissue Res 299: 39–46. 28. Pal-Ghosh S...with associated secondary pathologies, collectively referred to as mustard gas keratopathy (MGK). MGK involves a progressive corneal degeneration...resulting in chronic ocular discomfort and impaired vision for which clinical interventions have typically had poor outcomes. Using a rabbit corneal vapor

  20. Correlation of Biomicroscopic Findings with Confocal Microscopy in Eyes with Amiodarone-Induced Cornea Verticillata

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    Emine Kaya

    2014-01-01

    Full Text Available Objectives: To investigate the correlation between biomicroscopic and confocal microscopic findings in eyes with amiodarone-induced cornea verticillata. Materials and Methods: Sixteen eyes of 8 patients with amiodarone-induced cornea verticillata were evaluated. Eyes with keratopathy were staged according to Orlando slit-lamp microscopy classification. Confocal laser-scanning microscopy was performed by Rostock cornea modulated to HRT II (Heidelberg Engineering GmbH, Heidelberg, Germany, and staging was done according to Falke’s classification that is based on the degree of epithelial basal cell deposit accumulation. The relation between biomicroscopic staging and corneal involvement detected on confocal microscopy was assessed by Spearman correlation analysis. Results: The mean age of the 8 patients (5 male, 3 female was 63.1±7.2 (50 to 69 years. The mean duration of drug treatment was 12.1±11.8 (3 to 36 months, and the mean drug treatment dose was 312.5±223.2 (100 to 800 mg/day. At the time of examination, 50% of the patients had already given up the treatment at a mean of 29.5±15.8 (6 to 40 months ago, whereas the other 50% were still on amiodarone therapy. Hyper-reflecting deposits were observed in the basal epithelium, anterior-, mid-and deep-stroma, and in the endothelium on confocal microscopic examination. Correlation was detected between biomicroscopic and confocal microscopic stages (r=0.770, p<0.001. Frequency of detecting deposits in the stroma and endothelium was found to be increasing as the biomicroscopic stage increased (r=0.844; p<0.001 and r=0.551; p<0.01, respectively. Conclusion: In amiodarone-induced cornea verticillata, correlated results were detected between biomicroscopic and confocal microscopic staging. Therefore, in clinics where confocal microscopy is not available, biomicroscopic staging can be used as a guiding parameter in eyes with amiodarone-induced cornea verticillata. (Turk J Ophthalmol 2014; 44: 63-67

  1. Anatomy and physiology of the cornea.

    Science.gov (United States)

    DelMonte, Derek W; Kim, Terry

    2011-03-01

    The importance of the cornea to the ocular structure and visual system is often overlooked because of the cornea's unassuming transparent nature. The cornea lacks the neurobiological sophistication of the retina and the dynamic movement of the lens; yet, without its clarity, the eye would not be able to perform its necessary functions. The complexity of structure and function necessary to maintain such elegant simplicity is the wonder that draws us to one of the most important components of our visual system.

  2. Lymphangiogenesis Occurring in Transplanted Corneas

    Institute of Scientific and Technical Information of China (English)

    LING Shiqi; XIAO Qing; HU Yanhua

    2006-01-01

    To study corneal lymphangiogenesis after corneal transplantation, corneal allogenic transplantation models were established in rats. 8 female Wister rats were used as donors, and 16 Sprague Dawley (SD) rats were used as recipients and 2 SD served as controls. Corneal lymphangiogenesis and hemangiogenesis was examined by electron microscopy 1 and 2 weeks after corneal penetrating transplantation, and the expression of lymphatic vessel endothelial receptor (LYVE-1) was examined 1, 3, 7, 14 days after the transplantation respectively. In addition, 19 allograft failed human corneas were examined by 5'-nase-alkaline phosphatase (5'-NA-ALP) doubleenzyme-histochemistry staining to detect corneal lymphangiogenesis and hemangiogenesis. By immunohistochemistry for LYVE-1, it was found that blown lymphatics were localized in the stroma 3days after the corneal transplantation. With electron microscopy, new lymphatic vessels and blood vessels were found 1 and 2 weeks after the corneal transplantation. By 5'-NA-ALP enzyme-histochemistry, corneal hemangiogenesis was found in all allograft failed huma n corneas and 5 of 19(26.3%) cases had developed corneal lymphangiogenesis. It is concluded that corneal lymphangiogenesis is present after corneal transplantation, which may play an important role in allograft rejection.

  3. Clinical Relevance of Autoantibodies in Patients with Autoimmune Bullous Dermatosis

    Directory of Open Access Journals (Sweden)

    Lilla Mihályi

    2012-01-01

    Full Text Available The authors present their experience related to the diagnosis, treatment, and followup of 431 patients with bullous pemphigoid, 14 patients with juvenile bullous pemphigoid, and 273 patients with pemphigus. The detection of autoantibodies plays an outstanding role in the diagnosis and differential diagnosis. Paraneoplastic pemphigoid is suggested to be a distinct entity from the group of bullous pemphigoid in view of the linear C3 deposits along the basement membrane of the perilesional skin and the “ladder” configuration of autoantibodies demonstrated by western blot analysis. It is proposed that IgA pemphigoid should be differentiated from the linear IgA dermatoses. Immunosuppressive therapy is recommended in which the maintenance dose of corticosteroid is administered every second day, thereby reducing the side effects of the corticosteroids. Following the detection of IgA antibodies (IgA pemphigoid, linear IgA bullous dermatosis, and IgA pemphigus, diamino diphenyl sulfone (dapsone therapy is preferred alone or in combination. The clinical relevance of autoantibodies in patients with autoimmune bullous dermatosis is stressed.

  4. Diffuse Bullous Eruptions in an Elderly Woman: Late-Onset Bullous Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Prajwal Boddu

    2016-10-01

    Full Text Available Vesiculobullous eruptions in the elderly represent a diverse range of varying pathophysiologies and can present a significant clinical dilemma to the diagnostician. Diagnosis requires a careful review of clinical history, attention to detail on physical and histomorphological examination, and appropriate immunofluorescence testing. We describe the case of a 73-year-old female who presented to our hospital with a painful blistering skin rash developed over 2 days. Examination of the skin was remarkable for numerous flaccid hemorrhagic bullae on a normal-appearing nonerythematous skin involving both the upper and lower extremities. Histopathology of the biopsy lesion showed interface change at the epidermo-dermal region with subepidermal blister formation, mild dermal fibrosis, and sparse interstitial neutrophilic infiltrate. Immunohistological analysis was significant for positive IgG basement membrane zone antibodies with a dermal pattern of localization on direct immunofluorescence and positive IgG antinuclear antibodies on indirect immunofluorescence. Evidence of antibodies to type VII collagen suggested the diagnosis of epidermolysis bullosa acquisita versus bullous systemic lupus erythematosus (BSLE. A diagnosis of BSLE was made based on positive American College of Rheumatology criteria, acquired vesiculo-bullous eruptions with compatible histopathological and immunofluorescence findings. This case illustrates one of many difficulties a physician encounters while arriving at a diagnosis from a myriad of immunobullous dermatoses. Also, it is important for internists and dermatologists alike to be aware of and differentiate this uncommon and nonspecific cutaneous SLE manifestation from a myriad of disorders presenting with vesiculobullous skin eruptions in the elderly.

  5. A case of mixed bullous disease of epidermolysis bullosa acquisita and linear IgA bullous dermatosis.

    Science.gov (United States)

    Osawa, Masumi; Demitsu, Toshio; Toda, Sunao; Yokokura, Hideto; Umemoto, Naoka; Yamada, Tomoko; Yoneda, Kozo; Kakurai, Maki; Yoshida, Mariko; Hashimoto, Takashi

    2005-01-01

    A 75-year-old Japanese male visited us with bullous eruptions on the extremities. Physical examination revealed large bullae on the hands, lower legs and feet. The oral mucosa was also involved. Histology disclosed subepidermal blister with inflammatory cell infiltrates in the dermis. Direct immunofluorescence showed deposits of IgG and IgA at the cutaneous basement membrane zone. Indirect immunofluorescence on 1 M NaCl-split human skin sections demonstrated that the patient's IgG antibodies reacted with the dermal side of the split, while IgA antibodies reacted with the epidermal side. Immunoblotting showed that the patient's serum reacted with the NC1 domain of type VII collagen (290-kDa epidermolysis bullosa acquisita antigen) as well as the 120-kDa linear IgA bullous dermatosis antigen, LAD-1. Systemic prednisolone resulted in a favorable response. From the clinicopathological findings, the present case is not consistent with either epidermolysis bullosa acquisita or IgA bullous dermatosis. Therefore, we regarded the case as mixed bullous disease of epidermolysis bullosa acquisita and linear IgA bullous dermatosis. Such a case has not been previously reported.

  6. High-Frequency Color Doppler Sonography of Bullous Pemphigoid: Correlation With Histologic Findings.

    Science.gov (United States)

    Porriño-Bustamante, María Librada; Alfageme, Fernando; Suárez, Lola; de Domingo, María Antonia González; Hospital, Mercedes; Roustán, Gastón

    2016-08-01

    Bullous pemphigoid is the most frequent autoimmune-mediated blistering skin disease, belonging to the group of subepidermal bullae. We performed high-frequency color Doppler sonography in 3 cases of bullous pemphigoid, in bullous and adjacent non-bullous skin, which showed homogeneous sonographic findings. Subepidermal cystic structures with dermal hypoechogenicity were observed in bullous skin. In nonbullous skin, the dermis showed hypoechogenicity compared to normal skin. Color Doppler signals were increased in both areas. These findings correlate histologically with subepidermal bullae and dermal inflammatory infiltrates.

  7. Effects of diabetic keratopathy on corneal optical density, central corneal thickness, and corneal endothelial cell counts.

    Science.gov (United States)

    Gao, Feng; Lin, Tao; Pan, Yingzhe

    2016-09-01

    Diabetic keratopathy is an ocular complication that occurs with diabetes. In the present study, the effect of diabetic keratopathy on corneal optical density, central corneal thickness, and corneal endothelial cell count was investigated. One hundred and eighty diabetic patients (360 eyes) were enrolled in the study during the period from March, 2012 to March, 2013. The patients were divided into three age groups: 10 years, with 60 patients per group (120 eyes). During the same period, 60 healthy cases (120 eyes) were selected and labeled as the normal control group. The Pentacam was used to measure the corneal optical density, and central corneal thickness. Specular microscopy was used to examine the corneal endothelial cell density. The coefficient of partial correlation was used to control age and correlate the analysis between the corneal optical density, corneal endothelial cell density, and central corneal thickness. The stage of the disease, the medial and intimal corneal optical density and central corneal thickness was analyzed in the diabetes group. The corneal optical density in the diabetes group increased compared with that of the normal control group. The medial and intimal corneal optical density and central corneal thickness were positively correlated with the course of the disease. However, the corneal endothelial cell density was not associated with the course of diabetes. There was a positive association between the medial and intimal corneal optical density and central corneal thickness of the diabetic patients. In conclusion, the results of the present study show that medial and intimal corneal optical density and central corneal thickness were sensitive indicators for early diabetic keratopathy.

  8. The Clinical Diagnosis of Autoimmune Bullous Diseases Sürekli Eğitim

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    Rıfkiye Küçükoğlu

    2011-06-01

    Full Text Available The autoimmune bullous diseases were diagnosed on the clinical and histopathological basis, before the introduction of the immunological assays. However, not the clinical features, but the classification of the diseases has recently changed during the immunological development. According to this new classification, pemphigus group diseases include, pemphigus vulgaris, pemphigus vegetans, pemphigus foliaceus, pemphigus erythematosus, endemic pemphigus, IgA pemphigus, pemphigus herpetiformis, paraneoplastic pemphigus, and drug-induced pemphigus. The subepidermal bullous diseases are classified as pemphigoid group diseases, epidermolysis bullosa acquisita, dermatitis herpetiformis, and linear IgA bullous dermatosis. The pemphigoid-group diseases consist of bullous pemphigoid, childhood bullous pemphigoid, localised bullous pemphigoid, drug-induced pemphigoid, anti p200 pemphigoid, pemphigoid gestationes, pemphigoid nodularis, and cicatricial pemphigoid. In this review, the clinical features of the autoimmune bullous diseases are discussed according to the above mentioned classification. (Turkderm 2010; 45 Suppl 1: 16-25

  9. Effect of torsional mode phacoemulsification on cornea in eyes with/without pseudoexfoliation

    Institute of Scientific and Technical Information of China (English)

    Süleyman; Demircan; Mustafa; Atas; Yusufcan; Yurtsever

    2015-01-01

    an increased risk of bullous keratopathy.

  10. Bullous reactions to bed bug bites reflect cutaneous vasculitis

    Science.gov (United States)

    This study evaluates bullous cutaneous reactions and sequential histopathology in an individual sensitized to bed bug bites in an effort to better understand the allergic response and histology associated with these bites. There was a progression of the inflammatory response across time ranging from...

  11. Bullous impetigo associated with Abiotrophia defectiva in an immunocompetent adult.

    Science.gov (United States)

    Anderson, Heather M; Miller, Cathy; Kemp, Earl; Huntington, Mark K

    2012-07-01

    Infection of humans by Abiotrophia defectiva, a nutritionally variant streptococcus, most commonly takes the form of endocarditis, though a variety of other manifestations ranging from central nervous system abscesses to orthopaedic infections have been seen. We report here what we believe is the first case of bullous impetigo associated with this organism.

  12. Drug-induced linear IgA bullous dermatosis.

    Science.gov (United States)

    Navi, Daniel; Michael, Daniel J; Fazel, Nasim

    2006-09-08

    A 73-year-old man was admitted to the University of California Davis Medical Center for treatment of a pleural effusion and congestive heart failure. His hospital course was complicated by asymptomatic sustained ventricular tachycardia requiring placement of an implantable cardiac defibrillator. The patient was treated with vancomycin and cefazolin during the procedure. After 3 days he developed tense vesicles over the dorsal aspect of the hands. Perilesional skin biopsy showed subepidermal cleavage with a neutrophilic infiltrate. Direct immunofluorescence revealed granular IgA and C3 deposition along the dermal epidermal junction. A diagnosis of drug-induced linear IgA bullous dermatosis secondary to vancomycin was established. Linear IgA bullous dermatosis is a rare autoimmune blistering disorder with clinical features that can overlap with bullous pemphigoid and dermatitis herpetiformis. Drug-induced linear IgA bullous dermatosis is a less common variant that is correspondingly less well characterized. Although a variety of medications have been implicated, vancomycin is the most common associated drug.

  13. Linear IgA bullous dermatosis following influenza vaccination.

    Science.gov (United States)

    Alberta-Wszolek, Lauren; Mousette, Alyse M; Mahalingam, Meera; Levin, Nikki A

    2009-11-15

    Linear IgA Bullous Dermatosis (LABD) is an immune-mediated subepidermal vesiculobullous eruption characterized by linear deposits of IgA at the basement membrane zone. Most cases are idiopathic but medications, infections, and malignancies have also been reported to induce LABD. We report the case of a 54-year-old woman who developed LABD shortly after receiving an influenza vaccination.

  14. Childhood linear IgA bullous dermatosis in Tunisia.

    Science.gov (United States)

    Kenani, Nesrine; Mebazaa, Amel; Denguezli, Mohamed; Ghariani, Najet; Sriha, Badreddine; Belajouza, Colandane; Nouira, Rafia

    2009-01-01

    The objective was to determine the demographic characteristics, the clinical features, the immuno-histological findings and response to treatment of childhood linear IgA bullous dermatosis (LABD) in Tunisia. We collected all the cases of auto-immune bullous diseases of childhood, diagnosed from January 1987 to December 2006. Based on clinical, histological, and immunofluorescent features, we identified 25 cases of LABD. Sixteen male and nine female children with a mean age of 7.5 years were identified. Clinical manifestations were characterized by a vesiculo-bullous eruption in all cases associated with mucous membrane involvement in two cases. Dapsone was the main therapy in 19 cases, associated with systemic corticosteroids in eight cases. Exclusive antibiotic therapy was successful in five cases. Sixteen of those patients had resolution of disease after a mean period of 15 months and eight patients had severe clinical presentation and required a prolonged follow-up. Childhood LABD is the most frequent bullous dermatosis in Tunisia. The majority of our patients responded rapidly to dapsone treatment and were stabilized for long time. Our cases were characterized by a minimal mucosal involvement and favorable outcome. Treatment with antibiotherapy was interesting. Erythromycin and oxacillin may be considered as an alternative therapy.

  15. BULLOUS PEMPHIGOID SUCCESSFULLY CONTROLLED BY TETRACYCLINE AND NICOTINAMIDE

    NARCIS (Netherlands)

    KOLBACH, DN; REMME, JJ; BOS, WH; JONKMAN, MF; DEJONG, MCJM; PAS, HH; VANDERMEER, JB

    1995-01-01

    In 1986, Berk and Lorincz reported the efficacy of tetracycline and nicotinamide in the treatment of bullous pemphigoid (BP). In the present study of seven patients with BP, we found that a regimen of 2 g tetracycline combined with 2 g nicotinamide daily was effective in clearing the skin lesions. T

  16. Bullous Pemphigoid as Pruritus in the Elderly A Common Presentation

    NARCIS (Netherlands)

    Bakker, Christiaan V.; Terra, Jorrit B.; Pas, Hendri H.; Jonkman, Marcel F.

    2013-01-01

    IMPORTANCE In the literature, patients with bullous pemphigoid have been reported to have itch without blisters. Clinical observations in these patients have varied from eczematous or urticarial to papular or nodular skin lesions. Here we investigated the spectrum of clinical variants. OBSERVATIONS

  17. Construction of Tissue Engineering Artificial Cornea with Skin Stem Cells

    Institute of Scientific and Technical Information of China (English)

    Yuan LIU; Yan JIN

    2005-01-01

    @@ 1 Introduction The clinical need for an alternative to donor corneal tissue has encouraged much interests in recent years. An artificial cornea must fulfill the functions of the cornea it replaces. More recently, the idea of a bio-engineered cornea has risen. Corneal equivalents have been reconstructed by tissue engineering method. Aim of this study is to construct an artificial rabbit cornea by employing tissue engineering method and to determine if skin stem cells have a role in tissue engineered cornea construction.

  18. Case of linear immunoglobulin A bullous dermatosis associated with acquired hemophilia.

    Science.gov (United States)

    Arakaki, Osao; Yamamoto, Yu-ichi; Awazawa, Ryoko; Nonaka, Kimiko; Taira, Kiyohito; Asato, Yutaka; Hagiwara, Keisuke; Oyama, Bungo; Ishii, Norito; Hashimoto, Takashi; Uezato, Hiroshi

    2008-07-01

    Linear immunoglobulin (Ig)A bullous dermatosis is a rare autoimmune subepidermal bullous dermatosis caused by circulating IgA autoantibodies directed against the antigens at the basement membrane zone. Most linear IgA bullous dermatosis cases are idiopathic, but some are associated with the use of certain drugs, infections, lymphoproliferative disorders, internal malignancies, autoimmune disorders, collagen diseases or, very rarely, other skin diseases, including autoimmune bullous diseases. Acquired hemophilia is also rare; it is a coagulation disease caused by anti-factor VIII IgG antibodies. Acquired hemophilia has been reported to be associated with malignant tumors, pregnancy or postpartum, drug reactions, collagen diseases such as rheumatoid arthritis, autoimmune disorders, and skin diseases such as psoriasis and pemphigus. We report a case of hemophilia acquired during the course of linear IgA bullous dermatosis and review reported cases of autoimmune bullous dermatoses associated with acquired hemophilia.

  19. Nummular keratopathy in a patient with Hyper-IgD Syndrome

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    Culican Susan M

    2009-08-01

    Full Text Available Abstract Purpose To report a case of recurrent nummular keratitis in a pediatric patient with Hyperimmunoglobulinemia D syndrome. Methods A retrospective chart review. Results A 14-year-old boy with Hyperimmunoglobulinemia D syndrome (HIDS presented with photophobia and ocular irritation concomitant with disease exacerbation. He was found on exam to have significant nummular keratitis, which responded to a short course of topical steroids. Despite acute response to local immunosuppression, the patient had several recurrent attacks and eventually developed a large corneal scar and decreased vision. After initiation of infliximab therapy his ocular sequelae improved dramatically and his vision returned to 20/20. Conclusion One possible form of end-organ damage associated with HIDS is vision threatening nummular keratopathy.

  20. Nonpreserved amniotic membrane transplantation for bilateral toxic keratopathy caused by topical anesthetic abuse: a case report

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    Altinok Ayse

    2010-08-01

    Full Text Available Abstract Introduction Corneal damage associated with abuse of topical anesthetics is a rare clinic entity. Topical anesthetic abuse is one of the causes of ring keratitis. Ring keratitis is easily overlooked because it can mimic acanthamoeba keratitis or other infectious keratitis. The outcome is often poor, leading to persistent epithelial defects, corneal scarring, and perforations. Case presentation We report the clinical presentation, diagnosis, and treatment of a 65-year-old Caucasian man, who worked as a health care worker, with bilateral toxic keratopathy caused by topical anesthetic abuse. Nonpreserved amniotic membrane transplantation was performed for both eyes of the patient. Conclusion It is important to identify and treat patients who abuse topical anesthetics before permanent vision loss ensues. Nonpreserved amniotic membrane transplantation may be useful in relieving pain and improving corneal surface in anesthetic agent abusers.

  1. Intertriginous bullous morphea: A clue for the pathogenesis?

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    Kavala Mukaddes

    2007-01-01

    Full Text Available Bullae occurring in lesions of morphea are uncommon. The cause of bullae formation in morphea is multifactorial, although lymphatic obstruction from the sclerodermatous process is considered the likeliest cause. Bullous morphea may be confused clinically with lichen sclerosus et atrophicus since both diseases may cause bullae in sclerodermatous plaques. A 69-year-old woman presented with a history of generalized morphea diagnosed 9 years earlier; and a 1-month history of pruritic bullae on her inframammary folds, axillary regions, lower abdomen, upper extremities and inguinal folds. Physical examination revealed multiple erythematous erosions, hemorrhagic vesicles and eroded bullae with slight scale or crusts overlying hypopigmented, indurated, shiny plaques. Skin biopsy revealed prominent edema in the papillary dermis, resulting in bulla formation and thickening of collagen fibers within the dermis. Direct immunofluorescence was negative. According to histologic and clinical features, the diagnosis of bullous morphea was established.

  2. In vivo ultrathin Descemet stripping automated endothelial keratoplasty with a low-energy and high-frequency femtosecond laser

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    Gustavo Victor

    2014-04-01

    Full Text Available This case report describes the production of an ultrathin endothelial donor corneal lamella using a femtosecond laser with low energy and a high frequency. In addition, we report its use in vivo in an eye with pseudophakic bullous keratopathy. The outcomes were observed 3 months after surgery in terms of the change in endothelial donor lamella and full cornea thickness (including pachymetric mapping, visual acuity, and endothelial cell count.

  3. Hemorrhagic bullous dermatosis: a rare heparin-induced cutaneous manifestation.

    Science.gov (United States)

    Govind, Bhuvanesh; Gnass, Esteban; Merli, Geno; Eraso, Luis

    2016-01-01

    Heparin is one of the most widely prescribed medications. Cutaneous reactions distant to the injection site are rare and under-reported in the literature. We present an elderly man with history of CNS lymphoma who underwent treatment of a deep venous thrombosis with enoxaparin and subsequently developed well demarcated bullous lesions within days of heparin initiation. The exact pathophysiology is not well understood. Hemorrhagic bullous dermatosis is a rare cutaneous reaction that is temporally associated with the initiation of heparin products. The handful of cases thus far suggest that regression of these seemingly benign lesions may or may not be associated with dose reduction or discontinuation of heparin products and typically occur within a few weeks. Elderly age appears to be one potential risk factor for development of these rare asymptomatic lesions. Malignancy may have some contributing factor and differentiation between this rare cutaneous manifestation from heparin products and other dermatological findings in patients with malignancy is key. Because of the asymptomatic and self-limiting nature of hemorrhagic bullous dermatoses in the setting of heparin product use, we presume that the reported incidence does not reflect true clinical practice.

  4. Histopathological analysis of vesicular and bullous lesions in Kaposi sarcoma

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    Kandemir Nilüfer

    2012-08-01

    Full Text Available Abstract Background In this study, the clinical and morphological features of vesiculobullous lesions observed in Kaposi sarcoma are analyzed, and the features of bullous Kaposi sarcoma cases are emphasized. Methods A total of 178 biopsy materials of 75 cases diagnosed as classic-type cutaneous Kaposi sarcoma were reviewed. Twenty-five cases showing vesiculobullous features were included in the study. Tumor, epidermis, dermis, and clinical data regarding these cases was evaluated. Results Vesicular changes were observed in 21 (12% out of 178 lesions of the 75 cases, while bullous changes were present in only 4 (2%. In all cases where vesicular and bullous changes were detected, tumor, epidermis, and dermis changes were similar. All cases were nodular stage KS lesions, whereas hyperkeratosis and serum exudation in the epidermis, marked edema in the dermis, and enlarged lymphatic vessels and chronic inflammatory response were observed. Conclusions Our findings suggest that changes in vascular resistance occurring during tumor progression are the most important factors comprising vesiculobullous morphology. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1646397188748474

  5. Annular bullous lesions with atypical erythema multiforme in leprosy.

    Science.gov (United States)

    Shah, Aishani; Mahajan, Rashmi; Ninama, Kishan; Bilimoria, Freny

    2014-09-01

    Erythema nodosum leprosum (ENL) is an immune complex-mediated reaction that may complicate the course of multibacillary leprosy. Bullous lesions in Type II reaction, though reported, are exceedingly rare. We report the case of a 32 year old female patient who presented initially at our OPD with erythema nodosum. Cutaneous examination revealed impaired sensation over dorsum of right foot and thickened right lateral popliteal nerve. Slit skin smear (SSS) from ear lobes revealed AFB with a bacteriological index of 2+. She was started on MDT, tablet ofloxacin 200 mg twice a day, and 30 mg oral prednisolone. Two months later, she presented with generalised pruritus, large target lesions over the back, and hemorrhagic bullae over lower extremities and annular pattern of bullae, over both arms. A SSS was repeated which was positive for AFB. Histopathology from bullous lesions was consistent with ENL. Direct Immunofluorescence (DIF) study was negative. Our patient improved rapidly after she was started on thalidomide 100 mg twice daily, with withdrawal of ofloxacin. Erythema Multiforme (EMF) and annular bullous lesions have been reported in patients on treatment with ofloxacin. This case is being presented due to the unusual and varied manifestation of Type II lepra reaction in a 34 year old female patient.

  6. Bullous pemphigoid in a leg affected with hemiparesia: a possible relation of neurological diseases with bullous pemphigoid?

    Science.gov (United States)

    Foureur, N; Descamps, V; Lebrun-Vignes, B; Picard-Dahan, C; Grossin, M; Belaich, S; Crickx, B

    2001-01-01

    We report a typical case of bullous pemphigoid (BP) associated with a neurological disorder and study a possible link between neurological disorders and BP. An 84-year-old hemiplegic woman presented with unilateral BP on the hemiparetic side. BP was confirmed by histological and immunofluorescence data. The medical records of the previous 46 consecutive patients with BP were retrospectively analyzed (average age: 79; median age: 85). Thirty of the 46 patients with BP had neurological disorders. These disorders included dementia, epilepsy, multiple sclerosis, cerebral stroke, Parkinson's disease, gonadotropic adenoma, trembling, dyskinesia, lumbar spinal stenosis. In a control group of the 46 consecutive oldest patients (older than 71; average age: 82,5; median age: 80) with another skin disease referred during the previous two-year-period to our one-day-unit only, 13 patients had a neurological disorder. This study demonstrates that there is a high prevalence of neurological disorders in patients with BP (p = 0.0004). A prospective case control study with neurological examination and psychometrical evaluation is warranted to confirm these data. We speculate that neuroautoimmunity associated with the aging process or neurological disorders may be involved in pemphigoid development via an autoimmune response against dystonin which shares homology with bullous pemphigoid antigen 1. Bullous pemphigoid could be considered to be a marker of neurological disorder.

  7. Linear IgA bullous dermatosis in a patient with renal cell carcinoma

    NARCIS (Netherlands)

    Van der Waal, RIF; Van de Scheur, MR; Pas, HH; Jonkman, MF; Van Groeningen, CJ; Nieboer, C; Starink, TM

    2001-01-01

    Linear IgA bullous dermatosis (LABD) is an autoimmune subepidermal bullous disease with heterogeneous clinical manifestations, characterized by linear deposition of IgA along the epidermal basement membrane zone. We report a patient with a metastasized renal cell carcinoma who developed an extensive

  8. Linear IgA bullous dermatosis: report of an exuberant case.

    Science.gov (United States)

    Souza, Beatriz Cavalcanti de; Fregonesi, Nádire Cristina Freire Pontes; Tebcherani, Antônio José; Sanchez, Ana Paula Galli; Aoki, Valéria; Fernandes, Juliana Christien

    2013-01-01

    Linear immunoglobulin A dermatosis is a rare autoimmune bullous disease, but the most common autoimmune bullous dermatosis in children. We report a typical exuberant case of linear IgA dermatosis in a ten-month old child, who showed good response to treatment with corticosteroids and dapsone.

  9. Linear IgA bullous dermatosis: report of an exuberant case*

    OpenAIRE

    Souza,Beatriz Cavalcanti de; Fregonesi, Nádire Cristina Freire Pontes; Tebcherani,Antônio José; Sanchez,Ana Paula Galli; AOKI, Valéria; Fernandes, Juliana Christien

    2013-01-01

    Linear immunoglobulin A dermatosis is a rare autoimmune bullous disease, but the most common autoimmune bullous dermatosis in children. We report a typical exuberant case of linear IgA dermatosis in a ten-month old child, who showed good response to treatment with corticosteroids and dapsone.

  10. IgA autoantibodies in the pemphigoids and linear IgA bullous dermatosis

    NARCIS (Netherlands)

    Horvath, Barbara; Niedermeier, Andrea; Podstawa, Eva; Mueller, Ralf; Hunzelmann, Nicolas; Karpati, Sarolta; Hertl, Michael

    2010-01-01

    Background: Patients with bullous pemphigoid (BP), mucous membrane pemphigoid (MMP) and pemphigoid gestationis (PG) have IgG antibodies against BP180 and BP230, components of the hemidesmosomes. Patients with linear IgA bullous dermatosis (LABD) have IgA autoantibodies against a 97/120-kDa protein w

  11. Bullous lesions as a manifestation of systemic lupus erythematosus in two Mexican teenagers

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    López-Corella Eduardo

    2010-07-01

    Full Text Available Abstract Rarely, systemic lupus erythematosus (SLE presents with bullous lesions due to severe edema and hydropic degeneration of the basal layer, or as a subepidermal blistering disease. Here, we describe two Mexican teenagers, one with SLE with blisters and another with bullous SLE. We also discuss the mechanisms and clinical implications of lesion formation in patients with SLE and bullae.

  12. Designing a perfect cornea: computational aspects

    Science.gov (United States)

    Rubinstein, Jacob; Wolansky, Gershon

    2002-12-01

    We analyze an algorithm for the design of a perfect cornea that exactly focuses a preselected object or a preselected wave front on the retina. The algorithm can be used, for example, in refractive surgery. We consider the sensitivity of the algorithm to various errors, including errors in the measurements of the aberrations, the original corneal topography and the ablation process.

  13. A rare case of concomitant sicca keratopathy and ipsilateral central facial palsy in Wallenberg’s dorsolateral medullary syndrome

    Science.gov (United States)

    De Bruyn, Deborah; Van Aken, Elisabeth; Herman, Kristien

    2017-01-01

    Objective: To describe a patient with a right-sided supranuclear facial palsy and concomitant sicca keratopathy of the right eye following right-sided dorsolateral medullary infarction. Methods: Our patient underwent a complete ophthalmologic and neurologic examination including biomicroscopy, fundus examination, cranial nerve examination, Shirmer I test, and magnetic resonance imaging of the brain. Results: A 61-year-old woman presented in emergency with a central facial nerve palsy on the right side and truncal ataxia. Neurologic assessment revealed a concurrent dysphagia, dysarthria, hypoesthesia of the right face, and weakness of the right upper limb. Magnetic resonance imaging of the brain showed an old left-sided cerebellar infarction, but a recent ischemic infarction at the level of the right dorsolateral medulla oblongata was the cause of our patient’s current problems. One month after diagnosis of the right-sided dorsolateral medullary syndrome, there were complaints of ocular irritation and a diminished visual acuity in the right eye. Biomicroscopy showed a sicca keratopathy with nearly complete absence of tear secretion on the Shirmer I test, but with normal eye closure and preserved corneal reflexes and sensitivity. Conclusion: A dorsolateral medullary syndrome can have a variable expression in symptomatology. Our case is special because of the combination of an ipsilateral supranuclear facial palsy with normal upper facial muscle function together with an ipsilateral sicca keratopathy as a result of a nearly absent tear secretion. We hypothesized that the mechanism underlying the patient’s sicca keratopathy ipsilateral to the supranuclear facial palsy involved the superior salivatory nucleus, which is situated in the caudal pons inferiorly of the motor facial nucleus and is most probably affected by a superior extension of the infarcted area in the right medulla oblongata. PMID:28293537

  14. Construction of Tissue Engineering Artificial Cornea with Skin Stem Cells

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    1 IntroductionThe clinical need for an alternative to donor corneal tissue has encouraged much interests in recent years. An artificial cornea must fulfill the functions of the cornea it replaces. More recently, the idea of a bio-engineered cornea has risen. Corneal equivalents have been reconstructed by tissue engineering method. Aim of this study is to construct an artificial rabbit cornea by employing tissue engineering method and to determine if skin stem cells have a role in tissue engineered cornea co...

  15. LL-37 via EGFR transactivation to promote high glucose-attenuated epithelial wound healing in organ-cultured corneas.

    Science.gov (United States)

    Yin, Jia; Yu, Fu-Shin X

    2010-04-01

    Purpose. Patients with diabetes are at higher risk for delayed corneal reepithelialization and infection. Previous studies indicated that high glucose (HG) impairs epidermal growth factor receptor (EGFR) signaling and attenuates ex vivo corneal epithelial wound healing. The authors investigated the effects of antimicrobial peptide LL-37 on HG-attenuated corneal epithelial EGFR signaling and wound closure. Methods. Human corneal epithelial cells (HCECs) were stimulated with LL-37. Heparin-binding EGF-like growth factor (HB-EGF) shedding was assessed by measuring the release of alkaline phosphatase (AP) in a stable HCEC line expressing HB-EGF-AP. Activation of EGFR, phosphoinositide 3-kinase (PI3K), and extracellular signal-regulated kinases 1/2 (ERK1/2) was determined by Western blot analysis. Corneal epithelial wound closure was assessed in cultured HCECs and porcine corneas. LL-37 expression was determined by immune dot blot. Results. LL-37 induced HB-EGF-AP release and EGFR activation in a dose-dependent manner. LL-37 prolonged EGFR signaling in response to wounding. LL-37 enhanced the closure of a scratch wound in cultured HCECs and partially rescued HG-attenuated wound healing in an EGFR- and a PI3K-dependent manner and restored HG-impaired EGFR signaling in cultured porcine corneas. HG attenuated wounding-induced LL-37 expression in cultured HCECs. Conclusions. LL-37 is a tonic factor promoting EGFR signaling and enhancing epithelial wound healing in normal and high glucose conditions. With both antimicrobial and regenerative capabilities, LL-37 may be a potential therapeutic for diabetic keratopathy.

  16. Linear IGA bullous dermatosis in Tunisian children : 31 cases

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    Kharfi Monia

    2011-01-01

    Full Text Available Background: Linear IgA bullous dermatosis (LAD of children is relatively frequent in Africa. Aim: We undertook this study to evaluate the frequency of this disease among autoimmune bullous diseases (AIBDs in Tunisian children. Materials and Methods: We present a 32-year retrospective study (January 1976 to December 2007. Children with chronic acquired bullous diseases seen at the Charles Nicolle Hospital of Tunis and for who direct immunofluorescence (DIF of the perilesional skin demonstrated linear IgA immunoglobulin deposits were included in the study population. Results: Thirty-one children with LAD were selected representing 65.9% of all AIBDs of children selected in the same period, with a mean age of 5.5 years and a sex ratio (M/F of 2.4. Most of the children had generalized eruption (28/31, more profuse on the face, pelvic region, buttocks and limbs. Mucosal lesions happened in only four children (12.9%. The mean duration of the disease was 14 months. DIF demonstrated linear IgA deposits along the dermal-epidermal junction in all patients. IgG, IgM, and complement were also seen (20/31. Indirect immunofluorescence was negative in 67% of cases. Eight patients responded to dapsone; however, prednisone had to be added in seven children to control the disease and erythromycin in four others. A long-term remission period was achieved in 76.1% of patients. Conclusion: This study confirms that LAD is the most common AIBD in children in Tunisia which frequently occurs in preschool-aged males. Independently of the used drug, a long-term remission is frequently observed.

  17. Case Report of Bullous Pemphigoid following Fundus Fluorescein Angiography

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    Goktug Demirci

    2010-05-01

    Full Text Available Purpose: To report a first case of bullous pemphigoid (BP following intravenous fluorescein for fundus angiography. Clinical Features: A 70-year-old male patient was admitted to the intensive care unit with BP and sepsis. He reported a history of fundus fluorescein angiography with a pre-diagnosis of senile macular degeneration 2 months prior to presentation. At that time, fluorescein extravasated at the antecubital region. Following the procedure, pruritus and erythema began at the wrists bilaterally, and quickly spread to the entire body. The patient also reported a history of allergy to human albumin solution (Plamasteril®; Abbott 15 years before, during bypass surgery. On dermatologic examination, erythematous patches were present on the scalp, chest and anogenital region. Vesicles and bullous lesions were present on upper and lower extremities. On day 2 of hospitalization, tense bullae appeared on the upper and lower extremities. The patient was treated with oral methylprednisolone 48 mg (Prednol®; Mustafa Nevzat, topical clobetasol dipropionate 0.05% cream (Dermovate®; Glaxo SmithKline, and topical 4% urea lotion (Excipial Lipo®; Orva for presumptive bullous pemphigoid. Skin punch biopsy provided tissue for histopathology, direct immunofluorescence examination, and salt extraction, which were all consistent with BP. After 1 month, the patient was transferred to the intensive care unit with sepsis secondary to urinary tract infection; he died 2 weeks later from sepsis and cardiac failure. Conclusions: To our knowledge, this is the first reported case of BP following fundus fluorescein angiography in a patient with known human albumin solution allergy. Consideration should be made to avoid fluorescein angiography, change administration route, or premedicate with antihistamines in patients with known human albumin solution allergy. The association between fundus fluorescein angiography and BP should be further investigated.

  18. [Linear IgA bullous dermatosis of children].

    Science.gov (United States)

    Pierchalla, A; Bruch-Gerharz, D; Homey, B; Reifenberger, J

    2011-04-01

    Linear IgA bullous dermatosis is an acquired autoimmune subepidermal blistering disease, characterized by linear IgA deposits at the basement membrane zone. Described in both children and adults, it occurs as tense pruritic vesicles and bullae in a "cluster of jewels" configuration with central crusting on an inflammatory elevated base. It is typically located on the face, anogenital region and trunk. Whilst the adult manifestations can be chronic, in children a spontaneous remission has often been reported. Our patient showed a spontaneous remission after 8 weeks of symptomatic topic treatment with methylprednisolone and oral cetirizine dihydrochloride.

  19. Pseudo-Kaposi sarcoma (acroangiodermatitis): occurring after bullous erysipelas.

    Science.gov (United States)

    Kutlubay, Zekayi; Yardimci, Gürkan; Engin, Burhan; Demirkesen, Cuyan; Aydin, Övgü; Khatib, Rashid; Tuzun, Yalçın

    2015-05-18

    Pseudo-Kaposi sarcoma is a benign reactive vascular proliferative disorder, which can be seen at any age. It occurs when the chronic venous pressure changes result in vascular proliferation in the upper and mid dermis. This disease is divided into two subtypes: the most frequent subtype is the Mali type and seen in early ages. The Mali type is seen in chronic venous insufficiency and in those patients with arteriovenous shunts. The rare subtype is the Stewart-Bluefarb type. This disease must be distinguished from Kaposi sarcoma because of their clinical resemblance. Herein, we present a patient with pseudo-Kaposi sarcoma, which developed after bullous erysipelas.

  20. Association of bullous pemphigoid with malignancy: A myth or reality?

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    Joycelin Fernandes

    2014-01-01

    Full Text Available Bullous pemphigoid (BP is an autoimmune sub-epidermal blistering disorder of the skin. The association of BP with internal malignancy has always been a matter of debate with no consensus reached despite many published case reports and clinical trials. However, we report a hitherto unreported association of BP with squamous cell carcinoma of the tongue, wherein the patient had a recalcitrant downhill course despite adequate treatment measures with control of skin lesions being achieved only following excision of the tumor, and relapse coinciding with detection of metastasis. Hence, given the clinical behavior, it is reasonable to speculate that the association of malignancy was more than co-incidental.

  1. Feline corneal disease.

    Science.gov (United States)

    Moore, Phillip Anthony

    2005-05-01

    The cornea is naturally transparent. Anything that interferes with the cornea's stromal architecture, contributes to blood vessel migration, increases corneal pigmentation, or predisposes to corneal edema, disrupts the corneas transparency and indicates corneal disease. The color, location, and shape and pattern of a corneal lesion can help in determining the underlying cause for the disease. Corneal disease is typically divided into congenital or acquired disorders. Congenital disorders, such as corneal dermoids are rare in cats, whereas acquired corneal disease associated with nonulcerative or ulcerative keratitis is common. Primary ocular disease, such as tear film instability, adenexal disease (medial canthal entropion, lagophthalmus, eyelid agenesis), and herpes keratitis are associated with the majority of acquired corneal disease in cats. Proliferative/eosinophilic keratitis, acute bullous keratopathy, and Florida keratopathy are common feline nonulcerative disorders. Nonprogressive ulcerative disease in cats, such as chronic corneal epithelial defects and corneal sequestration are more common than progressive corneal ulcerations.

  2. A case of crusted scabies with a bullous pemphigoid-like eruption and nail involvement.

    Science.gov (United States)

    Nakamura, Eri; Taniguchi, Hiroko; Ohtaki, Noriko

    2006-03-01

    We report a case of a 71-year-old man infected at a nursing home who developed a bullous pemphigoid-like eruption with nail involvement. He was diagnosed by his family doctor as suffering from eczema and was treated with topical corticosteroids, then blisters started appearing. He was next diagnosed as suffering from bullous pemphigoid and treated with oral prednisolone, which worsened his condition. He was finally diagnosed as having crusted scabies with bullous pemphigoid-like eruptions and nail involvement at our clinic. He was then prescribed oral ivermectin (two doses of 12 mg ivermectin with a 1-week interval) and topical lindane (1%gamma-BHC in petrolatum) for scabies with 5% salicylic acid in plastibase as an additional treatment for the crusted lesions on his soles. He showed remarkable improvement in 2 weeks, and his nails showed complete recovery after 7 weeks of occlusive dressing treatment with 1%gamma-BHC. One and a half years later, the patient showed no sign of a recurrence of scabies. The histology of a blister taken from this patient was similar to that of bullous pemphigoid. Direct immunofluorescence showed immunoglobulin (Ig)G and C3 deposition at the dermoepidermal junction similar to that of bullous pemphigoid, but indirect immunofluorescence was negative. The bullous symptoms of this patient were considered to be due to the scabies, because the patient recovered completely after receiving treatment for scabies. Indirect immunofluorescent study is important to distinguish between scabies with blister formation and true bullous pemphigoid.

  3. Accidental bullous phototoxic reactions to bergamot aromatherapy oil.

    Science.gov (United States)

    Kaddu, S; Kerl, H; Wolf, P

    2001-09-01

    Oil of bergamot is an extract from the rind of bergamot orange (Citrus aurantium ssp bergamia) that has a pleasant, refreshing scent; until a few years ago it had been widely used as an ingredient in cosmetics but was restricted or banned in most countries because of certain adverse effects. More recently, oil of bergamot preparations have been gaining renewed popularity in aromatherapy. Oil of bergamot possesses photosensitive and melanogenic properties because of the presence of furocoumarins, primarily bergapten (5-methoxypsoralen [5-MOP]). However, 5-MOP is also potentially phototoxic and photomutagenic. Despite its increasing application, there are only a few recent reports of phototoxic reactions to bergamot aromatherapy oil. We describe two patients with localized and disseminated bullous phototoxic skin reactions developing within 48 to 72 hours after exposure to bergamot aromatherapy oil and subsequent ultraviolet exposure. One patient (case 2) had no history of direct contact with aromatherapy oil but developed bullous skin lesions after exposure to aerosolized (evaporated) aromatherapy oil in a sauna and subsequent UVA radiation in a tanning salon. This report highlights the potential health hazard related to the increasing use of psoralen-containing aromatherapy oils.

  4. PSEUDOSINDACTILIA EN EPIDERMÓLISIS BULLOSA Pseudosyndactylia in bullous epidermolysis

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    Enríque Vergara Amador

    2009-01-01

    Full Text Available La epidermólisis bullosa comprende un grupo de patologías que se caracterizan por la fragilidad de la piel, formación de ampollas, y en las formas distróficas, la formación de pseudosindactilias. Debido a lo exótico de la entidad y la dificultad para el enfoque de tratamiento, se presenta un caso clínico con desarrollo de pseudosindactilias, característico usualmente de las formas distróficas. Se describe en aspectos clínicos de la entidad, el tratamiento quirúrgico de las pseudosindactilias y de las contracturas en las manos, y se discuten aspectos de la enfermedad y de los tipos de tratamientoBullous epidermolysis comprises a group of pathologies characterized by skin fragility, formation of bullae and, in its dystrophic forms, by the formation of pseudosyndactylias. Due to the exotic nature of the disease and the difficulty in focusing its treatment, a case is presented in which pseudosyndactylias developed, a usual characteristic of the dystrophic forms. This article addresses clinical aspects of bullous epidermolysis, surgical treatment of pseudosyndactilia and hand contractures and other aspects of the disease and its treatment

  5. Bullous pemphigoid: associations and management guidelines: facts and controversies.

    Science.gov (United States)

    Ruocco, Eleonora; Wolf, Ronni; Caccavale, Stefano; Brancaccio, Gabriella; Ruocco, Vincenzo; Lo Schiavo, Ada

    2013-01-01

    Bullous pemphigoid (BP) is an organ-specific human autoimmune disease typical of the elderly, which may be associated with many different disorders (immune, neurologic, psychiatric, hematologic, pulmonary, and cardiovascular), as well as with different types of tumors. The crucial question is whether these associations are casual or causal. In particular, the relationship between BP and malignancy is still a matter of debate. Although this association often has been emphasized, it is not clear whether the coexistent malignancy and BP are pathogenically connected or if their association is merely linked to aging. In our survey, the BP/neoplasm association ratios have not increased with age. Instead, significantly higher ratios have been found in younger patients; therefore, a meticulous investigation for a malignant neoplasm should always be pursued in young or middle-aged patients with BP, in particular regarding the severe forms of the disorder or those refractory to conventional treatment. The management of BP strictly depends on the multifactorial pathogenesis of this disorder. In fact, inflammation in BP seems to be more crucial for blister formation than in other autoimmune bullous disorders, such as pemphigus. Even if first-line treatments are typically immunosuppressants, newer therapeutic agents targeting specific pathogenic steps that are linked with inflammation have been proposed. Treatments selectively suppressing autoantibody formation, inflammation cascade, or both are available. Grouping therapies according to their mechanism of action may be useful to test new drug associations or to evaluate efficacy and tolerability of drugs with the same target.

  6. Nursing diagnoses in patients with immune-bullous dermatosis

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    Euzeli da Silva Brandão

    Full Text Available ABSTRACT Objective: identify nursing diagnoses in patients with immune-bullous dermatosis. Method: a quantitative and descriptive research, carried out in three institutions located in Rio de Janeiro and Mato Grosso do Sul, Brazil, using the Client Assessment Protocol in Dermatology during a nursing consultation. Simple descriptive statistics was used for data analysis. Results: 14 subjects participated in the study, nine with a diagnosis of pemphigus vulgaris, pemphigus two and three of bullous pemphigoid. The age ranged between 27 and 82 years, predominantly females (11. 14 nursing diagnoses were discussed and identified from a clinical rationale in all study participants, representing the most common human responses in this sample. The application of the Assessment Protocol in Dermatology facilitated the comprehensive assessment, in addition to providing the identification of diagnostics according to the North American Nursing Diagnosis Association International. Conclusion: the nursing diagnoses presented confirm the necessity of interdisciplinary work during the care for this clientele. For better description of the phenomena related to the client in question, it is suggested the inclusion of two risk factors related in three diagnoses of this taxonomy. It is worth noting the contribution of the findings for the care, education and research in nursing in dermatology.

  7. Nursing diagnoses in patients with immune-bullous dermatosis 1

    Science.gov (United States)

    Brandão, Euzeli da Silva; dos Santos, Iraci; Lanzillotti, Regina Serrão; Ferreira, Adriano Menis; Gamba, Mônica Antar; Azulay-Abulafia, Luna

    2016-01-01

    ABSTRACT Objective: identify nursing diagnoses in patients with immune-bullous dermatosis. Method: a quantitative and descriptive research, carried out in three institutions located in Rio de Janeiro and Mato Grosso do Sul, Brazil, using the Client Assessment Protocol in Dermatology during a nursing consultation. Simple descriptive statistics was used for data analysis. Results: 14 subjects participated in the study, nine with a diagnosis of pemphigus vulgaris, pemphigus two and three of bullous pemphigoid. The age ranged between 27 and 82 years, predominantly females (11). 14 nursing diagnoses were discussed and identified from a clinical rationale in all study participants, representing the most common human responses in this sample. The application of the Assessment Protocol in Dermatology facilitated the comprehensive assessment, in addition to providing the identification of diagnostics according to the North American Nursing Diagnosis Association International. Conclusion: the nursing diagnoses presented confirm the necessity of interdisciplinary work during the care for this clientele. For better description of the phenomena related to the client in question, it is suggested the inclusion of two risk factors related in three diagnoses of this taxonomy. It is worth noting the contribution of the findings for the care, education and research in nursing in dermatology. PMID:27533274

  8. The Etiopathogenesis of Autoimmune Bullous Diseases Sürekli Eğitim

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    Şebnem Aktan

    2011-06-01

    Full Text Available which are mediated by pathogenic autoantibodies against target antigens whose function is adhesion within the epidermis or adhesion of epidermis to dermis. The pathogenesis of these disorders has been extensively investigated with advanced techniques in recent years. This review focuses on the etiopathogenesis of main autoimmune bullous disorders including pemphigus, bullous pemphigoid, anti-p200 pemphigoid, cicatricial pemphigoid, pemphigoid gestationis, dermatitis herpetiformis, linear IgA bullous dermatosis and epidermolysis bullosa acquisita. (Turkderm 2011; 45 Suppl 1: 8-15

  9. UNUSUAL CLINICOPATHOLOGICAL AND IMMUNOLOGICAL PRESENTATION OF CHRONIC BULLOUS DERMATOSIS OF CHILDHOOD (LINEAR IGA DERMATOSIS)

    OpenAIRE

    Al-Saif Fahad; Al-Rikabi Ammar

    2011-01-01

    Linear IgA bullous dermatosis is a rare sulfone-responsive subepidermal blistering disorder of unknown etiology in which smooth linear deposits of IgA are found in the basement membrane zone. Chronic bullous dermatosis of childhood is equivalent to linear IgA disease of adulthood and is characterized by an abrupt onset of large, widespread and tense bullae on a normal or erythematous base. In this case, we describe an unusual presentation of chronic bullous dermatosis in a 14-month-old Saudi ...

  10. Bullous disorders as a manifestation of immune reconstitution inflammatory syndrome: A series of three cases

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    Rama Das

    2013-01-01

    Full Text Available Bullous disorders such as pemphigus vulgaris, bullous pemphigoid after the initiation of highly active antiretroviral therapy in certain human immunodeficiency virus reactive individuals have been described in this case series as a manifestation of an immune reconstitution inflammatory syndrome. This phenomenon should be suspected in individuals who present with bullous lesions within 3-8 weeks after initiation of therapy despite of improved immunological response. Strong clinical suspicion, through clinical examination, appropriate laboratory investigation such as CD4 T-cell count, histopathological examinations with H and E stain, direct immunofluorescence test are required for diagnosis.

  11. Tissue Factor in Dermatitis Herpetiformis and Bullous Pemphigoid: Link between Immune and Coagulation System in Subepidermal Autoimmune Bullous Diseases

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    Agnieszka Zebrowska

    2015-01-01

    Full Text Available Dermatitis herpetiformis (DH and bullous pemphigoid (BP are skin diseases associated with eosinophilic and neutrophilic infiltrations. Although chemokines are critical for the selective accumulation and activation of various leukocyte subsets in the inflammatory process, there are few findings concerning inflammatory cells and production of coagulation factors in blistering diseases. Skin biopsies were taken from 14 patients with DH, 27 with BP, and 20 control subjects. The localization and expression of tissue factor (TF in skin lesions and perilesional skin were studied by immunohistochemistry and confirmed by Western Blot. Moreover the plasma concentrations of TF were measured by immunoassays. D dimers, fibrinogen, and selected coagulation parameters were measured by routine methods. Expression of TF in the epidermis and in inflammatory influxed cells in dermis was detected in skin biopsies from BP patients. Examined TF expression was detected in perilesional skin of all BP patients too. The expression of TF was not observed in biopsies from healthy people and DH patients. The findings of the study show an increased expression of tissue factor in the lesional and perilesional skin of patients with bullous pemphigoid. The difference in chemokine pattern expression and variations in the cellular infiltration in BP and DH cause variable expression of TF.

  12. Early cystic bleb needling revision after glaucoma filtering surgery with toxic keratopathy

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    S. Yu. Petrov

    2015-01-01

    Full Text Available Clinical case of high thin-wall cystic limited filtering bleb needling revision in the early post-op period after trabeculectomy with sinusotomy accompanied by toxic keratopathy is presented. Optical coherence tomography (OCT demonstrated that filtering bleb height was 2700 μm and bleb wall thickness was 70 μm. Bleb needling revision with its lateralwall dissection and subconjunctival injection of dexamethasone, fluorouracil, and ranibizumab near to the bleb site was performed. In 1.5 hours after the procedure, bleb height decreased to 550 μm (by 5 times while bleb wall thickness increased up to 100 μm. Topical antibacterial, steroid, and non-steroid anti-inflammatory therapy was recommended. The next day IOP level reduced from 11 mm Hg to 4.5 mm Hg. It was accompanied by choroidal effusion that was managed conservatively with cycloplegic agents (drops and injections for 3 days. On day 6, central corneal edema affecting all layers, Descemet’s membrane folds, and ocular hypertension were revealed. Metabolic therapy resolved corneal edema within 3 days. Re-needling bleb revision decreased IOP level to 6.2 mm Hg. This resulted in transient Descemet’s membrane folds. This paper describes filtering bleb needling revision with its lateral wall dissection and anti-inflammatory, cytostatic, and anti-VEGF agents use to prolong glaucoma filtering surgery effect in excessive scarring. The procedure was accompanied by toxic corneal endothelium decompensation with corneal edema and Descemet’s membrane folds treated with active metabolic therapy.

  13. Electron microscopic studies of primary band-shaped keratopathy and gelatinous, drop-like corneal dystrophy in two brothers.

    Science.gov (United States)

    Kanai, A; Kaufman, H E

    1982-06-01

    We present here a case of bilateral primary band-shaped keratopathy that changed into a gelatinous, drop-like dystrophy over two years. To our knowledge, this is the first such case reported in the literature. In the first examination of the right eye, histologic evidence revealed no amyloid deposits and the presence of disorganized collagen lamellae with a high-density amorphous substance. The left corneal disc, obtained two years after the first and second examinations, revealed an agglomeration of amyloid fibrils in the subepithelial portion.

  14. Bullous pemphigoid. Occurrence in a patient with mycosis fungoides receiving PUVA and topical nitrogen mustard therapy

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    Patterson, J.W.; Ali, M.; Murray, J.C.; Hazra, T.A.

    1985-04-01

    A 57-year-old woman with mycosis fungoides developed blisters within cutaneous plaques while receiving PUVA therapy and topical nitrogen mustard. Direct and indirect immunofluorescence studies showed the findings of bullous pemphigoid. Her bullous disease was controlled after cessation of these therapies and institution of prednisone and methotrexate. During the 5 months following completion of a course of electron-beam therapy, she has been free of the cutaneous manifestations of both diseases. Previous instances of PUVA-related pemphigoid have occurred in psoriatics. The role of ultraviolet light in the induction of pemphigoid is discussed, particularly with regard to its possible interaction with the altered skin of psoriasis or mycosis fungoides. Some of the rare cases of bullous mycosis fungoides might actually have represented ultraviolet-unmasked bullous pemphigoid.

  15. Tetracycline and niacinamide control bullous pemphigoid but not pemphigus foliaceus when these conditions coexist.

    Science.gov (United States)

    Shiohara, Junko; Yoshida, Kanako; Hasegawa, Junichi; Uhara, Hisashi; Takata, Minoru; Saida, Toshiaki; Ohyama, Bungo; Oyama, Bungo; Hashimoto, Takashi

    2010-07-01

    Pemphigus and pemphigoid are different types of autoimmune bullous disease and can occur in the same patient. We report a female patient with this condition. At first, we diagnosed her with bullous pemphigoid, and we treated her with tetracycline, niacinamide and a topical steroid. Tense bullas disappeared shortly after that, but crusted erythemas mainly on her head and trunk persisted. We examined BP180 and desmoglein 1 enzyme-linked immunosorbent assays, and also histological features, which showed coexistence of bullous pemphigoid and pemphigus foliaceus concurrently. Therefore, we tried prednisolone, which could control both conditions. This case showed that tetracycline and niacinamide could control bullous pemphigoid, but could not control pemphigus foliaceus, and that prednisolone was effective for both conditions.

  16. Penfigóide bolhoso no lactente Bullous pemphigoid in childhood

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    Ada Lobato Quattrino

    2007-02-01

    Full Text Available O penfigóide bolhoso é doença que comumente acomete pessoas idosas. Desde o primeiro caso na infância, confirmado por imunofluorescência em 1970, cerca de 50 casos foram relatados e poucos ocorreram em crianças com menos de um ano de idade. Apresentase caso de penfigóide bolhoso em lactente de quatro meses de idade e discutem-se as características clínicas e imunopatológicas dessa rara bulose da infância.Bullous pemphigoid typically affects the elderly. Since the first description of bullous pemphigoid in childhood in 1970, about 50 cases have been reported, but only 10 were reported in children under the first year of age. We report a case of bullous pemphigoid in a 4-month-old girl and discuss the clinical and immunopathological features of this rare bullous disease of infancy.

  17. Epidemiology of Autoimmune Bullous Diseases Sürekli Eğitim

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    Erkan Alpsoy

    2011-06-01

    Full Text Available We have very limited knowledge about aotuimmune bullous disesases which are important causes of morbidity and mortality. They are generally rare disases in population. The yearly over all incidences of pemphigus and bullous pemhigoid are between 0.5 to 16.1/million and 2.5 to 42.8/million, respectively. Pemphigus vulgaris is the major type of pemphigus and it is most prevalent between ages of 40 and 50. Bullous pemphigoid is tpypically most prevalent in ages of over 70. In this review the results obtained from the studies which are especially about epidemiology of pemphigus and bullous pemphigoid were analised according to geographic regions. (Turkderm 2011; 45 Suppl 1: 3-7

  18. Outbreak of staphylococcal bullous impetigo in a maternity ward linked to an asymptomatic healthcare worker.

    Science.gov (United States)

    Occelli, P; Blanie, M; Sanchez, R; Vigier, D; Dauwalder, O; Darwiche, A; Provenzano, B; Dumartin, C; Parneix, P; Venier, A G

    2007-11-01

    An outbreak of staphylococcal bullous impetigo occurred over a period of five months in a maternity ward involving seven infected and two colonised neonates. The skin lesions were due to epidermolytic toxin A-producing Staphylococcus aureus. Infection control measures were implemented and a retrospective case-control study performed. Contact with an auxiliary nurse was the only risk factor for cases of bullous impetigo (Pimpetigo and the auxiliary nurse was reassigned to an adult ward.

  19. The Etiopathogenesis of Autoimmune Bullous Diseases Sürekli Eğitim

    OpenAIRE

    2011-01-01

    which are mediated by pathogenic autoantibodies against target antigens whose function is adhesion within the epidermis or adhesion of epidermis to dermis. The pathogenesis of these disorders has been extensively investigated with advanced techniques in recent years. This review focuses on the etiopathogenesis of main autoimmune bullous disorders including pemphigus, bullous pemphigoid, anti-p200 pemphigoid, cicatricial pemphigoid, pemphigoid gestationis, dermatitis herpetiformis, linear IgA ...

  20. Systemic Lupus Erythematosus and Bullous Pemphigoid with Dramatic Response to Dapsone

    Science.gov (United States)

    Maggio, Maria Cristina; Corsello, Giovanni; Prinzi, Eugenia; Cimaz, Rolando

    2017-01-01

    Patient: Female, 11 Final Diagnosis: Bullous pemphigoid in systemic lupus erythematosus Symptoms: Bullous lupus • photosensitive rash • synovitis Medication:— Clinical Procedure: Pharmacological treatment Specialty: Rheumatology Objective: Unusual clinical course Background: Bullous pemphigoid is an autoimmune blistering disease, with relapses, isolated or associated with other autoimmune diseases such as systemic lupus erythematosus (SLE). Joint manifestations rapidly respond to small or moderate doses of corticosteroids, whereas skin manifestations usually respond to antimalarial drugs. Case Report: We describe the clinical case of an 11-year-old girl with SLE. She showed bullous skin lesions with arthralgia, mild proteinuria, resolved after steroid treatment. At the tapering of her prednisone dose, the patient had new skin lesions requiring an increased dose of prednisone. She started dapsone at the dosage of 1 mg/kg/day, maintaining low dose prednisone; this treatment was successfully followed by the dramatic disappearance of skin lesions and limb pain. Conclusions: Bullous skin lesions can represent the first clinical presentation of pediatric SLE and could influence the treatment and the outcome of these patients. This case showed an atypical course as both skin manifestations and arthritis promptly and persistently resolved with dapsone without the use of high-dose glucocorticoids. Only a few cases of patients with SLE associated with bullous pemphigoid have been reported in the literature, and very few in the pediatric population. PMID:28352068

  1. Figurate and bullous eruption in association with breast carcinoma.

    Science.gov (United States)

    Watsky, K L; Orlow, S J; Bolognia, J L

    1990-05-01

    We describe a patient with two coexistent cutaneous eruptions: (1) trauma-induced bullae of the distal extremities and elbows and (2) multiple concentric gyrate lesions on the trunk and extremities, some of which became bullous. The gyrate lesions were stationary and nonpruritic. Biopsy of both types of lesions showed a subepidermal blister and a minimal inflammatory infiltrate. Direct immunofluorescence revealed linear deposition of IgG and C3 at the dermoepidermal junction and indirect immunofluorescence was negative. By immunoelectron microscopy, these immune deposits were localized to the lower lamina lucida. The eruption was not controlled despite high-dose (80 mg/d) oral administration of prednisone and required the addition of an oral administration of methotrexate (20 mg weekly). On further evaluation, an intraductal mammary carcinoma was detected. Following radiation therapy, the methotrexate and prednisone therapy were tapered without recurrence of the eruption during a follow-up period of 18 months.

  2. Sulfasalazine-induced linear immunoglobulin A bullous dermatosis with DRESS.

    Science.gov (United States)

    Hernández, N; Borrego, L; Soler, E; Hernández, J

    2013-05-01

    Linear immunoglobulin (Ig) A dermatosis is an immune-mediated bullous disease characterized by linear deposits of IgA along the basal membrane. While usually idiopathic, it can occasionally be induced by drug exposure. We report the case of a 60-year-old woman with rheumatoid arthritis being treated with sulfasalazine who developed linear IgA dermatosis and drug rash with eosinophilia and systemic symptoms (DRESS). The dermatosis and associated symptoms resolved following withdrawal of the drug and treatment with systemic corticosteroids for 2 months. This is the first report of sulfasalazine-induced linear IgA dermatosis in association with DRESS and we believe that sulfasalazine should be added to the list of drugs that can cause linear IgA dermatosis.

  3. Bleb Point: Mimicker of Pneumothorax in Bullous Lung Disease

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    Gelabert, Christopher

    2015-05-01

    Full Text Available In patients presenting with severe dyspnea, several diagnostic challenges arise in distinguishing the diagnosis of pneumothorax versus several other pulmonary etiologies like bullous lung disease, pneumonia, interstitial lung disease, and acute respiratory distress syndrome. Distinguishing between large pulmonary bullae and pneumothorax is of the utmost importance, as the acute management is very different. While multiple imaging modalities are available, plain radiographs may be inadequate to make the diagnosis and other advanced imaging may be difficult to obtain. Ultrasound has a very high specificity for pneumothorax. We present a case where a large pulmonary bleb mimics the lung point and therefore inaccurately suggests pneumothorax. [West J Emerg Med. 2015;16(3:447–449.

  4. Chronic wound state exacerbated by oxidative stress in Pax6+/- aniridia-related keratopathy.

    Science.gov (United States)

    Ou, J; Walczysko, P; Kucerova, R; Rajnicek, A M; McCaig, C D; Zhao, M; Collinson, J M

    2008-08-01

    Heterozygosity for the transcription factor PAX6 causes eye disease in humans, characterized by corneal opacity. The molecular aetiology of such disease was investigated using a Pax6+/- mouse model. We found that the barrier function of uninjured Pax6+/- corneas was compromised and that Ca2+-PKC/PLC-ERK/p38 signalling pathways were abnormally activated, mimicking a 'wounded' epithelial state. Using proteomic analysis and direct assay for oxidized proteins, Pax6+/- corneas were found to be susceptible to oxidative stress and they exhibited a wound-healing delay which could be rescued by providing reducing agents such as glutathione. Pax6 protein was oxidized and excluded from the nucleus of stressed corneal epithelial cells, with concomitant loss of corneal epithelial markers and expression of fibroblast/myofibroblast markers. We suggest a chronic wound model for Pax6-related corneal diseases, in which oxidative stress underlies a positive feedback mechanism by depleting nuclear Pax6, delaying wound healing, and activating cell signalling pathways that lead to metaplasia of the corneal epithelium. The study mechanistically links a relatively minor dosage deficiency of a transcription factor with potentially catastrophic degenerative corneal disease.

  5. Dermatoses bolhosas auto-imunes Autoimmune bullous dermatoses

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    Paulo R. Cunha

    2009-04-01

    Full Text Available Dermatoses bolhosas autoimunes são doenças cuja manifestação cutânea primária e fundamental consiste em vesículas e bolhas. Classificam-se conforme a localização da bolha, em intraepidérmica e subepidérmica. Os pacientes produzem autoanticorpos contra estruturas específicas da pele detectáveis por técnicas de imunofluorescência, immunobloting e Elisa. Os recentes avanços da biologia molecular e celular têm permitido conhecer esses autoantígenos, contra os quais os pacientes se sensibilizam e que estão localizados na epiderme ou na junção dermoepidérmica. São doenças de baixa incidência, porém de elevada morbidade e por vezes letais. O objetivo deste trabalho é revisar e descrever os progressos nos conhecimentos de quatro doenças vésico-bolhosas autoimunes: pênfigo foliáceo endêmico (fogo selvagem, pênfigo vulgar, penfigóide bolhoso e dermatite herpetiforme.Autoimmune bullous dermatoses are diseases in which blisters and vesicles are the primary and fundamental types of skin lesion. Their classification is based on the location of the blister: intraepidermal and subepidermal. Patients produce autoantibodies against self-specific structures of the skin detectable by immunofluorescence techniques, immunoblotting and ELISA. Recent advances in molecular and cellular biology have brought to knowledge these self-antigens, against which patients are sensitized, and which are found in epidermis or in the dermo-epidermal junction. These are low incidence, but high morbidity diseases that may be fatal. The aim of this article is to review and describe the progress of four autoimmune vesiculobullous disorders: endemic pemphigus foliaceous (wild fire, pemphigus vulgaris, bullous pemphigoid and dermatitis herpetiformis.

  6. Awareness of Cornea Donation of Registered Tissue Donors in Nanjing

    Institute of Scientific and Technical Information of China (English)

    Ting Chu; Lin-nong Wang; Hao Yu; Ru-yang Zhang

    2013-01-01

    Objective To evaluate the current cornea donation awareness of tissue donors in the city of Nanjing,China. Methods Altogether 2000 registered tissue donors in the Red Cross Eye Bank of Nanjing by the end of 2010 and 2000 control residents of Nanjing in February to June 2011 were randomly selected to par-ticipate in our field questionnaire survey. The questionnaire consisted of questions regarding the understand-ing of cornea donation,the attitude toward cornea donation,and attitude toward legislation and free dona-tion. The awareness of cornea donation between the registered tissue donors and residents was compared. Related factors of the willingness to donate corneas and to become a tissue donor were evaluated with uni-variate and multiple logistic regression analysis. Results A total of 1867 (response rate: 93.4%) tissue donors and 1796 (response rate: 89.8%; ef-fective questionnaires: 1697) residents participated in this survey. For the questions about the knowledge of cornea donation,90.3% tissue donors (residents: 78.9%) knew that donated corneas could be used for transplantations; 71.2% tissue donors (residents: 47.6%) knew that the appearance would not be destroyed after cornea donation; 70.7% tissue donors (residents: 20.0%) knew the formalities to become a cornea do-nor. For attitude toward cornea donation,82.2% tissue donors (residents: 45.1%) were willing to donate corneas or eyeballs after death; 84.0% tissue donors (residents: 30.2%) had discussed with their families about donation; 85.1% tissue donors (residents: 24.8%) supported their families' or friends' cornea donation. For attitude toward legislation and free donation,88.3% tissue donors (residents: 61.3%) approved of legis-lation to regular cornea donation; 72.2% tissue donors (residents: 38.8%) thought that cornea or organ do-nation should be gratis. The difference between two groups was significant (P<0.001). However,some tissue donors did not know cornea donation well,some even opposed the

  7. Investigation of Friction-induced Damage to the Pig Cornea

    NARCIS (Netherlands)

    da Cruz Barros, Raquel; Van Kooten, Theo G.; Veeregowda, Deepak Halenahally

    2015-01-01

    Mechanical friction causes damage to the cornea. A friction measurement device with minimal intervention with the pig cornea tear film revealed a low friction coefficient of 0.011 in glycerine solution. Glycerine molecules presumably bind to water, mucins, and epithelial cells and therewith improve

  8. Estimation of the surface tension of ocular cornea

    Science.gov (United States)

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

    2008-12-01

    Considering the potential clinical importance, the surface tension of ocular cornea under the action of normal physiological intraocular pressure is estimated, and a novel technique and a simple mechanical model for determining the tension are also presented in this paper. An instrument embodying mainly a CCD camera, an optical staff gauge and a manometer was developed primarily to measure both the surface point displacement and intraocular pressure of the cornea. A simple theoretical model was used to characterize the tensions of the ocular corneas under the action of the intraocular pressure. Due to the difficulty in obtaining the human cornea, laboratory experiments were carried out on porcine cornea specimens. The thickness of the specimens was accurately measured by optical coherence tomography. The matrix and collagen properties within the corneal tissue were manifested in the experiment. Experimental results on porcine corneas showed that the present technique is applicable to estimate the surface tension. In the normal physiological intraocular pressure range, both meridian and circumference tensions of the porcine corneas along the radial coordinate distribute are not uniform.

  9. [Linear IgA bullous dermatosis: the importance of a correct differential diagnosis].

    Science.gov (United States)

    Colombo, M; Volpini, S; Orini, S; Fazi, M C; Vettore, E; Tedoldi, S; Cappellaro, E

    2008-06-01

    Linear IgA bullous dermatosis is an acquired subepidermal blistering disease which belongs to bullous autoimmune diseases, along with dermatitis herpetiformis and bullous pemphigoid. Inflammatory blisters are the main clinical characteristics and the areas of common involvement are: perioral region, abdomen, perineum, buttocks and the interior side of thighs. Essential for the diagnosis is to find by direct immunofluorescence the presence of a linear band of IgA antibodies at the level of the basement membrane. We present the case of a 5 year-old Moroccan girl which arrived at our First Aid Department for bullous dermatitis, localized mainly on the abdomen, legs and thighs. During a short stay in Morocco, a month before, the little girl was stung by an insect and developed bullous dermatitis by a residual lesion. The child was in a good state of health but blood exams showed an increase of total IgE antibodies. The girl was admitted and during her hospitalisation we made a skin biopsy which led to a diagnosis of linear IgA dermatosis. She began a steroid therapy and there was a progressive regression of the lesions. At present, she does not take medicines anymore, she feels well and is submitted to ambulatory medical follow-up.

  10. Crystalline-Like Keratopathy after Intravenous Immunoglobulin Therapy with Incomplete Kawasaki Disease: Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Elif Erdem

    2013-01-01

    Full Text Available A 7-year-old girl had presented with high body temperature and joint pain which continued for 3 days. Because of the prolonged history of unexplained fever, rash, bilateral nonpurulent conjunctival injection, oropharyngeal erythema, strawberry tongue, and extreme of age, incomplete Kawasaki disease was considered and started on an intravenous immunoglobulin infusion. Six days after this treatment, patient was referred to eye clinic with decreased vision and photophobia. Visual acuity was reduced to 20/40 in both eyes. Slit-lamp examination revealed bilateral diffuse corneal punctate epitheliopathy and anterior stromal haze. Corneal epitheliopathy seemed like crystal deposits. One day after presentation, mild anterior uveitis was added to clinical picture. All ocular findings disappeared in one week with topical steroid and unpreserved artificial tear drops. We present a case who was diagnosed as incomplete Kawasaki disease along with bilateral diffuse crystalline-like keratopathy. We supposed that unusual ocular presentation may be associated with intravenous immunoglobulin treatment.

  11. Localized linear IgA/IgG bullous dermatosis.

    Science.gov (United States)

    Shimizu, Satoko; Natsuga, Ken; Shinkuma, Satoru; Yasui, Chikako; Tsuchiya, Kikuo; Shimizu, Hiroshi

    2010-11-01

    Linear IgA/IgG bullous dermatosis (LAGBD) is an auto-immune blistering disease characterized by the local accumulation of IgA- and IgG-class anti-basement membrane autoantibodies. It typically presents as a generalized pruritic vesiculobullous eruption. No cases of localized LAGBD have yet been reported. We report a case of a 78-year-old man with LAGBD localized to the perianal area. The patient complained of suffering from persistent ulcers around the anus for more than 3 years. Physical examination revealed several blisters and ulcers up to 2-cm in diameter around the anus. No lesions were found elsewhere on the body. Histological analysis of a skin biopsy revealed subepidermal blistering, while direct immunofluorescence showed the linear deposition of IgA and IgG antibodies at the dermoepidermal junction. Indirect immunofluorescence of normal human skin whose layers had been separated using 1M NaCl showed the binding of both IgA and IgG to the epidermal side. Immunoblotting demonstrated the presence of circulating IgA and IgG autoantibodies that bound to a 120-kDa protein. This is the first case of localized LAGBD whose skin lesions were restricted to the perianal region.

  12. Mediators of Mast Cells in Bullous Pemphigoid and Dermatitis Herpetiformis

    Directory of Open Access Journals (Sweden)

    Agnieszka Zebrowska

    2014-01-01

    Full Text Available Bullous pemphigoid (BP and dermatitis herpetiformis (DH are skin diseases associated with inflammation. However, few findings exist concerning the role of mast cells in autoimmune blistering disease. Skin biopsies were taken from 27 BP and 14 DH patients, as well as 20 healthy individuals. Immunohistochemistry was used to identify the localization and mast cell expression of TNFα and MMP9 in skin lesions and perilesional skin. The serum concentrations of TNFα, MMP9, chymase, tryptase, PAF, and IL-4 were measured by immunoassay. TNFα and MMP9 expression in the epidermis and in inflammatory influxed cells in the dermis was detected in skin biopsies from patients. Although these mediators were found to be expressed in the perilesional skin of all patients, the level was much lower than that in lesional skin. Increased serum PAF levels were observed in BP patients. Mast cells may play an essential role in activating inflammation, which ultimately contributes to the tissue damage observed in BP and DH. Our findings suggest that differences in the pattern of cytokine expression directly contribute to variations in cellular infiltration in DH and BP.

  13. Unusual clinicopathological and immunological presentation of chronic bullous dermatosis of childhood (linear IgA dermatosis

    Directory of Open Access Journals (Sweden)

    Al-Saif Fahad

    2011-01-01

    Full Text Available Linear IgA bullous dermatosis is a rare sulfone-responsive subepidermal blistering disorder of unknown etiology in which smooth linear deposits of IgA are found in the basement membrane zone. Chronic bullous dermatosis of childhood is equivalent to linear IgA disease of adulthood and is characterized by an abrupt onset of large, widespread and tense bullae on a normal or erythematous base. In this case, we describe an unusual presentation of chronic bullous dermatosis in a 14-month-old Saudi girl. Histopathological examination revealed subepidermal cell poor blisters with linear deposition of IgA, IgG, IgM, and C3 along the dermoepidermal junction. The unusual clinical, histopathological and immunofluorescence findings in this patient are discussed, with an account on the differential diagnosis in such cases along with a detailed review of the relevant literature.

  14. Unusual clinicopathological and immunological presentation of chronic bullous dermatosis of childhood (linear IgA dermatosis).

    Science.gov (United States)

    Fahad, Al-Saif; Ammar, Al-Rikabi

    2011-01-01

    Linear IgA bullous dermatosis is a rare sulfone-responsive subepidermal blistering disorder of unknown etiology in which smooth linear deposits of IgA are found in the basement membrane zone. Chronic bullous dermatosis of childhood is equivalent to linear IgA disease of adulthood and is characterized by an abrupt onset of large, widespread and tense bullae on a normal or erythematous base. In this case, we describe an unusual presentation of chronic bullous dermatosis in a 14-month-old Saudi girl. Histopathological examination revealed subepidermal cell poor blisters with linear deposition of IgA, IgG, IgM, and C3 along the dermoepidermal junction. The unusual clinical, histopathological and immunofluorescence findings in this patient are discussed, with an account on the differential diagnosis in such cases along with a detailed review of the relevant literature.

  15. Treatment of Subepidermal Autoimmune Bullous Diseases Sürekli Eğitim

    Directory of Open Access Journals (Sweden)

    Ekin Şavk

    2011-06-01

    Full Text Available The common therapeutic goal for all subepidermal bullous diseases is to prevent inflammation and production of pathogenic autoantibodies and/or to facilitate the elimination of these antibodies. Diseases included in this group are the pemphigoids, linear IgA dermatosis, epidermolysis bullosa acquisita, dermatitis herpetiformis and bullous systemic erythematosus. Corticosteroids are the most commonly used systemic medication. Other alternatives include dapsone, various antibiotics and nicotinamide, azathioprine, cyclophosphamide, methotrexate, cycloporine, mycophenolate mofetil, IV immunoglobulins and plasmapheresis. Rapid reepithelialization and prevention of secondary infections are provided by local hygenic measures including antiseptic baths and wound care. (Turkderm 2011; 45 Suppl 1: 54-8

  16. "Half-half" blisters in bullous pemphigoid successfully treated with adjuvant high-dose intravenous immunoglobulin.

    Science.gov (United States)

    Pacheco, David; Lopes, Leonor; Soares-Almeida, Luis; Marques, Manuel Sacramento; Filipe, Paulo

    2012-09-01

    Bullous pemphigoid is a rare, autoimmune blistering disease. Its clinical presentation is tense blisters that may arise on normal-appearing or erythematous skin. Bullous pemphigoid refractory to systemic corticosteroids in combination with immunosuppressants such as azathioprine and mycophenolate mofetil may benefit from adjuvant high-dose intravenous immunoglobulin (IVIg). We describe a particular case with an unusual clinical presentation unresponsive to systemic corticosteroids plus azathioprine, in which the addition of high-dose IVIg was successful. The combined therapy of systemic corticosteroids and azathioprine plus high-dose IVIg can be an option in refractory cases due to its efficiency and tolerability.

  17. Bullous lung diseases as a risk factor for lung cancer: A case report

    Directory of Open Access Journals (Sweden)

    Nagorni-Obradović Ljudmila

    2016-01-01

    Full Text Available Introduction. A possible association between lung cancer and bullous lung disease has been suggested and recently supported by the results of genetic studies. Case report. A previously healthy 43-year-old man, smoker, was diagnosed with bullous lung disease at the age of 31 years. He was followed up for 12 years when lung cancer (adenocarcinoma was found at the site. In the meantime, he was treated for recurrent respiratory infections. Conclusion. There is the need for active approach in following up the patients with pulmonary bulla for potential development of lung cancer.

  18. Collagen cross-linking in thin corneas

    Directory of Open Access Journals (Sweden)

    Prema Padmanabhan

    2013-01-01

    Full Text Available Collagen cross-linking (CXL has become the standard of care for progressive keratoconus, after numerous clinical studies have established its efficacy and safety in suitably selected eyes. The standard protocol is applicable in eyes which have a minimum corneal thickness of 400 μm after epithelial debridement. This prerequisite was stipulated to protect the corneal endothelium and intraocular tissues from the deleterious effect of ultraviolet-A (UVA radiation. However, patients with keratoconus often present with corneal thickness of less than 400 μm and could have otherwise benefited from this procedure. A few modifications of the standard procedure have been suggested to benefit these patients without a compromise in safety. Transepithelial cross-linking, pachymetry-guided epithelial debridement before cross-linking, and the use of hypoosmolar riboflavin are some of the techniques that have been attempted. Although clinical data is limited at the present time, these techniques are worth considering in patients with thin corneas. Further studies are needed to scientifically establish their efficacy and safety.

  19. Measurement of the anisotropic thermal conductivity of the porcine cornea.

    Science.gov (United States)

    Barton, Michael D; Trembly, B Stuart

    2013-10-01

    Accurate thermal models for the cornea of the eye support the development of thermal techniques for reshaping the cornea and other scientific purposes. Heat transfer in the cornea must be quantified accurately so that a thermal treatment does not destroy the endothelial layer, which cannot regenerate, and yet is responsible for maintaining corneal transparency. We developed a custom apparatus to measure the thermal conductivity of ex vivo porcine corneas perpendicular to the surface and applied a commercial apparatus to measure thermal conductivity parallel to the surface. We found that corneal thermal conductivity is 14% anisotropic at the normal state of corneal hydration. Small numbers of ex vivo feline and human corneas had a thermal conductivity perpendicular to the surface that was indistinguishable from the porcine corneas. Aqueous humor from ex vivo porcine, feline, and human eyes had a thermal conductivity nearly equal to that of water. Including the anisotropy of corneal thermal conductivity will improve the predictive power of thermal models of the eye.

  20. A 12-year retrospective review of bullous systemic lupus erythematosus in cutaneous and systemic lupus erythematosus patients.

    Science.gov (United States)

    Chanprapaph, K; Sawatwarakul, S; Vachiramon, V

    2017-01-01

    Objective The aim of this study was to investigate the clinical features, laboratory findings, systemic manifestations, treatment and outcome of patients with bullous systemic lupus erythematosus in a tertiary care center in Thailand. Methods We performed a retrospective review from 2002 to 2014 of all patients who fulfilled the diagnostic criteria for bullous systemic lupus erythematosus to evaluate for the clinical characteristics, extracutaneous involvement, histopathologic features, immunofluorescence pattern, serological abnormalities, internal organ involvement, treatments and outcome. Results Among 5149 patients with cutaneous lupus erythematosus and/or systemic lupus erythematosus, 15 developed vesiculobullous lesions. Ten patients had validation of the diagnosis of bullous systemic lupus erythematosus, accounting for 0.19%. Bullous systemic lupus erythematosus occurred after the diagnosis of systemic lupus erythematosus in six patients with a median onset of 2.5 months (0-89). Four out of 10 patients developed bullous systemic lupus erythematosus simultaneously with systemic lupus erythematosus. Hematologic abnormalities and renal involvement were found in 100% and 90%, respectively. Polyarthritis (40%) and serositis (40%) were less frequently seen. Systemic corticosteroids, immunosuppressants, antimalarials and dapsone offered resolution of cutaneous lesions. Conclusion Bullous systemic lupus erythematosus is an uncommon presentation of systemic lupus erythematosus. Blistering can occur following or simultaneously with established systemic lupus erythematosus. We propose that clinicians should carefully search for systemic involvement, especially hematologic and renal impairment, in patients presenting with bullous systemic lupus erythematosus.

  1. Portable light transmission measuring system for preserved corneas

    Science.gov (United States)

    Ventura, Liliane; de Jesus, Gabriel Torres; de Oliveira, Gunter Camilo Dablas; Sousa, Sidney JF

    2005-01-01

    Background The authors have developed a small portable device for the objective measurement of the transparency of corneas stored in preservative medium, for use by eye banks in evaluation prior to transplantation. Methods The optical system consists of a white light, lenses, and pinholes that collimate the white light beams and illuminate the cornea in its preservative medium, and an optical filter (400–700 nm) that selects the range of the wavelength of interest. A sensor detects the light that passes through the cornea, and the average corneal transparency is displayed. In order to obtain only the tissue transparency, an electronic circuit was built to detect a baseline input of the preservative medium prior to the measurement of corneal transparency. The operation of the system involves three steps: adjusting the "0 %" transmittance of the instrument, determining the "100 %" transmittance of the system, and finally measuring the transparency of the preserved cornea inside the storage medium. Results Fifty selected corneas were evaluated. Each cornea was submitted to three evaluation methods: subjective classification of transparency through a slit lamp, quantification of the transmittance of light using a corneal spectrophotometer previously developed, and measurement of transparency with the portable device. Conclusion By comparing the three methods and using the expertise of eye bank trained personnel, a table for quantifying corneal transparency with the new device has been developed. The correlation factor between the corneal spectrophotometer and the new device is 0,99813, leading to a system that is able to standardize transparency measurements of preserved corneas, which is currently done subjectively. PMID:16372912

  2. Evidence-based treatments for pemphigus vulgaris, pemphigus foliaceus, and bullous pemphigoid: A systematic review

    Directory of Open Access Journals (Sweden)

    Sanjay Singh

    2011-01-01

    Full Text Available Background: Pemphigus, bullous pemphigoid, and epidermolysis bullosa acquisita are autoimmune diseases of skin associated with considerable morbidity and sometimes mortality. There is no cure for these diseases. Aims: To summarize evidence-based treatments for these diseases by performing a systematic review. Methods: The research protocol included the following steps: identification of databases to be searched, defining search strategy, searching the databases for references, first-stage screening of the abstracts, second-stage screening of full texts of articles identified after the first-stage screening, data extraction from the identified articles after second-stage screening, quality appraisal of the studies using the Delphi list, and summarizing the findings. Results: No randomized controlled trials of interventions in pemphigus vegetans, pemphigus erythematosus, and epidermolysis bullosa acquisita could be found. After the second-stage screening, 12 randomized controlled trials were analyzed, which included patients with pemphigus vulgaris or pemphigus vulgaris and pemphigus foliaceus, and 7 which included patients with bullous pemphigoid. Conclusions: Number of high-quality randomized controlled trials conducted on pemphigus and bullous pemphigoid is small. Oral corticosteroid along with a steroid-sparing agent appears to be the most effective treatment for pemphigus. Azathioprine may be most effective as a steroid-sparing agent. Topical corticosteroid therapy (as studied is effective for bullous pemphigoid and appears to be superior to oral corticosteroid for extensive disease. Some suggestions about future research are made.

  3. Bullous Systemic Lupus Erythematosus and Lupus Nephritis in a Young Girl

    Directory of Open Access Journals (Sweden)

    Tooba Momen

    2016-11-01

    Full Text Available Bullous systemic lupus erythematosus (BSLE is an autoimmune blistering disease occurring in patients with systemic lupus erythematosus (SLE. It is a rare disease, especially in children. A 14-year-old girl initially presented with fatigue, generalized vesiculobullous skin lesions, and ulcers over the hard palate and oral mucosa. Clinical investigations revealed hematuria and proteinuria, a high erythrocyte sedimentation rate and titer of antinuclear antibody, and anti-double-stranded DNA. Skin biopsy findings were suggestive of BSLE. A renal biopsy confirmed the features of class V lupus nephritis. Based on the clinical features and investigations, a diagnosis of BSLE with nephritis was made. She received methylprednisolone pulse therapy and hydroxychloroquine; however, it did not alleviate the vesiculobullous eruption, so treatment with dapsone started and resulted in the dramatic disappearance of the lesions. Interruption of dapsone due to hemolysis did not aggravate the bullous disease. During follow-up, she had multiple flare-ups of disease and nephritis without rebound of bullous lesions. BSLE is a rare presentation of SLE in children. Differentiating it from other skin bullous diseases and SLE with blister is important for the correct management. The unusual presentation of this disease may delay the diagnosis and therefore requires a high index of clinical suspicion.

  4. Spheroid degeneration of conjunctiva and cornea. Two years' follow up.

    Science.gov (United States)

    Norn, M

    1980-10-01

    Twenty-six subjects with spheroid degeneration were followed up after two years. The number of colourless conjunctival droplets was seen to have increased by on an average 46% (2 alpha = 0.05) and that of autofluorescent conjunctival droplets by 223% (2 alpha less than 0.01). Counting within the individual sites sites disclosed that some droplets will disappear (not less than 30 and 21% respectivelY), while recently formed will constitute at least 76 and 243%. The number of areas with band-shaped keratopathy was found to rise from 3 to 26 (P less than 0.001) out of 104 possibilities, (nasally and temporally of right and left eye). Vital staining (fluorescein, rose bengal, tetrazolium, alcian blue) showed the epithelium above the droplets to be intact, and the droplet-containing eyes were found not to be abnormally dry (break up time, tear production).

  5. Nerve repulsion by the lens and cornea during cornea innervation is dependent on Robo-Slit signaling and diminishes with neuron age.

    Science.gov (United States)

    Schwend, Tyler; Lwigale, Peter Y; Conrad, Gary W

    2012-03-01

    The cornea, the most densely innervated tissue on the surface of the body, becomes innervated in a series of highly coordinated developmental events. During cornea development, chick trigeminal nerve growth cones reach the cornea margin at embryonic day (E)5, where they are initially repelled for days from E5 to E8, instead encircling the corneal periphery in a nerve ring prior to entering on E9. The molecular events coordinating growth cone guidance during cornea development are poorly understood. Here we evaluated a potential role for the Robo-Slit nerve guidance family. We found that Slits 1, 2 and 3 expression in the cornea and lens persisted during all stages of cornea innervation examined. Robo1 expression was developmentally regulated in trigeminal cell bodies, expressed robustly during nerve ring formation (E5-8), then later declining concurrent with projection of growth cones into the cornea. In this study we provide in vivo and in vitro evidence that Robo-Slit signaling guides trigeminal nerves during cornea innervation. Transient, localized inhibition of Robo-Slit signaling, by means of beads loaded with inhibitory Robo-Fc protein implanted into the developing eyefield in vivo, led to disorganized nerve ring formation and premature cornea innervation. Additionally, when trigeminal explants (source of neurons) were oriented adjacent to lens vesicles or corneas (source of repellant molecules) in organotypic tissue culture both lens and cornea tissues strongly repelled E7 trigeminal neurites, except in the presence of inhibitory Robo-Fc protein. In contrast, E10 trigeminal neurites were not as strongly repelled by cornea, and presence of Robo-Slit inhibitory protein had no effect. In full, these findings suggest that nerve repulsion from the lens and cornea during nerve ring formation is mediated by Robo-Slit signaling. Later, a shift in nerve guidance behavior occurs, in part due to molecular changes in trigeminal neurons, including Robo1 downregulation

  6. File list: ALL.Oth.05.AllAg.Cornea [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Oth.05.AllAg.Cornea mm9 All antigens Others Cornea SRX437637,SRX437636,SRX24830...2,SRX248301,SRX437638 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Oth.05.AllAg.Cornea.bed ...

  7. File list: ALL.Oth.20.AllAg.Cornea [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Oth.20.AllAg.Cornea mm9 All antigens Others Cornea SRX437637,SRX437636,SRX24830...2,SRX248301,SRX437638 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Oth.20.AllAg.Cornea.bed ...

  8. File list: ALL.Oth.50.AllAg.Cornea [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Oth.50.AllAg.Cornea mm9 All antigens Others Cornea SRX437637,SRX437636,SRX24830...2,SRX248301,SRX437638 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Oth.50.AllAg.Cornea.bed ...

  9. File list: ALL.Oth.10.AllAg.Cornea [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available ALL.Oth.10.AllAg.Cornea mm9 All antigens Others Cornea SRX437637,SRX248302,SRX43763...6,SRX248301,SRX437638 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/assembled/ALL.Oth.10.AllAg.Cornea.bed ...

  10. Biomechanical Measurement of Rabbit Cornea by a Modified Scheimpflug Device

    Science.gov (United States)

    Zhang, Bo; Gu, Jianjun; Zhang, Xiaoxiao; Yang, Bin

    2016-01-01

    Purpose. To explore the probability and variation in biomechanical measurements of rabbit cornea by a modified Scheimpflug device. Methods. A modified Scheimpflug device was developed by imaging anterior segment of the model imitating the intact eye at various posterior pressures. The eight isolated rabbit corneas were mounted on the Barron artificial chamber and images of the anterior segment were taken at posterior pressures of 15, 30, 45, 60, and 75 mmHg by the device. The repeatability and reliability of the parameters including CCT, ACD, ACV, and CV were evaluated at each posterior pressure. All the variations of the parameters at the different posterior pressures were calculated. Results. All parameters showed good intraobserver reliability (Cronbach's alpha; intraclass correlation coefficient, α, ICC > 0.96) and repeatability in the modified Scheimpflug device. With the increase of posterior pressures, the ratio of CCT decreased linearly and the bulk modulus gradually reduced to a platform. The increase of ACD was almost linear with the posterior pressures elevated. Conclusions. The modified Scheimpflug device was a valuable tool to investigate the biomechanics of the cornea. The posterior pressure 15–75 mmHg range produced small viscoelastic deformations and nearly linear pressure-deformation response in the rabbit cornea. PMID:27446608

  11. Linear IgA Bullous Dermatosis: A Rare Clinicopathologic Entity with an Unusual Presentation.

    Science.gov (United States)

    Chaudhari, Soham; Mobini, Narciss

    2015-10-01

    Linear immunoglobulin A bullous dermatosis is a rare autoimmune mucocutaneous disorder caused by immunoglobulin A autoantibodies produced against several different antigens in the basement membrane zone. Clinically, it is characterized by tense vesicles or bullae, which on histopathological exam demonstrate subepidermal blister with a predominantly neutrophilic infiltrate. A smooth, linear pattern of immunoglobulin A deposition in the basement membrane zone on direct immunofluorescence is considered the gold standard for establishing a diagnosis. Treatment consists of dapsone or sulfapyridine. The authors report a 60-year-old woman who presented with pruritic erythematous patches and plaques on her trunk, back, and legs without blisters, who was diagnosed with eczema for several months with no response to prior treatments. A biopsy was performed, which was consistent with linear immunoglobulin A bullous dermatosis and later confirmed by direct immunofluorescence studies. The authors present this case to increase awareness of this rare disease, which could manifest in a nonclassical, nonblistering fashion.

  12. Linear IgA bullous dermatosis: a retrospective study of 23 patients in Denmark.

    Science.gov (United States)

    Lings, Kristina; Bygum, Anette

    2015-04-01

    Linear IgA bullous dermatosis (LAD) is an autoimmune, chronic bullous disease affecting primarily young children and adults. Studies on LAD are relatively sparse and from Scandinavia we could only find a few case reports. Therefore we decided to conduct a retrospective investigation of patients seen at our department since 1972. A total of 23 patients were identified; 7 children (F:M ratio 0.75) and 16 adults (F:M ratio 0.78). Mean age at disease onset in the two age groups were 2.7 and 56.8 years. Estimated incidence rate in our region: 0.67 per million per year. The most commonly used treatment modalities were corticosteroids, dapsone and sulphapyridine.

  13. Linear IgA bullous dermatosis induced by interferon-alpha 2a.

    Science.gov (United States)

    Kocyigit, P; Akay, B N; Karaosmanoglu, N

    2009-07-01

    Linear Ig A bullous dermatosis (LABD) is an acquired autoimmune subepidermal blistering disorder with linear deposits of IgA along the basement membrane zone. Its cause is unclear, although it appears to have an immune-mediated basis. Idiopathic, systemic disorder-related, and rarely drug-induced forms of LABD have been described. We describe a case of LABD associated with interferon-alpha 2A used for the treatment of Kaposi's sarcoma.

  14. Drug-induced linear IgA bullous dermatosis simulating toxic epidermal necrolysis.

    Science.gov (United States)

    Nasr, Joanna; Ammoury, Alfred; Chouairy, Camil; Mégarbané, Halal; El Habr, Constantin

    2014-01-01

    Linear IgA bullous dermatosis (LAD) is an autoimmune subepidermal blistering disorder. LAD may be either idiopathic or drug related; the most common drug being vancomycin. The clinical presentations of both idiopathic and drug-related LAD are variable and may mimic other blistering disorders. We report a case of a 76-year-old man known to have a renal cell carcinoma who presented a vancomycin-induced LAD that clinically mimicked toxic epidermal necrolysis (TEN).

  15. Changing patterns of infectious keratitis : Overview of clinical and histopathologic features of keratitis due to acanthamoeba or atypical mycobacteria, and of infectious crystalline keratopathy

    Directory of Open Access Journals (Sweden)

    Kinota Stanislaus

    1993-01-01

    Full Text Available Acanthamoeba keratitis, infectious crystalline keratopathy and atypical mycobacterial keratitis have recently emerged as important types of infectious keratitis. These corneal infections have been associated with contact lens wear and with corneal surgical procedures such as radial keratotomy and penetrating keratoplasty, and the clinical setting of each of these infections is important in alerting the clinician to the possible diagnosis. There have been improvements in rapid diagnostic techniques for such infections in the last several years. Treatment has also improved, but remains a difficult problem, especially for Acanthamoeba. An overview of recent developments in the clinical and histopathologic methods for diagnosis and treatment options of these three corneal infections is provided.

  16. Interstitial pneumonia associated with linear immunoglobulin A/immunoglobulin G bullous dermatosis.

    Science.gov (United States)

    Kakugawa, Tomoyuki; Tomimura, Saori; Hayashi, Tomayoshi; Sakamoto, Noriho; Ishimatsu, Yuji; Mukae, Hiroshi; Kohno, Shigeru

    2013-01-01

    A 76-year-old man with interstitial lung disease was admitted to our institution after developing persistent dyspnea upon effort. He also had a relapse of bullous eruptions on the skin of the trunk and extremities, previously diagnosed as vesicular pemphigoid. Direct immunofluorescence of a skin biopsy specimen using fluorescence microscopy showed the linear deposition of immunglobulin A (IgA), IgG and C3 along the basement membrane. These findings indicated a definitive diagnosis of linear IgA/IgG bullous dermatosis. Chest computed tomography, bronchoalveolar lavage and transbronchial lung biopsy findings suggested nonspecific interstitial pneumonia. Direct immunofluorescence of the lung biopsy specimens using fluorescence microscopy also showed a deposition of IgA, IgG and C3 along the epithelial cell membranes and basement membranes of the bronchioles and alveoli. Lung disorders associated with linear IgA/IgG bullous dermatosis are extremely rare and, to our knowledge, this is the first report of such a case of interstitial pneumonia.

  17. Development of bullous pemphigoid during the haemodialysis of a young man: case report and literature survey.

    Science.gov (United States)

    Osipowicz, Katarzyna; Kalinska-Bienias, Agnieszka; Kowalewski, Cezary; Wozniak, Katarzyna

    2017-02-01

    Haemodialysis is the most frequent form of renal replacement therapy (RRT) in patients with end-stage renal disorder (ESRD). Patients with ESRD frequently develop skin problems, mainly xerosis, pruritus and hyperpigmentation, as well as bullous diseases, mainly porphyria or pseudoporphyria and, in some cases, bullous pemphigoid (BP). BP is the most common autoimmune sub-epidermal blistering disease, and it predominantly affects elderly people. Clinically, BP is characterised by generalised pruritic, bullous eruptions and urticaria-like lesions. Usually, BP is an idiopathic disorder; however, in some cases, underlying internal disorders are present, like diabetes or neurological disorders. Herein, we present a 33-year-old man with ESRD, maintained on haemodialysis, who developed BP. There are only six cases with BP provoked by the placement of a fistula for haemodialysis. BP in the current patient was confirmed by direct immunofluorescence (DIF) and indirect immunofluorescence using BIOCHIP. The patient responded promptly to tertracycline and 0·05% clobetasol propionate lesionally. However, the relationship between BP and the fistula for haemodialisys still remains unknown. It is highly likely that the skin injury associated with fistula placement was responsible for the alteration of the basement membrane zone (BMZ) and the stimulation of the immune system, leading to BP development. To explain the real role of fistula placement as a provocative factor in BP, other such cases are required for assessment.

  18. The transparent lens and cornea in the mouse and zebra fish eye.

    Science.gov (United States)

    Greiling, Teri M S; Clark, John I

    2008-04-01

    The lens and cornea combine to form a single optical element in which transparency and refraction are the fundamental biophysical characteristics required for a functional visual system. Although lens and cornea have different cellular and extracellular specializations that contribute to transparency and refraction, their development is closely related. In the embryonic mouse, the developing cornea and lens separate early. In contrast, zebra fish lens and cornea remain connected during early development and the optical properties of the cornea and lens observed by slit lamp and quasielastic laser light scattering spectroscopy (QLS) are more similar in the zebra fish eye than in the mouse eye. Optical similarities between cornea and lens of zebra fish may be the result of similarities in the cellular development of the cornea and lens.

  19. Acanthamoeba castellanii: morphological analysis of the interaction with human cornea.

    Science.gov (United States)

    Omaña-Molina, Maritza; González-Robles, Arturo; Salazar-Villatoro, Lizbeth Iliana; Cristóbal-Ramos, Ana Ruth; González-Lázaro, Mónica; Salinas-Moreno, Edmundo; Méndez-Cruz, Rene; Sánchez-Cornejo, Manuel; De la Torre-González, Enrique; Martínez-Palomo, Adolfo

    2010-09-01

    The present study demonstrates that when Acanthamoeba castellanii trophozoites are co-cultivated with isolated human corneas, the amoeba can be invasive and cause damage to the intact corneal epithelium without the requirement of previous corneal abrasion. After adhesion, A. castellanii trophozoites migrate between cells forming bumps on the corneal cell layers and reaching Bowman s membrane in 3h, although no evidence of cell damage was observed until the phagocytic process was detected. Likewise, conditioned medium produced damage to the corneal cells that was proportional to the time of incubation, but this cytophatic effect involved only the most superficial layer of the human cornea and was not enough to explain amoebic invasion of Bowman s membrane. As a result of our observations, we suggest that the mechanical action of the trophozoites and phagocytosis of corneal cells during the process of corneal invasion are more important than previously suggested.

  20. Live imaging of newly formed lymphatic vessels in the cornea

    Institute of Scientific and Technical Information of China (English)

    Don Yuen; Xiufeng Wu; Alex C Kwan; Jeffrey LeDue; Hui Zhang; Tatiana Ecoiffier; Bronislaw Pytowski; Lu Chen

    2011-01-01

    Dear Editor,Lymphatic research denotes a field of new discovery and has experienced exponential growth in recent years [1-3].Though lymphatic dysfunction has been found in a broad spectrum of disorders from transplant rejection to cancer metastasis,to date,there is still little effective treatment for lymphatic diseases,so it is a field with urgent demand for new experimental approaches and therapeutic protocols.The cornea provides an ideal site for lymphatic research due to its accessible location,transparent nature,and alymphatic status under normal condition [2,4].Indeed,the use of this tissue for tumor angiogenesis research dates back to 1970s [5].Most recently,we have demonstrated that the cornea possesses a full range of plasticity in lymphatic formation and regression [6].An advanced technology for live imaging of lymphatic vessels in this tissue would therefore have widespread applications in biomedical research.

  1. Posterior polymorphous dystrophy of the cornea. An ultrastructural study.

    Science.gov (United States)

    de Felice, G P; Braidotti, P; Viale, G; Bergamini, F; Vinciguerra, P

    1985-01-01

    A corneal button excised from a 2-month-old infant with congenital posterior polymorphous dystrophy of the cornea, a rare disease affecting Descemet's membrane and endothelium, was examined by electron microscopy. We observed irregularly arranged, sometimes multilayered cells with marked epithelial features, lining the posterior surface of the cornea in place of the endothelium, and Descemet's membrane with focal alterations sometimes involving all of its layers. We interpreted these abnormal cells as epithelial-like cells. As these findings were in a very young patient, which is unusual, we concluded that the onset of the disease may take place in the early period of intrauterine life, corresponding to the beginning of Descemet's membrane production.

  2. Management of chemical burns of the canine cornea

    OpenAIRE

    Christmas, Richard

    1991-01-01

    Significant clinical signs and general principles of treatment for chemical burns of the canine cornea are presented using three typical case studies for illustration. Alkali burns are more common in dogs than acid burns. The sources of alkali in this study were soap, cement, and mortar dust. Common signs of chemical burns are ocular pain, corneal ulceration, tear film inadequacy, corneal edema, and marked corneal neovascularity. Successful treatment requires thorough ocular lavage, treatment...

  3. Ultrahigh-resolution OCT imaging of the human cornea

    Science.gov (United States)

    Werkmeister, René M.; Sapeta, Sabina; Schmidl, Doreen; Garhöfer, Gerhard; Schmidinger, Gerald; Aranha dos Santos, Valentin; Aschinger, Gerold C.; Baumgartner, Isabella; Pircher, Niklas; Schwarzhans, Florian; Pantalon, Anca; Dua, Harminder; Schmetterer, Leopold

    2017-01-01

    We present imaging of corneal pathologies using optical coherence tomography (OCT) with high resolution. To this end, an ultrahigh-resolution spectral domain OCT (UHR-OCT) system based on a broad bandwidth Ti:sapphire laser is employed. With a central wavelength of 800 nm, the imaging device allows to acquire OCT data at the central, paracentral and peripheral cornea as well as the limbal region with 1.2 µm x 20 µm (axial x lateral) resolution at a rate of 140 000 A-scans/s. Structures of the anterior segment of the eye, not accessible with commercial OCT systems, are visualized. These include corneal nerves, limbal palisades of Vogt as well as several corneal pathologies. Cases such as keratoconus and Fuchs’s endothelial dystrophy as well as infectious changes caused by diseases like Acanthamoeba keratitis and scarring after herpetic keratitis are presented. We also demonstrate the applicability of our system to visualize epithelial erosion and intracorneal foreign body after corneal trauma as well as chemical burns. Finally, results after Descemet’s membrane endothelial keratoplasty (DMEK) are imaged. These clinical cases show the potential of UHR-OCT to help in clinical decision-making and follow-up. Our results and experience indicate that UHR-OCT of the cornea is a promising technique for the use in clinical practice, but can also help to gain novel insight in the physiology and pathophysiology of the human cornea. PMID:28271013

  4. [Temporary biokeratoprostheses in total destruction of the cornea].

    Science.gov (United States)

    Onishchenko, A L; Kolbasko, A V; Kramer, E R

    2016-01-01

    The paper presents an original method for temporary biokeratoprothetics in total destruction of the cornea, which consists of the following. In the operating room a 12-mm disc is cut out of patient's conchal cartilage by a trephine and then thinned down to 1 mm with a blade. The prepared autograft is placed in front of the iris completely overlapping corneal defect and sutured to the sclera with 10--12 U-shaped interrupted stitches using a 7/0 suture. Between the stitches 0.2--0.3 ml of viscoelastic are injected into the anterior chamber. Temporary blepharorrhaphy is done within the temporal one-third of the eyelids with a U-shaped suture 6/0. The authors present an own clinical observation of patient D., aged 46, with purulent corneal ulcer and total destruction of the cornea. In ophthalmic emergency, if no donor cornea is available, the described method allows to save the eyeball from its anatomical and functional loss. Further routine keratoplasty or optical keratoprosthetics may bring some functional improvement.

  5. Penfigoide bolhoso no adulto mais jovem: relato de três casos Bullous pemphigoid in younger adults: three case reports

    Directory of Open Access Journals (Sweden)

    Roberta Richter Zanella

    2011-04-01

    Full Text Available O penfigoide bolhoso é uma dermatose bolhosa autoimune subepidérmica, mais comumente observada na população idosa (acima dos 70 anos. Autoanticorpos são formados contra antígenos específicos da zona de membrana basal: BP180 e BP230 (proteínas do hemidesmossomo. Apresentamos três casos de penfigoide bolhoso, em adultos com menos de 50 anos de idade, destacan do as peculiaridades clínicas na faixa etária mais jovem.Bullous pemphigoid is an autoimmune subepidermal bullous dermatosis more commonly observed in the elderly (over 70 years old. Autoantibodies are produced for specific antigens of the epidermal basement membrane zone: BP 180 and BP 230 (hemidesmosome proteins. We report three cases of bullous pemphigoid in adults younger than 50 years old, discussing the clinical characteristics of the disease in younger patients.

  6. Proteinases of the cornea and preocular tear film.

    Science.gov (United States)

    Ollivier, F J; Gilger, B C; Barrie, K P; Kallberg, M E; Plummer, C E; O'Reilly, S; Gelatt, K N; Brooks, D E

    2007-01-01

    Maintenance and repair of corneal stromal extracellular matrix (ECM) requires a tightly coordinated balance of ECM synthesis, degradation and remodeling in which proteolytic enzymes (proteinases) perform important functions. There are natural proteinase inhibitors present in preocular tear film (PTF) and cornea simultaneously with proteinases that prevent excessive degradation of normal healthy tissue. Disorders occur when there is an imbalance between proteinases and proteinase inhibitors in favor of the proteinases, causing pathologic degradation of stromal collagen and proteoglycans in the cornea. Two matrix metalloproteinases (MMPs), MMP-2 and MMP-9, are of major importance in terms of remodeling and degradation of the corneal stromal collagen. Immunohistochemical studies have shown different origins of MMP-2 and -9. MMP-2 is synthesized by corneal keratocytes and performs a surveillance function in the normal cornea, becoming locally activated to degrade collagen molecules that occasionally become damaged. Alternatively, MMP-9 may be produced by epithelial cells and polymorphonuclear neutrophils following corneal wounding. Because the cornea is in close contact with the preocular tear film (PTF), proteinases have been evaluated in the PTF. In damaged corneas, total proteolytic activity in the tear fluid was found to be significantly increased compared to normal eyes and contralateral eyes. Studies analyzing the proteolytic activity in serial PTF samples during corneal healing led to the following conclusions: ulcerative keratitis in animals is associated with initially high levels of tear film proteolytic activity, which decrease as ulcers heal; proteinase levels in melting ulcers remain elevated leading to rapid progression of the ulcers. The success of medical and surgical treatment of the corneal ulcers is reflected by the proteolytic activity in tears. In animals, successful treatment leads to a rapid reduction in tear film proteolytic activity that

  7. Irritant bullous contact dermatitis caused by a rove beetle: an illustrated clinical course.

    Science.gov (United States)

    McGrath, Lindsay; Piliouras, Peter; Robertson, Ivan

    2013-05-01

    A 26-year-old Australian female traveller in Sierra Leone presented with an irritant bullous contact dermatitis consistent with paederus dermatitis. The lesions were treated with a potent topical corticosteroid with good effect. The affected area resolved in 6 weeks and hyperpigmention persisted for months until complete resolution. This dermatitis occurs when beetles of the genus Paederus (rove beetles) are crushed on the skin, releasing pederin. The same dermatitis ensues with Australian Paederus species. Serial clinical photographs are presented which will aid Australian dermatologists in the diagnosis of this dermatitis, which presents in regional Australian patients and returned overseas travellers.

  8. Bullous mycosis fungoides associated with an extensive ulcer and a severe leukemoid reaction

    Directory of Open Access Journals (Sweden)

    Shuei Sato

    2011-12-01

    Full Text Available This report presents a case of bullous mycosis fungoides associated with an extensive ulcer and a severe leukemoid reaction. The rash began as indurated erythema which was always followed by ulceration. The rashes initially responded to radiation therapy, but multiple recurrences appeared. Several bullae appeared on the trunk during the course of the illness, without any evidence of paraneoplastic pemphigus. Finally, the ulcer covered a large part of the trunk, and the patient died of sepsis with an extreme leukocyte count of 118,000/μL. A bone marrow analysis revealed a leukemoid reaction and an autopsy revealed pseudomembranous colitis.

  9. Atypical response to treatment in linear IgA bullous dermatosis of childhood: Revision of literature.

    Science.gov (United States)

    Moleiro, Susana; Santos, Vera; Calha, Manuela; Pessoa, Graça

    2011-06-15

    A three-year-old boy presented with 2 months of worsening skin lesions characterized by multiple clear vesicles and bullae. The histopathological and immunohistochemical examinations revealed changes consistent with linear IgA bullous dermatosis of childhood. Treatment with dapsone and prednisolone resulted in gradual clinical improvement. However, within a week of therapy he presented with diabetic ketoacidosis, the onset of type I diabetes mellitus. Since then, keeping this child asymptomatic has been a challenge. This case emphasizes the importance of close monitoring of patients taking systemic corticosteroids; the coexistence of other immune mediated conditions may influence the success of treatment.

  10. Advances in understanding and managing bullous pemphigoid [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Cathy Y. Zhao

    2015-11-01

    Full Text Available Bullous pemphigoid (BP is the commonest subtype of autoimmune blistering disease in most countries of the world. It occurs most frequently in elderly patients and is characterised clinically by large, tense blisters in the skin preceded by urticarial plaques and pruritus. Immunopathologically, it is characterised by autoantibodies directed against the 180 kD antigen (BP180 and the 230 kD antigen (BP230. New knowledge regarding BP is being continually uncovered. This article reviews the recent advances in BP, including newer diagnostic tests, standardised outcome measures and emerging therapeutic options, as well as the evidence supporting their use.

  11. Bullous Variant of Sweet’s Syndrome after Herpes Zoster Virus Infection

    OpenAIRE

    2011-01-01

    Aim: Cutaneous manifestations of Sweet’s syndrome (SS) are typically painful plaque-forming erythematous papules, while bullae are quite uncommon. We present a case of bullous variant of SS in acute myeloid leukaemia. In this case, herpes infection of the left mandible had preceded the development of SS. Case Report: A 75-year-old male with myelodysplastic syndrome first presented with herpes zoster virus infection-like bullae and erosive plaques on the left side of the face and neck. Treatme...

  12. The Ets transcription factor EHF as a regulator of cornea epithelial cell identity.

    Science.gov (United States)

    Stephens, Denise N; Klein, Rachel Herndon; Salmans, Michael L; Gordon, William; Ho, Hsiang; Andersen, Bogi

    2013-11-29

    The cornea is the clear, outermost portion of the eye composed of three layers: an epithelium that provides a protective barrier while allowing transmission of light into the eye, a collagen-rich stroma, and an endothelium monolayer. How cornea development and aging is controlled is poorly understood. Here we characterize the mouse cornea transcriptome from early embryogenesis through aging and compare it with transcriptomes of other epithelial tissues, identifying cornea-enriched genes, pathways, and transcriptional regulators. Additionally, we profiled cornea epithelium and stroma, defining genes enriched in these layers. Over 10,000 genes are differentially regulated in the mouse cornea across the time course, showing dynamic expression during development and modest expression changes in fewer genes during aging. A striking transition time point for gene expression between postnatal days 14 and 28 corresponds with completion of cornea development at the transcriptional level. Clustering classifies co-expressed, and potentially co-regulated, genes into biologically informative categories, including groups that exhibit epithelial or stromal enriched expression. Based on these findings, and through loss of function studies and ChIP-seq, we show that the Ets transcription factor EHF promotes cornea epithelial fate through complementary gene activating and repressing activities. Furthermore, we identify potential interactions between EHF, KLF4, and KLF5 in promoting cornea epithelial differentiation. These data provide insights into the mechanisms underlying epithelial development and aging, identifying EHF as a regulator of cornea epithelial identity and pointing to interactions between Ets and KLF factors in promoting epithelial fate. Furthermore, this comprehensive gene expression data set for the cornea is a powerful tool for discovery of novel cornea regulators and pathways.

  13. Expression of glutathione transferases in corneal cell lines, corneal tissues and a human cornea construct.

    Science.gov (United States)

    Kölln, Christian; Reichl, Stephan

    2016-06-15

    Glutathione transferase (GST) expression and activity were examined in a three-dimensional human cornea construct and were compared to those of excised animal corneas. The objective of this study was to characterize phase II enzyme expression in the cornea construct with respect to its utility as an alternative to animal cornea models. The expression of the GSTO1-1 and GSTP1-1 enzymes was investigated using immunofluorescence staining and western blotting. The level of total glutathione transferase activity was determined using 1-chloro-2,4- dinitrobenzene as the substrate. Furthermore, the levels of GSTO1-1 and GSTP1-1 activity were examined using S-(4-nitrophenacyl)glutathione and ethacrynic acid, respectively, as the specific substrates. The expression and activity levels of these enzymes were examined in the epithelium, stroma and endothelium, the three main cellular layers of the cornea. In summary, the investigated enzymes were detected at both the protein and functional levels in the cornea construct and the excised animal corneas. However, the enzymatic activity levels of the human cornea construct were lower than those of the animal corneas.

  14. Delivery of antisense oligonucleotide to the cornea by iontophoresis.

    Science.gov (United States)

    Berdugo, M; Valamanesh, F; Andrieu, C; Klein, C; Benezra, D; Courtois, Y; Behar-Cohen, F

    2003-04-01

    We wished to evaluate the potential of iontophoresis to promote the delivery of antisense oligonucleotides (ODN) directed at the vascular endothelial growth factor (VEGF)-R2 receptor (KDR/Flk) to the cornea of the rat eye. Fluorescence (CY5)-labeled ODNs in phosphate-buffered saline (PBS) (20 microM) were locally administered to rat eyes, and their fate within the anterior segment was studied. Thirty-four male, 5-week-old Wistar rats were used for all experiments. The rats were divided in four groups. In group I (12 rats, 12 eyes), the ODNs (20 microM) were delivered by iontophoresis (300 microA for 5 minutes) using a specially designed corneal applicator. In group II (12 rats, 12 eyes), the ODNs (20 microM) were delivered using the same applicator, but no electrical current was applied. In group III (6 rats, 6 eyes), a corneal neovascular reaction was induced prior to the application of ODNs (20 microM), and iontophoresis electrical current was delivered as for group I rats. Group IV (4 rats, 4 eyes) received ODN (60 microM) iontophoresis application (300 microA for 5 minutes) and were used for ODN integrity studies. The animals were killed 5 minutes, 90 minutes, and 24 hours after a single ODN application and studied. Topically applied ODNs using the same iontophoresis applicator but without current do not penetrate the cornea and remain confined to the superficial epithelial layer. ODNs delivered with transcorneoscleral iontophoresis penetrate into all corneal layers and are also detected in the iris. In corneas with neovascularization, ODNs were particularly localized within the vascular endothelial cells of the stroma. ODNs extracted from eye tissues 24 hours after iontophoresis remained unaltered. The iontophoresis current did not cause any detectable ocular damage under these conditions. Iontophoresis promotes the delivery of ODNs to the anterior segment of the eye, including all corneal layers. Iontophoresis of ODNs directed at VEGF-R2 may be used for the

  15. 大疱性硬斑病1例%A case of bullous morphea

    Institute of Scientific and Technical Information of China (English)

    贾虹; 赵春霞; 石继海; 曹元华; 曾学思

    2001-01-01

    A rare case of bullous morphea(BM) was reported. A 25-year-oldman was seen in our hospital with a 3-year history of cutaneous lesions, and the movement of his joints was limited. Bullous lesions appeared one year later. The lesions were markedly atrophic and sclerotic. Some joints were stiffened. Some blisters were present over the extensor surface of the left arm. Nikolsky' s sign was negative. No Raynaud's phenomenon and internal organ involvement were observed. Biopsy of the skin lesion showed bundles of collagen fibers extending throughout the dermis. The blister was subepidermal in position.%报告1例少见的大疱性硬斑病。患者男性,25岁。四肢皮肤明显硬化萎缩,部分关节强直固定。左前臂伸侧大小不等的水疱,尼氏征阴性。无雷诺现象等系统损害。病理检查为典型的真皮均-化胶原纤维变性等硬皮病表现及表皮下水疱。

  16. Linear immunoglobulin A/immunoglobulin G bullous dermatosis associated with Vogt-Koyanagi-Harada disease.

    Science.gov (United States)

    Yanagihara, Shigeto; Mizuno, Nobuyuki; Naruse, Akiko; Tateishi, Chiharu; Tsuruta, Daisuke; Ishii, Masamitsu

    2011-08-01

    Vogt-Koyanagi-Harada disease is characterized by marked bilateral uveitis associated with symmetric vitiligo, alopecia, poliosis and dysacousia. Linear immunoglobulin (Ig)A bullous dermatosis (LABD) is characterized by small, tense, subepidermal bullae caused by IgA type autoantibody targeting the basal lamina. LABD patients sometimes show coexistence of IgG type autoantibody, termed linear IgA/IgG bullous dermatosis (LAGBD). We reported a 35-year-old Japanese male case of combined LAGBD and Vogt-Koyanagi-Harada disease. His human leukocyte antigen typing was -A24, B52, C*1202, DR*1502, DQ*0601. Immunoblot revealed that patient sera reacted to both 180- and 230-kDa proteins at the IgA and IgG level. Because Vogt-Koyanagi-Harada disease and LABD are reported to be associated with other autoimmune diseases, it is probable that Vogt-Koyanagi-Harada disease and LAGBD in our case may be associated with each other in the pathomechanism. However, we cannot exclude the possibility of this being mere coincidence.

  17. A Rare Case of Vancomycin-Induced Linear Immunoglobulin A Bullous Dermatosis

    Science.gov (United States)

    Swanson, Kurtis; Stromich, Jeremiah; Michalski, Basia M.; Olasz, Edit

    2017-01-01

    Linear IgA bullous dermatosis (LABD) is an autoimmune vesiculobullous disease, which is typically idiopathic but can also rarely be caused by medications or infections. Vancomycin is the most common drug associated with LABD. Lesions typically appear 24 hours to 15 days after the first dose of vancomycin. It is best characterized pathologically by subepidermal bulla (blister) formation with linear IgA deposition at the dermoepidermal junction. Here we report an 86-year-old male with a history of left knee osteoarthritis who underwent a left knee arthroplasty and subsequently developed a prosthetic joint infection. This infection was treated with intravenous vancomycin as well as placement of a vancomycin impregnated joint spacer. Five days following initiation of antibiotic therapy, he presented with a vesiculobullous eruption on an erythematous base over his trunk, extremities, and oral mucosa. The eruption resolved completely when intravenous vancomycin was discontinued and colchicine treatment was begun. Curiously, complete resolution occurred despite the presence of the vancomycin containing joint spacer. The diagnosis of vancomycin-induced linear IgA bullous dermatosis was made based on characteristic clinical and histopathologic presentations. PMID:28168063

  18. A Rare Case of Vancomycin-Induced Linear Immunoglobulin A Bullous Dermatosis

    Directory of Open Access Journals (Sweden)

    Pinky Jha

    2017-01-01

    Full Text Available Linear IgA bullous dermatosis (LABD is an autoimmune vesiculobullous disease, which is typically idiopathic but can also rarely be caused by medications or infections. Vancomycin is the most common drug associated with LABD. Lesions typically appear 24 hours to 15 days after the first dose of vancomycin. It is best characterized pathologically by subepidermal bulla (blister formation with linear IgA deposition at the dermoepidermal junction. Here we report an 86-year-old male with a history of left knee osteoarthritis who underwent a left knee arthroplasty and subsequently developed a prosthetic joint infection. This infection was treated with intravenous vancomycin as well as placement of a vancomycin impregnated joint spacer. Five days following initiation of antibiotic therapy, he presented with a vesiculobullous eruption on an erythematous base over his trunk, extremities, and oral mucosa. The eruption resolved completely when intravenous vancomycin was discontinued and colchicine treatment was begun. Curiously, complete resolution occurred despite the presence of the vancomycin containing joint spacer. The diagnosis of vancomycin-induced linear IgA bullous dermatosis was made based on characteristic clinical and histopathologic presentations.

  19. Linear IgA bullous dermatosis: an unusual cause of upper eyelid cicatricial entropion.

    Science.gov (United States)

    Carruth, Bryant P; Meyer, Dale R

    2013-01-01

    Chronic cicatrizing conjunctivitis is a relatively uncommon condition resulting in significant ophthalmic morbidity, including keratoconjunctivitis sicca, cicatricial entropion, trichiasis, corneal scarring, significant discomfort, and visual loss. The potential causes of cicatrizing conjunctivitis are varied and include commonly encountered entities such as ocular cicatricial pemphigoid, Stevens-Johnson syndrome, and trachoma and many more rare causes which are particularly difficult to diagnose and treat and may not be familiar to the ophthalmologist. The authors herein present a case of chronic cicatrizing conjunctivitis, cicatricial entropion, and trichiasis caused by a rare entity called linear IgA bullous dermatosis. The case presentation conforms to the tenets of the Declaration of Helsinki and is Health Insurance Portability and Accountability Act compliant. This chronic dermatosis has a varied presentation, and the ophthalmic manifestations in particular have been infrequently described. This case demonstrates the benefits of immunohistochemistry in diagnosis and the difficulties in medical and surgical management of linear IgA bullous dermatosis while underscoring the lifelong difficulties in managing chronic inflammatory conditions causing ocular cicatrization.

  20. Aberrant Expression and Secretion of Heat Shock Protein 90 in Patients with Bullous Pemphigoid

    Science.gov (United States)

    Tukaj, Stefan; Kleszczyński, Konrad; Vafia, Katerina; Groth, Stephanie; Meyersburg, Damian; Trzonkowski, Piotr; Ludwig, Ralf J.; Zillikens, Detlef; Schmidt, Enno; Fischer, Tobias W.; Kasperkiewicz, Michael

    2013-01-01

    The cell stress chaperone heat shock protein 90 (Hsp90) has been implicated in inflammatory responses and its inhibition has proven successful in different mouse models of autoimmune diseases, including epidermolysis bullosa acquisita. Here, we investigated expression levels and secretory responses of Hsp90 in patients with bullous pemphigoid (BP), the most common subepidermal autoimmune blistering skin disease. In comparison to healthy controls, the following observations were made: (i) Hsp90 was highly expressed in the skin of BP patients, whereas its serum levels were decreased and inversely associated with IgG autoantibody levels against the NC16A immunodominant region of the BP180 autoantigen, (ii) in contrast, neither aberrant levels of circulating Hsp90 nor any correlation of this protein with serum autoantibodies was found in a control cohort of autoimmune bullous disease patients with pemphigus vulgaris, (iii) Hsp90 was highly expressed in and restrictedly released from peripheral blood mononuclear cells of BP patients, and (iv) Hsp90 was potently induced in and restrictedly secreted from human keratinocyte (HaCaT) cells by BP serum and isolated anti-BP180 NC16A IgG autoantibodies, respectively. Our results reveal an upregulated Hsp90 expression at the site of inflammation and an autoantibody-mediated dysregulation of the intracellular and extracellular distribution of this chaperone in BP patients. These findings suggest that Hsp90 may play a pathophysiological role and represent a novel potential treatment target in BP. PMID:23936217

  1. Aberrant expression and secretion of heat shock protein 90 in patients with bullous pemphigoid.

    Directory of Open Access Journals (Sweden)

    Stefan Tukaj

    Full Text Available The cell stress chaperone heat shock protein 90 (Hsp90 has been implicated in inflammatory responses and its inhibition has proven successful in different mouse models of autoimmune diseases, including epidermolysis bullosa acquisita. Here, we investigated expression levels and secretory responses of Hsp90 in patients with bullous pemphigoid (BP, the most common subepidermal autoimmune blistering skin disease. In comparison to healthy controls, the following observations were made: (i Hsp90 was highly expressed in the skin of BP patients, whereas its serum levels were decreased and inversely associated with IgG autoantibody levels against the NC16A immunodominant region of the BP180 autoantigen, (ii in contrast, neither aberrant levels of circulating Hsp90 nor any correlation of this protein with serum autoantibodies was found in a control cohort of autoimmune bullous disease patients with pemphigus vulgaris, (iii Hsp90 was highly expressed in and restrictedly released from peripheral blood mononuclear cells of BP patients, and (iv Hsp90 was potently induced in and restrictedly secreted from human keratinocyte (HaCaT cells by BP serum and isolated anti-BP180 NC16A IgG autoantibodies, respectively. Our results reveal an upregulated Hsp90 expression at the site of inflammation and an autoantibody-mediated dysregulation of the intracellular and extracellular distribution of this chaperone in BP patients. These findings suggest that Hsp90 may play a pathophysiological role and represent a novel potential treatment target in BP.

  2. An adaptive algorithm for the cornea modeling from keratometric data

    CERN Document Server

    Martinez-Finkelshtein, Andrei; Castro-Luna, Gracia M; Alio, Jorge L

    2010-01-01

    In this paper we describe an adaptive and multi-scale algorithm for the parsimonious fit of the corneal surface data that allows to adapt the number of functions used in the reconstruction to the conditions of each cornea. The method implements also a dynamical selection of the parameters and the management of noise. It can be used for the real-time reconstruction of both altimetric data and corneal power maps from the data collected by keratoscopes, such as the Placido rings based topographers, decisive for an early detection of corneal diseases such as keratoconus. Numerical experiments show that the algorithm exhibits a steady exponential error decay, independently of the level of aberration of the cornea. The complexity of each anisotropic gaussian basis functions in the functional representation is the same, but their parameters vary to fit the current scale. This scale is determined only by the residual errors and not by the number of the iteration. Finally, the position and clustering of their centers,...

  3. Wide-angle cornea-sclera (OCULAR) topography

    Science.gov (United States)

    Klein, Stanley A.; Corzine, John; Corbin, Jacob A.; Wechsler, Sheldon; Carney, Thom

    2002-06-01

    Most corneal topographers are slope-based instruments, measuring corneal slope based on light reflected by the cornea acting as a mirror. This mirror method limits corneal coverage to about 9 mm diameter. Both refractive surgery and contact lens fitting actually require a larger coverage than is obtainable using slope-based instruments. Height-based instruments should be able to measure a cornea/sclera area that is twice the size (four times the area) of slope-based topographers with an accuracy of a few microns. We have been testing a prototype of a new model height-based topographer manufactured by Euclid Systems. We find that single shots can produce a corneal coverage of up to 16 mm vertical and 20 mm horizontal. The heights and slopes in the corneal region have good replicability. Although the scleral region is noisier, it is the only topographer available able to measure scleral topography that is critically important to contact lens fitting. There are a number of improvements to the Euclid software and hardware that would enable it to fill an important niche in eye care and eye research.

  4. Efficient numerical modeling of the cornea, and applications

    Science.gov (United States)

    Gonzalez, L.; Navarro, Rafael M.; Hdez-Matamoros, J. L.

    2004-10-01

    Corneal topography has shown to be an essential tool in the ophthalmology clinic both in diagnosis and custom treatments (refractive surgery, keratoplastia), having also a strong potential in optometry. The post processing and analysis of corneal elevation, or local curvature data, is a necessary step to refine the data and also to extract relevant information for the clinician. In this context a parametric cornea model is proposed consisting of a surface described mathematically by two terms: one general ellipsoid corresponding to a regular base surface, expressed by a general quadric term located at an arbitrary position and free orientation in 3D space and a second term, described by a Zernike polynomial expansion, which accounts for irregularities and departures from the basic geometry. The model has been validated obtaining better adjustment of experimental data than other previous models. Among other potential applications, here we present the determination of the optical axis of the cornea by transforming the general quadric to its canonical form. This has permitted us to perform 3D registration of corneal topographical maps to improve the signal-to-noise ratio. Other basic and clinical applications are also explored.

  5. Morphology, topography, and optics of the orthokeratology cornea

    Science.gov (United States)

    Faria-Ribeiro, Miguel; Belsue, Rafael Navarro; López-Gil, Norberto; González-Méijome, José Manuel

    2016-07-01

    The goal of this work was to objectively characterize the external morphology, topography, and optics of the cornea after orthokeratology (ortho-k). A number of 24 patients between the ages of 17 and 30 years (median=24 years) were fitted with Corneal Refractive Therapy® contact lenses to correct myopia between -2.00 and -5.00 diopters (D) (median=-3.41 D). A classification algorithm was applied to conduct an automatic segmentation based on the mean local curvature. As a result, three zones (optical zone, transition zone, and peripheral zone) were delimited. Topographical analysis was provided through global and zonal fit to a general ellipsoid. Ray trace on partially customized eye models provided wave aberrations and retinal image quality. Monozone topographic description of the ortho-k cornea loses accuracy when compared with zonal description. Primary (C40) and secondary (C60) spherical aberration (SA) coefficients for a 5-mm pupil increased 3.68 and 19 times, respectively, after the treatments. The OZ area showed a strong correlation with C40 (r=-0.49, p<0.05) and a very strong correlation with C60 (r=0.78, p<0.01). The OZ, as well as the TZ, areas did not correlate with baseline refraction. The increase in the eye's positive SA after ortho-k is the major factor responsible for the decreased retinal optical quality of the unaccommodated eye.

  6. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Frikke-Schmidt, Ruth; Schnohr, Peter

    2011-01-01

    To test the hypothesis that xanthelasmata and arcus corneae, individually and combined, predict risk of ischaemic vascular disease and death in the general population.......To test the hypothesis that xanthelasmata and arcus corneae, individually and combined, predict risk of ischaemic vascular disease and death in the general population....

  7. Comparison of confocal microscopy and two-photon microscopy in mouse cornea in vivo.

    Science.gov (United States)

    Lee, Jun Ho; Lee, Seunghun; Gho, Yong Song; Song, In Seok; Tchah, Hungwon; Kim, Myoung Joon; Kim, Ki Hean

    2015-03-01

    High-resolution imaging of the cornea is important for studying corneal diseases at cellular levels. Confocal microscopy (CM) has been widely used in the clinic, and two-photon microscopy (TPM) has recently been introduced in various pre-clinical studies. We compared the performance of CM and TPM in normal mouse corneas and neovascularized mouse corneas induced by suturing. Balb/C mice and C57BL/6 mice expressing green fluorescent protein (GFP) were used to compare modalities based on intrinsic contrast and extrinsic fluorescence contrast. CM based on reflection (CMR), CM based on fluorescence (CMF), and TPM based on intrinsic/extrinsic fluorescence and second harmonic generation (SHG) were compared by imaging the same sections of mouse corneas sequentially in vivo. In normal mouse corneas, CMR visualized corneal cell morphologies with some background noise, and CMF visualized GFP expressing corneal cells clearly. TPM visualized corneal cells and collagen in the stroma based on fluorescence and SHG, respectively. However, in neovascularized mouse corneas, CMR could not resolve cells deep inside the cornea due to high background noise from the effects of increased structural irregularity induced by suturing. CMF and TPM visualized cells and induced vasculature better than CMR because both collect signals from fluorescent cells only. Both CMF and TPM had signal decays with depth due to the structural irregularity, with CMF having faster signal decay than TPM. CMR, CMF, and TPM showed different degrees of image degradation in neovascularized mouse corneas.

  8. Public Health Implications of the 1540 nm Laser on the Cornea

    Science.gov (United States)

    2007-05-30

    7; 2003. Isnard N, Bourles-Dagonet F, Robert L, Renard G. Studies on corneal wound healing. Effect of fucose on iodine vapor-burnt rabbit corneas... Fucose On Iodine Vapor-Burnt Rabbit Corneas. Ophthalmologica 219, no. 6: 324-33. Jane’s international defense review. 2005. Jane’s. Jester, J. V., A

  9. Multiphoton Imaging of Rabbit Cornea Treated with Mitomycin C after Photorefractive Keratectomy

    Science.gov (United States)

    Hsueh, Chiu-Mei; Lo, Wen; Wang, Tsung-Jen; Hu, Fung-Rong; Dong, Chen-Yuan

    2007-07-01

    In this work we use multiphoton microscopy to observe the post surgery structure variation of rabbit cornea after photorefractive keratectomy (PRK). In addition, we added mitomycin C (MMC) to the post surgery rabbit cornea in order to investigate the effect of MMC treatment on the postoperative regeneration.

  10. Prevalence and clinical consequences of herpes simplex virus type 1 DNA in human cornea tissues

    NARCIS (Netherlands)

    L. Remeijer (Lies); R. Duan (Rui); J.M. van Dun (Jessica); M.A.W. Bettink; A.D.M.E. Osterhaus (Ab); G.M.G.M. Verjans (George)

    2009-01-01

    textabstractBackground. We determined the prevalence and clinical consequences of herpes simplex virus (HSV) type 1 (HSV-1), HSV type 2 (HSV-2), and varicella-zoster virus (VZV) in cornea tissues obtained after penetrating keratoplasty (PKP) was performed. Methods. The excised corneas of 83 patients

  11. Corneal decompensation following filtering surgery with the Ex-PRESS® mini glaucoma shunt device

    Directory of Open Access Journals (Sweden)

    Tojo N

    2015-03-01

    Full Text Available Naoki Tojo, Atsushi Hayashi, Akio Miyakoshi Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan Purpose: To report a case of corneal decompensation due to the Ex-PRESS® mini glaucoma shunt device (Ex-PRESS.Patient and methods: A 75-year-old man had pseudoexfoliation glaucoma in his right eye. He underwent filtration surgery with Ex-PRESS. His intraocular pressure was 7 mmHg after 9 months.Results: We observed partial decompensation of the corneal endothelium adjacent to the filtering bleb. Specular microscopy revealed a marked decrease in the endothelial cell density at the center of the cornea.Conclusion: Anterior segment optical coherence tomography is very useful for evaluating corneal edema and the position of Ex-PRESS. It is important to follow up with an examination of the corneal endothelial cells. Keywords: Ex-PRESS, bullous keratopathy, trabeculectomy, complication, cornea 

  12. Polymicrobial Infection of the Cornea Due to Contact Lens Wear

    Science.gov (United States)

    Sızmaz, Selçuk; Bingöllü, Sibel; Erdem, Elif; Kibar, Filiz; Koltaş, Soner; Yağmur, Meltem; Ersöz, Reha

    2016-01-01

    A 38-year-old male presented with pain and redness in his left eye. He had a history of wearing contact lenses. His ophthalmic examination revealed a large corneal ulcer with surrounding infiltrate. Cultures were isolated from the contact lenses, lens solutions, storage cases, and conjunctivae of both eyes and also corneal scrapings of the left eye. Fortified vancomycin and amikacin drops were started hourly. Culture results of conjunctivae of each eye and left cornea were positive for Pseudomonas aeruginosa; cultures from the contact lenses, lens solution and storage case of both eyes revealed Pseudomonas aeruginosa and Alcaligenes xylosoxidans. Polymerase chain reaction of the corneal scraping was positive for Acanthameoba. The topical antibiotics were changed with ones that both bacteria were sensitive to and anti-amoebic therapy was added. The patient had two recurrences following initial presentation despite intensive therapy. Keratitis occurred due to multiple pathogens; the relapsing course despite adequate therapy is potentially associated with this polymicrobial etiology. PMID:27800266

  13. Epithelial ion transport in rabbit corneas following myopic keratomileusis.

    Science.gov (United States)

    Swinger, C A; Candia, O A; Marcus, S; Barker, B A; Kornmehl, E W

    1986-08-01

    In isolated rabbit corneas that had undergone lamellar keratectomy or myopic keratomileusis, the stimulation of chloride transport by 10(-5) M epinephrine was completely inhibited at 1 week following surgery. At 28 days following surgery, both groups responded to 10(-7) M epinephrine. The response to 10(-5) M amphotericin B was normal both at 1 week and at 28 days following surgery. We conclude that, although the Na-K pump was not affected by the lamellar keratectomy and cryolathing, that either the epithelial beta receptors and/or the cAMP pathway were temporarily inhibited for at least 1 week following surgery. A lamellar keratectomy, therefore, can have an adverse effect on the epithelial transport system of the corneal epithelium even though the epithelium may appear normal clinically.

  14. Tissue Engineering the Cornea: The Evolution of RAFT.

    Science.gov (United States)

    Levis, Hannah J; Kureshi, Alvena K; Massie, Isobel; Morgan, Louise; Vernon, Amanda J; Daniels, Julie T

    2015-01-22

    Corneal blindness affects over 10 million people worldwide and current treatment strategies often involve replacement of the defective layer with healthy tissue. Due to a worldwide donor cornea shortage and the absence of suitable biological scaffolds, recent research has focused on the development of tissue engineering techniques to create alternative therapies. This review will detail how we have refined the simple engineering technique of plastic compression of collagen to a process we now call Real Architecture for 3D Tissues (RAFT). The RAFT production process has been standardised, and steps have been taken to consider Good Manufacturing Practice compliance. The evolution of this process has allowed us to create biomimetic epithelial and endothelial tissue equivalents suitable for transplantation and ideal for studying cell-cell interactions in vitro.

  15. Tissue Engineering the Cornea: The Evolution of RAFT

    Directory of Open Access Journals (Sweden)

    Hannah J. Levis

    2015-01-01

    Full Text Available Corneal blindness affects over 10 million people worldwide and current treatment strategies often involve replacement of the defective layer with healthy tissue. Due to a worldwide donor cornea shortage and the absence of suitable biological scaffolds, recent research has focused on the development of tissue engineering techniques to create alternative therapies. This review will detail how we have refined the simple engineering technique of plastic compression of collagen to a process we now call Real Architecture for 3D Tissues (RAFT. The RAFT production process has been standardised, and steps have been taken to consider Good Manufacturing Practice compliance. The evolution of this process has allowed us to create biomimetic epithelial and endothelial tissue equivalents suitable for transplantation and ideal for studying cell-cell interactions in vitro.

  16. Xanthelasma palpebrarum with arcus cornea: A clinical and biochemical study

    Directory of Open Access Journals (Sweden)

    Pragya Ashok Nair

    2016-01-01

    Full Text Available Background: Xanthelasma palpebrarum (XP is characterized by sharply demarcated yellowish flat plaques on upper and lower eyelids. It is commonly seen in women with a peak incidence at 30–50 years. It is also considered as the cutaneous marker of underlying atherosclerosis along with the disturbed lipid metabolism. XP and corneal arcus are associated with increased levels of serum cholesterol and low-density lipoprotein (LDL cholesterol. Aims and Objectives: To study the clinical pattern of XP, its relationship with lipid profile and association with arcus cornea. Materials and Methods: This study was conducted at Department of Dermatology and Opthalmology, between August 2013 and January 2015. Patients with clinical diagnosis of XP who visited skin outpatient department and willing to undergo lipid profile test and eye examination were included in the study. Data regarding demographics, clinical findings, family history, and past history were noted along with the lipid profile details. Data of age-matched healthy controls were taken for comparison. The clinical profile of the participants was presented using frequency and proportions. Gender wise analysis comparing the lipid profile in cases with XP and without XP was done using independent sample t-test. Results: Total 49 patients of XP, 81.6% were females. Maximum, 35% patients were among 50–60 years of age and 69.4% were homemakers by occupation. The average lipid values were-cholesterol 210.57 mg%, triglyceride 123.06 mg%. LDL 142.79 mg% and VLDL 30.95 mg% among patients of XP. Arcus cornea was found in 20% cases of XP. Conclusions: Patients of XP requires proper investigation at the onset and regular follow-up thereafter for any altered lipid profile and early diagnosis of coronary artery disease.

  17. Bullous Dermatosis in an End-Stage Renal Disease Patient: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Zeenat Yousuf Bhat

    2016-01-01

    Full Text Available Patients with advanced chronic kidney disease including ESRD patients may present with a wide spectrum of cutaneous abnormalities, ranging from xerosis to hyperpigmentation to severe deforming necrotizing lesions. Skin problems are not uncommon in this population of patients, with a clinical presentation that can be quite bizarre, mandating a long list of differential diagnostic possibilities, and subsequent rise of a puzzling diagnostic challenge. We describe an ESRD patient who presented with blistering, nonhealing ulcerative lesions with a diagnostic skin biopsy revealing a mixed pattern of linear IgA bullous dermatosis and dermatitis herpetiformis. A clinical remission could be achieved with pulse intravenous steroids followed by oral maintenance in combination with dapsone, with no evidence of recurrence.

  18. Bullous Dermatosis in an End-Stage Renal Disease Patient: A Case Report and Literature Review

    Science.gov (United States)

    Abu Minshar, Marwan; Thompson, Andrew; Malik, Yahya Osman

    2016-01-01

    Patients with advanced chronic kidney disease including ESRD patients may present with a wide spectrum of cutaneous abnormalities, ranging from xerosis to hyperpigmentation to severe deforming necrotizing lesions. Skin problems are not uncommon in this population of patients, with a clinical presentation that can be quite bizarre, mandating a long list of differential diagnostic possibilities, and subsequent rise of a puzzling diagnostic challenge. We describe an ESRD patient who presented with blistering, nonhealing ulcerative lesions with a diagnostic skin biopsy revealing a mixed pattern of linear IgA bullous dermatosis and dermatitis herpetiformis. A clinical remission could be achieved with pulse intravenous steroids followed by oral maintenance in combination with dapsone, with no evidence of recurrence. PMID:28003921

  19. Linear IgA Bullous Dermatosis Secondary to Infliximab Therapy in a Patient with Ulcerative Colitis.

    Science.gov (United States)

    Hoffmann, Jochen; Hadaschik, Eva; Enk, Alexander; Stremmel, Wolfgang; Gauss, Annika

    2015-01-01

    Linear IgA bullous disease (LABD) is a rare vesiculobullous autoimmune skin disorder whose etiology and pathogenesis are not completely understood. Its occurrence has been related to malignancies, inflammatory diseases and several drugs. This report describes a 49-year-old Caucasian male with a 14-year history of ulcerative colitis who received infliximab to treat the refractory course of his bowel disease. During induction therapy with infliximab, he developed LABD. Treatment with infliximab was discontinued, and the skin lesions were successfully treated with oral steroids and dapsone. Considering the close chronological relation between administration of the tumor necrosis factor-α inhibitor and onset of the skin disease, we hypothesize that this is the first reported case of infliximab-induced LABD. Similar to psoriasis, it may represent a 'paradoxical' autoimmune reaction triggered by anti-tumor necrosis factor-α therapy.

  20. Development of bullous pemphigoid during treatment of psoriatic onycho-pachydermo periostitis with ustekinumab.

    Science.gov (United States)

    Nakayama, Chihiro; Fujita, Yasuyuki; Watanabe, Mika; Shimizu, Hiroshi

    2015-10-01

    Ustekinumab is a human monoclonal antibody that specifically binds to the p40 subunit of interleukin (IL)-12 and IL-23, inhibiting the activity of both cytokines, thereby blocking the T-helper (Th)1 and Th17 inflammatory pathways. While biologic agents have dramatically changed the strategies of psoriasis treatment, increasing cases of autoimmune diseases during the use of such agents have been reported. We experienced a case of bullous pemphigoid occurring during treatment of a rare variant of psoriatic arthritis, psoriatic onycho-pachydermo periostitis with ustekinumab. Only six cases of autoimmune blistering diseases during treatment with biologic agents have ever been reported including our case, and we herein review the published work of these cases. Dermatologists must be attentive to the possibility of autoimmune blistering diseases during ustekinumab treatment.

  1. A Retrospective and Comparative Study of Familial and Non-familial Bullous Lichen Planus

    Institute of Scientific and Technical Information of China (English)

    HUANG Changzheng; YAN Xiaofeng; YANG Lingyun; ZHANG Jing; TIAN Jin; LI Jiawen; WANG Chunsen; TU Yating

    2007-01-01

    In order to compare the clinical characteristics of familial and non-familial bullous lichen planus (BLP), the archival data of 36 BLP patients with positive family history and 21 BLP patients with negative family history diagnosed according to the clinical features and histopathology were collected in our department from 1956 to 2003. The clinical features were analyzed and compared. There were significant differences between familial and non-familial BLP in age of onset, duration of disease and extension of eruption (P<0.01). It was concluded that familial BLP appeared to differ from the non-familial form in its earlier age of onset, longer duration of the disease, more extensive eruption and more tendency to involve nails. Hereditary factors may play a role in the pathogenesis of familial BLP.

  2. Bullous pemphigoid: role of complement and mechanisms for blister formation within the lamina lucida.

    Science.gov (United States)

    Iwata, Hiroaki; Kitajima, Yasuo

    2013-06-01

    Bullous pemphigoid (BP), an autoimmune subepidermal blistering skin disease, demonstrates tense blisters with or without widespread erythema, blistering along the lamina lucida, immunoglobulin G and/or complement deposits at the basement membrane zone, and the presence of circulating autoantibodies against hemidesmosomal molecules. These autoantibodies usually react against 180-kDa and/or 230-kDa proteins, designated as BP180 and BP230, respectively. The precise blistering mechanisms after autoantibodies bind to antigens are not fully understood. Immune complexes are thought to initially activate the complement cascade, which may induce activation of proteases and/or cytokines and cause dermal-epidermal separation. However, why does separation run specifically within the lamina lucida in a space as narrow as 500 nm wide? This review mainly focuses on the possible mechanisms of BP-specific blistering and how separation occurs along the lamina lucida, based on existing evidence.

  3. Development of a disease registry for autoimmune bullous diseases: initial analysis of the pemphigus vulgaris subset.

    Science.gov (United States)

    Shah, Amit Aakash; Seiffert-Sinha, Kristina; Sirois, David; Werth, Victoria P; Rengarajan, Badri; Zrnchik, William; Attwood, Kristopher; Sinha, Animesh A

    2015-01-01

    Pemphigus vulgaris (PV) is a rare, potentially life threatening, autoimmune blistering skin disease. The International Pemphigus and Pemphigoid Foundation (IPPF) has recently developed a disease registry with the aim to enhance our understanding of autoimmune bullous diseases with the long-term goal of acquiring information to improve patient care. Patients were recruited to the IPPF disease registry through direct mail, e-mail, advertisements, and articles in the IPPF-quarterly, -website, -Facebook webpage, and IPPF Peer Health Coaches to complete a 38-question survey. We present here the initial analysis of detailed clinical information collected on 393 PV patients. We report previously unrecognized gender differences in terms of lesion location, autoimmune comorbidity, and delay in diagnosis. The IPPF disease registry serves as a useful resource and guide for future clinical investigation.

  4. Herpes Simplex Virus Infection Mimicking Bullous Disease in an Immunocompromised Patient

    Directory of Open Access Journals (Sweden)

    Anne L.Y. Lecluse

    2010-06-01

    Full Text Available Immunodeficient patients are at risk of developing extended or atypical herpes simplex virus infections, which can be easily misdiagnosed. We present the case of a 79-year-old, treatment-induced (oral corticosteroid, immunocompromised female with an extensive atypical herpes simplex virus infection. This patient presented with multiple erosions and vesicles on the trunk with a subacute onset. The clinical differential diagnosis was herpes simplex infection, herpes zoster infection, pemphigus vulgaris or bullous pemphigoid. Due to the atypical clinical presentation and negative Tzanck test, suspicion of viral infection was low. High-dose steroid treatment was initiated. Subsequent histopathology, however, showed a herpes simplex virus infection. After discontinuing steroid treatment and initiating antiviral treatment, the patient recovered within a week. Emphasis must be placed on the importance of clinical awareness of extended and clinically atypical herpes simplex infections in immunocompromised patients. A negative Tzanck test does not rule out the possibility of a herpes infection.

  5. Preliminary study on the effect of stiffness on lamb wave propagation in bovine corneas.

    Science.gov (United States)

    Zhang, Xin-Yu; Yin, Yin; Guo, Yan-Rong; Diao, Xian-Fen; Chen, Xin

    2013-01-01

    The viscoelastic properties of human cornea could provide valuable information for various clinical applications. Particularly, it will be helpful to achieve a patient-specific biomechanical optimization in LASIK refractive surgery, early detection of corneal ecstatic disease or improved accuracy of intraocular pressure (IOP) measurement. However, there are few techniques that are capable of accurately assessing the corneal elasticity in situ in a nondestructive fashion. In order to develop a quantitative method for assessing both elasticity and viscosity of the cornea, we use ultrasound radiation force to excite Lamb waves in cornea, and a pulse echo transducer to track the tissue vibration. The fresh postmortem bovine eyes were treated via collagen cross-linking to make the cornea stiff. The effect of stiffness was studied by comparing the propagation of Lamb waves in normal and treated corneas. It was found that the waveform of generated Lamb waves changed significantly due to the increase in higher modes in treated corneas. This result indicated that the generated waveform was a complex of multiple harmonics and the varied stiffness will affect the energy distribution over different components. Therefore, it is important for assessing the viscoelastic properties of the cornea to know the components of Lamb wave and calculate the phase velocity appropriately.

  6. Effects of the holmium laser on the human cornea: a preliminary study

    Science.gov (United States)

    Mueller, Linda J.; Tassignon, Marie J.; Trau, Rene; Pels, Liesbeth; Vrensen, Gijs F.

    1996-12-01

    Treatment of peripheral post-mortem human corneas with the Holmium laser in a ring pattern resulted in opaque spots. One pair of treated eyes was immediately processed for light and electron microscopy and three other treated eyes were preserved for 4 days in medium in order to compare direct and short-term effects of the Holmium laser. Cross as well as frontal light microscopical sections of all eyes revealed interconnecting bands between the spots. At the ultrastructural level the anterior corneal tissue within these spots was characterized by coagulation of cells and collagen and shoed either a dramatic distorting effect on the epithelium in the eyes processed immediately or a single layer of flattened multi-nucleolated epithelial cells having more than one nucleolus per nucleus in the eyes stored in medium. Furthermore, the spots showed disturbed Bowman's layer, destroyed keratocytes and collagen fibrils which were either coagulated or organized chaotically. The interconnecting bands contained alternating normal and coagulated collagen fibers. The rest of the cornea outside the spots had a normal appearance. In corneas stored in medium, both keratocytes and epithelial cells over the entire cornea exhibited accumulations of cytoplasmic fibrils and glycogen particles. These phenomena were not observed in non-preserved corneas, suggesting that the differences are due to preservation and not due to the laser treatment. It is concluded that morphological changes occur mainly in the treated peripheral cornea whereas the central untreated cornea remains unaffected,indicating that the Holmium laser is a reliable instrument to treat hypermetropic patients.

  7. A comparison of three methods of decellularization of pig corneas to reduce immunogenicity

    Institute of Scientific and Technical Information of China (English)

    Whayoung; Lee; Yuko; Miyagawa; Cassandra; Long; David; K.; C.; Cooper; Hidetaka; Hara

    2014-01-01

    ·AIM: To investigate whether decellularization using different techniques can reduce immunogenicity of the cornea, and to explore the decellularized cornea as a scaffold for cultured corneal endothelial cells(CECs).Transplantation of decellularized porcine corneas increases graft transparency and survival for longer periods compared with fresh grafts.·METHODS: Six-month-old wild-type pig corneas were cut into 100-200 μm thickness, and then decellularized by three different methods: 1) 0.1% sodium dodecyl sulfate(SDS); 2) hypoxic nitrogen(N2); and 3) hypertonic NaCl. Thickness and transparency were assessed visually. Fresh and decellularized corneas were stained with hematoxylin/eosin(H&E), and for the presence of galactose-α1,3-galactose(Gal) and N-glycolylneuraminic acid(NeuGc, a nonGal antigen). Also, a human IgM/IgG binding assay was performed. Cultured porcine CECs were seeded on the surface of the decellularized cornea and examined after H&E staining.· RESULTS: All three methods of decellularization reduced the number of keratocytes in the stromal tissue by >80% while the collagen structure remained preserved. No remaining nuclei stained positive for Gal or NeuGc, and expression of these oligosaccharides on collagen was also greatly decreased compared to expression on fresh corneas. Human IgM/IgG binding to decellularized corneal tissue was considerably reduced compared to fresh corneal tissue. The cultured CECs formed a confluent monolayer on the surface of decellularized tissue.· CONCLUSION: Though incomplete, the significant reduction in the cellular component of the decellularized cornea should be associated with a significantly reduced in vivo immune response compared to fresh corneas.

  8. A time-delay calibrated method for cornea hysteresis and intraocular pressure measurement

    Science.gov (United States)

    Wang, Kuo-Jen; Tsai, Che-Liang; Wang, Wai; Hsu, Long; Hsu, Ken-Yuh

    2016-04-01

    The presence of cornea hysteresis (CH) in characterizing the intraocular pressure (IOP) of a human eye deteriorates the accuracy of IOP. To suppress CH, the pressure gauge of a tonometer must be located as close as possible to the cornea. However, this arrangement is unpractical because appropriate working distance to the cornea is required. In this paper, a time-delay calibrated (TDC) method is proposed to counteract the undesired effect of CH in characterizing the IOP. Employing this TDC method, the CH approaches to zero for most eyes measured.

  9. Dual-path handheld system for cornea and retina imaging using optical coherence tomography

    Science.gov (United States)

    Shirazi, Muhammad Faizan; Wijesinghe, Ruchire Eranga; Ravichandran, Naresh Kumar; Kim, Pilun; Jeon, Mansik; Kim, Jeehyun

    2016-11-01

    A dual-path handheld system is proposed for cornea and retina imaging using spectral domain optical coherence tomography. The handheld sample arm is designed to acquire two images simultaneously. Both eyes of a person can be imaged at the same time to obtain the images of the cornea of one eye and the retina of the other eye. Cornea, retina, and optic disc images are acquired with the proposed sample arm. Experimental results demonstrate the usefulness of this system for imaging of different eye segments. This system reduces the time required for imaging of the two eyes and is cost effective.

  10. An Immunohistochemical Study of Langerhans Cells,T-Cells and the HLA Antigen in Human Cornea

    Institute of Scientific and Technical Information of China (English)

    1993-01-01

    The distribution of Langerhans cells (LC),T-cell subsets andHLA antigen in 12 normal and 7 morbid corneas,including 4 of suppurativecorneal ulcer and 3 of uveogenic endophthalmitis,was investigated withmonoclonal antibodies.The results revealed that a small amount of LC andT-cell subsets were present in the limbal region of normal corneas,whilelarge numbers of LC and OKT_4~+ were observed in the corneas of suppurativeulcer.HLA-A,B,C antigens were expressed on the epithelial cells andkeratocytes of the n...

  11. The lesional skin of linear IgA bullous dermatosis expresses growth-regulated peptide (GRO)-alpha.

    Science.gov (United States)

    Tsunemi, Yuichiro; Ihn, Hironobu; Saeki, Hidehisa; Tamaki, Kunihiko

    2004-07-01

    The patient was a 62-year-old man with erythema with tense vesiculobullae and erosions on the bilateral elbows, right knee, and one buttock. A skin biopsy specimen revealed subepidermal blister formation with a predominant infiltration of neutrophils and papillary neutrophilic microabscesses. Direct immunofluorescence study showed linear deposition of IgA and weak deposition of IgG at the basement membrane zone of the lesional skin, and indirect immunofluorescence study showed linear deposition of IgA at the epidermal side of the 1M NaCl-separated normal skin. He was diagnosed with linear IgA bullous dermatosis. Immunohistochemical study revealed that the lesional and perilesional keratinocytes expressed growth-regulated peptide (GRO) -alpha, a potent chemoattractant for neutrophils. This suggests that GRO-alpha plays a role in the infiltration of neutrophils into the lesional skin and in bulla formation in linear IgA bullous dermatosis.

  12. 水疱型毛母质瘤1例%Pilomatricoma with Bullous Appearance:A Case Report

    Institute of Scientific and Technical Information of China (English)

    孔玉龙; 王克玉

    2014-01-01

    患者,男,12岁。右侧颈部及右上臂囊性肿物2年。皮损组织病理示:表皮正常,真皮内见镜影细胞及嗜碱性粒细胞浸润,可见多处钙化区,其周围被纤维组织包绕。诊断:水疱型毛母质瘤。%A 12-year-old male patient presented with purplish red bullous on right neck and right upper arm. The histopathology of the skin lession showed a normal epidermis. Shadow cells and basophilic cell infil-tration with calcifying areas, surrounded by fibrous tissue. He was diagnosed as pilomatricoma with bullous appearance.

  13. A CONTROVERSIAL ON THE DIAGNOSIS OF CHRONIC BULLOUS TYPE MUCOCUTANEOUS DISEASE INVOLVING ORAL MUCOSA (A CASE REPORT)

    OpenAIRE

    Isadora Gracia; Harum Sasanti

    2006-01-01

    A case of chronic bullous type mucocutaneous disease involving oral mucosa was reported from a 56 years old man with never healing oral ulcers and wound on the perianal skin for three years. There were also red and black spots on the limb and back skin and a lesion on nail. Painful oral lesion consisted of mucous erosion, desquamative gingivitis, and sloughing area on palate and tongue. The patient is diabetic. The first perianal skin diagnosis was granulomatous candidasis with differential d...

  14. A role for smoothened during murine lens and cornea development.

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    Janet J Y Choi

    Full Text Available Various studies suggest that Hedgehog (Hh signalling plays roles in human and zebrafish ocular development. Recent studies (Kerr et al., Invest Ophthalmol Vis Sci. 2012; 53, 3316-30 showed that conditionally activating Hh signals promotes murine lens epithelial cell proliferation and disrupts fibre differentiation. In this study we examined the expression of the Hh pathway and the requirement for the Smoothened gene in murine lens development. Expression of Hh pathway components in developing lens was examined by RT-PCR, immunofluorescence and in situ hybridisation. The requirement of Smo in lens development was determined by conditional loss-of-function mutations, using LeCre and MLR10 Cre transgenic mice. The phenotype of mutant mice was examined by immunofluorescence for various markers of cell cycle, lens and cornea differentiation. Hh pathway components (Ptch1, Smo, Gli2, Gli3 were detected in lens epithelium from E12.5. Gli2 was particularly localised to mitotic nuclei and, at E13.5, Gli3 exhibited a shift from cytosol to nucleus, suggesting distinct roles for these transcription factors. Conditional deletion of Smo, from ∼E12.5 (MLR10 Cre did not affect ocular development, whereas deletion from ∼E9.5 (LeCre resulted in lens and corneal defects from E14.5. Mutant lenses were smaller and showed normal expression of p57Kip2, c-Maf, E-cadherin and Pax6, reduced expression of FoxE3 and Ptch1 and decreased nuclear Hes1. There was normal G1-S phase but decreased G2-M phase transition at E16.5 and epithelial cell death from E14.5-E16.5. Mutant corneas were thicker due to aberrant migration of Nrp2+ cells from the extraocular mesenchyme, resulting in delayed corneal endothelial but normal epithelial differentiation. These results indicate the Hh pathway is required during a discrete period (E9.5-E12.5 in lens development to regulate lens epithelial cell proliferation, survival and FoxE3 expression. Defective corneal development occurs

  15. Climatic Droplet Keratopathy in Argentina: Involvement of Environmental Agents in Its Genesis Which Would Open the Prospect for New Therapeutic Interventions

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    María Fernanda Suárez

    2015-01-01

    Full Text Available Climatic droplet keratopathy (CDK is a degenerative corneal disease of unknown etiology. We described CDK for the first time in Latin America in the Argentinean Patagonia (El Cuy. A deeper knowledge of CDK pathogenic mechanisms will provide new therapeutic strategies. For that reason we investigated the prevalence of CDK in El Cuy and its existence in other 3 provinces with similar climate. Patients eyes were examined, habits throughout lives were inquired about, and serum ascorbate (sAA was determined. All individuals work outdoors for most of the day. All regions had normal O3 levels. Individuals from regions 1, 2, and 3 had very low consumption of vegetables/fruits and low sAA levels. Conversely, region 4 individuals had balanced diet and higher sAA concentrations. CDK was only found in region 3 where individuals had partial deficiency of sAA and did not use eye protection. No CDK was found in regions 1 and 2 where individuals had similar work activities and dietary habits to those in region 3 but wear eye protection. No disease was found in region 4 where individuals work outdoors, have balanced diet, and use eye protection. To summarize, the CDK existence was related not only to climate but also to the dietary habits and lack of protection from sunlight.

  16. Accelerating repaired basement membrane after bevacizumab treatment on alkali-burned mouse cornea

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    Koon-Ja Lee

    2013-04-01

    Full Text Available To understand the corneal regeneration induced by bevacizumab,we investigated the structure changes of stroma andbasement membrane regeneration. A Stick soaked in 0.5 NNaOH onto the mouse cornea and 2.5 mg/ml of bevacizumabwas delivered into an alkali-burned cornea (2 μl by subconjunctivalinjections at 1 hour and 4 days after injury. At 7 daysafter injury, basement membrane regeneration was observedby transmission electron microscope. Uneven and thin epithelialbasement membrane, light density of hemidesmosomes,and edematous collagen fibril bundles are shown in thealkali-burned cornea. Injured epithelial basement membraneand hemidesmosomes and edematous collagen fibril bundlesresulting from alkali-burned mouse cornea was repaired bybevacizumab treatment. This study demonstrates that bevacizumabcan play an important role in wound healing in thecornea by accelerating the reestablishment of basementmembrane integrity that leads to barriers for scar formation.[BMB Reports 2013; 46(4: 195-200

  17. Brittle Cornea Syndrome Associated with a Missense Mutation in the Zinc-Finger 469 Gene

    DEFF Research Database (Denmark)

    Christensen, Anne Elisabeth; Knappskog, Per Morten; Midtbø, Marit

    2010-01-01

    Purpose: To investigate the diverse clinical manifestations, identify the causative mutation and explain the association with red hair in a family with brittle cornea syndrome (BCS). Methods: Eight family members in three generations underwent ophthalmic, dental, and general medical examination, ...

  18. Zinc oxide tetrapods inhibit herpes simplex virus infection of cultured corneas

    Science.gov (United States)

    Duggal, Neil; Jaishankar, Dinesh; Yadavalli, Tejabhiram; Hadigal, Satvik; Mishra, Yogendra Kumar; Adelung, Rainer

    2017-01-01

    Purpose Infection of the human cornea by herpes simplex virus type-1 (HSV-1) can cause significant vision loss. The purpose of this study was to develop an ex vivo model to visualize viral growth and spread in the cornea. The model was also used to analyze cytokine production and study the antiviral effects of zinc oxide tetrapods. Methods A β-galactosidase-expressing recombinant virus, HSV-1(KOS)tk12, was used to demonstrate the ability of the virus to enter and develop blue plaques on human corneal epithelial (HCE) cells and corneal tissues. Freshly obtained porcine corneas were cultured and then scratched before infection with HSV-1(KOS)tk12. The blue plaques on the corneas were imaged using a stereomicroscope. Western blot analysis for HSV-1 proteins was performed to verify HSV-1 infection of the cornea. Using the ex vivo model, zinc oxide tetrapods were tested for their anti-HSV-1 potential, and a cytokine profile was developed to assess the effects of the treatment. Results Cultured corneas and the use of β-galactosidase-expressing HSV-1(KOS)tk12 virus can provide an attractive ex vivo model to visualize and study HSV-1 entry and spread of the infection in tissues. We found that unlike cultured HCE cells, which demonstrated nearly 100% infectivity, HSV-1 infection of the cultured cornea was more restrictive and took longer to develop. We also found that the zinc oxide tetrapod–shaped nano- and microstructures inhibited HSV infection of the cultured cells, as well as the cultured corneas. The cytokine profile of the infected samples was consistent with previous studies of HSV-1 corneal infection. Conclusions The ability to visualize HSV-1 growth and spread in corneal tissues can provide new details about HSV-1 infection of the cornea and the efficacy of new cornea-specific antiviral drug candidates. The ex vivo model also demonstrates antiviral effects of zinc oxide tetrapods and adequately portrays the drug delivery issues that cornea-specific treatments

  19. Hyperglycemia-induced abnormalities in rat and human corneas: the potential of second harmonic generation microscopy.

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    Gaël Latour

    Full Text Available BACKGROUND: Second Harmonic Generation (SHG microscopy recently appeared as an efficient optical imaging technique to probe unstained collagen-rich tissues like cornea. Moreover, corneal remodeling occurs in many diseases and precise characterization requires overcoming the limitations of conventional techniques. In this work, we focus on diabetes, which affects hundreds of million people worldwide and most often leads to diabetic retinopathy, with no early diagnostic tool. This study then aims to establish the potential of SHG microscopy for in situ detection and characterization of hyperglycemia-induced abnormalities in the Descemet's membrane, in the posterior cornea. METHODOLOGY/PRINCIPAL FINDINGS: We studied corneas from age-matched control and Goto-Kakizaki rats, a spontaneous model of type 2 diabetes, and corneas from human donors with type 2 diabetes and without any diabetes. SHG imaging was compared to confocal microscopy, to histology characterization using conventional staining and transmitted light microscopy and to transmission electron microscopy. SHG imaging revealed collagen deposits in the Descemet's membrane of unstained corneas in a unique way compared to these gold standard techniques in ophthalmology. It provided background-free images of the three-dimensional interwoven distribution of the collagen deposits, with improved contrast compared to confocal microscopy. It also provided structural capability in intact corneas because of its high specificity to fibrillar collagen, with substantially larger field of view than transmission electron microscopy. Moreover, in vivo SHG imaging was demonstrated in Goto-Kakizaki rats. CONCLUSIONS/SIGNIFICANCE: Our study shows unambiguously the high potential of SHG microscopy for three-dimensional characterization of structural abnormalities in unstained corneas. Furthermore, our demonstration of in vivo SHG imaging opens the way to long-term dynamical studies. This method should be easily

  20. Diabetic cornea wounds produce significantly weaker electric signals that may contribute to impaired healing

    OpenAIRE

    Yunyun Shen; Trisha Pfluger; Fernando Ferreira; Jiebing Liang; Navedo, Manuel F; Qunli Zeng; Brian Reid; Min Zhao

    2016-01-01

    Wounds naturally produce electric signals which serve as powerful cues that stimulate and guide cell migration during wound healing. In diabetic patients, impaired wound healing is one of the most challenging complications in diabetes management. A fundamental gap in knowledge is whether diabetic wounds have abnormal electric signaling. Here we used a vibrating probe to demonstrate that diabetic corneas produced significantly weaker wound electric signals than the normal cornea. This was conf...

  1. Material Properties from Air Puff Corneal Deformation by Numerical Simulations on Model Corneas

    Science.gov (United States)

    Dorronsoro, Carlos; de la Hoz, Andrés; Marcos, Susana

    2016-01-01

    Objective To validate a new method for reconstructing corneal biomechanical properties from air puff corneal deformation images using hydrogel polymer model corneas and porcine corneas. Methods Air puff deformation imaging was performed on model eyes with artificial corneas made out of three different hydrogel materials with three different thicknesses and on porcine eyes, at constant intraocular pressure of 15 mmHg. The cornea air puff deformation was modeled using finite elements, and hyperelastic material parameters were determined through inverse modeling, minimizing the difference between the simulated and the measured central deformation amplitude and central-peripheral deformation ratio parameters. Uniaxial tensile tests were performed on the model cornea materials as well as on corneal strips, and the results were compared to stress-strain simulations assuming the reconstructed material parameters. Results The measured and simulated spatial and temporal profiles of the air puff deformation tests were in good agreement (< 7% average discrepancy). The simulated stress-strain curves of the studied hydrogel corneal materials fitted well the experimental stress-strain curves from uniaxial extensiometry, particularly in the 0–0.4 range. Equivalent Young´s moduli of the reconstructed material properties from air-puff were 0.31, 0.58 and 0.48 MPa for the three polymer materials respectively which differed < 1% from those obtained from extensiometry. The simulations of the same material but different thickness resulted in similar reconstructed material properties. The air-puff reconstructed average equivalent Young´s modulus of the porcine corneas was 1.3 MPa, within 18% of that obtained from extensiometry. Conclusions Air puff corneal deformation imaging with inverse finite element modeling can retrieve material properties of model hydrogel polymer corneas and real corneas, which are in good correspondence with those obtained from uniaxial extensiometry

  2. Polymicrobial Infection of the Cornea Due to Contact Lens Wear

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    Selçuk Sızmaz

    2016-04-01

    Full Text Available A 38-year-old male presented with pain and redness in his left eye. He had a history of wearing contact lenses. His ophthalmic examination revealed a large corneal ulcer with surrounding infiltrate. Cultures were isolated from the contact lenses, lens solutions, storage cases, and conjunctivae of both eyes and also corneal scrapings of the left eye. Fortified vancomycin and amikacin drops were started hourly. Culture results of conjunctivae of each eye and left cornea were positive for Pseudomonas aeruginosa; cultures from the contact lenses, lens solution and storage case of both eyes revealed Pseudomonas aeruginosa and Alcaligenes xylosoxidans. Polymerase chain reaction of the corneal scraping was positive for Acanthameoba. The topical antibiotics were changed with ones that both bacteria were sensitive to and anti-amoebic therapy was added. The patient had two recurrences following initial presentation despite intensive therapy. Keratitis occurred due to multiple pathogens; the relapsing course despite adequate therapy is potentially associated with this polymicrobial etiology.

  3. Cross-linking da cornea: protocolo padrão

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    Marcony R. Santhiago

    Full Text Available RESUMO O objetivo desta revisão é de determinar as indicações e eficácia da cirurgia que promove novas ligações covalentes entre as fibras de colágeno da córnea, conhecida como Cross-Linking (CXL, assim como esclarecer seus objetivos. O ceratocone é uma doença ectasica da córnea, bilateral, assimétrica, que, principalmente, cursa com encurvamento e afinamentos progressivo, e se inicia em geral na segunda década de vida. O uso primário do CXL tem sido na interrupção da progressão do Ceratocone. Apesar do conhecido encurvamento no estroma da córnea ocorrer nesses pacientes, a fisiopatologia por trás do ceratocone ainda é desconhecida e parece ser multifatorial. Pela evidencia literária disponível até o momento, o CXL da córnea esta, portanto indicado nos pacientes com doença em progressão. Concluímos que existe evidencia suficiente para afirmar que o CXL da córnea é eficaz na estabilização da doença ectásica da cornea.

  4. Ocular allergic inflammation: interaction between the cornea and conjunctiva.

    Science.gov (United States)

    Fukuda, Ken; Nishida, Teruo

    2010-11-01

    Severe ocular allergic diseases such as vernal keratoconjunctivitis are characterized not only by conjunctival allergic inflammation, including infiltration of T helper 2 cells and eosinophils into the conjunctiva, but also by various corneal disorders such as persistent epithelial defects and shield ulcer. Although the cornea and conjunctiva are thought to influence each other during ocular allergic inflammation, direct evidence for interaction between these tissues in vivo has been lacking. Eosinophils and eosinophil-derived factors are implicated in the pathogenesis of corneal lesions associated with ocular allergy, with cytotoxic granule proteins such as major basic protein and matrix metalloproteinase 9 derived from eosinophils having been detected in shield ulcer. Major basic protein exhibits cytotoxic effects in cultured corneal epithelial cells and inhibits corneal epithelial wound healing in organ culture, whereas matrix metalloproteinase 9 can degrade the corneal epithelial basement membrane. In vitro studies have revealed that cytokines and other inflammatory mediators directly impair the barrier function of corneal epithelial cells and increase the expression of chemokines and adhesion molecules by corneal stromal fibroblasts, effects that may enhance allergic inflammation. We have recently shown that removal of the corneal epithelium augmented late-phase clinical signs and conjunctival eosinophilia, whereas conjunctival inflammation delayed corneal epithelial wound healing, in a rat model of ocular allergy. Conjunctival allergic inflammation and corneal epithelial disorders thus interact with each other in vivo to generate a vicious cycle, interruption of which might provide the basis for novel approaches to the treatment of severe ocular allergy.

  5. Human cornea wound healing in organ culture after Er:YAG laser ablation

    Science.gov (United States)

    Shen, Jin-Hui; Joos, Karen M.; Robinson, Richard D.; Shetlar, Debra J.; O'Day, Denis M.

    1998-06-01

    Purpose: To study the healing process in cultured human corneas after Er:YAG laser ablation. Methods: Human cadaver corneas within 24 hours post mortem were ablated with a Q- switched Er:YAG laser at 2.94 micrometer wavelength. The radiant exposure was 500 mJ/cm2. The cornea was cultured on a tissue supporting frame immediately after the ablation. Culture media consisted of 92% minimum essential media, 8% fetal bovine serum, 0.125% HEPES buffer solution, 0.125% gentamicin, and 0.05% fungizone. The entire tissue frame and media container were kept in an incubator at 37 degrees Celsius and 5% CO2. Serial macroscopic photographs of the cultured corneas were taken during the healing process. Histology was performed after 30 days of culture. Results: A clear ablated crater into the stroma was observed immediately after the ablation. The thickness of thermal damage ranges between 1 and 25 micrometer. Haze development within the crater varies from the third day to the fourteenth day according to the depth and the roughness of the crater. Histologic sections of the cultured cornea showed complete re- epithelization of the lased area. Loose fibrous tissue is observed filling the ablated space beneath the epithelium. The endothelium appeared unaffected. Conclusions: The intensity and time of haze development appears dependent upon the depth of the ablation. Cultured human corneas may provide useful information regarding the healing process following laser ablation.

  6. Intrastromal Injection of China Painting Ink in Corneas of Male Rabbits: Clinical and Histological Study

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    Alahmady Hamad Alsmman Hassan

    2016-01-01

    Full Text Available Background. Many patients with corneal opacity or complicated cataract in blind eye ask for cosmoses. In this study we tried to investigate the staining of corneas of male rabbits by Rotring China painting ink and to study the histological changes. Method. 10 eyes of 10 male Baladi Egyptian rabbits were injected (0.1 mL intrastromally in the cornea by the use of China painting ink (Rotring Tinta China through insulin syringe (27-gauge needle by single injection; clinical follow-up is for 6 months and lastly the rabbits were scarified and the stained eyes were enucleated for histological analysis. Results. Clinically the stain was stable in color and distribution in corneas with no major complications. Histological results of the stained rabbit corneas showed blackish pigmentation in the corneal stroma without any inflammatory cellular infiltration. Some fibroblast cells had pigment granules in their cytoplasm in the adjacent layers. Conclusion. Corneal staining by China painting ink is effective and safe in staining of male rabbits cornea; however further study in human corneas with longer follow-up period is advisable.

  7. Unilateral bullous pemphigoid without erythema and eosinophil infiltration in a hemiplegic patient.

    Science.gov (United States)

    Tsuruta, Daisuke; Nishikawa, Takeji; Yamagami, Jun; Hashimoto, Takashi

    2012-09-01

    In this report, we describe an 88-year-old male stroke patient with unilateral bullous pemphigoid limited to the hemiplegic side. Physical examinations revealed multiple tense bullae with clear and/or bloody contents without apparent erythema on the right thigh and lower leg, accompanied by erosions on the right chest. Histopathologically, no eosinophils were infiltrated into and around the subepidermal bullae. Immunofluorescence revealed deposited and circulating immunoglobulin (Ig)G anti-basement membrane zone antibodies. Immunoblot assays using various antigen sources and enzyme-linked immunosorbent assay revealed that IgG antibodies in this case reacted with unique epitopes between NC16a and C-terminal domains on the 120-kDa LAD-1, the extracellular truncated form of BP180. Three observations were unique in our case. First, the distribution of bullae in our patient was limited to the hemiplegic side. Second, there was no apparent erythema clinically and no eosinophilic infiltration histopathologically. Third, the patient achieved remission without the use of oral corticosteroids. The unusual epitopes in this case may contribute to these phenomena.

  8. Quality of life, depression, anxiety and loneliness in patients with bullous pemphigoid. A case control study*

    Science.gov (United States)

    Kouris, Anargyros; Platsidaki, Eftychia; Christodoulou, Christos; Armyra, Kalliopi; Korkoliakou, Panagiota; Stefanaki, Christina; Tsatovidou, Revekka; Rigopoulos, Dimitrios; Kontochristopoulos, George

    2016-01-01

    Background Bullous pemphigoid (BP) is a chronic, autoimmune blistering skin disease that affects patients' daily life and psychosocial well-being. Objective The aim of the study was to evaluate the quality of life, anxiety, depression and loneliness in BP patients. Methods Fifty-seven BP patients and fifty-seven healthy controls were recruited for the study. The quality of life of each patient was assessed using the Dermatology Life Quality Index (DLQI) scale. Moreover, they were evaluated for anxiety and depression according to the Hospital Anxiety Depression Scale (HADS-scale), while loneliness was measured through the Loneliness Scale-Version 3 (UCLA) scale. Results The mean DLQI score was 9.45±3.34. Statistically significant differences on the HADS total scale and in HADS-depression subscale (p=0.015 and p=0.002, respectively) were documented. No statistically significant difference was found between the two groups on the HADS-anxiety subscale. Furthermore, significantly higher scores were recorded on the UCLA Scale compared with healthy volunteers (p=0.003). Conclusion BP had a significant impact on quality of life and the psychological status of patients, probably due to the appearance of unattractive lesions on the skin, functional problems and disease chronicity. PMID:27828632

  9. Risk of Death in Bullous Pemphigoid: A Retrospective Database Study in Finland.

    Science.gov (United States)

    Försti, Anna-Kaisa; Jokelainen, Jari; Timonen, Markku; Tasanen, Kaisa

    2016-08-23

    Bullous pemphigoid (BP) is an autoimmune skin disease of elderly people, which is associated with increased mortality. The aim of this study was to investigate the standardized mortality ratio (SMR) for BP in Finland, and concomitant comorbidities and medications. This was a retrospective database study of all cases of BP diagnosed at the Department of Dermatology, Oulu University Hospital, Finland, between 1985 and 2012. A total of 198 immunologically confirmed cases of BP were found. One-year mortality was 16.7%, and SMR 7.56 (95% confidence interval (CI) 4.98-10.14). The most common comorbidities were cardiovascular diseases (76.3%) and neurodegenerative diseases (40.9%). Malignancies (8.6%) were associated with increased mortality (hazard ratio = 2.4, 95% CI 1.1-5.5, p = 0.047). A novel finding was that polypharmacy was very common in patients with BP, and the higher the number of drugs, the greater the mortality. In conclusion, the mortality for BP in Finland is 7.6-fold that of a reference population, and malignancies and polypharmacy are associated with increased mortality.

  10. Refractory linear IgA bullous dermatosis successfully treated with mycophenolate sodium.

    Science.gov (United States)

    Marzano, Angelo V; Ramoni, Stefano; Spinelli, Diana; Alessi, Elvio; Berti, Emilio

    2008-01-01

    Linear IgA bullous dermatosis (LABD) is a rare, blistering autoimmune disease characterized by linear deposits of IgA at the basement membrane zone (BMZ), with the possible presence of circulating IgA anti-BMZ antibodies. LABD of childhood is usually self-healing, while in adults it follows a more prolonged course and refractory cases may rarely occur. The first-line treatment for LABD is dapsone in monotherapy or in combination with systemic corticosteroids, but various therapeutic approaches have been used in non-responder patients. We report two adult patients with refractory LABD successfully treated with enteric-coated mycophenolate sodium (EC-MPS), a recently introduced formulation of mycophenolic acid (MPA). MPA is an immunosuppressive agent that acts by inhibiting monophosphate dehydrogenase, a key enzyme in the novo synthesis of purines. Based on the present cases, we indicate EC-MPS as being a safe and effective adjuvant therapy in the treatment of LABD when dapsone or the other steroid-sparing drugs fail. It seems to offer an improved gastric side effect profile in comparison with the classic formulation of MPA, namely its ester mycophenolate mofetil (MMF).

  11. Role of methotrexate in the treatment of bullous pemphigoid in the elderly.

    Science.gov (United States)

    Patton, Timothy; Korman, Neil

    2008-01-01

    Bullous pemphigoid (BP) is an autoimmune blistering disease that commonly occurs in the elderly. Immunosuppressive medications are effective at controlling the disease in the majority of cases. Mortality can occur as a consequence of severe disease or as a result of the therapies that are frequently employed as treatment. Commonly employed therapies include systemic corticosteroids, azathioprine and mycophenolate mofetil. In a small subset of patients, these first- and second-line therapies do not control disease or are not tolerated by the patients. Optional therapies include nicotinamide (niacinamide), tetracycline, intravenous immunoglobulin, cyclophosphamide, dapsone and methotrexate. The majority of BP patients are elderly, and several considerations need to be taken into account before a specific therapy is chosen. Methotrexate provides several advantages in the elderly population in terms of practicality, cost and tolerability. Several retrospective and prospective studies have evaluated its effectiveness in the treatment of BP in the elderly population. The results of these studies indicate that methotrexate is an effective therapy for BP and is a reasonable option for treatment in the elderly population, although maybe not as a first- or second-line therapy.

  12. Exploring mechanisms of IgE-mediated autoimmunity through the lens of bullous pemphigoid.

    Science.gov (United States)

    Messingham, Kelly N; Randall, Grant; Fairley, Janet

    2016-04-01

    Bullous pemphigoid (BP) is the most common autoimmune blistering disease characterized by pathogenic autoantibodies targeting collagen XVII (col XVII), a hemidesmosomal adhesion molecule. Early studies utilizing IgG were critical for establishing col XVII-specific antibodies as primary mediators of blister formation; however, these studies lacked key features of the disease, including urticarial erythema and eosinophilic infiltration, which are often associated with IgE. Although it was recognized that BP patients often had elevated circulating IgE, investigations into the pathogenicity of these antibodies was delayed until discovery of col XVII-specific IgE in BP sera. Since then, a variety of in-vivo and in-vitro studies have provided clear evidence that IgE autoantibodies are a key component of BP. Furthermore, studies utilizing IgE receptor blockade in BP patients were the first to confirm a pathogenic role of IgE autoantibodies in human autoimmunity. In this review we will utilize BP as a prototypical autoimmune disease to better understand how IgE autoantibodies participate in human autoimmunity.

  13. Treatment of Intraepidermal Autoimmune Bullous Diseases Sürekli Eğitim

    Directory of Open Access Journals (Sweden)

    Tamer İrfan Kaya

    2011-06-01

    Full Text Available Pemfigus is an autoimmune bullous skin disease, characterized by intraepidermal blisters. It is a severe and potentially life-threatening chronic disease with blisters and erosions on the mucosae and the skin. Treatment options do not differ for two most common types of pemphigus, pemphigus vulgaris and pemphigus foliaceus, except that the latter is usually less resistant to treatment and corticosteroids can often be started at lower doses. Systemic corticosteroids are still the most widely used drugs in the treatment of pemphigus and continue to be the mainstay of therapy for this disease. Adjuvant drugs are commonly used in combination with the aims of increasing efficacy and of having a steroid-sparing action, thereby allowing reduced corticosteroid side-effects. Mortality and complete remission rates have improved since the introduction of adjuvant drugs to pemphigus. Adjuvant drugs include immunoadsorbtion, corticosteroid pulse therapy, intravenous immunoglobulin (IVIG, immunosuppressive agents such as azathioprine, cyclophosphamide, mycophenolate mofetil and and anti-CD20 monoclonal antibody (rituximab. The lack of consensus in the published literature about the treatment of this disorder is responsible for different treatment strategies. Treatments need to be chosen after careful consideration of the potential benefits and side effects according to the patients’ medical condition. Here, both conventional therapies and novel treatment regimens for pemphigus are discussed. (Turkderm 2011; 45 Suppl 1: 44-53

  14. Trasplante de córnea Cornea transplant

    Directory of Open Access Journals (Sweden)

    A. Garralda

    2006-08-01

    Full Text Available La queratoplastia o trasplante de córnea es una de las técnicas quirúrgicas más antiguas de la oftalmología cuyas indicaciones son: 1 tectónicas, para preservar la anatomía e integridad corneal, 2 clínicas, para eliminar el tejido corneal inflamado en casos refractarios al tratamiento médico, 3 ópticas, para mejorar la agudeza visual y 4 cosméticas para mejorar el aspecto del ojo. El perfeccionamiento en la técnica y en el instrumental, así como en el tratamiento postoperatorio y en los medios de conservación del tejido donante han mejorado la supervivencia de los injertos realizados. El Modelo Pamplona de coordinación de trasplantes del Hospital Virgen del Camino (HVC está considerado como original y único en España, y en la logística de este programa se incluye el protocolo de detección y extracción de córneas así como el de queratoplastias.The keratoplasty, or corena transplant, is one of the oldest surgical techniques in opthalmology, whose indication are: 1 tectonic, in order to preserve corneal anatomy and integrity; 2 clinical, in order to eliminate the inflamed corneal tissue in cases refractory to medical treatment; 3 optical, in order to improve visual acuity; and 4 cosmetic, in order to improve the appearance of the eye. Improvements in technique and instruments, as well as in post-operative treatment and the means of preserving donated tissue, have improved survival of the grafts. The Pamplona Model of transplant coordination of the Virgen del Camino Hospital is considered to be original and unique in Spain. The logistics of this program include the protocol for detection and extraction of corneas as well as for keratoplasties.

  15. Effect of epithelial debridement on human cornea proteoglycans

    Directory of Open Access Journals (Sweden)

    E.S. Soriano

    2001-03-01

    Full Text Available Corneal transparency is attributed to the regular spacing and diameter of collagen fibrils, and proteoglycans may play a role in fibrillogenesis and matrix assembly. Corneal scar tissue is opaque and this opacity is explained by decreased ultrastructural order that may be related to proteoglycan composition. Thus, the objectives of the present study were to characterize the proteoglycans synthesized by human corneal explants and to investigate the effect of mechanical epithelial debridement. Human corneas unsuitable for transplants were immersed in F-12 culture medium and maintained under tissue culture conditions. The proteoglycans synthesized in 24 h were labeled metabolically by the addition of 35S-sulfate to the medium. These compounds were extracted by 4 M GuHCl and identified by a combination of agarose gel electrophoresis, enzymatic degradation with protease and mucopolysaccharidases, and immunoblotting. Decorin was identified as the main dermatan sulfate proteoglycan and keratan sulfate proteoglycans were also prominent components. When the glycosaminoglycan side chains were analyzed, only keratan sulfate and dermatan sulfate were detected (~50% each. Nevertheless, when these compounds were 35S-labeled metabolically, the label in dermatan sulfate was greater than in keratan sulfate, suggesting a lower synthesis rate for keratan sulfate. 35S-Heparan sulfate also appeared. The removal of the epithelial layer caused a decrease in heparan sulfate labeling and induced the synthesis of dermatan sulfate by the stroma. The increased deposit of dermatan sulfate proteoglycans in the stroma suggests a functional relationship between epithelium and stroma that could be related to the corneal opacity that may appear after epithelial cell debridement.

  16. Gene transfer of integration defective anti-HSV-1 meganuclease to human corneas ex vivo.

    Science.gov (United States)

    Elbadawy, H M; Gailledrat, M; Desseaux, C; Salvalaio, G; Di Iorio, E; Ferrari, B; Bertolin, M; Barbaro, V; Parekh, M; Gayon, R; Munegato, D; Franchin, E; Calistri, A; Palù, G; Parolin, C; Ponzin, D; Ferrari, S

    2014-03-01

    Corneal graft rejection is a major problem in chronic herpetic keratitis (HK) patients with latent infection. A new class of antiviral agents targeting latent and active forms of herpes simplex virus type 1 (HSV-1) is importantly required. Meganucleases are sequence-specific homing endonucleases capable of inducing DNA double-strand breaks. A proof-of-concept experiment has shown that tailor-made meganucleases are efficient against HSV-1 in vitro. To take this work a step forward, we hypothesized that the pre-treatment of human corneas in eye banks using meganuclease-encoding vectors will allow HK patients to receive a medicated cornea to resist the recurrence of the infection and the common graft rejection problem. However, this strategy requires efficient gene delivery to human corneal endothelium. Using recombinant adeno-associated virus, serotype 2/1 (rAAV2/1), efficient gene delivery of a reporter gene was demonstrated in human corneas ex vivo. The optimum viral dose was 3.7 × 10(11) VG with an exposure time of 1 day, followed by 6 days incubation in de-swelling medium. In addition, 12 days incubation can result in transgene expression in excess of 70%. Using similar transduction conditions, meganuclease transgene expression was detected in 39.4% of the endothelial cells after 2 weeks in culture. Reduction of the total viral load in the media and the endothelial cells of corneas infected with HSV-1 was shown. Collectively, this work provides information about the optimum conditions to deliver genetic material to the cornea, and demonstrates for the first time the expression of meganuclease in human corneas ex vivo and its antiviral activity. In conclusion, we demonstrate that the treatment of human corneas in eye banks before transplantation is a new approach to address the unmet clinical needs in corneal diseases.

  17. Cornea nerve fiber quantification and construction of phenotypes in patients with fibromyalgia

    Science.gov (United States)

    Oudejans, Linda; He, Xuan; Niesters, Marieke; Dahan, Albert; Brines, Michael; van Velzen, Monique

    2016-01-01

    Cornea confocal microscopy (CCM) is a novel non-invasive method to detect small nerve fiber pathology. CCM generally correlates with outcomes of skin biopsies in patients with small fiber pathology. The aim of this study was to quantify the morphology of small nerve fibers of the cornea of patients with fibromyalgia in terms of density, length and branching and further phenotype these patients using standardized quantitative sensory testing (QST). Small fiber pathology was detected in the cornea of 51% of patients: nerve fiber length was significantly decreased in 44% of patients compared to age- and sex-matched reference values; nerve fiber density and branching were significantly decreased in 10% and 28% of patients. The combination of the CCM parameters and sensory tests for central sensitization, (cold pain threshold, mechanical pain threshold, mechanical pain sensitivity, allodynia and/or windup), yielded four phenotypes of fibromyalgia patients in a subgroup analysis: one group with normal cornea morphology without and with signs of central sensitization, and a group with abnormal cornea morphology parameters without and with signs of central sensitization. In conclusion, half of the tested fibromyalgia population demonstrates signs of small fiber pathology as measured by CCM. The four distinct phenotypes suggest possible differences in disease mechanisms and may require different treatment approaches. PMID:27006259

  18. Diabetic cornea wounds produce significantly weaker electric signals that may contribute to impaired healing.

    Science.gov (United States)

    Shen, Yunyun; Pfluger, Trisha; Ferreira, Fernando; Liang, Jiebing; Navedo, Manuel F; Zeng, Qunli; Reid, Brian; Zhao, Min

    2016-06-10

    Wounds naturally produce electric signals which serve as powerful cues that stimulate and guide cell migration during wound healing. In diabetic patients, impaired wound healing is one of the most challenging complications in diabetes management. A fundamental gap in knowledge is whether diabetic wounds have abnormal electric signaling. Here we used a vibrating probe to demonstrate that diabetic corneas produced significantly weaker wound electric signals than the normal cornea. This was confirmed in three independent animal models of diabetes: db/db, streptozotocin-induced and mice fed a high-fat diet. Spatial measurements illustrated that diabetic cornea wound currents at the wound edge but not wound center were significantly weaker than normal. Time lapse measurements revealed that the electric currents at diabetic corneas lost the normal rising and plateau phases. The abnormal electric signals correlated significantly with impaired wound healing. Immunostaining suggested lower expression of chloride channel 2 and cystic fibrosis transmembrane regulator in diabetic corneal epithelium. Acute high glucose exposure significantly (albeit moderately) reduced electrotaxis of human corneal epithelial cells in vitro, but did not affect the electric currents at cornea wounds. These data suggest that weaker wound electric signals and impaired electrotaxis may contribute to the impaired wound healing in diabetes.

  19. Systematic assessment of microneedle injection into the mouse cornea

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    Matthaei Mario

    2012-06-01

    Full Text Available Abstract Background Corneal intrastromal injection is an important mode of gene-vector application to subepithelial layers. In a mouse model, this procedure is substantially complicated by the reduced corneal dimensions. Furthermore, it may be difficult to estimate the corneal area reached by the volume of a single injection. This study aimed to investigate intrastromal injections into the mouse cornea using different microneedles and to quantify the effect of injecting varying volumes. A reproducible injection technique is described. Methods Forty eyes of 20 129 Sv/J mice were tested. India ink was intrastromally injected using 30° beveled 33 G needles, tri-surface 25° beveled 35 G needles, or hand-pulled and 25° beveled glass needles. Each eye received a single injection of a volume of 1 or 2 μL. Corneoscleral buttons were fixed and flat mounted for computer-assisted quantification of the affected corneal area. Histological assessment was performed to investigate the intrastromal location of the injected dye. Results A mean corneal area of 5.0 ±1.4 mm2 (mean ± SD and 7.7 ±1.4 mm2 was covered by intrastromal injections of 1 and 2 μL, respectively. The mean percentage of total corneal area reached ranged from 39% to 53% for 1 μL injections, and from 65% to 81% for 2 μL injections. Injections using the 33 G needles tended to provide the highest distribution area. Perforation rates were 8% for 30° beveled 33 G needles and 44% for tri-surface beveled 35 G needles. No perforation was observed with glass needle; however, intrastromal breakage of needle tips was noted in 25% of these cases. Conclusions Intracorneal injection using a 30° beveled 33 G needle was safe and effective. The use of tri-surface beveled 35 G needles substantially increased the number of corneal perforations. Glass needles may break inside the corneal stroma. Injections of 1 μL and 2 μL resulted in an overall mean of 49% and 73% respectively

  20. Diagnostic value of eccrine glands and hair follicles in direct immunofluorescent analysis of pemphigus vulgaris and bullous pemphigoid.

    Science.gov (United States)

    Zhou, Cheng; Yu, Yan; Elston, Dirk M

    2016-04-01

    The immunofluorescence pattern in adnexal structures may be of value, especially when the epidermis is not well represented in diagnostic sections. We studied a total of 88 cases of pemphigus vulgaris (PV) and bullous pemphigoid (BP) accessioned between 2010 and 2015 (40 cases of PV and 48 cases of BP). Immunofluorescence patterns and sensitivity in adnexal structures were similar to those observed in the epidermis. One case of PV and three cases of BP showed weak or absent fluorescence in the epidermis, while the eccrine glands were strongly positive, suggesting that careful examination of adnexal structures can be of value.

  1. Three-year observation of the patients with bullous pemphigoid: 29 cases

    Directory of Open Access Journals (Sweden)

    Özlem Ekiz

    2013-12-01

    Full Text Available Background and Design: Bullous pemphigoid (BP is a chronic, autoimmune, subepidermal blistering disease. The aim of this study was to determine the clinico-epidemiologic data’s of patients diagnosed as BP in our clinic and compare these data with other studies in our country and in the world. Material and Method: We researched the documents of BP cases diagnosed by clinical and histopathological examinations from January 2009 to January 2013, retrospectively. We evaluated clinical and dermographical characteristics of all patients such as age, sex, existence of oral mucosal lesions, association of pruritus, duration of disease, presence of triggering factors, features of skin lesions, results of direct immunofluorescence (DIF investigation, drug intake, recurrence and mortality rates and causes of detected mortality. Results: Of the 29 patients included in the study %48,3 were female, %51,7 were male. The average age was 70,17 and the mean duration of disease was 15.41 months. In five cases oral mucosal involvement and in 24 cases pruritus was detected. Drugs in three cases and malignity in one case were assessed as triggering factors. The results of DIF investigation revealed the linear IgG and C3 deposition at the dermoepidermal junction in 12 cases, C3 deposition in 10 cases. The initial treatment was topical corticosteroid in 11, tetracycline and nicotinamide combination in six, systemic corticosteroid in 10 individuals. After initial therapy recurrence appeared in 7 patients in one year. Mortality during hospitalization was observed in 2 cases. Conclusions: We presented the clinical and epidemiological features of patients diagnosed as BP in our clinics in the last three years. Because of having different ethnical originated, heterogeneous population of our city, we believe that our investigation will contribute to having opinion about epidemiology of BP in our country. Nevertheless, prospective, long term and multicentre studies based on

  2. An immunohistochemical study of the distribution of plasminogen and plasminogen activators in bullous pemphigoid.

    Science.gov (United States)

    Venning, V A; Wojnarowska, F; Cederholm-Williams, S

    1993-03-01

    Abnormalities of the cutaneous plasminogen/plasminogen activator system have been associated with acantholytic disorders, psoriasis, keratinocytes in culture, and epidermis in healing wounds. The present study was undertaken to investigate the possible role of the plasmin/plasminogen protease system in lesion development in bullous pemphigoid (BP). Using polyclonal antibodies and a fluorescent technique, the immunohistochemical distribution of plasmin/plasminogen, fibrinogen and the plasminogen activators, urokinase (uPA) and tissue plasminogen activator (tPA), were studied in lesional and non-lesional skin from nine BP patients, one with linear IgA disease (LAD) and one with pemphigoid gestationis (PG). The distribution of the proteases was compared with that in normal skin (n = 4) and in suction blisters (n = 2). In normal skin, fibrinogen, tPA and uPA were absent from the epidermis and plasminogen was confined to the basal layer. Uninvolved BP skin was identical to controls. Focal areas of suprabasal plasminogen expression in the region of a blister was seen in 3/9 BP lesions and in 1/2 suction blisters. In 6/9 BP lesions and both uninvolved and lesional LAD and PG skin were identical to controls, and no suprabasal expression of plasminogen was present. These findings suggest that suprabasal plasminogen expression is unlikely to play a fundamental role in the pathogenesis of blister formation in BP as enhanced expression was not present in every case and the finding was not specific to BP, also occurring in a suction blister. Enhanced plasminogen expression rather may be a reflection of the processes of tissue repair.

  3. Expression of βig-h3 in keratoconus and normal cornea%βig-h3在圆锥角膜和正常角膜中的表达

    Institute of Scientific and Technical Information of China (English)

    赵桂秋; 王传富; 孙为荣; 张文卿; 李艳; 生晖; 梁涛

    2002-01-01

    Objectives To observe the expression of βig-h3 in normal cornea and keratoconus and to elucidate the role of extracellular matrix in keratoconus. Methods In situ hybridization was used to detect the expression of βig-h3 in the cornea. The cDNA library was screened with human βig-h3 cDNA probe to locate βig-h3 mRNA in cells. Results Expression of βig-h3 was found mainly in the stroma of the normal cornea and keratoconus, but decrease depending on the degree of keratopathy. In some serious cases, no expression signal was detected. The strongest expression was seen at the border of the normal region and keratoconus. Conclusions βig-h3,the structural component of the extracellular matrix, can affect cell adhensiveness in the development of corneal fibrous interstitial organization. During the development of keratoconus, decreasing levels of βig-h3 cause the diminution of corneal steadiness, which is related to formation of keratoconus.%目的观察圆锥角膜患者及正常人角膜组织中βig-h3的表达,探讨细胞外基质结构成分在圆锥角膜病变中的作用.方法采用原位杂交技术,以BIGH3基因的cDNA探针对圆锥角膜患者及正常人角膜组织中βig-h3mRNA进行细胞定位,检测角膜组织中βig-h3基因表达的水平.结果正常角膜组织中βig-h3表达主要在基质层;圆锥角膜患者βig-h3在基质层表达因角膜病变的程度不同而呈不同程度的减弱,严重者未检测到βig-h3的阳性表达信号.在圆锥角膜的正常和病变交界处,可见βig-h3表达呈强阳性.结论细胞外基质结构成分βig-h3在角膜纤维间质有序化的发育中起细胞粘附作用,在圆锥角膜病变的发生过程中 ,βig-h3的水平下降,导致角膜的稳固性下降,可能与圆锥角膜形成有关.

  4. [Cornea bank of Lyon: from quality diagnosis to ISO 9001 certification].

    Science.gov (United States)

    Pascal, P; Chalochet, A; Damour, O

    2001-12-01

    The tissue and cell bank of the HCL (Hospices Civils de Lyon) has, since 10 June 1999, consisted of two sections with related activities: cell culture for the Skin Substitutes Laboratory (Laboratoire des Substituts Cutanés, LSC) and preservation of corneas at 31 degrees C for the Cornea Bank. As the LSC had been ISO 9001 certified since March 1997 our aim, since merger, was to raise the Cornea Bank to the same level of quality as the LSC, so as to coincide with the renewal of the LSC certificate in February 2000. The methods we used (project, quality control, analysis and process optimization) led us to receive official certification only nine months after the merger. The procedure started with a program of quality control at the Cornea Bank from February 1999 onwards, in order to list the work and equipment required, evaluate its documentation system and what was needed to incorporate this new activity into the existing system of quality assurance at the LSC. On the 7th March 2000, the Tissue and Cell Bank of the HCL obtained an ISO 9001 certificate for its combined functions. As well as achieving our objectives and the strong points highlighted by the auditor during the renewal process, this quality assessment revealed many advantages: improvements in the conservation of corneas, economies in staff replacement and reductions in both the cost of maintaining quality, the cost of the corneas themselves, etc. The decree 'Banque' no. 99-741 of 30th August 1999, which put in place the system of authorization of tissue banks in France, demands quality control. Our application for certification which started in early 1999 had anticipated this regulation. This helped us enormously when compiling the dossier accompanying the official request and was an essential element in obtaining the favourable response of the ASSAPS on 21 June 2000.

  5. Differentially expressed wound healing-related microRNAs in the human diabetic cornea.

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    Vincent A Funari

    Full Text Available MicroRNAs are powerful gene expression regulators, but their corneal repertoire and potential changes in corneal diseases remain unknown. Our purpose was to identify miRNAs altered in the human diabetic cornea by microarray analysis, and to examine their effects on wound healing in cultured telomerase-immortalized human corneal epithelial cells (HCEC in vitro. Total RNA was extracted from age-matched human autopsy normal (n=6 and diabetic (n=6 central corneas, Flash Tag end-labeled, and hybridized to Affymetrix® GeneChip® miRNA Arrays. Select miRNAs associated with diabetic cornea were validated by quantitative RT-PCR (Q-PCR and by in situ hybridization (ISH in independent samples. HCEC were transfected with human pre-miR™miRNA precursors (h-miR or their inhibitors (antagomirs using Lipofectamine 2000. Confluent transfected cultures were scratch-wounded with P200 pipette tip. Wound closure was monitored by digital photography. Expression of signaling proteins was detected by immunostaining and Western blot. Using microarrays, 29 miRNAs were identified as differentially expressed in diabetic samples. Two miRNA candidates showing the highest fold increased in expression in the diabetic cornea were confirmed by Q-PCR and further characterized. HCEC transfection with h-miR-146a or h-miR-424 significantly retarded wound closure, but their respective antagomirs significantly enhanced wound healing vs. controls. Cells treated with h-miR-146a or h-miR-424 had decreased p-p38 and p-EGFR staining, but these increased over control levels close to the wound edge upon antagomir treatment. In conclusion, several miRNAs with increased expression in human diabetic central corneas were found. Two such miRNAs inhibited cultured corneal epithelial cell wound healing. Dysregulation of miRNA expression in human diabetic cornea may be an important mediator of abnormal wound healing.

  6. Holographic interferometry of intact and radially incised human eye-bank corneas.

    Science.gov (United States)

    Smolek, M K

    1994-05-01

    Many methods to measure corneal elasticity destroy the tissue and thereby produce erroneous results. Holographic interferometry, a highly precise nondestructive optical comparison technique, was used to evaluate corneal elasticity of intact eye-bank eyes. A double-pulse holographic interferometer operating at 632.8 nm was used to measure corneal deformation in 20 whole-globe eyes from donors 45 to 83 years of age for intraocular pressures from 16 mm Hg to 21 mm Hg. Stress was computed from LaPlace's law, and arc length strain was derived from z-axis distention of the central cornea. The stress-strain relationship in the normal physiological range of intraocular pressure was linear with a Young's elastic modulus of 1.03 gigapascals for the central cornea (r = 0.999). During interferometry of radial keratotomy of the cornea, interference fringe patterns developed in association with each incision as it was made. When four incisions were placed deep along each of the primary semimeridians, the fringe pattern developed as expected, based on current keratotomy models. When incisions were shallow (approximately 50% depth) and placed asymmetrically along the nasal, temporal, and superior semimeridians, the resulting surface strain was symmetrical about the central cornea, forming an annular pattern of interference fringes. These results indicate that when the cornea was stressed at physiological pressures as part of the intact whole globe, it was less elastic than excised corneal tissue tested by strip extensiometry. Radially incised corneas demonstrated strain patterns suggestive of inherent structural anisotropy with a possible inferior quadrant weakness.

  7. Localized bullous pemphigoid: report of a case with an immunofluorescence and electron microscopical studies on the lesional distribution of 180-KD bullous pemphigoid antigen, beta 4 integrin, and type VII collagen.

    Science.gov (United States)

    Kitajima, Y; Suzuki, M; Johkura, Y; Yaoita, H

    1993-07-01

    A 67-year-old woman with a left-sided hemiplegia had localized bullous pemphigoid demonstrating typical clinical lesions on the left pretibial skin and the radial-side skin of the right forearm. The histology showed a subepidermal blister with extensive hyperkeratosis, hypergranulosis, and acanthosis. Direct immunofluorescence revealed distinct linear deposits of IgG and C3 at the dermo-epidermal junction in the perilesional skin and in the roof of the blisters, but few deposits in nonlesional skin. Electron microscopy revealed separation in the lamina lucida. Indirect immunofluorescence of type VII collagen showed its localization in the blister floor. The distribution of the 180-KD bullous pemphigoid antigen (BPA) and beta 4 integrin, hemidesmosomal transmembrane proteins, were studied in the lesional skin by indirect immunofluorescence. Both 180-KD BPA and beta 4 integrin were localized in the blister roof. By immunoelectron microscopy, beta 4 integrin was detected in small groups on the cell surface facing the blister cavity. Since the epitope of the monoclonal antibody to 180-KD BPA used here is known to be localized at a distance of 20 to 50 nm from the membrane surface and this epitope retained in the blister roof, it appears that the blister was produced in the deep lamina lucida. The lesions were cleared with topical 0.05% clobetasole propionate ointment.

  8. Second harmonic generation imaging of collagen fibrils in cornea and sclera

    Science.gov (United States)

    Han, Meng; Giese, Günter; Bille, Josef F.

    2005-07-01

    Collagen, as the most abundant protein in the human body, determines the unique physiological and optical properties of the connective tissues including cornea and sclera. The ultrastructure of collagen, which conventionally can only be resolved by electron microscopy, now can be probed by optical second harmonic generation (SHG) imaging. SHG imaging revealed that corneal collagen fibrils are regularly packed as a polycrystalline lattice, accounting for the transparency of cornea. In contrast, scleral fibrils possess inhomogeneous, tubelike structures with thin hard shells, maintaining the high stiffness and elasticity of the sclera.

  9. Morphological characterization of keratoconus-affected human corneas by SHG imaging and correlation analysis

    Science.gov (United States)

    Mercatelli, R.; Ratto, F.; Tatini, F.; Rossi, F.; Menabuoni, L.; Nicoletti, R.; Pini, R.; Pavone, Frederick; Cicchi, R.

    2016-03-01

    Keratoconus is an ophthalmic disease in which the cornea acquires an abnormal conical shape that prevents the correct focusing on the retina, causing visual impairment. The late diagnosis of keratoconus is among the principal causes of corneal transplantation surgery. In this study, we characterize the morphology of keratoconic corneas by means of the correlation of SHG images, finding that keratoconus can be diagnosed by analyzing the inclination of lamellae below Bowman's membrane. In addition, imaging performed with both sagittal and "en face" geometry demonstrated that this morphological features can be highlighted both ex vivo and in vivo.

  10. Computer driven optical keratometer and method of evaluating the shape of the cornea

    Science.gov (United States)

    Baroth, Edmund C. (Inventor); Mouneimme, Samih A. (Inventor)

    1994-01-01

    An apparatus and method for measuring the shape of the cornea utilize only one reticle to generate a pattern of rings projected onto the surface of a subject's eye. The reflected pattern is focused onto an imaging device such as a video camera and a computer compares the reflected pattern with a reference pattern stored in the computer's memory. The differences between the reflected and stored patterns are used to calculate the deformation of the cornea which may be useful for pre-and post-operative evaluation of the eye by surgeons.

  11. Bullous pemphigoid and linear IgA dermatosis sera recognize a similar 120-kDa keratinocyte collagenous glycoprotein with antigenic cross-reactivity to BP180

    NARCIS (Netherlands)

    Pas, HH; Kloosterhuis, GJ; Heeres, K; vanderMeer, JB; Jonkman, MF

    1997-01-01

    Circulating IgG from a large subset of bullous pein; phigoid (SP) patients reacted on immunoblot with a 120-kDa protein in conditioned keratinocyte culture medium and in keratinocyte cell extracts, A protein with a similar molecular weight was recognized by circulating IgA from a subset of patients

  12. Techniques for posterior lamellar keratoplasty through a scleral incision

    NARCIS (Netherlands)

    Melles, GRJ; Kamminga, N

    2003-01-01

    Purpose. To describe several techniques for posterior lamellar keratoplasty through a scleral incision, for management of corneal endothelial disorders like pseudophacic bullous keratopathy and Fuchs' endothelial dystrophy, and to report the mid-term clinical results. Methods. Three techniques have

  13. Preliminary results of femtosecond laser-assisted descemet stripping endothelial keratoplasty.

    NARCIS (Netherlands)

    Cheng, Y.Y.; Hendrikse, F.; Pels, E.; Wijdh, R.J.; Cleynenbreugel, H. van; Eggink, C.A.; Rij, G. van; Rijneveld, W.J.; Nuijts, R.M.

    2008-01-01

    OBJECTIVE: To evaluate the preliminary visual results of femtosecond laser-assisted Descemet stripping endothelial keratoplasty (FS-DSEK). METHODS: We prospectively analyzed results of 20 consecutive patients with Fuchs endothelial dystrophy or aphakic/pseudophakic bullous keratopathy who underwent

  14. Model of Mass and Heat Transfer during Vacuum Freeze-Drying for Cornea

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    Zou Huifen

    2012-01-01

    Full Text Available Cornea is the important apparatus of organism, which has complex cell structure. Heat and mass transfer and thermal parameters during vacuum freeze-drying of keeping corneal activity are studied. The freeze-drying cornea experiments were operated in the homemade vacuum freeze dryer. Pressure of the freeze-drying box was about 50 Pa and temperature was about −10°C by controlled, and operating like this could guarantee survival ratio of the corneal endothelium over the grafting normal. Theory analyzing of corneal freeze-drying, mathematical model of describing heat and mass transfer during vacuum freeze-drying of cornea was established. The analogy computation for the freeze-drying of cornea was made by using finite-element computational software. When pressure of the freeze-drying box was about 50 Pa and temperature was about −10°C, time of double-side drying was 170 min. In this paper, a moving-grid finite-element method was used. The sublimation interface was tracked continuously. The finite-element mesh is moved continuously such that the interface position always coincides with an element node. Computational precision was guaranteed. The computational results were agreed with the experimental results. It proved that the mathematical model was reasonable. The finite-element software is adapted for calculating the heat and mass transfer of corneal freeze-drying.

  15. Crosslinked collagen-gelatin-hyaluronic acid biomimetic film for cornea tissue engineering applications

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Yang; Ren, Li, E-mail: psliren@scut.edu.cn; Wang, Yingjun, E-mail: imwangyj@163.com

    2013-01-01

    Cornea disease may lead to blindness and keratoplasty is considered as an effective treatment method. However, there is a severe shortage of donor corneas worldwide. This paper presents the crosslinked collagen (Col)-gelatin (Gel)-hyaluronic acid (HA) films developed by making use of 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide (EDC) and N-hydroxysuccinimide (NHS) as the crosslinker. The test results on the physical and biological properties indicate that the CGH631 film (the mass ratio of Col:Gel:HA = 6:3:1) has appropriate optical performance, hydrophilicity and mechanical properties. The diffusion properties of the CGH631 film to NaCl and tryptophan are also satisfactory and the measured data are 2.43 Multiplication-Sign 10{sup -6} cm{sup 2}/s and 7.97 Multiplication-Sign 10{sup -7} cm{sup 2}/s, respectively. In addition, cell viability studies demonstrate that the CGH631 film has good biocompatibility, on which human corneal epithelial cells attached and proliferated well. This biocompatible film may have potential use in cornea tissue engineering. - Highlights: Black-Right-Pointing-Pointer Crosslinked collagen-gelatin-hyaluronic acid films were fabricated in this study. Black-Right-Pointing-Pointer The film had appropriate physical properties. Black-Right-Pointing-Pointer Diffusion coefficient of the film was comparable with the human cornea. Black-Right-Pointing-Pointer HCEC viability studies confirmed the biocompatibility of the film.

  16. Shape of the anterior cornea : Comparison of height data from 4 corneal topographers

    NARCIS (Netherlands)

    de Jong, Tim; Sheehan, Matthew T.; Dubbelman, Michiel; Koopmans, Steven A.; Jansonius, Nomdo M.

    2013-01-01

    PURPOSE: To compare the ability of clinical corneal topographers to describe the shape of the anterior cornea for optical modeling. SETTING: University Medical Center Groningen, Groningen, Netherlands. DESIGN: Cross-sectional study. METHODS: The anterior corneal shape of healthy subjects was assesse

  17. Spectroscopic measurements and terahertz imaging of the cornea using a rapid scanning terahertz time domain spectrometer

    Science.gov (United States)

    Wen-Quan, Liu; Yuan-Fu, Lu; Guo-Hua, Jiao; Xian-Feng, Chen; Zhi-Sheng, Zhou; Rong-Bin, She; Jin-Ying, Li; Si-Hai, Chen; Yu-Ming, Dong; Jian-Cheng, Lv

    2016-06-01

    Spectroscopic measurements and terahertz imaging of the cornea are carried out by using a rapid scanning terahertz time domain spectroscopy (THz-TDS) system. A voice coil motor stage based optical delay line (VCM-ODL) is developed to provide a rather simple and robust structure with both the high scanning speed and the large delay length. The developed system is used for THz spectroscopic measurements and imaging of the corneal tissue with different amounts of water content, and the measurement results show the consistence with the reported results, in which the measurement time using VCM-ODL is a factor of 360 shorter than the traditional motorized optical delay line (MDL). With reducing the water content a monotonic decrease of the complex permittivity of the cornea is observed. The two-term Debye relaxation model is employed to explain our experimental results, revealing that the fast relaxation time of a dehydrated cornea is much larger than that of a hydrated cornea and its dielectric behavior can be affected by the presence of the biological macromolecules. These results demonstrate that our THz spectrometer may be a promising candidate for tissue hydration sensing and practical application of THz technology. Project supported by the National Natural Science Foundation of China (Grant No. 61205101), the Shenzhen Municipal Research Foundation, China (Grant Nos. GJHZ201404171134305 and JCYJ20140417113130693), and the Marie Curie Actions-International Research Staff Exchange Scheme (IRSES) (Grant No. FP7 PIRSES-2013-612267).

  18. Bacterial cellulose and bacterial cellulose/polycaprolactone composite as tissue substitutes in rabbits' cornea

    Directory of Open Access Journals (Sweden)

    Rodrigo V. Sepúlveda

    Full Text Available ABSTRACT: In order to test the performance of bacterial cellulose/polycaprolactone composite (BC/PCL and pure bacterial cellulose (BC as tissue substitutes in rabbits' cornea, a superficial ulcer containing 5mm in diameter and 0.2mm deep was made in the right cornea of 36 rabbits, then a interlayer pocket was created from the basis of this ulcer. Twelve rabbits received BC/PCL membrane and 12 were treated with BC membranes, both membranes with 8mm in diameter. The remaining rabbits received no membrane constituting the control group. The animals were clinically followed up for 45 days. Three animals of each group were euthanized at three, seven, 21, and 45 days after implantation for histological examination of the cornea along with the implant. Clinical observation revealed signs of moderate inflammatory process, decreasing from day 20th in the implanted groups. Histology showed absence of epithelium on the membranes, fibroplasia close to the implants, lymph inflammatory infiltrate with giant cells, collagen disorganization, with a predominance of immature collagen fibers in both groups with implants. Although inflammatory response is acceptable, the membranes used does not satisfactorily played the role of tissue substitute for the cornea during the study period.

  19. Influx of immunoglobulins from the vascular compartment into a grafted cornea

    NARCIS (Netherlands)

    VanDerVeen, G; Broersma, L; Bruyne, [No Value; Verhagen, C; VanRij, G; VanDerGaag, R; Ruijter, J

    1997-01-01

    Purpose. To determine the effect of a fresh corneal wound or a healed corneal Methods. F344 rats were immunized with human serum albumin (HSA) 1 week before an autologous rotational keratoplasty of the right cornea or 1 year after an autograft was performed. One group of rats also was treated with g

  20. Wavelength-dependent ultraviolet induction of cyclobutane pyrimidine dimers in the human cornea.

    Science.gov (United States)

    Mallet, Justin D; Rochette, Patrick J

    2013-08-01

    Exposition to ultraviolet (UV) light is involved in the initiation and the progression of skin cancer. The genotoxicity of UV light is mainly attributed to the induction of cyclobutane pyrimidine dimers (CPDs), the most abundant DNA damage generated by all UV types (UVA, B and C). The human cornea is also exposed to the harmful UV radiations, but no UV-related neoplasm has been reported in this ocular structure. The probability that a specific DNA damage leads to a mutation and eventually to cellular transformation is influenced by its formation frequency. To shed light on the genotoxic effect of sunlight in the human eye, we have analyzed CPD induction in the cornea and the iris following irradiation of ex vivo human eyes with UVA, B or C. The extent of CPD induction was used to establish the penetrance of the different UV types in the human cornea. We show that UVB- and UVC-induced CPDs are concentrated in the corneal epithelium and do not penetrate deeply beyond this corneal layer. On the other hand, UVA wavelengths penetrate deeper and induce CPDs in the entire cornea and in the first layers of the iris. Taken together, our results are undoubtedly an important step towards better understanding the consequences of UV exposure to the human eye.

  1. Successful treatment of Fusarium keratitis with cornea transplantation and topical and systemic voriconazole.

    NARCIS (Netherlands)

    Klont, R.R.; Eggink, C.A.; Rijs, A.J.M.M.; Wesseling, P.; Verweij, P.E.

    2005-01-01

    A case of invasive Fusarium keratitis in a previously healthy male patient was treated successfully with cornea transplantation and systemic and topical voriconazole after treatment failure with topical amphotericin B and systemic itraconazole. Topical voriconazole was well tolerated, and, in conjun

  2. Pretreatment methods to improve nerve immunostaining in corneas from long-term fixed embryonic quail eyes

    Science.gov (United States)

    Barrett, J. E.; Wells, D. C.; Conrad, G. W.

    1999-01-01

    Pretreatment methods were used to improve neurofilament immunostaining in corneas from embryonic day 16 Japanese quail corneas that had been stored in fixative solution for several months. A sequential combination of the following three pretreatments: brief microwave heating in saline, followed by extraction with sodium dodecyl sulfate (SDS) at 37 degrees C, followed by digestion with hyaluronidase at 37 degrees C, produced significantly increased antibody staining of corneal neurofilament proteins, compared with embryonic corneas subjected to no prior pretreatments or to single or two-step protocols. After applying the sequence of all three pretreatments, darkest nerve staining and increased numbers of fine branches were observed, together with lower background staining. Thus, the result of applying the three-step pretreatment sequence is better than that of applying any of its component single pretreatments or even combinations of any two of them. These findings therefore suggest that each of these three pretreatments causes a unique effect, beneficial to immunostaining of neurofilament proteins, and that their individual effects are independent and additive. In addition to embryonic corneas, the three-step procedure also may be useful for immunostaining of nerves in other very delicate, highly-hydrated tissues containing an abundance of extracellular matrix.

  3. Impression cytology and in vivo confocal microscopy in corneas with total limbal stem cell deficiency

    Directory of Open Access Journals (Sweden)

    Aline Lütz de Araújo

    2013-10-01

    Full Text Available PURPOSES: To describe corneal changes seen on in vivo confocal microscopy in patients with total limbal stem cell deficiency and to correlate them with cytological findings. METHODS: A prospective case series including 13 eyes (8 patients with total limbal deficiency was carried out. Stem cell deficiency was diagnosed clinically and by corneal impression cytology. Confocal images of the central cornea were taken with the Heidelberg Retina Tomograph II, Rostock Corneal Module (Heidelberg Engineering, Heidelberg, Germany. RESULTS: Impression cytology of the cornea revealed conjunctival epithelial cells and goblet cells in all cases. In vivo confocal microscopy showed disruption of normal layers of the corneal epithelium in all eyes. Confocal images showed cells with characteristics of conjunctival epithelium at the cornea in 76.9% of the total. These findings on confocal microscopy were compatible to limbal stem cell deficiency. Additionally, goblet cells, squamous metaplasia, inflammatory cells and dendritic cells were observed. The sub-basal nerve plexus was not identified in any of the corneas. Corneal neovessels were observed at the epithelium and stroma. All cases showed diffuse hyper-reflective images of the stroma corresponding to opacity of the tissue. CONCLUSIONS: Limbal stem cell deficiency had been confirmed by impression cytology in all cases, and 76.9% of the cases could also be diagnosed by in vivo confocal microscopy through the conjunctival epithelial cell visualization on the corneal surface. Frequent confocal microscopy findings were abnormal cells at the cornea (conjunctival epithelial, goblet and inflammatory cells, corneal neovessels and diffuse hyper-reflection of the stroma.

  4. Variable depth thermal lesions in rabbit corneas using a tunable thulium fiber laser

    Science.gov (United States)

    Fried, Nathaniel M.; Noguera, Guillermo; Castro-Combs, Juan; Behrens, Ashley

    2007-02-01

    Laser-induced thermal changes in the cornea have been used clinically for refractive surgery. This study describes the creation of variable depth thermal lesions in the cornea using a tunable Thulium fiber laser. Thermal lesions were created in fresh rabbit corneas, ex vivo, at three different wavelengths (1873 nm, 1890 nm, and 1904 nm) (n=6 corneas each). All other laser parameters were kept fixed with power of 5.5 W, 25-ms exposure time, and 650-μm diameter spot, yielding a single pulse exposure of 138 mJ, and a fluence of 42 J/cm2. Optical coherence tomography (OCT) and histology were used to measure pre- and post-operative corneal thickness and lesion dimensions. OCT measurements of pre and post-operative corneal thickness and lesion depth (in microns) were: (1873 nm: 450+/-30, 801+/-95, 655+/-51), (1890 nm: 460+/-27, 618+/-70, 332+/-56), (1904 nm: 448+20, 550+/-42, 245+36), respectively. By comparison, histologic measurements were: (1873 nm: 470+25, 828+21, 540+/-31), (1890 nm: 457+/-13, 625+/-17, 350+/-43), (1904 nm: 465+/-40, 627+/-35, 239+/-23), respectively. OCT lesion depth measured 82%, 54%, and 45% of corneal thickness, compared to histologic analysis of 65%, 56%, and 38%. This is the first preliminary test of a compact and tunable Thulium fiber laser for creating variable depth thermal lesions in the cornea. The Thulium fiber laser may have potential use as a replacement for the Ho:YAG and diode lasers for thermal keratoplasty.

  5. Simultaneous bilensectomy and endothelial keratoplasty for angle-supported phakic intraocular lens-induced corneal decompensation

    Directory of Open Access Journals (Sweden)

    Vikas Mittal

    2011-01-01

    Full Text Available A 40-year-old lady presented with severe endothelial cell loss in both eyes 14 years after angle-supported phakic intraocular lens (AS PIOL implantation. The left eye had severe corneal edema with bullous keratopathy. The right eye had markedly reduced endothelial cell count (655 cells/mm 2 although the cornea was clear. She underwent simultaneous bilensectomy (AS PIOL explantation and phacoemulsification and Descemet′s stripping and endothelial keratoplasty (DSEK in the left eye. Explanted AS PIOL was identified as ZSAL-4 (Morcher, Stuttgart, Germany model. Corneal edema cleared completely in 2 months with a best corrected visual acuity (-2.25 D sph of 20/60. No intervention was done in the right eye. The present case illustrates that AS PIOL-induced endothelial decompensation can be effectively managed by simultaneous bilensectomy and endothelial keratoplasty.

  6. Toxic Anterior Segment Syndrome following Phacoemulsification Secondary to Overdose of Intracameral Gentamicin

    Directory of Open Access Journals (Sweden)

    Yaran Koban

    2014-01-01

    Full Text Available Objective. To report a case of toxic anterior segment syndrome (TASS that was caused by inadvertent anterior chamber and cornea stromal injection with high dose gentamicin following cataract surgery. Methods. Case report. Results. We report a 72-year-old female patient who developed TASS that was caused by high dose gentamicin (20 mg/0.5 mL, which was inadvertently used during the formation of the anterior chamber and hydration of the corneal incision. Unlike previous cases, hyphema and hemorrhagic fibrinous reaction were seen in the anterior chamber. Despite treatment, bullous keratopathy developed and penetrating keratoplasty was performed. The excised corneal button was sent for histopathological examination. Conclusions. Subconjunctival gentamicin is highly toxic to the corneal endothelium and anterior chamber structures. Including it on the surgical table carries a potentially serious risk for contamination of the anterior chamber.

  7. Toxic Anterior Segment Syndrome following Phacoemulsification Secondary to Overdose of Intracameral Gentamicin

    Science.gov (United States)

    Koban, Yaran; Genc, Selim; Cagatay, Halil Huseyin; Ekinci, Metin; Gecer, Melin; Yazar, Zeliha

    2014-01-01

    Objective. To report a case of toxic anterior segment syndrome (TASS) that was caused by inadvertent anterior chamber and cornea stromal injection with high dose gentamicin following cataract surgery. Methods. Case report. Results. We report a 72-year-old female patient who developed TASS that was caused by high dose gentamicin (20 mg/0.5 mL), which was inadvertently used during the formation of the anterior chamber and hydration of the corneal incision. Unlike previous cases, hyphema and hemorrhagic fibrinous reaction were seen in the anterior chamber. Despite treatment, bullous keratopathy developed and penetrating keratoplasty was performed. The excised corneal button was sent for histopathological examination. Conclusions. Subconjunctival gentamicin is highly toxic to the corneal endothelium and anterior chamber structures. Including it on the surgical table carries a potentially serious risk for contamination of the anterior chamber. PMID:25574173

  8. Harnessing of corneas captured and processed for transplantation in an ocular tissue bank of North-eastern Brazil

    Directory of Open Access Journals (Sweden)

    Izaura Luzia Silvério Freire

    Full Text Available The aim of this study was to describe the harnessing of corneas captured and processed for transplantation in an ocular tissue bank in north-eastern Brazil. This was a transverse and retrospective study, with a sample group of 612 individuals whose corneas were donated and captured between January/2007 and July/2012. This study was approved by the Research Ethics Committee under number 007.0.294.000-10, and research was based on an instrument consisting of social, demographic and clinical data of the donors. Of the 1209 corneas captured, 868 were used and 341 were discarded. Of the 612 donors, the corneas of 597 (97.5% were captured from both eyes, being that 423 (70.9% of these corneas were used. Further studies are required on the reasons for discarding corneas and clarifications as to the conduct of professionals when processing corneas, considering the increase in the quantity of donors and the elevated number of discarded ocular tissue.

  9. Differential expression and processing of transforming growth factor beta induced protein (TGFBIp) in the normal human cornea during postnatal development and aging

    DEFF Research Database (Denmark)

    Karring, Henrik; Runager, Kasper; Valnickova, Zuzana

    2010-01-01

    Transforming growth factor beta induced protein (TGFBIp, also named keratoepithelin) is an extracellular matrix protein abundant in the cornea. The purpose of this study was to determine the expression and processing of TGFBIp in the normal human cornea during postnatal development and aging....... TGFBIp in corneas from individuals ranging from six months to 86 years of age was detected and quantified by immunoblotting. The level of TGFBIp in the cornea increases about 30% between 6 and 14 years of age, and adult corneas contain 0.7-0.8 microg TGFBIp per mg wet tissue. Two-dimensional (2-D...... of corneal TGFBIp suggests that TGFBIp may play a role in the postnatal development and maturation of the cornea. Furthermore, these observations may be relevant to the age at which mutant TGFBIp deposits in the cornea in those dystrophies caused by mutations in the transforming growth factor beta induced...

  10. Measurement of quantitative viscoelasticity of bovine corneas based on lamb wave dispersion properties.

    Science.gov (United States)

    Zhang, Xinyu; Yin, Yin; Guo, Yanrong; Fan, Ning; Lin, Haoming; Liu, Fulong; Diao, Xianfen; Dong, Changfeng; Chen, Xin; Wang, Tianfu; Chen, Siping

    2015-05-01

    The viscoelastic properties of the human cornea can provide valuable information for clinical applications such as the early detection of corneal diseases, better management of corneal surgery and treatment and more accurate measurement of intra-ocular pressure. However, few techniques are capable of quantitatively and non-destructively assessing corneal biomechanics in vivo. The cornea can be regarded as a thin plate in which the vibration induced by an external vibrator propagates as a Lamb wave, the properties of which depend on the thickness and biomechanics of the tissue. In this study, pulses of ultrasound radiation force with a repetition frequency of 100 or 200 Hz were applied to the apex of corneas, and the linear-array transducer of a SonixRP system was used to track the tissue motion in the radial direction. Shear elasticity and viscosity were estimated from the phase velocities of the A0 Lamb waves. To assess the effectiveness of the method, some of the corneas were subjected to collagen cross-linking treatment, and the changes in mechanical properties were validated with a tensile test. The results indicated that the shear modulus was 137 ± 37 kPa and the shear viscosity was 3.01 ± 2.45 mPa · s for the group of untreated corneas and 1145 ± 267 kPa and was 0.16 ± 0.11 mPa · s for the treated group, respectively, implying a significant increase in elasticity and a significant decrease in viscosity after collagen cross-linking treatment. This result is in agreement with the results of the mechanical tensile test and with reports in the literature. This initial investigation illustrated the ability of this ultrasound-based method, which uses the velocity dispersion of low-frequency A0 Lamb waves, to quantitatively assess both the elasticity and viscosity of corneas. Future studies could discover ways to optimize this system and to determine the feasibility of using this method in clinical situations.

  11. Characterizing the effects of VPA, VC and RCCS on rabbit keratocytes onto decellularized bovine cornea.

    Directory of Open Access Journals (Sweden)

    Ying Dai

    Full Text Available To investigate the morphological and growth characteristics of rabbit keratocytes when cultured on decellularized cornea under simulate microgravity (SMG rotary cell culture system (RCCS and static culture or in plastic culture supplemented with small molecules of valproic acid (VPA and vitamin C (VC. Bovine corneas were firstly decellularized with Triton X-100 and NH(4OH and through short-term freezing process. Then cell count kit-8 (CCK-8 and flow cytometry were used to test the effects of VPA and VC on the proliferation, cell cycle and apoptosis of rabbit keratocytes. Hematoxylin-eosin (H&E staining and scanning electron microscopy (SEM imaging showed that cells were eliminated in the decellularized bovine corneas. The proliferation of cultured keratocytes was promoted by VPA and VC in the cell proliferation assay. VPA and VC moderately decreased the number of apoptotic cells and obviously promoted cell-cycle entrance of keratocytes. Rabbit keratocytes in plastic displayed spindle shape and rare interconnected with or without VPA and VC. Cells revealed dendritic morphology and reticular cellular connections when cultured on the carriers of decellularized corneas supplemented with VPA and VC even in the presence of 10% fetal bovine serum (FBS. When cultured in RCCS supplemented with VPA, VC and 10% FBS, keratocytes displayed round shape with many prominences and were more prone to grow into the pores of carriers with aggregation. Reverse transcription-polymerase chain reaction (RT-PCR analysis proved that the keratocytes cultured on decellularized bovine cornea under SMG with VPA and VC expressed keratocan and lumican. Keratocytes cultured on plastic expressed lumican but not keratocan. Immunofluorescence identification revealed that cells in all groups were positively immunostained for vimentin. Keratocytes on decellularized bovine cornea under SMG or in static culture were positively immunostained for keratocan and lumican. Thus, we

  12. Investigation of the influence of riboflavin-UV induced crosslinking on the cornea in the experiment

    Directory of Open Access Journals (Sweden)

    S. I. Anisimov

    2012-01-01

    Full Text Available Purpose: Morphological examination of the efficiency of the influence of various doses of riboflavin-UV induced crosslinking on the state of the corneal stroma in experimental animals.Methods: In the work were used rabbits males breed Chinchilla mass of 1.5-2.0 kg. the experiment was conducted on 20 eyes of 10 animals, which performed the routine crosslinking. Experimental animals, depending on the power UV-laser irradiation, were divided into 4 groups: the animals of the 1 group with the minimum intensity of radiation (30 minutes, 0.27 J, animals 2 group with medium intensity of radiation (15 minutes, 0.34 J, animals 3 groups with high intensity of radiation (30 minutes, 0.34 J, the control group 4 (without UV-radiation. Date of dynamic observation of the experimental animals was 5 days, after which the animals were taken out of the experiment. Morphological investigations were carried out by means of light and electron microscopy.Results: In groups of experimental animals with the impact of riboflavin UV-radiation in the stroma of the cornea were found the appearance of the areas of cross-stitched collagen fibers and fibrils. In the zone of the crosslinking were found activated keratoblasts.Near the membranes of these cells the contents of the vacuoles are released and filaments finish building of the collagen fibers. the epithelium of the corneas of all experimental animals recovered fully, with no morphological signs of endothelial damage has been found. Electron-microscopic investigation of stroma of corneas of the experimental animals of the control group after the experiment showed the presence of keratocytes in an inactive form and collagen fibers of stroma, packed in the form of plates or beams with a characteristic orientation.Conclusion: Studies have shown that UV-irradiation of the cornea leads to the appearance of linking between the fibers of collagen and actively synthesizing cells in the stroma of the cornea, which points to a

  13. Investigation of the influence of riboflavin-UV induced crosslinking on the cornea in the experiment

    Directory of Open Access Journals (Sweden)

    S. I. Anisimov

    2014-07-01

    Full Text Available Purpose: Morphological examination of the efficiency of the influence of various doses of riboflavin-UV induced crosslinking on the state of the corneal stroma in experimental animals.Methods: In the work were used rabbits males breed Chinchilla mass of 1.5-2.0 kg. the experiment was conducted on 20 eyes of 10 animals, which performed the routine crosslinking. Experimental animals, depending on the power UV-laser irradiation, were divided into 4 groups: the animals of the 1 group with the minimum intensity of radiation (30 minutes, 0.27 J, animals 2 group with medium intensity of radiation (15 minutes, 0.34 J, animals 3 groups with high intensity of radiation (30 minutes, 0.34 J, the control group 4 (without UV-radiation. Date of dynamic observation of the experimental animals was 5 days, after which the animals were taken out of the experiment. Morphological investigations were carried out by means of light and electron microscopy.Results: In groups of experimental animals with the impact of riboflavin UV-radiation in the stroma of the cornea were found the appearance of the areas of cross-stitched collagen fibers and fibrils. In the zone of the crosslinking were found activated keratoblasts.Near the membranes of these cells the contents of the vacuoles are released and filaments finish building of the collagen fibers. the epithelium of the corneas of all experimental animals recovered fully, with no morphological signs of endothelial damage has been found. Electron-microscopic investigation of stroma of corneas of the experimental animals of the control group after the experiment showed the presence of keratocytes in an inactive form and collagen fibers of stroma, packed in the form of plates or beams with a characteristic orientation.Conclusion: Studies have shown that UV-irradiation of the cornea leads to the appearance of linking between the fibers of collagen and actively synthesizing cells in the stroma of the cornea, which points to a

  14. Efficacious and safe tissue-selective controlled gene therapy approaches for the cornea.

    Science.gov (United States)

    Mohan, Rajiv R; Sinha, Sunilima; Tandon, Ashish; Gupta, Rangan; Tovey, Jonathan C K; Sharma, Ajay

    2011-04-12

    Untargeted and uncontrolled gene delivery is a major cause of gene therapy failure. This study aimed to define efficient and safe tissue-selective targeted gene therapy approaches for delivering genes into keratocytes of the cornea in vivo using a normal or diseased rabbit model. New Zealand White rabbits, adeno-associated virus serotype 5 (AAV5), and a minimally invasive hair-dryer based vector-delivery technique were used. Fifty microliters of AAV5 titer (6.5×10(12) vg/ml) expressing green fluorescent protein gene (GFP) was topically applied onto normal or diseased (fibrotic or neovascularized) rabbit corneas for 2-minutes with a custom vector-delivery technique. Corneal fibrosis and neovascularization in rabbit eyes were induced with photorefractive keratectomy using excimer laser and VEGF (630 ng) using micropocket assay, respectively. Slit-lamp biomicroscopy and immunocytochemistry were used to confirm fibrosis and neovascularization in rabbit corneas. The levels, location and duration of delivered-GFP gene expression in the rabbit stroma were measured with immunocytochemistry and/or western blotting. Slot-blot measured delivered-GFP gene copy number. Confocal microscopy performed in whole-mounts of cornea and thick corneal sections determined geometric and spatial localization of delivered-GFP in three-dimensional arrangement. AAV5 toxicity and safety were evaluated with clinical eye exam, stereomicroscopy, slit-lamp biomicroscopy, and H&E staining. A single 2-minute AAV5 topical application via custom delivery-technique efficiently and selectively transduced keratocytes in the anterior stroma of normal and diseased rabbit corneas as evident from immunocytochemistry and confocal microscopy. Transgene expression was first detected at day 3, peaked at day 7, and was maintained up to 16 weeks (longest tested time point). Clinical and slit-lamp eye examination in live rabbits and H&E staining did not reveal any significant changes between AAV5-treated and

  15. Efficacious and safe tissue-selective controlled gene therapy approaches for the cornea.

    Directory of Open Access Journals (Sweden)

    Rajiv R Mohan

    Full Text Available Untargeted and uncontrolled gene delivery is a major cause of gene therapy failure. This study aimed to define efficient and safe tissue-selective targeted gene therapy approaches for delivering genes into keratocytes of the cornea in vivo using a normal or diseased rabbit model. New Zealand White rabbits, adeno-associated virus serotype 5 (AAV5, and a minimally invasive hair-dryer based vector-delivery technique were used. Fifty microliters of AAV5 titer (6.5×10(12 vg/ml expressing green fluorescent protein gene (GFP was topically applied onto normal or diseased (fibrotic or neovascularized rabbit corneas for 2-minutes with a custom vector-delivery technique. Corneal fibrosis and neovascularization in rabbit eyes were induced with photorefractive keratectomy using excimer laser and VEGF (630 ng using micropocket assay, respectively. Slit-lamp biomicroscopy and immunocytochemistry were used to confirm fibrosis and neovascularization in rabbit corneas. The levels, location and duration of delivered-GFP gene expression in the rabbit stroma were measured with immunocytochemistry and/or western blotting. Slot-blot measured delivered-GFP gene copy number. Confocal microscopy performed in whole-mounts of cornea and thick corneal sections determined geometric and spatial localization of delivered-GFP in three-dimensional arrangement. AAV5 toxicity and safety were evaluated with clinical eye exam, stereomicroscopy, slit-lamp biomicroscopy, and H&E staining. A single 2-minute AAV5 topical application via custom delivery-technique efficiently and selectively transduced keratocytes in the anterior stroma of normal and diseased rabbit corneas as evident from immunocytochemistry and confocal microscopy. Transgene expression was first detected at day 3, peaked at day 7, and was maintained up to 16 weeks (longest tested time point. Clinical and slit-lamp eye examination in live rabbits and H&E staining did not reveal any significant changes between AAV5

  16. Sensitivity and rapidity of blood culture bottles in the detection of cornea organ culture media contamination by bacteria and fungi

    OpenAIRE

    Thuret, G; Carricajo, A.; Chiquet, C.; Vautrin, A C; Celle, N; Boureille, M; Acquart, S; Aubert, G.; Maugery, J; Gain, P.

    2002-01-01

    Aims: To test the bactericidal activity of standard organ culture medium, and to compare the sensitivity and rapidity of blood culture bottles with conventional microbiological methods for detection of bacteria and fungi inoculated in a standard cornea organ culture medium.

  17. Physicochemical properties of biodegradable polyvinyl alcohol-agar films from the red algae Hydropuntia cornea.

    Science.gov (United States)

    Madera-Santana, Tomás J; Robledo, Daniel; Freile-Pelegrín, Yolanda

    2011-08-01

    Agar obtained from the red alga Hydropuntia cornea was blended with polyvinyl alcohol (PVOH) in order to produce biodegradable films. In this study, we compare the properties of biopolymeric films formulated with agars extracted from H. cornea collected at different seasons (rainy and dry) in the Gulf of Mexico coast and PVOH as synthetic matrix. The films were prepared at different agar contents (0%, 25%, 50%, 75%, and 100%) and their optical, mechanical, thermal, and morphological properties analyzed. The tensile strength of PVOH-agar films increased when agar content was augmented. The formulation with 50% agar from rainy season (RS) had a significant higher tensile strength when compared to those from dry season (DS; p biodegradable packaging industry.

  18. Tectonic deep anterior lamellar keratoplasty in impending corneal perforation using cryopreserved cornea.

    Science.gov (United States)

    Jang, Ji Hye; Chang, Sung Dong

    2011-04-01

    We report a case of tectonic corneal transplantation for impending corneal perforation to preserve anatomic integrity using cryopreserved donor tissue. An 82-year-old woman exhibiting impending corneal perforation suffered from moderate ocular pain in the left eye for one week. After abnormal tissues around the impending perforation area were carefully peeled away using a Crescent blade and Vannas scissors, the patient received tectonic deep anterior lamellar keratoplasty using a cryopreserved cornea stored in Optisol GS® solution at -70℃ for four weeks. At six months after surgery, the cornea remained transparent and restored the normal corneal thickness. There were no complications such as corneal haze or scars, graft rejection, recurrent corneal ulcer, and postoperative rise of intraocular pressure. Cryopreserved donor lamellar tissue is an effective substitute in emergency tectonic lamellar keratoplasty, such as impending corneal perforation and severe necrotic corneal keratitis.

  19. A new optical system for 3-dimensional mapping of the cornea

    Science.gov (United States)

    Franco, Sandra; Almeida, José B.

    2007-07-01

    In this work the authors present an optical corneal tomographer that uses two Scheimpflug cameras attached to an innovative illumination system that allows a rotary scanning of the entire cornea. The measurements are made from corneal optical sections obtained by illumination with a collimated beam expanded in a fan by a small cylindrical lens. This lens is provided with motor driven rotation in order to perform automated rotary scan of the whole cornea. The authors expect to achieve a scanning speed that will allow producing complete tomography maps without consideration of eye movements. Two Scheimpflug cameras are used to capture the images of the optical sections. With this system it is possible to obtain 3-D representation of the corneal thickness as well as corneal topography. Maps of the corneal thickness and elevation maps are shown. As Scheimpflug cameras are used, it is expected to obtained data from the lens too.

  20. Collagens and proteoglycans of the cornea: importance in transparency and visual disorders.

    Science.gov (United States)

    Massoudi, Dawiyat; Malecaze, Francois; Galiacy, Stephane D

    2016-02-01

    The cornea represents the external part of the eye and consists of an epithelium, a stroma and an endothelium. Due to its curvature and transparency this structure makes up approximately 70% of the total refractive power of the eye. This function is partly made possible by the particular organization of the collagen extracellular matrix contained in the corneal stroma that allows a constant refractive power. The maintenance of such an organization involves other molecules such as type V collagen, FACITs (fibril-associated collagens with interrupted triple helices) and SLRPs (small leucine-rich proteoglycans). These components play crucial roles in the preservation of the correct organization and function of the cornea since their absence or modification leads to abnormalities such as corneal opacities. Thus, the aim of this review is to describe the different corneal collagens and proteoglycans by highlighting their importance in corneal transparency as well as their implication in corneal visual disorders.

  1. New insight into the shortening of the collagen fibril D-period in human cornea.

    Science.gov (United States)

    Jastrzebska, Maria; Tarnawska, Dorota; Wrzalik, Roman; Chrobak, Artur; Grelowski, Michal; Wylegala, Edward; Zygadlo, Dorota; Ratuszna, Alicja

    2017-02-01

    Collagen fibrils type I display a typical banding pattern, so-called D-periodicity, of about 67 nm, when visualized by atomic force or electron microscopy imaging. Herein we report on a significant shortening of the D-period for human corneal collagen fibrils type I (21 ± 4 nm) upon air-drying, whereas no changes in the D-period were observed for human scleral collagen fibrils type I (64 ± 4 nm) measured under the same experimental conditions as the cornea. It was also found that for the corneal stroma fixed with glutaraldehyde and air-dried, the collagen fibrils show the commonly accepted D-period of 61 ± 8 nm. We used the atomic force microscopy method to image collagen fibrils type I present in the middle layers of human cornea and sclera. The water content in the cornea and sclera samples was varying in the range of .066-.085. Calculations of the D-period using the theoretical model of the fibril and the FFT approach allowed to reveal the possible molecular mechanism of the D-period shortening in the corneal collagen fibrils upon drying. It was found that both the decrease in the shift and the simultaneous reduction in the distance between tropocollagen molecules can be responsible for the experimentally observed effect. We also hypothesize that collagen type V, which co-assembles with collagen type I into heterotypic fibrils in cornea, could be involved in the observed shortening of the corneal D-period.

  2. Demonstration of cornea Dua's layer at a deep anterior lamellar keratoplasty surgery

    OpenAIRE

    Yusuf Kocluk; Ayse Burcu; Emine Alyamac Sukgen

    2016-01-01

    The authors aimed to present a deep anterior lamellar keratoplasty (DALK) surgery case with mixed type bubble demonstrating Dua′s layer (DL). This was a reported case of DALK surgery. The authors encountered cornea DL structure at DALK surgery while cleaning the remaining stromal pieces. We also observed perforation in the central part of DL. However, DALK surgery could be completed. It is possible to encounter DL in a DALK surgery performed with mixed type big-bubble.

  3. Demonstration of cornea Dua′s layer at a deep anterior lamellar keratoplasty surgery

    Directory of Open Access Journals (Sweden)

    Yusuf Kocluk

    2016-01-01

    Full Text Available The authors aimed to present a deep anterior lamellar keratoplasty (DALK surgery case with mixed type bubble demonstrating Dua′s layer (DL. This was a reported case of DALK surgery. The authors encountered cornea DL structure at DALK surgery while cleaning the remaining stromal pieces. We also observed perforation in the central part of DL. However, DALK surgery could be completed. It is possible to encounter DL in a DALK surgery performed with mixed type big-bubble.

  4. Pathogenic strains of Acanthamoeba are recognized by TLR4 and initiated inflammatory responses in the cornea.

    Directory of Open Access Journals (Sweden)

    Hassan Alizadeh

    Full Text Available Free-living amoebae of the Acanthamoeba species are the causative agent of Acanthamoeba keratitis (AK, a sight-threatening corneal infection that causes severe pain and a characteristic ring-shaped corneal infiltrate. Innate immune responses play an important role in resistance against AK. The aim of this study is to determine if Toll-like receptors (TLRs on corneal epithelial cells are activated by Acanthamoeba, leading to initiation of inflammatory responses in the cornea. Human corneal epithelial (HCE cells constitutively expressed TLR1, TLR2, TLR3, TLR4, and TLR9 mRNA, and A. castellanii upregulated TLR4 transcription. Expression of TLR1, TLR2, TLR3, and TLR9 was unchanged when HCE cells were exposed to A. castellanii. IL-8 mRNA expression was upregulated in HCE cells exposed to A. castellanii. A. castellanii and lipopolysaccharide (LPS induced significant IL-8 production by HCE cells as measured by ELISA. The percentage of total cells positive for TLR4 was higher in A. castellanii stimulated HCE cells compared to unstimulated HCE cells. A. castellanii induced upregulation of IL-8 in TLR4 expressing human embryonic kidney (HEK-293 cells, but not TLR3 expressing HEK-293 cells. TLR4 neutralizing antibody inhibited A. castellanii-induced IL-8 by HCE and HEK-293 cells. Clinical strains but not soil strains of Acanthamoeba activated TLR4 expression in Chinese hamster corneas in vivo and in vitro. Clinical isolates but not soil isolates of Acanthamoeba induced significant (P< 0.05 CXCL2 production in Chinese hamster corneas 3 and 7 days after infection, which coincided with increased inflammatory cells in the corneas. Results suggest that pathogenic species of Acanthamoeba activate TLR4 and induce production of CXCL2 in the Chinese hamster model of AK. TLR4 may be a potential target in the development of novel treatment strategies in Acanthamoeba and other microbial infections that activate TLR4 in corneal cells.

  5. Atmospheric-Pressure Cold Plasma Induces Transcriptional Changes in Ex Vivo Human Corneas.

    Directory of Open Access Journals (Sweden)

    Umberto Rosani

    Full Text Available Atmospheric pressure cold plasma (APCP might be considered a novel tool for tissue disinfection in medicine since the active chemical species produced by low plasma doses, generated by ionizing helium gas in air, induces reactive oxygen species (ROS that kill microorganisms without substantially affecting human cells.In this study, we evaluated morphological and functional changes in human corneas exposed for 2 minutes (min to APCP and tested if the antioxidant n-acetyl l-cysteine (NAC was able to inhibit or prevent damage and cell death.Immunohistochemistry and western blotting analyses of corneal tissues collected at 6 hours (h post-APCP treatment demonstrated no morphological tissue changes, but a transient increased expression of OGG1 glycosylase that returned to control levels in 24 h. Transcriptome sequencing and quantitative real time PCR performed on different corneas revealed in the treated corneas many differentially expressed genes: namely, 256 and 304 genes showing expression changes greater than ± 2 folds in the absence and presence of NAC, respectively. At 6 h post-treatment, the most over-expressed gene categories suggested an active or enhanced cell functioning, with only a minority of genes specifically concerning oxidative DNA damage and repair showing slight over-expression values (<2 folds. Moreover, time-related expression analysis of eight genes up-regulated in the APCP-treated corneas overall demonstrated the return to control expression levels after 24 h.These findings of transient oxidative stress accompanied by wide-range transcriptome adjustments support the further development of APCP as an ocular disinfectant.

  6. Synthesis of type III collagen by fibroblasts from the embryonic chick cornea

    OpenAIRE

    1980-01-01

    Synthesis of collagen types I, II, III, and IV in cells from the embryonic chick cornea was studied using specific antibodies and immunofluorescence. Synthesis of radioactively labeled collagen types I and III was followed by fluorographic detection of cyanogen bromide peptides on polyacrylamide slab gels and by carboxymethylcellulose chromatography followed by disc gel electrophoresis. Type III collagen had been detected previously by indirect immunofluorescence in the corneal epithelial cel...

  7. Inflammation Modulatory Protein TSG-6 for Chemical Injuries to the Cornea

    Science.gov (United States)

    2015-10-01

    protein TNF -stimulating gene 6 (TSG-6). TSG-6 may modulate the excessive inflammatory response that exacerbates the injury to the cornea caused by...period. The inflammatory response as measured by biochemical markers correlated with concentration of NAOH applied and began within 2 hours of injury...Goal – Establish the appropriate conditions for testing TSG-6 Determine timing and patterns of cellular and cytokine inflammatory responses as a

  8. Proteoglycan biosynthesis by human corneas from patients with types 1 and 2 macular corneal dystrophy

    Energy Technology Data Exchange (ETDEWEB)

    Midura, R.J.; Hascall, V.C.; MacCallum, D.K.; Meyer, R.F.; Thonar, E.J.; Hassell, J.R.; Smith, C.F.; Klintworth, G.K. (National Institute of Dental Research, Bethesda, MD (USA))

    1990-09-15

    Corneal buttons were obtained from patients with types 1 and 2 macular corneal dystrophy (MCD) and from control patients with Fuchs' dystrophy or keratoconus. Buttons were incubated for 20 h in the presence of (3H)glucosamine or (2-3H)mannose. Radiolabeled proteoglycans and lactosaminoglycan-glycoproteins (L-GPs) were purified using chromatography on Q-Sepharose, Superose 6, and octyl-Sepharose. They were identified using chondroitinase ABC, keratanase or endo-beta-galactosidase digestion, and sodium dodecyl sulfate-polyacrylamide gel electrophoresis or Superose 6 chromatography. This study confirms previous reports that type 1 MCD corneas synthesize a normal dermatan sulfate-proteoglycan (DS-PG) and an abnormal keratan sulfate-proteoglycan (KS-PG). The data indicate that typ 1 MCD corneas synthesize L-GP instead of KS-PG. This L-GP has a core protein of similar hydrophobicity (elution from octyl-Sepharose) and nearly similar mass (42 kDa) as the core protein of the KS-PG. It has identical glycoconjugates as those of the KS-PG except that they lack sulfate. Thus, type 1 MCD fails to synthesize keratan sulfate as a result of a defect in a sulfotransferase specific for sulfating lactosaminoglycans. Further, proteoglycans synthesized by a cornea from a patient with type 2 MCD were studied. This cornea synthesized a normal ratio of KS-PG to DS-PG although net synthesis of proteoglycans was approximately 30% below normal. The KS-PG appeared normal whereas the DS-PG had dermatan sulfate chains that were approximately 40% shorter than normal.

  9. A Cornea Substitute Derived from Fish Scale: 6-Month Followup on Rabbit Model

    OpenAIRE

    Fei Yuan; Liyan Wang; Chien-Chen Lin; Cheng-Hung Chou; Lei Li

    2014-01-01

    A fish scale-derived cornea substitute (Biocornea) is proposed as an alternative for human donor corneal tissue. We adopt a regenerative medicine approach to design a primary alternative to the use of fish scale for restoring sight by corneal replacement. Biocornea with corneal multilayer arrangement collagen was implanted to rabbits by pocket implantation. Our study demonstrated the safety and detailed morphologic and physiologic results from the 6 months of followup of rabbit model. In the ...

  10. Piperacillin-tazobactam-induced linear IgA bullous dermatosis presenting clinically as Stevens-Johnson syndrome/toxic epidermal necrolysis overlap.

    Science.gov (United States)

    Adler, N R; McLean, C A; Aung, A K; Goh, M S Y

    2017-04-01

    Linear IgA bullous dermatosis (LABD) is a subepidermal autoimmune bullous disease characterized by linear IgA deposition at the basement membrane zone, which is visualized by direct immunofluorescence. Patients with LABD typically present with widespread vesicles and bullae; however, this is not necessarily the case, as the clinical presentation of this disease is heterogeneous. LABD clinically presenting as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) is an infrequent, yet well-described phenomenon. Most cases of LABD are idiopathic, but some cases are drug-induced. Multiple drugs have been implicated in the development of LABD. We report a case of piperacillin-tazobactam-induced LABD presenting clinically as SJS/TEN overlap. This is the first reported case of a strong causal association between piperacillin-tazobactam and the development of LABD.

  11. A case of vancomycin-associated linear IgA bullous dermatosis and IgA antibodies to the α3 subunit of laminin-332.

    Science.gov (United States)

    Zenke, Y; Nakano, T; Eto, H; Koga, H; Hashimoto, T

    2014-04-01

    Linear IgA bullous dermatosis (LABD) is a rare autoimmune bullous disease, which is defined by the histopathological finding of subepidermal vesicles with neutrophilic infiltration and linear IgA deposits in the basement membrane zone, revealed by immunofluorescence study. We present a case of LABD in which vancomycin (VCM) administration triggered LABD, and immunoblot analysis showed IgA antibodies reactive to the 145- and 165-kDa α3 subunits of laminin-332. This is the first report of VCM-associated LABD in which the target antigen was laminin-332. In the present case, we were compelled to continue administration of VCM along with systemic steroids, which eventually led to the attenuation of the symptoms, normalization of the serum IgA level, and negative results on both indirect immunofluorescence of 1 mol L(-1) NaCl-split skin and immunoblot analysis.

  12. Fractal analysis of AFM images of the surface of Bowman's membrane of the human cornea.

    Science.gov (United States)

    Ţălu, Ştefan; Stach, Sebastian; Sueiras, Vivian; Ziebarth, Noël Marysa

    2015-04-01

    The objective of this study is to further investigate the ultrastructural details of the surface of Bowman's membrane of the human cornea, using atomic force microscopy (AFM) images. One representative image acquired of Bowman's membrane of a human cornea was investigated. The three-dimensional (3-D) surface of the sample was imaged using AFM in contact mode, while the sample was completely submerged in optisol solution. Height and deflection images were acquired at multiple scan lengths using the MFP-3D AFM system software (Asylum Research, Santa Barbara, CA), based in IGOR Pro (WaveMetrics, Lake Oswego, OR). A novel approach, based on computational algorithms for fractal analysis of surfaces applied for AFM data, was utilized to analyze the surface structure. The surfaces revealed a fractal structure at the nanometer scale. The fractal dimension, D, provided quantitative values that characterize the scale properties of surface geometry. Detailed characterization of the surface topography was obtained using statistical parameters, in accordance with ISO 25178-2: 2012. Results obtained by fractal analysis confirm the relationship between the value of the fractal dimension and the statistical surface roughness parameters. The surface structure of Bowman's membrane of the human cornea is complex. The analyzed AFM images confirm a fractal nature of the surface, which is not taken into account by classical surface statistical parameters. Surface fractal dimension could be useful in ophthalmology to quantify corneal architectural changes associated with different disease states to further our understanding of disease evolution.

  13. Temperature limitation may explain the containment of the trophozoites in the cornea during Acanthamoeba castellanii keratitis.

    Science.gov (United States)

    Nielsen, Mattias Kiel; Nielsen, Kim; Hjortdal, Jesper; Sørensen, Uffe B Skov

    2014-12-01

    Acanthamoeba keratitis is a serious sight-threatening disease. The relatively low temperature of the cornea may explain why amoebic infections usually are localized in this tissue and rarely spread to other parts of the eye. In this study, the growth rate of the amoeba Acanthamoeba castellanii was examined at different temperatures. The aim was to establish the optimal growth temperature for A. castellanii and to examine the growth within the vicinity of the core body temperature. The growth rates of four clinical and two environmental strains of A. castellanii were estimated at different temperatures, and temperature limitations for the trophozoite stage was established. Movements influenced by temperature gradients were monitored for two clinical strains of A. castellanii. The highest growth rate for each of the six amoebic strains tested was found to be close to 32 °C. The growth of the trophozoites of all examined strains was greatly reduced or completely halted at temperatures above 36 °C and encysted at the elevated temperature. Thus, the optimal growth temperature for the four strains of A. castellanii is close to the surface temperature of the human cornea, while the higher body core-temperature induced encysting of the amoebae. This may explain why most amoebic eye infections are confined to the cornea.

  14. Safety of cornea and iris in ocular surgery with 355-nm lasers.

    Science.gov (United States)

    Wang, Jenny; Chung, Jae Lim; Schuele, Georg; Vankov, Alexander; Dalal, Roopa; Wiltberger, Michael; Palanker, Daniel

    2015-09-01

    A recent study showed that 355-nm nanosecond lasers cut cornea with similar precision to infrared femtosecond lasers. However, use of ultraviolet wavelength requires precise assessment of ocular safety to determine the range of possible ophthalmic applications. In this study, the 355-nm nanosecond laser was evaluated for corneal and iris damage in rabbit, porcine, and human donor eyes as determined by minimum visible lesion (MVL) observation, live/dead staining of the endothelium, and apoptosis assay. Single-pulse damage to the iris was evaluated on porcine eyes using live/dead staining. In live rabbits, the cumulative median effective dose (ED50) for corneal damage was 231 J/cm2, as seen by lesion observation. Appearance of endothelial damage in live/dead staining or apoptosis occurred at higher radiant exposure of 287 J/cm2. On enucleated rabbit and porcine corneas, ED50 was 87 and 52 J/cm2, respectively, by MVL, and 241 and 160 J/cm2 for endothelial damage. In human eyes, ED50 for MVL was 110 J/cm2 and endothelial damage at 453 J/cm2. Single-pulse iris damage occurred at ED 50 of 208 mJ/cm2. These values determine the energy permitted for surgical patterns and can guide development of ophthalmic laser systems. Lower damage threshold in corneas of enucleated eyes versus live rabbits is noted for future safety evaluation.

  15. A Cornea Substitute Derived from Fish Scale: 6-Month Followup on Rabbit Model

    Directory of Open Access Journals (Sweden)

    Fei Yuan

    2014-01-01

    Full Text Available A fish scale-derived cornea substitute (Biocornea is proposed as an alternative for human donor corneal tissue. We adopt a regenerative medicine approach to design a primary alternative to the use of fish scale for restoring sight by corneal replacement. Biocornea with corneal multilayer arrangement collagen was implanted to rabbits by pocket implantation. Our study demonstrated the safety and detailed morphologic and physiologic results from the 6 months of followup of rabbit model. In the peripheral Biocornea, the collagen fibrils were arranged in reticular fashion. Slit lamp examination showed that haze and an ulcer were not observed in all groups at 3 months postoperatively while all corneas with Biocornea were clear at both 3 months and 6 months postoperatively. The interface of Biocornea and stromal tissue were filled successfully and without observable immune cells at postoperative day 180. Moreover, the Biocornea was not dissolved and degenerated but remained transparent and showed no apparent fragmentation. Our study demonstrated that the Biocornea derived from fish scale as a good substitute had high biocompatibility and support function after a long-term evaluation. This revealed that the new approach of using Biocornea may yield an ideal artificial cornea substitute for long-term inlay placement.

  16. Contribution of the cornea and internal surfaces to the change of ocular aberrations with age

    Science.gov (United States)

    Artal, Pablo; Berrio, Esther; Guirao, Antonio; Piers, Patricia

    2002-01-01

    We studied the age dependence of the relative contributions of the aberrations of the cornea and the internal ocular surfaces to the total aberrations of the eye. We measured the wave-front aberration of the eye with a Hartmann-Shack sensor and the aberrations of the anterior corneal surface from the elevation data provided by a corneal topography system. The aberrations of the internal surfaces were obtained by direct subtraction of the ocular and corneal wave-front data. Measurements were obtained for normal healthy subjects with ages ranging from 20 to 70 years. The magnitude of the RMS wave-front aberration (excluding defocus and astigmatism) of the eye increases more than threefold within the age range considered. However, the aberrations of the anterior corneal surface increase only slightly with age. In most of the younger subjects, total ocular aberrations are lower than corneal aberrations, while in the older subjects the reverse condition occurs. Astigmatism, coma, and spherical aberration of the cornea are larger than in the complete eye in younger subjects, whereas the contrary is true for the older subjects. The internal ocular surfaces compensate, at least in part, for the aberrations associated with the cornea in most younger subjects, but this compensation is not present in the older subjects. These results suggest that the degradation of the ocular optics with age can be explained largely by the loss of the balance between the aberrations of the corneal and the internal surfaces.

  17. Resazurin metabolism assay is a new sensitive alternative test in isolated pig cornea.

    Science.gov (United States)

    Perrot, Sébastien; Dutertre-Catella, Hélène; Martin, Chantal; Rat, Patrice; Warnet, Jean-Michel

    2003-03-01

    The main object of our study was to investigate whether the resazurin metabolism assay is a sensitive surfactant and alcohol toxicity test in isolated pig cornea and to compare this recently developed fluorometric assay with the data collected in the eye irritation reference chemical data bank. Resazurin is a substrate that changes color in response to metabolic activity. Isolated pig corneas were immersed for 10 min in surfactants and alcohol irritant solutions. After incubation, resorufin fluorescence was read and corneal viability was assessed. This corneal viability was compared with the maximal modified average score published in the report of ECETOC. This assay highlighted different concentration-dependent irritation potentials of the three surfactants tested, and the same results were obtained with corneas treated with the alcohols. We observed that the degree of surfactant- and alcohol-induced decrease in corneal viability, using the resazurin reduction test, was correlated with the in vivo irritancy measurements as determined by the Draize test and scored with the Modified Maximum Average Score (MMAS). This assay allowed us to classify the ocular irritancy of the tested surfactants and alcohols in the same ranking order as the Draize classification. Corneal viability measurement can be used as a potential alternative for the toxicological assessment of surfactants and alcohols. The nontoxic, nonradioactive resazurin metabolism assay allows rapid assessment of many samples with simple equipment and at reduced cost for continuous monitoring of corneal viability. This assay seems to be suitable as a toxicological screening test for eye irritation determination.

  18. Surface modification of silicone rubber membrane by plasma induced graft copolymerization as artificial cornea.

    Science.gov (United States)

    Hsiue, G H; Lee, S D; Chang, P C

    1996-11-01

    In this study a highly biocompatible polymer membrane was prepared by surface modification. An artificial cornea was also developed for clinical applications. Silicone rubber (SR) membrane was grafted with hydrophilic monomers such as 2-hydroxyethyl methacrylate (HEMA) and acrylic acid by plasma induced grafted polymerization. Surface properties of the SR were characterized using secondary ions mass spectra, Fourier transform infrared/attenuated total reflection, and element spectra for chemical analysis. The corneal epithelial (CE) cell was cultured in vitro, and penetrating keratoplasty of albino rabbit cornea (in vivo) was performed to evaluate biological properties of modified SR membranes. The ability of the CE cell to attach onto various SR membranes was observed by inverted microscopy. The proliferation of CE cell was conducted in approximately 96 h. Experimental results indicated that the attachment and growth of CE onto SR-g-pHEMA (75 micrograms/ cm2) is enhanced. The morphologies of an attached CE cell are similar to those of a primary CE cell. In the in vivo study, the depth of anterior chamber was maintained 2 weeks after penetrating keratoplasty was performed with a SR grafted with pHEMA (210 micrograms/cm2). This phenomenon displayed a high biocompatibility of modified SR membrane with the CE cell. Furthermore, results in this study provide a valuable reference for application of the modified SR for an artificial cornea.

  19. In vivo multiphoton imaging of the cornea: polarization-resolved second harmonic generation from stromal collagen

    Science.gov (United States)

    Latour, G.; Gusachenko, I.; Kowalczuk, L.; Lamarre, I.; Schanne-Klein, M.-C.

    2012-03-01

    Multiphoton microscopy provides specific and contrasted images of unstained collagenous tissues such as tendons or corneas. Polarization-resolved second harmonic generation (SHG) measurements have been implemented in a laserscanning multiphoton microscope. Distortion of the polarimetric response due to birefringence and diattenuation during propagation of the laser excitation has been shown in rat-tail tendons. A model has been developed to account for these effects and correct polarization-resolved SHG images in thick tissues. This new modality is then used in unstained human corneas to access two quantitative parameters: the fibrils orientation within the collagen lamellae and the ratio of the main second-order nonlinear tensorial components. Orientation maps obtained from polarization resolution of the trans-detected SHG images are in good agreement with the striated features observed in the raw images. Most importantly, polarization analysis of the epi-detected SHG images also enables to map the fibrils orientation within the collagen lamellae while epi-detected SHG images of corneal stroma are spatially homogenous and do not enable direct visualization of the fibrils orientation. Depth profiles of the polarimetric SHG response are also measured and compared to models accounting for orientation changes of the collagen lamellae within the focal volume. Finally, in vivo polarization-resolved SHG is performed in rat corneas and structural organization of corneal stroma is determined using epi-detected signals.

  20. Property-based design: optimization and characterization of polyvinyl alcohol (PVA) hydrogel and PVA-matrix composite for artificial cornea.

    Science.gov (United States)

    Jiang, Hong; Zuo, Yi; Zhang, Li; Li, Jidong; Zhang, Aiming; Li, Yubao; Yang, Xiaochao

    2014-03-01

    Each approach for artificial cornea design is toward the same goal: to develop a material that best mimics the important properties of natural cornea. Accordingly, the selection and optimization of corneal substitute should be based on their physicochemical properties. In this study, three types of polyvinyl alcohol (PVA) hydrogels with different polymerization degree (PVA1799, PVA2499 and PVA2699) were prepared by freeze-thawing techniques. After characterization in terms of transparency, water content, water contact angle, mechanical property, root-mean-square roughness and protein adsorption behavior, the optimized PVA2499 hydrogel with similar properties of natural cornea was selected as a matrix material for artificial cornea. Based on this, a biomimetic artificial cornea was fabricated with core-and-skirt structure: a transparent PVA hydrogel core, surrounding by a ringed PVA-matrix composite skirt that composed of graphite, Fe-doped nano hydroxyapatite (n-Fe-HA) and PVA hydrogel. Different ratio of graphite/n-Fe-HA can tune the skirt color from dark brown to light brown, which well simulates the iris color of Oriental eyes. Moreover, morphologic and mechanical examination showed that an integrated core-and-skirt artificial cornea was formed from an interpenetrating polymer network, no phase separation appeared on the interface between the core and the skirt.

  1. Lúpus eritematoso sistêmico bolhoso na infância: relato de caso Bullous systemic lupus erythematosus in the childhood: case report

    Directory of Open Access Journals (Sweden)

    Mariana Discacciati Chiminazzo

    2007-06-01

    Full Text Available É apresentado caso de lúpus eritematoso bolhoso na infância. Doente do sexo feminino, com nove anos, apresentava erupção vesicobolhosa no tronco, região cervical, genital e membros. O exame anatomopatológico mostrou bolha subepidérmica com neutrófilos, a imunofluorescência direta revelou depósito linear de IgA, IgM, IgG e C3 na zona da membrana basal, e a indireta foi negativa. Os anticorpos antinucleares e o anti-Sm estavam positivos. Houve regressão do quadro com dapsona e prednisona. Trata-se de caso raro de lúpus eritematoso sistêmico (LES na infância que se iniciou com bolhas disseminadas. O LES bolhoso deve ser incluído no diagnóstico diferencial das erupções bolhosas na infância.We report a case of bullous systemic lupus erythematosus in a 9-year-old female, with a vesiculobullous eruption on the trunk, neck, genitals and limbs. A skin biopsy specimen showed subepidermal blister with neutrophils. Direct immunofluorescence revealed deposition of IgA, IgG, IgM and C3 at the epithelial basement membrane zone and indirect immunofluorescence was negative. Antinuclear antibodies and anti-Sm were positive. Resolution of the blisters occurred following treatment with dapsone and prednisone. This is a rare case of systemic lupus erythematous (SLE in the childhood, whose initial manifestation was a bullous eruption. Bullous SLE should be considered in the differential diagnosis of children presenting with generalized bullous eruption.

  2. 重症大疱性药疹角质形成细胞凋亡的研究%Keratinocyte apoptosis in severe bullous drug eruptions

    Institute of Scientific and Technical Information of China (English)

    于燕华; 张美华

    2009-01-01

    Both Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) belong to severe bullous drug eruptions. Both of them are clinically characterized by extensive epidermal necrosis and exfoliation, and histologically characterized by generalized apoptosis of keratinocytes, a process that results in the separation of epidermis from dermis. There is evidence that keratinocyte apoptosis is mainly ascribed to perforin/granzyme B and Fas/FasL. Besides supportive treatment, the application of multiple antiapoptotic agents could be of potential benefit to the management of severe bullous drug eruptions. This article presents the antiapoptotic therapy of severe bullous drug eruptions.%重症多形红斑和中毒性表皮坏死松解症属于重症大疱性药疹,临床表现为广泛的表皮坏死剥脱,组织病理表现为广泛的角质形成细胞凋亡,表皮与真皮分离.研究认为,穿孔素/颗粒酶和Fas/FasL可能是参与诱导角质形成细胞凋亡的主要因素;提出可在支持疗法基础上联合应用多种抗凋亡药物.因此,文中对重症大疱性药疹的抗凋亡治疗进行综述.

  3. Optics of the average normal cornea from general and canonical representations of its surface topography.

    Science.gov (United States)

    Navarro, Rafael; González, Luis; Hernández, José L

    2006-02-01

    Generally, the analysis of corneal topography involves fitting the raw data to a parametric geometric model that includes a regular basis surface, plus some sort of polynomial expansion to adjust the more irregular residual component. So far, these parametric models have been used in their canonical form, ignoring that the observation (keratometric) coordinate system is different from corneal axes of symmetry. Here we propose, instead, to use the canonical form when the topography is referenced to the intrinsic corneal system of coordinates, defined by its principal axes of symmetry. This idea is implemented using the general expression of an ellipsoid to fit the raw data given by the instrument. Then, the position and orientation of the three orthogonal semiaxes of the ellipsoid, which define the intrinsic Cartesian system of coordinates for normal corneas, can be identified by passing to the canonical form, by standard linear algebra. This model has been first validated experimentally obtaining significantly lower values for rms fitting error as compared with previous standard models: spherical, conical, and biconical. The fitting residual was then adjusted by a Zernike polynomial expansion. The topographies of 123 corneas were analyzed obtaining their radii of curvature, conic constants, Zernike coefficients, and the direction and position of the optical axis of the ellipsoid. The results were compared with those obtained using the standard models. The general ellipsoid model provides more negative values for the conic constants and lower apex radii (more prolate shapes) than the standard models applied to the same data. If the data are analyzed using standard models, the resulting mean shape of the cornea is consistent with previous studies, but when using the ellipsoid model we find new interesting features: The mean cornea is a more prolate ellipsoid (apical power 50 D), the direction of the optical axis is about 2.3 degrees nasal, and the residual term shows

  4. Optics of the average normal cornea from general and canonical representations of its surface topography

    Science.gov (United States)

    Navarro, Rafael; González, Luis; Hernández, José L.

    2006-02-01

    Generally, the analysis of corneal topography involves fitting the raw data to a parametric geometric model that includes a regular basis surface, plus some sort of polynomial expansion to adjust the more irregular residual component. So far, these parametric models have been used in their canonical form, ignoring that the observation (keratometric) coordinate system is different from corneal axes of symmetry. Here we propose, instead, to use the canonical form when the topography is referenced to the intrinsic corneal system of coordinates, defined by its principal axes of symmetry. This idea is implemented using the general expression of an ellipsoid to fit the raw data given by the instrument. Then, the position and orientation of the three orthogonal semiaxes of the ellipsoid, which define the intrinsic Cartesian system of coordinates for normal corneas, can be identified by passing to the canonical form, by standard linear algebra. This model has been first validated experimentally obtaining significantly lower values for rms fitting error as compared with previous standard models: spherical, conical, and biconical. The fitting residual was then adjusted by a Zernike polynomial expansion. The topographies of 123 corneas were analyzed obtaining their radii of curvature, conic constants, Zernike coefficients, and the direction and position of the optical axis of the ellipsoid. The results were compared with those obtained using the standard models. The general ellipsoid model provides more negative values for the conic constants and lower apex radii (more prolate shapes) than the standard models applied to the same data. If the data are analyzed using standard models, the resulting mean shape of the cornea is consistent with previous studies, but when using the ellipsoid model we find new interesting features: The mean cornea is a more prolate ellipsoid (apical power 50 D), the direction of the optical axis is about 2.3° nasal, and the residual term shows three

  5. Chronic Lunar Dust Exposure on Rat Cornea: Evaluation by Gene Expression Profiling

    Science.gov (United States)

    Theriot, C. A.; Glass, A.; Lam, C-W.; James, J.; Zanello, S. B.

    2014-01-01

    Lunar dust is capable of entering habitats and vehicle compartments by sticking to spacesuits or other objects that are transferred into the spacecraft from the lunar surface and has been reported to cause irritation upon exposure. During the Apollo missions, crewmembers reported irritation specifically to the skin and eyes after contamination of the lunar and service modules. It has since been hypothesized that ocular irritation and abrasion might occur as a result of such exposure, impairing crew vision. Recent work has shown that both ultrafine and unground lunar dust exhibited minimal irritancy of the ocular surface (i.e., cornea); however, the assessment of the severity of ocular damage resulting from contact of lunar dust particles to the cornea has focused only on macroscopic signs of mechanical irritancy and cytotoxicity. Given the chemical reactive properties of lunar dust, exposure of the cornea may contribute to detrimental effects at the molecular level including but not limited to oxidative damage. Additionally, low level chronic exposures may confound any results obtained in previous acute studies. We report here preliminary results from a tissue sharing effort using 10-week-old Fischer 344 male rats chronically exposed to filtered air or jet milled lunar dust collected during Apollo 14 using a Jaeger-NYU nose-only chamber for a total of 120 hours (6 hours daily, 5 days a week) over a 4-week period. RNA was isolated from corneas collected from rats at 1 day and 7 days after being exposed to concentrations of 0, 20, and 60 mg/m3 of lunar dust. Microarray analysis was performed using the Affymetrix GeneChip Rat Genome 230 2.0 Array with Affymetrix Expression Console and Transcriptome Analysis Console used for normalization and secondary analysis. An Ingenuity iReport"TM" was then generated for canonical pathway identification. The number of differentially expressed genes identified increases with dose compared to controls suggesting a more severe

  6. In vitro permeation characteristics of moxifloxacin from oil drops through excised goat, sheep, buffalo and rabbit corneas.

    Science.gov (United States)

    Pawar, P K; Majumdar, D K

    2007-11-01

    The objective of present investigation was to study the in vitro permeation characteristics of moxifloxacin from oil drops through freshly excised goat, sheep, buffalo and rabbit corneas. Moxifloxacin, 0.043 to 0.048% (w/v) ophthalmic solutions with or without (0.5% v/v) benzyl alcohol were made in arachis, castor, cottonseed, olive, soybean, sunflower and sesame oils. Permeation studies were conducted by putting 1 ml oil formulation on cornea (0.50 cm2) fixed between donor and receptor compartments of an all glass modified Franz diffusion cell and measuring the drug permeated in receptor (containing 10 ml bicarbonate ringer, pH 7.4 at 37 degrees C under stirring) by spectrophotometry at 291 nm, after 120 min. Post permeation corneal hydration was measured to assess corneal damage. The study was designed with paired corneas i.e. one cornea of an animal received formulation without benzyl alcohol while the contralateral cornea received formulation with benzyl alcohol. Moxifloxacin ophthalmic solution in castor oil showed maximum permeation with all the corneas. Addition of benzyl alcohol, a preservative, to oil drops reduced permeation of moxifloxacin from each oil drop, with corneas of all the species. Partition experiments with moxifloxacin oil drops and phosphate buffer (pH 7.4) indicated higher partitioning of drug in the oil phase, in presence of benzyl alcohol. Thus results of permeation are consistent with the partition characteristics of drug between oil and aqueous phase. Corneal hydration obtained with all the formulations was between 75 to 80% indicating no corneal damage.

  7. Validation of an endothelial roll preparation for Descemet Membrane Endothelial Keratoplasty by a cornea bank using "no touch" dissection technique.

    Science.gov (United States)

    Marty, Anne-Sophie; Burillon, Carole; Desanlis, Adeline; Damour, Odile; Kocaba, Viridiana; Auxenfans, Céline

    2016-06-01

    Descemet Membrane Endothelial Keratoplasty (DMEK) selectively replaces the damaged posterior part of the cornea. However, the DMEK technique relies on a manually-performed dissection that is time-consuming, requires training and presents a potential risk of endothelial graft damages leading to surgery postponement when performed by surgeons in the operative room. To validate precut corneal tissue preparation for DMEK provided by a cornea bank in order to supply a quality and security precut endothelial tissue. The protocol was a technology transfer from the Netherlands Institute for Innovative Ocular Surgery (NIIOS) to Lyon Cornea Bank, after formation in NIIOS to the DMEK "no touch" dissection technique. The technique has been validated in selected conditions (materials, microscope) and after a learning curve, cornea bank technicians prepared endothelial tissue for DMEK. Endothelial cells densities (ECD) were evaluated before and after preparation, after storage and transport to the surgery room. Microbiological and histological controls have been done. Twenty corneas were manually dissected; 18 without tears. Nineteen endothelial grafts formed a double roll. The ECD loss after cutting was 3.3 % (n = 19). After transportation 7 days later, we found an ECD loss of 25 % (n = 12). Three days after cutting and transportation, we found 2.1 % of ECD loss (n = 7). Histology found an endothelial cells monolayer lying on Descemet membrane. The mean thickness was 12 ± 2.2 µm (n = 4). No microbial contamination was found (n = 19). Endothelial roll stability has been validated at 3 days in our cornea bank. Cornea bank technicians trained can deliver to surgeons an ECD controlled, safety and ready to use endothelial tissue, for DMEK by "no touch" technique, allowing time saving, quality and security for surgeons.

  8. Homozygous ALOXE3 Nonsense Variant Identified in a Patient with Non-Bullous Congenital Ichthyosiform Erythroderma Complicated by Superimposed Bullous Majocchi’s Granuloma: The Consequences of Skin Barrier Dysfunction

    Directory of Open Access Journals (Sweden)

    Tao Wang

    2015-09-01

    Full Text Available Non-bullous congenital ichthyosiform erythroderma (NBCIE is a hereditary disorder of keratinization caused by pathogenic variants in genes encoding enzymes important to lipid processing and terminal keratinocyte differentiation. Impaired function of these enzymes can cause pathologic epidermal scaling, significantly reduced skin barrier function. In this study, we have performed a focused, genetic analysis of a probrand affected by NBCIE and extended this to his consanguineous parents. Targeted capture and next-generation sequencing was performed on NBCIE associated genes in the proband and his unaffected consanguineous parents. We identified a homozygous nonsense variant c.814C>T (p.Arg272* in ALOXE3 (NM_001165960.1 in the proband and discovered that his parents are both heterozygous carriers of the variant. The clinical manifestations of the proband’s skin were consistent with NBCIE, and detailed histopathological assessment revealed epidermal bulla formation and Majocchi’s granuloma. Infection with Trichophyton rubrum was confirmed by culture. The patient responded to oral terbinafine antifungal treatment. Decreased skin barrier function, such as that caused by hereditary disorders of keratinization, can increase the risk of severe cutaneous fungal infections and the formation of Majocchi’s granuloma and associated alopecia. Patients with NBCIE should be alerted to the possible predisposition for developing dermatophytoses and warrant close clinical follow-up.

  9. 药物源性角膜病变临床特征和治疗回顾分析%Retrospective analysis of clinical features and management for drug-induced keratopathy

    Institute of Scientific and Technical Information of China (English)

    刘艳红; 王婷; 史伟云; 李素霞

    2014-01-01

    变的治疗主要是停用原有药物,给予促进角膜修复的药物及抗炎治疗,同时治疗干眼症及睑板腺功能障碍等眼表问题.治疗周期为1~8周,角膜修复期间与SⅠt结果呈负相关(r=-0.835,P<0.01).结论 局部用药导致的角膜病变会影响角膜全层,临床医师应了解药物导致的眼部损害.药物源性角膜病变的早期诊断主要依靠病史及临床特征,采取综合的治疗措施是治疗的关键.%Background In recent years,incidence of drug-induced keratopathy is increasing highly.Druginduced keratopathy is lack of typical clinical features and offen confused with the primary disease.Therefore,summarizing and concluding the clinicals feature and standard treatments of drug-induced keratopathy are key problem need to be solved urgently for us.Objective This study was to retrospectively analyze the clinical features and therapeutic procedure of drug-induced keratopathy.Methods A retrospective case series analysis method was adopted.The clinical data of 36 eyes (31 patients) with drug-induced keratopathy were collected by Shandong Eye Hospital from 2008 to 2012,including eye disease history,medication history,medication dosage and duration.A series of relevant examinations were performed,including best corrected visual acuity (BCVA) before and 1 month after treatment,Schirmer test Ⅰ (S Ⅰ t),tear film break-up time (BUT),meibomian gland findings,the location of the keratopathy,the characteristics of keratophthy before and after fluorescein staining.The treating were given,including cessating of the original drugs,applying corneal repair promotion and anti-inflammatory drugs as well as the comprehensive treatment for meibomian gland embolization and dry eye,such as the hot packs and massage in the eyes with meibomian gland dysfunction and a tear dot embolization therapy in the eyes with S Ⅰ t < 5 mm and BUT<5 s.Paired t test and repeated measured one-way analysis of variance in SPSS 17

  10. Corneal Collagen Cross-Linking with Hypoosmolar Riboflavin Solution in Keratoconic Corneas

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    Shaofeng Gu

    2014-01-01

    Full Text Available Purpose. To report the 12-month outcomes of corneal collagen cross-linking (CXL with a hypoosmolar riboflavin and ultraviolet-A (UVA irradiation in thin corneas. Methods. Eight eyes underwent CXL using a hypoosmolar riboflavin solution after epithelial removal. The corrected distance visual acuity (CDVA, manifest refraction, the mean thinnest corneal thickness (MTCT, and the endothelial cell density (ECD were evaluated before and 6 and 12 months after CXL. Results. The MTCT was 413.9 ± 12.4 μm before treatment and reduced to 381.1 ± 7.3 μm after the removal of the epithelium. After CXL, the thickness decreased to 410.3 ± 14.5 μm at the last follow-up. Before treatment, the mean K-value of the apex of the keratoconus corneas was 58.7 ± 3.5 diopters and slightly decreased (57.7 ± 4.9 diopters at 12 months. The mean CDVA was 0.54 ± 0.23 logarithm of the minimal angle of resolution before treatment and increased to 0.51 ± 0.21 logarithm at the last follow-up. The ECD was 2731.4 ± 191.8 cells/mm2 before treatment and was 2733.4 ± 222.6 cells/mm2 at 12 months after treatment. Conclusions. CXL with a hypoosmolar riboflavin in thin corneas seems to be a promising method for keratoconic eyes with the mean thinnest corneal thickness less than 400 μm without epithelium.

  11. Localization and expression of CHST6 and keratan sulfate proteoglycans in the human cornea.

    Science.gov (United States)

    Di Iorio, Enzo; Barbaro, Vanessa; Volpi, Nicola; Bertolin, Marina; Ferrari, Barbara; Fasolo, Adriano; Arnaldi, Renato; Brusini, Paolo; Prosdocimo, Giovanni; Ponzin, Diego; Ferrari, Stefano

    2010-08-01

    Macular corneal dystrophy (MCD; OMIM 217800) is a rare autosomal recessive inherited disorder caused by mutations in the carbohydrate sulfotransferase 6 (CHST6) and characterised by the presence of unsulfated keratan sulfate proteoglycans (KSPGs) forming abnormal deposits that eventually lead to visual impairment. The aim of this study is to understand in which corneal cells CHST6 and KSPGs are expressed and exert their activity. Expression and localization of CHST6, keratan sulfate (KS) and proteins of the KSPGs, such as mimecan and lumican, were assessed both in human cornea sections and in cultured primary keratinocytes (n = 3) and keratocytes (n = 4). Immunohistochemistry, semiquantitative RT-PCR, in situ RNA hybridization and HPLC analysis of glycosaminoglycans were used as read-outs. In human corneas KS was predominantly found in the stroma, but absent, or barely detectable, in the corneal epithelium. A similar pattern of distribution was found in the epidermis, with KS mainly localised in the derma. As expected, in the cornea CHST6 (the gene encoding the enzyme which transfers sulfate residues onto KSPGs) was found expressed in the suprabasal, but not basal, layers of the epithelium, in the stroma and in the endothelium. Analyses of KS by means of HPLC showed that in vitro cultured stromal keratocytes express and secrete more KS than keratinocytes, thus mirroring results observed in vivo. Similarly expression of the CHST6 gene and of KS proteoglycans such as mimecan, lumican is limited to stromal keratocytes. Unlike keratocytes, corneal keratinocytes do not synthesize mimecan or lumican, and express very little, if none, CHST6. Any drug/gene therapy or surgical intervention aimed at curing this rare genetic disorder must therefore involve and target stromal keratocytes. If coupled to the accuracy of HPLC-based assay that we developed to determine the amount of KS in serum, our findings could lead to more targeted therapeutic treatments of the ocular features

  12. Ethical Considerations on Heterogeneous Cornea Transplant%异种角膜移植的伦理考量

    Institute of Scientific and Technical Information of China (English)

    张燕

    2011-01-01

    由于移植技术的进步以及异种角膜移植技术自身的优势,异种角膜移植有望成为眼科临床常规诊疗手段之一,为缓解同种角膜移植供体短缺的压力提供可能.分析了异种角膜移植的可行性,并就异种角膜移植涉及的部分伦理问题、安全性问题;人的同一性及完整性问题;患者接受度问题;角膜供体资源管理和分配问题;动物保护问题进行了探讨.%According to advanced transplantation technology and the advantages of comeal stroma, heterogeneous cornea transplant is expected to become one of the conventional means of ophthalmology clinical treatment,and it provides the possibility for easing the shortage of the same cornea transplant donation. This paper analyzed the feasibility of heterogeneous cornea transplant and discussed some ethical issues about heterogeneous cornea transplant: safety issue, people in the identity and integrity problems, degree about patients received, heterogeneous donor cornea resources management and distribution issue and animal protection issue.

  13. Biocompatibility of poly(ethylene glycol) and poly(acrylic acid) interpenetrating network hydrogel by intrastromal implantation in rabbit cornea.

    Science.gov (United States)

    Zheng, Luo Luo; Vanchinathan, Vijay; Dalal, Roopa; Noolandi, Jaan; Waters, Dale J; Hartmann, Laura; Cochran, Jennifer R; Frank, Curtis W; Yu, Charles Q; Ta, Christopher N

    2015-10-01

    We evaluated the biocompatibility of a poly(ethylene glycol) and poly(acrylic acid) (PEG/PAA) interpenetrating network hydrogel designed for artificial cornea in a rabbit model. PEG/PAA hydrogel measuring 6 mm in diameter was implanted in the corneal stroma of twelve rabbits. Stromal flaps were created with a microkeratome. Randomly, six rabbits were assigned to bear the implant for 2 months, two rabbits for 6 months, two rabbits for 9 months, one rabbit for 12 months, and one rabbit for 16 months. Rabbits were evaluated monthly. After the assigned period, eyes were enucleated, and corneas were processed for histology and immunohistochemistry. There were clear corneas in three of six rabbits that had implantation of hydrogel for 2 months. In the six rabbits with implant for 6 months or longer, the corneas remained clear in four. There was a high rate of epithelial defect and corneal thinning in these six rabbits. One planned 9-month rabbit developed extrusion of implant at 4 months. The cornea remained clear in the 16-month rabbit but histology revealed epithelial in-growth. Intrastromal implantation of PEG/PAA resulted in a high rate of long-term complications.

  14. Case report: a novel KERA mutation associated with cornea plana and its predicted effect on protein function

    DEFF Research Database (Denmark)

    Roos, Laura; Bertelsen, Birgitte; Harris, Pernille;

    2015-01-01

    Background: Cornea plana (CNA) is a hereditary congenital abnormality of the cornea characterized by reduced corneal curvature, extreme hypermetropia, corneal clouding and hazy corneal limbus. The recessive form, CNA2, is associated with homozygous or compound heterozygous mutations of the kerato......Background: Cornea plana (CNA) is a hereditary congenital abnormality of the cornea characterized by reduced corneal curvature, extreme hypermetropia, corneal clouding and hazy corneal limbus. The recessive form, CNA2, is associated with homozygous or compound heterozygous mutations...... of the keratocan gene (KERA) on chromosome 12q22. To date, only nine different disease-associated KERA mutations, including four missense mutations, have been described. Case presentation: In this report, we present clinical data from a Turkish family with autosomal recessive cornea plana. In some of the affected...... individuals, hypotrichosis was found. KERA was screened for mutations using Sanger sequencing. We detected a novel KERA variant, p.(Ile225Thr), that segregates with the disease in the homozygous form. The three-dimensional structure of keratocan protein was modelled, and we showed that this missense variation...

  15. [Difficult cornea procurement: causes and consequences of the exceptional situation in France].

    Science.gov (United States)

    Delbosc, B

    2000-02-01

    Despite scientific advances, corneal grafting is still in a crucial situation in France in 1999. Over the last 3 years, the number of corneal grafts (2 903 in 1996, 3 213 in 1997, and 4 053 in 1998) has been insufficient to satisfy estimated needs (8 041 in 1996, 8 303 in 1997, 7 400 in 1998). The consequences are waiting lists, long time on waiting lists, and regional differences. This situation results more from difficulties in the cornea procurement system than from limited numbers of potential donors or restricted selection criteria. Progress will depend greatly on structural changes.

  16. Comparison of Scheimpflug imaging parameters between steep and keratoconic corneas of Caucasian eyes

    Directory of Open Access Journals (Sweden)

    Huseynova T

    2016-04-01

    Full Text Available Tukezban Huseynova,1 Farah Abdulaliyeva,2 Michele Lanza3 1Briz-L Eye Clinic, 2National Ophthalmology Center, Baku, Azerbaijan; 3Second University of Naples, Caserta, Campania, Italy Purpose: To compare the keratometric and pachymetric parameters of healthy eyes with those affected by steep cornea and keratoconus (KC using Scheimpflug camera.Setting: Briz-L Eye Clinic, Baku, Azerbaijan.Design: A cross-sectional study.Methods: In this study, 49 KC (Amsler–Krumeich stage 1 eyes and 36 healthy eyes were enrolled. A complete ophthalmic evaluation and a Scheimpflug camera scan were performed in every eye included in the study. Tomographic parameters such as parameters from the front and back cornea, maximum keratometry reading (Kmax, corneal volume (CV, anterior chamber volume (ChV, anterior chamber depth (ACD, anterior chamber angle (AC angle, keratometric power deviation (KPD, maximum front elevation (Max FE, and maximum back elevation (Max BE, as well as pachymetric progression indices (PPI, Ambrosio relational thickness (ART, index of surface variance (ISV, index of vertical asymmetry (IVA, center keratoconus index (CKI, index of height asymmetry (IHA, index of height decentration (IHD, and radius minimum (RM were collected and statistically compared between the two groups.Results: PPI, ART, ISV, IVA, CKI, IHA, IHD, and RM parameter values were significantly different (P<0.05 between the KC and healthy eyes. There were no significant differences in K mean and Q values of the frontal corneal parameters, as well as in Kmax, AC angle, RM, back, and front astigmatism, between stage 1 keratoconic and normal Caucasian eyes with steep cornea. All other parameters such as K mean and Q values of the back corneal parameters, Max FE, Max BE, ACD, ChV, and CV showed significant differences between the groups (P<0.05 for all. Conclusion: Scheimpflug imaging is able to detect corneal morphological differences between stage 1 KC eyes and healthy eyes with

  17. The use of typing methods and infection prevention measures to control a bullous impetigo outbreak on a neonatal ward

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    Koningstein Maike

    2012-11-01

    Full Text Available Abstract Background We describe an outbreak of Bullous Impetigo (BI, caused by a (methicillin susceptible, fusidic acid resistant Staphylococcus aureus (SA strain, spa-type t408, at the neonatal and gynaecology ward of the Jeroen Bosch hospital in the Netherlands, from March-November 2011. Methods We performed an outbreak investigation with revision of the hygienic protocols, MSSA colonization surveillance and environmental sampling for MSSA including detailed typing of SA isolates. Spa typing was performed to discriminate between the SA isolates. In addition, Raman-typing was performed on all t408 isolates. Results Nineteen cases of BI were confirmed by SA positive cultures. A cluster of nine neonates and three health care workers (HCW with SA t408 was detected. These strains were MecA-, PVL-, Exfoliative Toxin (ETA-, ETB+, ETAD-, fusidic acid-resistant and methicillin susceptible. Eight out of nine neonates and two out of three HCW t408 strains yielded a similar Raman type. Positive t408 HCW were treated and infection control procedures were reinforced. These measures stopped the outbreak. Conclusions We conclude that treatment of patients and HCW carrying a predominant SA t408, and re-implementing and emphasising hygienic measures were effective to control the outbreak of SA t408 among neonates.

  18. Diaminodiphenyl Sulfone-Induced Hemolytic Anemia and Alopecia in a Case of Linear IgA Bullous Dermatosis.

    Science.gov (United States)

    Akasaka, Eijiro; Kayo, Sato-Jin; Nakano, Hajime; Ishii, Norito; Hashimoto, Takashi; Sawamura, Daisuke

    2015-01-01

    Linear immunoglobulin A (IgA) bullous dermatosis (LABD) is an autoimmune mucocutaneous disease characterized by subepidermal blistering induced by IgA autoantibodies against several autoantigens in the basal membranous zone of the skin and mucosal tissue. Although diaminodiphenyl sulfone (DDS), also known as dapsone, is generally recognized as the first-line therapy for LABD, DDS can induce several severe side effects. We present a Japanese case of LABD with DDS-induced hemolytic anemia and alopecia. In the present case, the DDS-induced hemolytic anemia and hair loss made the DDS monotherapy difficult. When DDS is used in LABD patients with iron deficiency anemia (IDA), hemolytic anemia is concealed by IDA. It is thus necessary to carefully and frequently examine the laboratory data to find the signs of DDS-induced hemolytic anemia. Even though there is no literature on DDS-induced alopecia, alopecia was reported as one of the side effects of DDS in an FDA report, and, in our case, hair loss was improved after reducing its dosage. We have to recognize that alopecia is one of the side effects of DDS and that careful management is needed in order not to overlook the adverse side effects of DDS when treating LABD patients.

  19. Diaminodiphenyl Sulfone-Induced Hemolytic Anemia and Alopecia in a Case of Linear IgA Bullous Dermatosis

    Directory of Open Access Journals (Sweden)

    Eijiro Akasaka

    2015-07-01

    Full Text Available Linear immunoglobulin A (IgA bullous dermatosis (LABD is an autoimmune mucocutaneous disease characterized by subepidermal blistering induced by IgA autoantibodies against several autoantigens in the basal membranous zone of the skin and mucosal tissue. Although diaminodiphenyl sulfone (DDS, also known as dapsone, is generally recognized as the first-line therapy for LABD, DDS can induce several severe side effects. We present a Japanese case of LABD with DDS-induced hemolytic anemia and alopecia. In the present case, the DDS-induced hemolytic anemia and hair loss made the DDS monotherapy difficult. When DDS is used in LABD patients with iron deficiency anemia (IDA, hemolytic anemia is concealed by IDA. It is thus necessary to carefully and frequently examine the laboratory data to find the signs of DDS-induced hemolytic anemia. Even though there is no literature on DDS-induced alopecia, alopecia was reported as one of the side effects of DDS in an FDA report, and, in our case, hair loss was improved after reducing its dosage. We have to recognize that alopecia is one of the side effects of DDS and that careful management is needed in order not to overlook the adverse side effects of DDS when treating LABD patients.

  20. A CONTROVERSIAL ON THE DIAGNOSIS OF CHRONIC BULLOUS TYPE MUCOCUTANEOUS DISEASE INVOLVING ORAL MUCOSA (A CASE REPORT

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    Isadora Gracia

    2006-04-01

    Full Text Available A case of chronic bullous type mucocutaneous disease involving oral mucosa was reported from a 56 years old man with never healing oral ulcers and wound on the perianal skin for three years. There were also red and black spots on the limb and back skin and a lesion on nail. Painful oral lesion consisted of mucous erosion, desquamative gingivitis, and sloughing area on palate and tongue. The patient is diabetic. The first perianal skin diagnosis was granulomatous candidasis with differential diagnosis pemphigus vegetates and acuminarum condiloma. However the histopathologic examination did not support these diagnosis. After several histopathologic examinations, the latest perianal skin diagnosis was lichen planus with differential diagnosis granulomatous vasculitis, bowenoid papulosis and pyodema gangrenosum. Other skin diagnosis was erythema multiforme. Oral diagnosis was mucous membrane pemphigoid with differential diagnosis lichen planus, Behçet's syndrome and erythema multiforme. Oral histopathologic examinations showed a sub-epithelial blister, which supported mucous membrane pemphigoid. A lip balm, prednisone 5 mg oral rinse and multivitamins were given but oral improvement started after blood sugar level was controlled. Conclusion: It is not yet known whether skin and oral mucous lesions are from the same disease or not.

  1. Role of IgE in bullous pemphigoid: a review and rationale for IgE directed therapies.

    Science.gov (United States)

    Messingham, K N; Pietras, T A; Fairley, J A

    2012-06-01

    Bullous pemphigoid (BP) is an autoimmune blistering disorder that is characterized by elevated total serum IgE and both IgG and IgE class autoantibodies directed against the hemidesmosomal proteins BP180 and BP230. In BP, IgE is found at the basement membrane zone and coating mast cells in lesional skin. IgE binding to immune cells is mediated through its high affinity receptor, FcεRI on the surface of mast cells, basophils and eosinophils. In BP lesions, IgE binding is thought to be a critical step in the activation of these cells. Models of the disease have demonstrated that BP IgE can replicate the early stages of BP lesion formation. These findings suggest that IgE inhibition may be a therapeutic approach for BP. Omalizumab is a humanized monoclonal antibody that inhibits IgE binding to FcεRI and is currently FDA-approved for the treatment of severe allergic asthma. To date, two case reports have each described the efficacy of omalizumab in a patient with severe recalcitrant BP. These studies are the first to provide clear evidence of the contribution of IgE autoantibodies in the pathogenesis of human BP and suggest that omalizumab may provide an additional therapeutic tool for treatment.

  2. Animal study on expression of laminin and fibronectin in cornea during wound healing following alkali burn

    Institute of Scientific and Technical Information of China (English)

    赵桂秋; 马轶群; 梁涛; 姜涛; 王传富; 张妍霞

    2003-01-01

    Objective: To observe the expression of laminin and fibronectin in alkali-burned corneas in rats.Methods: A total of 18 normal Wistar rats were randomly divided into 6 groups (n=3 in each group). For each rat, one eye was injured by alkali burn, the other one was taken as the normal control. Then all the corneas were surgically removed and the expression of laminin and fibronectin was observed with immunohistochemistry respectively at 7 hours, 1 day, 3 days, 7 days, 14 days and 28 days after alkali burn. Results: Compared with that of the normal controls, the expression of laminin and fibronectin of the burned eyes was dramatically higher at 7 hours, reached peak at 14 days and decreased to the normal level at 28 days after alkali burn. Conclusions: In the process of wound healing after alkali burn, the expression of laminin and fibronectin increases dramatically, which suggests that laminin and fibronectin may participate in the process of corneal wound healing.

  3. Chromosome mutations and tissue regeneration in the cornea after the UV laser irradiation

    Science.gov (United States)

    Razhev, Alexander M.; Bagayev, Sergei N.; Lebedeva, Lidya I.; Akhmametyeva, Elena M.; Zhupikov, Andrey A.

    2003-06-01

    In present paper the findings on chromosome mutations, the nature of damage and the repair of the cornea tissue after UV irradiation by excimer lasers at 193, 223 and 248 nm were made. Structural mutations induced by short-pulses UV irradiation were shown to be similar to spontaneous ones by the type, time of formation in the mitotic cycle and location of acentrics. Ten hours after irradiation of the cornea with doses of 0,09 to 1,5 J/cm2 the incidence of cells with chromosome aberrations increased linearly with dose and amounted to 11,7% at 248 nm, 5,5% at 223 nm and 2,6% at 193 nm per 1 J/cm2. No induced chromosome aberrations occurred 72 hour following irradiation. Within the dose range from 3,0 to 18 J/cm2 the cytogenesis effect of radiation was less manifest than that with the doses mentioned above, the frequency of chromosome aberrations being independent of either radiation wavelength or radiation dose and amounted of 2,5 to 3,0%. Thus, large doses of powerful short-pulse UV radiation are safe according to the structural mutation criterion.

  4. Control of scar tissue formation in the cornea: strategies in clinical and corneal tissue engineering.

    Science.gov (United States)

    Wilson, Samantha L; El Haj, Alicia J; Yang, Ying

    2012-09-18

    Corneal structure is highly organized and unified in architecture with structural and functional integration which mediates transparency and vision. Disease and injury are the second most common cause of blindness affecting over 10 million people worldwide. Ninety percent of blindness is permanent due to scarring and vascularization. Scarring caused via fibrotic cellular responses, heals the tissue, but fails to restore transparency. Controlling keratocyte activation and differentiation are key for the inhibition and prevention of fibrosis. Ophthalmic surgery techniques are continually developing to preserve and restore vision but corneal regression and scarring are often detrimental side effects and long term continuous follow up studies are lacking or discouraging. Appropriate corneal models may lead to a reduced need for corneal transplantation as presently there are insufficient numbers or suitable tissue to meet demand. Synthetic optical materials are under development for keratoprothesis although clinical use is limited due to implantation complications and high rejection rates. Tissue engineered corneas offer an alternative which more closely mimic the morphological, physiological and biomechanical properties of native corneas. However, replication of the native collagen fiber organization and retaining the phenotype of stromal cells which prevent scar-like tissue formation remains a challenge. Careful manipulation of culture environments are under investigation to determine a suitable environment that simulates native ECM organization and stimulates keratocyte migration and generation.

  5. Cornea Collagen Cross-linking for Keratoconus: A Comparison between Accelerated and Conventional Methods

    Science.gov (United States)

    Razmjoo, Hasan; Peyman, Alireza; Rahimi, Ali; Modrek, Hoda Jafari

    2017-01-01

    Background: Keratoconus is a progressive degenerative disorder of the cornea in which structural changes in the cornea cause it to become thin and conical in shape. Recently, collagen cross-linking (CXL) has been introduced as an effective intervention in management of progressive keratoconus. Accelerated CXL is a new protocol of this procedure which reduces corneal ultraviolet irradiation exposure time to 5 min. This study aimed to compare visual acuity, keratometry and topographic criteria of keratoconic eyes after conventional and accelerated CXL with a six-month follow-up. Materials and Methods: In this prospective interventional study we assessed eyes of 40 patients. Patients were divided into two groups randomly. One group underwent accelerated (5 min) CXL and the other underwent conventional (30 min) CXL. Visual acuity, topographic criteria and keratometry were assessed preoperatively and 6 months postoperatively. Results: In the present study we assessed 40 patients, 50% of which were right eye (OD) and 50% were left eye (OS). Mean age of patients in the accelerated group was 22.10 and in the conventional group was 22.80 years. Our results showed no significant differences between visual acuity, keratometric and topographic criteria in the two groups before intervention. Likewise our results manifested no significant difference between visual acuity, keratometric, refractive and topographic criteria after intervention. Conclusion: According to our survey topographic criteria and keratometry improvement in the accelerated and conventional protocol are the same. So accelerated protocol is suggested as a safe and effective option for management of progressive keratoconus. PMID:28299302

  6. Control of Scar Tissue Formation in the Cornea: Strategies in Clinical and Corneal Tissue Engineering

    Directory of Open Access Journals (Sweden)

    Samantha L. Wilson

    2012-09-01

    Full Text Available Corneal structure is highly organized and unified in architecture with structural and functional integration which mediates transparency and vision. Disease and injury are the second most common cause of blindness affecting over 10 million people worldwide. Ninety percent of blindness is permanent due to scarring and vascularization. Scarring caused via fibrotic cellular responses, heals the tissue, but fails to restore transparency. Controlling keratocyte activation and differentiation are key for the inhibition and prevention of fibrosis. Ophthalmic surgery techniques are continually developing to preserve and restore vision but corneal regression and scarring are often detrimental side effects and long term continuous follow up studies are lacking or discouraging. Appropriate corneal models may lead to a reduced need for corneal transplantation as presently there are insufficient numbers or suitable tissue to meet demand. Synthetic optical materials are under development for keratoprothesis although clinical use is limited due to implantation complications and high rejection rates. Tissue engineered corneas offer an alternative which more closely mimic the morphological, physiological and biomechanical properties of native corneas. However, replication of the native collagen fiber organization and retaining the phenotype of stromal cells which prevent scar-like tissue formation remains a challenge. Careful manipulation of culture environments are under investigation to determine a suitable environment that simulates native ECM organization and stimulates keratocyte migration and generation.

  7. Geometrical custom modeling of human cornea in vivo and its use for the diagnosis of corneal ectasia.

    Directory of Open Access Journals (Sweden)

    Francisco Cavas-Martínez

    Full Text Available AIM: To establish a new procedure for 3D geometric reconstruction of the human cornea to obtain a solid model that represents a personalized and in vivo morphology of both the anterior and posterior corneal surfaces. This model is later analyzed to obtain geometric variables enabling the characterization of the corneal geometry and establishing a new clinical diagnostic criterion in order to distinguish between healthy corneas and corneas with keratoconus. METHOD: The method for the geometric reconstruction of the cornea consists of the following steps: capture and preprocessing of the spatial point clouds provided by the Sirius topographer that represent both anterior and posterior corneal surfaces, reconstruction of the corneal geometric surfaces and generation of the solid model. Later, geometric variables are extracted from the model obtained and statistically analyzed to detect deformations of the cornea. RESULTS: The variables that achieved the best results in the diagnosis of keratoconus were anterior corneal surface area (ROC area: 0.847, p<0.000, std. error: 0.038, 95% CI: 0.777 to 0.925, posterior corneal surface area (ROC area: 0.807, p<0.000, std. error: 0.042, 95% CI: 0,726 to 0,889, anterior apex deviation (ROC area: 0.735, p<0.000, std. error: 0.053, 95% CI: 0.630 to 0.840 and posterior apex deviation (ROC area: 0.891, p<0.000, std. error: 0.039, 95% CI: 0.8146 to 0.9672. CONCLUSION: Geometric modeling enables accurate characterization of the human cornea. Also, from a clinical point of view, the procedure described has established a new approach for the study of eye-related diseases.

  8. Assessing the viscoelasticity of green light induced CXL in the rabbit cornea by noncontact OCE and FEM

    Science.gov (United States)

    Han, Zhaolong; Li, Jiasong; Singh, Manmohan; Vantipalli, Srilatha; Aglyamov, Salavat R.; Wu, Chen; Liu, Chih-hao; Twa, Michael D.; Larin, Kirill V.

    2016-03-01

    The biomechanical properties of the cornea have a profound influence on its health and function. Rose bengal/green light corneal collagen cross-linking (RGX) has been proposed as an alternative to UV-A Riboflavin collagen cross-linking (UV-CXL) for treatment of keratoconus. However, the effects of RGX on the biomechanical properties of the cornea are not as well understood as UV-CXL. In this work, we demonstrate the feasibility of quantifying the viscoelasticity of the rabbit cornea before and after RGX using a noncontact method of phase-stabilized swept source optical coherence elastography (PhS-SSOCE) and finite element modeling (FEM). Viscoelastic FE models of the corneas were constructed to simulate the elastic wave propagation based on the OCE measurements. In addition, the effect of the fluid-structure interface (FSI) between the corneal posterior surface and aqueous humor on the elastic wave group velocity was also investigated. The effect of the FSI was first validated by OCE measurements and FEM simulations on contact lenses, and the OCE and FEM results were in good agreement. The Young's modulus of the rabbit cornea before RGX was assessed as E=80 kPa, and the shear viscosity was η=0.40 Pa•s at an intraocular pressure (IOP) of 15 mmHg. After RGX, the Young's modulus increased to E=112 kPa and shear viscosity decreased to η=0.37 Pa•s. Both the corneal OCE experiments and the FE simulations also demonstrated that the FSI significantly reduced the group velocity of the elastic wave, and thus, the FSI should be considered when determining the biomechanical properties of the cornea.

  9. Management of long-term persistent air leakage developed after bullectomy for giant bullous lung disease associated with neurofibromatosis type 1.

    Science.gov (United States)

    Kim, Si-Wook; Kim, Dohun

    2016-01-01

    Persistent air leakage is a serious and sometimes fatal complication of bullous lung disease surgery. A 32-year-old man with lung involvement of neurofibromatosis type I underwent bullectomy for huge bullae and recurrent pneumothorax. Persistent postoperative air leakage developed and the lung was totally collapsed. The initial surgery failed, but a second trial employing a novel suture technique on half-absorbed polyglycolic acid (PGA) felt successfully resolved the massive air leakage. Pneumothorax did not recur and the patient remained stable without dyspnea. Thus, a suture technique employing half-absorbed PGA felt was an effective option for managing persistent air leakage.

  10. Isolation and characterization of soluble sulfated polysaccharide from the red seaweed Glucaric cornea; Isolamento e caracterizacao do polissacarideo sulfatado soluvel extraido da alga vermelha Gracilaria cornea

    Energy Technology Data Exchange (ETDEWEB)

    Melo, Marcia R.S.; Freitas, Ana L.P. [Ceara Univ., Fortaleza, CE (Brazil). Dept. de Bioquimica e Biologia Molecular]. E-mail: rubiamelo@yahoo.com; Feitosa, Judith P.A.; Paula, Regina C.M. de [Ceara Univ., Fortaleza, CE (Brazil). Dept. de Quimica Organica e Inorganica]. E-mail: judith@dqoi.ufc.br

    2001-07-01

    The composition, structure and rheological properties of soluble sulphated polysaccharide Glucaric cornea from Brazilian red seaweeds were investigated. The main components of polysaccharide were 3,6-anhydrogalactose (24.7%) and galactose (64.6%). In addition, minor components as 6-O-methyl-galactose (8.5%), glucose (1.5%), xylose (0.7%) and sulfated groups (4.8%) were detected. Comparison between sulphates content determined by Ft-IR spectroscopy and micro elemental analysis was made. Data from {sup 13}C NMR and FT-IR provided evidence of sulphation in C-4 and C-6 of galactose. No gelation with 1.5, 2.0 and 3.0 % (w/v) aqueous solution was observed, even cooled up to 4 deg C. GPC indicated two majors polysaccharide fractions of M{sub pk} 7.4 x 10{sup 4} and 1.8 x 10{sup 4} g/mol and a minor fraction of M{sub pk} 2.1 x 10{sup 6} g/mol. (author)

  11. Corneal collagen crosslinking in keratoconus and other eye disease

    Institute of Scientific and Technical Information of China (English)

    Adel; Alhayek; Pei-Rong; Lu

    2015-01-01

    Keratoconus is a condition characterized by biomechanical instability of the cornea, presenting in a progressive, asymmetric and bilateral way. Corneal collagen crosslinking(CXL) with riboflavin and Ultraviolet-A(UVA) is a new technique of corneal tissue strengthening that combines the use of riboflavin as a photo sensitizer and UVA irradiation. Studies showed that CXL was effective in halting the progression of keratoconus over a period of up to four years. The published studies also revealed a reduction of max K readings by more than 2 D, while the postoperative spherical equivalent(SEQ) was reduced by an average of more than 1 D and refractive cylinder decreased by about1 D. The major indication for the use of CXL is to inhibit the progression of corneal ecstasies, such as keratoconus and pellucid marginal degeneration. CXL may also be effective in the treatment and prophylaxis of iatrogenic keratectasia, resulting from excessively aggressive photo ablation. This treatment has been used to treat infectious corneal ulcers with apparent favorable results. Most recent studies demonstrate the beneficial impact of CXL for iatrogenic ecstasies, pellucid marginal degeneration, infectious keratitis, bullous keratopathy and ulcerative keratitis. Several long-term and short-term complications of CXL have been studied and documented. The possibility of a secondary infection after the procedure exists because the patient is subject to epithelial debridement and the application of a soft contact lens. Formation of temporary corneal haze,permanent scars, endothelial damage, treatment failure,sterile infiltrates, bullous keratopathy and herpes reactivation are the other reported complications of this procedure.

  12. Linear IgA bullous disease with possible immunoreactivity to the basement membrane zone and dermal blood vessels

    Directory of Open Access Journals (Sweden)

    Ana Maria Abreu Velez

    2014-01-01

    Full Text Available Introduction: Linear IgA bullous dermatosis (LAD is an immunobullous disorder, in which IgA antibodies are deposited along the basement membrane zone (BMZ of the skin in a linear pattern. The cause of this disease is unknown, but the eruption may occur more commonly in association with certain medications. Case report: A 61 year old woman presented with blisters in the axillae and legs, with pain, itching and swelling. She was taking many medications for other conditions such diabetes and obesity. Tense blisters were seen, primarily on the legs and accompanied by some ankle swelling. Methods: Skin biopsies for hematoxylin and eosin (H&E examination, as well as for direct immunofluorescence (DIF, and immunohistochemistry (IHC studies were performed. Results: The H&E examination revealed a subepidermal blister, with small numbers of lymphocytes, neutrophils and eosinophils noted within the blister lumen. The dermis also displayed a mild, superficial, perivascular infiltrate of lymphocytes and histiocytes; eosinophils and neutrophils were also noted. DIF and IHC studies confirmed the diagnosis of linear IgA (LAD at the BMZ. However, in addition to immunoglobulin A, we also observed deposits of IgA, IgM, IgG, IgD, Kappa, Lambda, Complement/C3c, C1q, fibrinogen and albumin around upper dermal blood vessels. Conclusions: LAD has been most commonly associated with medication intake; the most common DIF immune response is the presence of linear IgA at the BMZ. However, here we found additional reactivity to against dermal blood vessels. Because the patient is affected by diabetes mellitus, it is difficult to know if the observed vascular reactivity was associated with the diabetes or solely an immune reaction to the vessels. Based on our findings, we encourage searching for vascular reactivity in cases of LAD.

  13. Clinical performance of KeraSoft® IC in irregular corneas

    Directory of Open Access Journals (Sweden)

    Su S

    2015-10-01

    Full Text Available Stephanie Su,1 Lynette Johns,2 Marjorie J Rah,3 Robert Ryan,1 Joseph Barr3 1Visionary Eye Associates of Rochester, Rochester, NY, USA; 2Custom Lab Channel Business, Bausch & Lomb Incorporated, Wilmington, MA, USA; 3Medical Affairs – Vision Care, Bausch & Lomb Incorporated, Rochester, NY, USA Purpose: This study evaluated the clinical performance of KeraSoft® IC (KIC soft contact lenses in subjects with irregular corneas.Patients and methods: This was a 12-month, prospective, open-label, observational study, which enrolled 43 subjects who were 18 years of age or older with irregular corneas. Subjects were fit according to the KIC Fitting Manual (kerasoftic.com. After achieving best fit according to the fitting manual, lenses were assessed for comfort, vision, centration, rotation, and movement. Subjects were instructed to wear their lenses between 8 and 16 hours each day. Assessments at the exit visit included logMAR visual acuity with high and low contrast, spherocylindrical overrefraction, slit-lamp findings, adverse events, and subjective outcomes.Results: The average base curve was 8.17±0.32 mm (n=70 eyes, and the average diameter dispensed was 14.53±0.12 mm (n=70 eyes. From the baseline to 12 months, there was statistically significant improvement in logMAR visual acuity with high contrast (P=0.038, but no significant difference in low-contrast visual acuity was observed (P>0.05. Slit-lamp findings were ≤ grade 1 for the majority of subjects (89%. Two nonserious adverse events were reported for two of the 84 enrolled eyes (two subjects. At 12 months, subjects reported improvements from habitual baseline for comfort and vision, both upon insertion and just before removal of lenses.Conclusion: Clinical outcomes at 12 months showed good visual, safety, and subjective outcomes for subjects with corneal irregularities who wore KeraSoft® IC soft contact lenses. Keywords: irregular corneas, keratoconus, soft contact lenses, KeraSoft® IC

  14. Changes in biomechanical properties of the cornea after modified transepithelial crosslinking

    Directory of Open Access Journals (Sweden)

    I. B. Medvedev

    2016-01-01

    Full Text Available The aim of the study was to evaluate changes in biomechanical properties of the cornea after conducting transepithelial crosslinking with the prior application of a 40 % glucose solution.Materials and methods. Just studied the biomechanical properties of the corneas of six rabbits breed Chinchilla (12 eyes. 4 rabbit entered in the experimental group, in which in one eye glucose solution was applied on the cornea and allowed to stay for 10 minutes, followed by the instillation of 0.1 % Riboflavin solution for 30 minutes. On a couple of the rabbit eye was applied a solution of Riboflavin without prior instillation of glucose. Then carried out the procedure of irradiation according to the conventional technology with UV with a wavelength of 370 μm and a beam energy of 3.0 mW / cm2. Two rabbits (4 eyes were included in the control group, in which crosslinking was not performed. After 1 month the euthanasia of the animals was performed with subsequent enucleation for corneal research on a tensile testing machine. In the control and experimental group compared, the relaxation curves and the following parameters were analyzed: initial stress (MPa, equilibrium stress (MPa modulus of elasticity.Results and their discussion. After the crosslinking the rise of the initial stress (in the control group and 0.7+0.1 MPa, in the experimental and 1.5+0.2 1.3+0.3 MPa, respectively. The stress relaxation is fast (equilibrium stress value is reached after 250 sec. and after the administration of glucose for approximately 75 seconds, which means a greater rigidity of experimental group of samples. In the experimental groups significantly changed and the modulus of elasticity: its value has increased approximately in 2 times in comparison with control samples. The equilibrium stress values in the experimental groups were different from the zero value that also indicates a change in the chemical structure of the samples.Conclusions. Holding transepithelial of

  15. Global and local contributions to surface curva- ture of healthy corneas

    Directory of Open Access Journals (Sweden)

    Alan Rubin

    2012-12-01

    Full Text Available This paper demonstrates for several healthy eyes the application of a simple model to understanding local and global contributions to short-term variation in anterior and posterior corneal curvature. Multiple axial anterior and posterior corneal radii and central corneal thicknesses for the right eyes of 10 young subjects were determined over time using a rotating Scheimpflug camera (Oculus Pentacam. The axial radii were transformed to corneal powers, and also to curvatures that were referred to a mid-corneal surface such that local and global contributions to short-term variation could be analyzed quantitatively.When variation of the anterior and posterior corneal surfaces of several healthy eyes are studied in terms of curvatures (rather than powers it is the posterior surfaces that are more variable withthe global or macroscopic rather than local effects dominating. (Harris and Gillan found the same for an eye with mild keratoconus. This finding is opposite to that when variation is considered in terms of dioptric power where the anterior corneal surface usually appears more variable. Possible reasons for this finding includes firstly that the posterior corneal surface has to be measured through the air-tear interface and anterior corneal surface,and thus some uncertainty in measurements of the posterior surface may relate to this limitation. Secondly, no attempt was made here to mathematically align the multiple surfaces as determined per eye and thus we cannot be certain that precisely the same central corneal region was measured each time.Investigators need to carefully consider whether they are more interested in the optical or physical nature of variation in surfaces such as the cornea since studies of the optical effects require theanalysis to be performed in terms of dioptric powers and  symmetric dioptric power space whereas studies of physical variation in the topography of the cornea and the possible reasons for such variability

  16. Collection, processing and testing of bone, corneas, umbilical cord blood and haematopoietic stem cells by European Blood Alliance members

    DEFF Research Database (Denmark)

    Närhi, M; Natri, O; Desbois, I;

    2013-01-01

    A questionnaire study was carried out in collaboration with the European Blood Alliance (EBA) Tissues and Cells (T&C) working group. The aim was to assess the level of involvement and commonality of processes on the procurement, testing and storage of bone, corneas, umbilical cord blood (UCB...

  17. Induction of morphological and electrophysiological changes in hamster cornea after in vitro interaction with trophozoites of Acanthamoeba spp.

    Science.gov (United States)

    Omaña-Molina, Maritza; Navarro-García, Fernando; González-Robles, Arturo; Serrano-Luna, José de Jesús; Campos-Rodríguez, Rafael; Martínez-Palomo, Adolfo; Tsutsumi, Víctor; Shibayama, Mineko

    2004-06-01

    Acanthamoeba castellani and Acanthamoeba polyphaga are free-living amebae that cause keratitis and granulomatous encephalitis in humans. We have analyzed the early morphological and electrophysiological changes occurring during the in vitro interaction of cultured amebae with intact or physically damaged corneas obtained from hamsters. Both species of Acanthamoeba produced similar cytopathic changes, as seen by light microscopy and scanning electron microscopy. After adhesion to the epithelial surface, trophozoites formed clumps and migrated toward the cell borders, causing the separation of adjacent cells at 1 h of coculture. At later stages (2 to 4 h), some amebae were found under desquamating epithelial cells whereas others were seen associated with damaged cells or forming amebostome-like structures to ingest detached epithelial cells. Control corneas incubated in culture medium conditioned with amebae showed a cytoplasmic vacuolization and blurring of the epithelial-stromal junction. The early stages of corneal epithelial damage caused by amebae were also analyzed by measuring the transepithelial resistance changes in corneas mounted in Ussing chambers. Both species of Acanthamoeba caused a rapid decrease in electrical resistance. The present observations demonstrate that under in vitro conditions, Acanthamoeba trophozoites rapidly cause significant damage to the corneal epithelium. Furthermore, in our experimental model, previous physical damage to the corneas was not a prerequisite for the development of amebic corneal ulcerations.

  18. Force analysis of bacterial transmission from contact lens cases to corneas, with the contact lens as the intermediary

    NARCIS (Netherlands)

    Qu, Wen-wen; Hooymans, Johanna MM; de Vries, Jacob; van der Mei, Henderina; Busscher, Hendrik

    2011-01-01

    PURPOSE. To determine the probability of transmission of a Staphylococcus aureus strain from a contact lens case, to the contact lens (CL) surfaces, to the cornea, on the basis of bacterial adhesion forces measured by using atomic force microscopy (AFM). METHODS. Adhesion forces between S. aureus st

  19. Corneal Sulfated Glycosaminoglycans and Their Effects on Trigeminal Nerve Growth Cone Behavior In Vitro: Roles for ECM in Cornea Innervation

    OpenAIRE

    Schwend, Tyler; Deaton, Ryan J.; Zhang, Yuntao; Caterson, Bruce; Conrad, Gary W.

    2012-01-01

    In this investigation, we describe differential spatiotemporal expression patterns of glycosaminoglycans KS, DS, and CSA/C during developmental stages of cornea innervation. We show that purified GAGs have divergent effects on trigeminal neuron behavior using in vitro neuronal explant cultures.

  20. Cultured corneas show dendritic spread and restrict herpes simplex virus infection that is not observed with cultured corneal cells

    Science.gov (United States)

    Thakkar, Neel; Jaishankar, Dinesh; Agelidis, Alex; Yadavalli, Tejabhiram; Mangano, Kyle; Patel, Shrey; Tekin, Sati Zeynep; Shukla, Deepak

    2017-01-01

    Herpes simplex virus-1 (HSV-1) causes life-long morbidities in humans. While fever blisters are more common, occasionally the cornea is infected resulting in vision loss. A very intriguing aspect of HSV-1 corneal infection is that the virus spread is normally restricted to only a small fraction of cells on the corneal surface that connect with each other in a dendritic fashion. Here, to develop a comprehensive understanding of the susceptibility of human corneal epithelial (HCE) cells to HSV-1 infection, we infected HCE cells at three different dosages of HSV-1 and measured the outcomes in terms of viral entry, gene and protein expression, viral replication and cytokine induction. In cultured cells, infectivity and cytokine induction were observed even at the minimum viral dosage tested, while a more pronounced dose-restricted infectivity was seen in ex vivo cultures of porcine corneas. Use of fluorescent HSV-1 virions demonstrated a pattern of viral spread ex vivo that mimics clinical findings. We conclude that HCE cell cultures are highly susceptible to infection whereas the cultured corneas demonstrate a higher ability to restrict the infection even in the absence of systemic immune system. The restriction is helped in part by local interferon response and the unique cellular architecture of the cornea. PMID:28198435

  1. Optical properties of the human cornea : Shape and wave aberration measurements using the VU topographer and Scheimpflug photography

    NARCIS (Netherlands)

    Sicam, V.A.D.P.

    2007-01-01

    In this study, the optical properties of the human cornea was investigated. Two major developments were made because current measurement techniques need improvement First, the VU topographer, which uses a color coded pattern, was validated with real eye data showing better performance compare to co

  2. Fibre optic spectrophotometry for the in vitro evaluation of ultraviolet radiation (UVR) spectral transmittance of rabbit corneas.

    Science.gov (United States)

    Walsh, J E; Bergmanson, J P G; Koehler, L V; Doughty, M J; Fleming, D P; Harmey, J H

    2008-03-01

    A fibre optic spectrophotometer front-end system for measuring corneas to overcome shortcomings associated with existing instruments was tested. The system allowed prompt measurement postmortem, minimizing beam pathlength to reduce the effects of scatter and unwanted refraction and eliminated optical interfaces and cuvette media. Rabbit corneas were excised immediately postmortem and placed on a detecting fibre optic coupled to an Ocean Optics spectrophotometer and illuminated by a deuterium-halogen source. The compact instrument with its small beam size allowed tissue profiling at test points across the corneal surface and efficient interchange for comparison of different tissues. This simplified system operation allowed rapid tissue altering to study induced changes on transmittance. The corneal transmittance data showed a consistent sharp cut-off at 320 nm in the ultraviolet radiation (UVR) spectrum, which decayed rapidly from postmortem swelling. Inter- and intra-corneal consistency was demonstrated by comparing data from different regions of the same cornea and those from opposite eyes. Changes to the spectra, particularly in the UVB below 300 nm, were evident when the corneal epithelium was removed, indicating that this layer is not the only corneal UVR filter. The new system reduced much of the variability associated with previous methods, as it rapidly measured corneal transmittance postmortem. Data are in broad agreement with published transmittance curves. The removal of the corneal epithelium revealed a substantial stromal contribution to the overall corneal UVR absorption, suggesting that corneas with pathologically or iatrogenically thinned stromas are less effective UVR blockers.

  3. Mutations in PRDM5 in Brittle Cornea Syndrome Identify a Pathway Regulating Extracellular Matrix Development and Maintenance

    NARCIS (Netherlands)

    Wright, Emma M. M. Burkitt; Spencer, Helen L.; Daly, Sarah B.; Manson, Forbes D. C.; Zeef, Leo A. H.; Urquhart, Jill; Zoppi, Nicoletta; Bonshek, Richard; Tosounidis, Ioannis; Mohan, Meyyammai; Madden, Colm; Dodds, Annabel; Chandler, Kate E.; Banka, Siddharth; Au, Leon; Clayton-Smith, Jill; Khan, Naz; Biesecker, Leslie G.; Wilson, Meredith; Rohrbach, Marianne; Colombi, Marina; Giunta, Cecilia; Black, Graeme C. M.

    2011-01-01

    Extreme corneal fragility and thinning, which have a high risk of catastrophic spontaneous rupture, are the cardinal features of brittle cornea syndrome (BCS), an autosomal-recessive generalized connective tissue disorder. Enucleation is frequently the only management option for this condition, resu

  4. Cadmium toxicity to the cornea of pregnant rats: Electron microscopy and x-ray microanalysis

    Energy Technology Data Exchange (ETDEWEB)

    Yoshizuka, M.; McCarthy, K.J.; Kaye, G.I.; Fujimoto, S. (Univ. of Occupational and Environmental Health, School of Medicine, Kitakyushu (Japan))

    1990-05-01

    Cadmium toxicity to the cornea of pregnant rats was studied using the electron microscope and x-ray microanalyzer. In in-vivo experiments, severe corneal edema occurred in pregnant dams that received intraperitoneal injections of cadmium sulphate for 4 days during gestation, but not in nonpregnant rats. Prominent swelling of mitochondria and the occurrence of intra- and intercellular vacuoles in the corneal endothelium were observed only in pregnant dams. In in-vitro experiments, electron-dense deposits consisting of cadmium-oxine complexes were preferentially found in swollen mitochondria of the endothelial cells. Cadmium peaks were obtained from these deposits with x-ray microanalysis. These data suggest that the corneal edema observed after administration of cadmium may imply the disturbance of pump function and barrier function of the corneal endothelium due to the primary toxic effects of this metal on mitochondria.

  5. Automatic pterygium detection on cornea images to enhance computer-aided cortical cataract grading system.

    Science.gov (United States)

    Gao, Xinting; Wong, Damon Wing Kee; Aryaputera, Aloysius Wishnu; Sun, Ying; Cheng, Ching-Yu; Cheung, Carol; Wong, Tien Yin

    2012-01-01

    In this paper, we present a new method to detect pterygiums using cornea images. Due to the similarity of appearances and spatial locations between pterygiums and cortical cataracts, pterygiums are often falsely detected as cortical cataracts on retroillumination images by a computer-aided grading system. The proposed method can be used to filter out the pterygium which improves the accuracy of cortical cataract grading system. This work has three major contributions. First, we propose a new pupil segmentation method for visible wavelength images. Second, an automatic detection method of pterygiums is proposed. Third, we develop an enhanced compute-aided cortical cataract grading system that excludes pterygiums. The proposed method is tested using clinical data and the experimental results demonstrate that the proposed method can improve the existing automatic cortical cataract grading system.

  6. Pathogenic strains of Acanthamoeba are recognized by TLR4 and initiated inflammatory responses in the cornea.

    Science.gov (United States)

    Alizadeh, Hassan; Tripathi, Trivendra; Abdi, Mahshid; Smith, Ashley Dawn

    2014-01-01

    Free-living amoebae of the Acanthamoeba species are the causative agent of Acanthamoeba keratitis (AK), a sight-threatening corneal infection that causes severe pain and a characteristic ring-shaped corneal infiltrate. Innate immune responses play an important role in resistance against AK. The aim of this study is to determine if Toll-like receptors (TLRs) on corneal epithelial cells are activated by Acanthamoeba, leading to initiation of inflammatory responses in the cornea. Human corneal epithelial (HCE) cells constitutively expressed TLR1, TLR2, TLR3, TLR4, and TLR9 mRNA, and A. castellanii upregulated TLR4 transcription. Expression of TLR1, TLR2, TLR3, and TLR9 was unchanged when HCE cells were exposed to A. castellanii. IL-8 mRNA expression was upregulated in HCE cells exposed to A. castellanii. A. castellanii and lipopolysaccharide (LPS) induced significant IL-8 production by HCE cells as measured by ELISA. The percentage of total cells positive for TLR4 was higher in A. castellanii stimulated HCE cells compared to unstimulated HCE cells. A. castellanii induced upregulation of IL-8 in TLR4 expressing human embryonic kidney (HEK)-293 cells, but not TLR3 expressing HEK-293 cells. TLR4 neutralizing antibody inhibited A. castellanii-induced IL-8 by HCE and HEK-293 cells. Clinical strains but not soil strains of Acanthamoeba activated TLR4 expression in Chinese hamster corneas in vivo and in vitro. Clinical isolates but not soil isolates of Acanthamoeba induced significant (PAcanthamoeba activate TLR4 and induce production of CXCL2 in the Chinese hamster model of AK. TLR4 may be a potential target in the development of novel treatment strategies in Acanthamoeba and other microbial infections that activate TLR4 in corneal cells.

  7. In vivo laser confocal microscopy findings of a cornea with osteogenesis imperfecta

    Directory of Open Access Journals (Sweden)

    Kobayashi A

    2014-02-01

    Full Text Available Akira Kobayashi, Tomomi Higashide, Hideaki Yokogawa, Natsuko Yamazaki, Toshinori Masaki, Kazuhisa Sugiyama Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan Objective: To report the in vivo laser confocal microscopy findings of a cornea with osteogenesis imperfecta (OI with special attention to the abnormality of Bowman's layer and sub-Bowman's fibrous structures (K-structures. Patients and methods: Two patients (67-year-old male and his 26-year-old son with OI type I were included in this study. Slit lamp biomicroscopic and in vivo laser confocal microscopic examinations were performed for both patients. Central corneal thickness and central endothelial cell density were also measured. Results: Although the corneas looked clear with normal endothelial density for both eyes in both patients, they were quite thin (386 µm oculus dexter (OD (the right eye and 384 µm oculus sinister (OS (the left eye in the father and 430 µm OD and 425 µm OS in the son. In both patients, slit lamp biomicroscopic and in vivo laser confocal microscopic examination showed similar results. Anterior corneal mosaics produced by rubbing the eyelid under fluorescein were completely absent in both eyes. In vivo laser confocal microscopy revealed an absent or atrophic Bowman's layer; a trace of a presumed Bowman's layer and/or basement membrane was barely visible with high intensity. Additionally, K-structures were completely absent in both eyes. Conclusion: The absence of K-structures and fluorescein anterior corneal mosaics strongly suggested an abnormality of Bowman's layer in these OI patients. Keywords: osteogenesis imperfecta, K-structure, confocal microscopy, Bowman's layer

  8. Turnover of bone marrow-derived cells in the irradiated mouse cornea

    Science.gov (United States)

    Chinnery, Holly R; Humphries, Timothy; Clare, Adam; Dixon, Ariane E; Howes, Kristen; Moran, Caitlin B; Scott, Danielle; Zakrzewski, Marianna; Pearlman, Eric; McMenamin, Paul G

    2008-01-01

    In light of an increasing awareness of the presence of bone marrow (BM)-derived macrophages in the normal cornea and their uncertain role in corneal diseases, it is important that the turnover rate of these resident immune cells be established. The baseline density and distribution of macrophages in the corneal stroma was investigated in Cx3cr1gfp transgenic mice in which all monocyte-derived cells express enhanced green fluorescent protein (eGFP). To quantify turnover, BM-derived cells from transgenic eGFP mice were transplanted into whole-body irradiated wild-type recipients. Additionally, wild-type BM-derived cells were injected into irradiated Cx3cr1+/gfp recipients, creating reverse chimeras. At 2, 4 and 8 weeks post-reconstitution, the number of eGFP+ cells in each corneal whole mount was calculated using epifluorescence microscopy, immunofluorescence staining and confocal microscopy. The total density of myeloid-derived cells in the normal Cx3cr1+/gfp cornea was 366 cells/mm2. In BM chimeras 2 weeks post-reconstitution, 24% of the myeloid-derived cells had been replenished and were predominantly located in the anterior stroma. By 8 weeks post-reconstitution 75% of the myeloid-derived cells had been replaced and these cells were distributed uniformly throughout the stroma. All donor eGFP+ cells expressed low to moderate levels of CD45 and CD11b, with approximately 25% coexpressing major histocompatibility complex class II, a phenotype characteristic of previous descriptions of corneal stromal macrophages. In conclusion, 75% of the myeloid-derived cells in the mouse corneal stroma are replenished after 8 weeks. These data provide a strong basis for functional investigations of the role of resident stromal macrophages versus non-haematopoietic cells using BM chimeric mice in models of corneal inflammation. PMID:18540963

  9. IgG BULLOUS PEMPHIGOID WITH ANTIBODIES TO IgD, DERMAL BLOOD VESSELS, ECCRINE GLANDS AND THE ENDOMYSIUM OF MONKEY ESOPHAGUS

    Directory of Open Access Journals (Sweden)

    Abreu Velez Ana Maria

    2011-04-01

    Full Text Available Context: Bullous pemphigoid is mediated by autoantibodies primarily targeting two structural proteins of basement membrane hemidesmosomes, BP180 (BPAG2; collagen XVII and BP230 (BPAG1. Case Report: A 70-year-old Caucasian male patient was evaluated for a seven day history of multiple itching, erythematous blisters on his extremities. Biopsies for hematoxylin and eosin examination, direct immunofluorescence and indirect immunofluorescence (including salt split skin analysis were performed. Results: Hematoxylin and eosin examination demonstrated a subepidermal blister. Within the blister lumen, numerous eosinophils and lymphocytes were noted. Direct and indirect immunofluorescence revealed linear deposits of IgG, Complement/C3 and fibrinogen at the basement membrane zone of the skin and surrounding selected dermal blood vessels and sweat glands. Positive intracytoplasmic staining for anti-human IgD was noted in most of the epidermis, as well as surrounding some dermal blood vessels. Indirect immunofluorescence utilizing monkey esophagus substrate demonstrated strong positivity within the endomysium for IgG antibodies. Conclusion: We report a unique case of bullous pemphigoid with reactivity to eccrine sweat glands, and selected dermal blood vessels. In addition, the observed reactivity of anti-human IgD, and of IgG to monkey esophagus endomysium warrant further investigation.

  10. Amniotic membrane covering promotes healing of cornea epithelium and improves visual acuity after debridement for fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    Bo; Zeng; Ping; Wang; Ling-Juan; Xu; Xin-Yu; Li; Hong; Zhang; Gui-Gang; Li

    2014-01-01

    AIM:To investigate the effect of amniotic membrane covering(AMC) on the healing of cornea epithelium and visual acuity for fungal keratitis after debridement.METHODS:Twenty fungal keratitis patients were divided into two groups randomly, the AMC group and the control group, ten patients each group. Both debridement of the infected cornea tissue and standard anti-fungus drugs treatments were given to every patients, monolayer amniotic membrane were sutured to the surface of the entire cornea and bulbar conjunctiva with 10-0 nylon suture for patients in the AMC group.The diameter of the ulcer was determined with slit lamp microscope and the depth of the infiltration was determined with anterior segment optical coherence tomography. Uncorrected visual acuity(UCVA) was tested before surgery and three month after healing of the epithelial layer. The healing time of the cornea epithelium, visual acuity(VA) was compared between the two groups using t- test.RESULTS:There was no statistical difference of the diameter of the ulcer, depth of the infiltration, height of the hypopyon and VA between the two groups beforesurgery(P >0.05). The average healing time of the AMC group was 6.89 ±2.98 d, which was statistically shorter than that of the control group(10.23±2.78d)(P <0.05).The average UCVA of the AMC group was 0.138 ±0.083,which was statistically better than that of the control group(0.053±0.068)(P <0.05).CONCLUSION:AMC surgery could promote healing of cornea epithelium after debridement for fungal keratitis and lead to better VA outcome.

  11. Novel micelle carriers for cyclosporin A topical ocular delivery: in vivo cornea penetration, ocular distribution and efficacy studies.

    Science.gov (United States)

    Di Tommaso, Claudia; Bourges, Jean-Louis; Valamanesh, Fatemeh; Trubitsyn, Gregory; Torriglia, Alicia; Jeanny, Jean-Claude; Behar-Cohen, Francine; Gurny, Robert; Möller, Michael

    2012-06-01

    Cornea transplantation is one of the most performed graft procedures worldwide with an impressive success rate of 90%. However, for "high-risk" patients with particular ocular diseases in addition to the required surgery, the success rate is drastically reduced to 50%. In these cases, cyclosporin A (CsA) is frequently used to prevent the cornea rejection by a systemic treatment with possible systemic side effects for the patients. To overcome these problems, it is a challenge to prepare well-tolerated topical CsA formulations. Normally high amounts of oils or surfactants are needed for the solubilization of the very hydrophobic CsA. Furthermore, it is in general difficult to obtain ocular therapeutic drug levels with topical instillations due to the corneal barriers that efficiently protect the intraocular structures from foreign substances thus also from drugs. The aim of this study was to investigate in vivo the effects of a novel CsA topical aqueous formulation. This formulation was based on nanosized polymeric micelles as drug carriers. An established rat model for the prevention of cornea graft rejection after a keratoplasty procedure was used. After instillation of the novel formulation with fluorescent labeled micelles, confocal analysis of flat-mounted corneas clearly showed that the nanosized carriers were able to penetrate into all corneal layers. The efficacy of a 0.5% CsA micelle formulation was tested and compared to a physiological saline solution and to a systemic administration of CsA. In our studies, the topical CsA treatment was carried out for 14 days, and the three parameters (a) cornea transparency, (b) edema, and (c) neovascularization were evaluated by clinical observation and scoring. Compared to the control group, the treated group showed a significant higher cornea transparency and significant lower edema after 7 and 13 days of the surgery. At the end point of the study, the neovascularization was reduced by 50% in the CsA-micelle treated

  12. Human Eosinophils Express the High Affinity IgE Receptor, FcεRI, in Bullous Pemphigoid

    Science.gov (United States)

    Messingham, Kelly N.; Holahan, Heather M.; Frydman, Alexandra S.; Fullenkamp, Colleen; Srikantha, Rupasree; Fairley, Janet A.

    2014-01-01

    Bullous pemphigoid (BP) is an autoimmune blistering disease mediated by autoantibodies targeting BP180 (type XVII collagen). Patient sera and tissues typically have IgG and IgE autoantibodies and elevated eosinophil numbers. Although the pathogenicity of the IgE autoantibodies is established in BP, their contribution to the disease process is not well understood. Our aims were two-fold: 1) To establish the clinical relationships between total and BP180-specific IgE, eosinophilia and other markers of disease activity; and 2) To determine if eosinophils from BP patients express the high affinity IgE receptor, FcεRI, as a potential mechanism of action for IgE in BP. Our analysis of 48 untreated BP patients revealed a correlation between BP180 IgG and both BP180 IgE and peripheral eosinophil count. Additionally, we established a correlation between total IgE concentration and both BP180 IgE levels and eosinophil count. When only sera from patients (n = 16) with total IgE≥400 IU/ml were analyzed, BP180 IgG levels correlated with disease severity, BP230 IgG, total circulating IgE and BP180 IgE. Finally, peripheral eosinophil count correlated more strongly with levels of BP180 IgE then with BP180 IgG. Next, eosinophil FcεRI expression was investigated in the blood and skin using several methods. Peripheral eosinophils from BP patients expressed mRNA for all three chains (α, β and γ) of the FcεRI. Surface expression of the FcεRIα was confirmed on both peripheral and tissue eosinophils from most BP patients by immunostaining. Furthermore, using a proximity ligation assay, interaction of the α- and β-chains of the FcεRI was observed in some biopsy specimens, suggesting tissue expression of the trimeric receptor form in some patients. These studies provide clinical support for the relevance of IgE in BP disease and provide one mechanism of action of these antibodies, via binding to the FcεRI on eosinophils. PMID:25255430

  13. Human eosinophils express the high affinity IgE receptor, FcεRI, in bullous pemphigoid.

    Directory of Open Access Journals (Sweden)

    Kelly N Messingham

    Full Text Available Bullous pemphigoid (BP is an autoimmune blistering disease mediated by autoantibodies targeting BP180 (type XVII collagen. Patient sera and tissues typically have IgG and IgE autoantibodies and elevated eosinophil numbers. Although the pathogenicity of the IgE autoantibodies is established in BP, their contribution to the disease process is not well understood. Our aims were two-fold: 1 To establish the clinical relationships between total and BP180-specific IgE, eosinophilia and other markers of disease activity; and 2 To determine if eosinophils from BP patients express the high affinity IgE receptor, FcεRI, as a potential mechanism of action for IgE in BP. Our analysis of 48 untreated BP patients revealed a correlation between BP180 IgG and both BP180 IgE and peripheral eosinophil count. Additionally, we established a correlation between total IgE concentration and both BP180 IgE levels and eosinophil count. When only sera from patients (n = 16 with total IgE ≥ 400 IU/ml were analyzed, BP180 IgG levels correlated with disease severity, BP230 IgG, total circulating IgE and BP180 IgE. Finally, peripheral eosinophil count correlated more strongly with levels of BP180 IgE then with BP180 IgG. Next, eosinophil FcεRI expression was investigated in the blood and skin using several methods. Peripheral eosinophils from BP patients expressed mRNA for all three chains (α, β and γ of the FcεRI. Surface expression of the FcεRIα was confirmed on both peripheral and tissue eosinophils from most BP patients by immunostaining. Furthermore, using a proximity ligation assay, interaction of the α- and β-chains of the FcεRI was observed in some biopsy specimens, suggesting tissue expression of the trimeric receptor form in some patients. These studies provide clinical support for the relevance of IgE in BP disease and provide one mechanism of action of these antibodies, via binding to the FcεRI on eosinophils.

  14. OrbscanⅡ角膜地形图系统筛查亚临床期圆锥角膜%Screening of Subclinical Keratoconus by OrbscanⅡ Cornea Topography

    Institute of Scientific and Technical Information of China (English)

    虞林丽; 赵刚平; 朱敏; 王艳华; 李追; 赵岭江; 张亚军

    2012-01-01

    Objective To evaluate the features of cornea topography in subclinical keratoconus. Methods Orbscan II cornea topography system was performed on 15 patients(26 eyes) with subclinical keratoconus. Diff values of cornea anterior surface and posterior surface, thickness of the thinnest cornea, center refractive power of cornea, and simulated keratometry were measured. Results Diff values of cornea anterior surface and posterior surface in subclinical keratoconus were 0. 025 and 0. 050 mm respectively, thickness of the thinnest cornea was (450.65 + 35.67) μm;SimK was (4. 55 + 1. 09)D, and center refractive power of cornea was (47. 1 ±3. 5) D. Diff value of cornea anterior surface had a positive correlation with diff value of cornea posterior surface and center refractive power of cornea. Conclusion Orbscan JJ cornea topography system can provide morphological basis for early diagnosis of subclinical keratoconus.%目的 研究亚临床期圆锥角膜的角膜地形图改变的特点.方法 应用 OrbscanⅡ角膜地形图系统检测15例(26只眼)亚临床期圆锥角膜患者的角膜,得到角膜前表面和后表面Diff 值、角膜最薄点厚度、角膜中央屈光力及角膜模拟镜差值(SimK 值),了解亚临床期圆锥角膜的敏感性指标以及各指标之间的相关关系.结果 亚临床期圆锥角膜的角膜前表面Diff 值是0.025 mm,角膜后表面Diff 值为0.050 mm;角膜最薄点厚度(450.65±35.67)μm;SimK值为(4.55±1.09)D;角膜中央屈光力为(47.1 ±3.5)D.角膜前表面Diff值与角膜后表面Diff值、角膜中央屈光力呈正相关关系;角膜后表面Diff值与角膜中央屈光力呈正相关关系.结论 OrbscanⅡ角膜地形图系统可为早期诊断亚临床期圆锥角膜提供形态学依据.

  15. Immunogenicity of a Moraxella bovis bacterin containing attachment and cornea-degrading enzyme antigens.

    Science.gov (United States)

    Gerber, J D; Selzer, N L; Sharpee, R L; Beckenhauer, W H

    1988-02-01

    An adjuvanted Moraxella bovis bacterin containing attachment antigens and cornea-degrading enzyme antigens protected cattle from infectious bovine keratoconjunctivitis (IBK) when experimentally challenged with homologous and heterologous challenge cultures of M. bovis. This bacterin also protected cattle against field exposure to M. bovis. Transmission electron microscopy and fluorescein labeled anti-M. bovis pili antiserum showed pili on the M. bovis bacterin strain. Scanning electron microscopy demonstrated a fibrillar glycocalyx. The bacterin strain of M. bovis, but not all strains of M. bovis, destroyed bovine corneal cell monolayers in vitro. Bovine corneal cells began to separate from each other within 5 min after M. bovis organisms were added and adhered to the cell monolayers. Moraxella bovis organisms remained attached to the disintegrating cells as the cell membrane separated and was digested. Vaccination stimulated bacterial agglutination antibodies. However, protection against experimental challenge was more closely related to the cornea-degrading enzyme content of the experimental bacterins. Twenty-two of 29 cattle (76%) vaccinated with bacterins containing a relative enzyme activity (REA) greater than 0.4 were protected in a rigorous challenge of immunity test. Only 1 of 21 non-vaccinated calves (5%) was free of IBK. Ninety-two percent (24/26) of calves vaccinated with a bacterin containing a REA greater than 0.29 remained free of IBK following field exposure, whereas 47% (8/17) non-vaccinated calves developed IBK. Only 8 of 12 calves (67%) vaccinated with a bacterin containing a REA of 0.09 remained free of IBK. In a larger field efficacy test consisting of 32 herds in six states, the incidence of IBK in individual herds ranged from 0% to 55%. The overall rate of infection was 11.2%. Vaccination of calves with an M. bovis bacterin that contained a REA of 0.63 reduced the incidence of IBK from 11.2% (217/1931) in the non-vaccinated controls to 4

  16. In-Vivo Slit Scanning Confocal Microscopy of Normal Corneas in Indian Eyes

    Directory of Open Access Journals (Sweden)

    Vanathi Murugesan

    2003-01-01

    Full Text Available Objective: To study the cellular populations of healthy corneas of Indian eyes using confocal microscopy and to evaluate the correlation with age, gender and laterality. Methods: The central corneas of 100 eyes of 50 healthy subjects were examined using an i n-vivo slit scanning confocal microscope (Confoscan 2. Images were analysed for cell densities of the epithelium, stroma and endothelium. Results: Good quality images enabling analysis of all cell layer populations were obtained in 74 eyes of 43 healthy subjects (22 males and 21 females with a mean age of 31.89 ± 13.47 (range 19-71 years. The basal epithelial cell density was 3601.38 ± 408.19 cells/mm2 (range 3017.3 -4231.1cells/mm2. The mean keratocyte nuclei density in the anterior stroma was 1005.02 ± 396.86 cells/mm2 (range 571.6 - 1249.6 cells/mm2 and in the posterior stroma was 654.32 ± 147.09 cells/mm2 (range 402.6 - 1049.1 cells/mm2. Posterior keratocyte nuclei density was 30.76% less than the anterior stromal keratocyte nuclei density. The difference in keratocyte nuclei density was statistically significant (P=0.001. The mean endothelial cell density was 2818.1 ± 361.03 cells/mm2 (range 2118.9 - 4434 cells/mm2 and the mean endothelial cell area was found to be 385.44 ± 42.66 mm2 (range 268.9 - 489.2 mm2. Hexagonal cells formed 22.5 - 69.4% of the endothelial cell populations (mean 42.04 ± 11.81%. Mean coefficient of cell size variation was 32.29 ± 3.06 (range 27.2 - 39.2. No statistically significant differences were found in cell densities of any corneal layer either between female and male patients or between right and left eyes. Basal epithelial cell density, anterior stromal keratocyte nuclei and posterior stromal keratocyte nuclei density were unaffected by age (r= 0.12, 0.07, - 0.12 respectively (P= 0.001. There was a statistically significant negative correlation between mean endothelial cell density and increase in age (r= - 0.42, P=0.001. Coefficient of cell size

  17. Keratinocyte Growth Factor-2 on the Proliferation of Corneal Epithelial Stem Cells in Rabbit Alkali Burned Cornea

    Institute of Scientific and Technical Information of China (English)

    Liu; Yongping; Shuqi; Huang; Jianxian; Lin; Wenxin; Zhang

    2007-01-01

    Purpose: To determine whether the topical application of keratinocyte growth factor-2 (KGF-2) can enhance corneal epithelial healing in rabbit alkali burned cornea. In addition, the distribution and proliferation of corneal epithelial stem cells in KGF-2-treated and control corneas were investigated to explain their mechanisms of effects on the epithelium.Methods: Twenty-four New Zealand eyes were divided into four groups, treated with KGF-2 solution (1, 50, 100 μg/ml) and PBS solution. Eighth millimeter filter paper discs, produced by standard paper punch, were soaked for 15 sec in 0.5N NaOH solution. The alkali-soaked discs were applied to the central cornea, centered on the pupil and held gently in position with forceps for 1 min. The cornea was finally irrigated over 1 min with 100 ml balanced salt solution (BSS). Keratinocyte growth factor-2 was then applied topically three times a day. The phosphate-buffered saline (PBS) group was served as a control. Each corneal epithelial defect was subsequently photographed every 24 hours with a slit lamp and was measured by computer-assisted digitizer. In each group, two rabbits were sacrificed for light microscopic examination after the interval of 7, 14 and 21 days. Meanwhile, the cornea epithelium was examined by immunohistochemistry for P63, AE5, EGFR.Results: Topical application of 10 μg/ml to 100 μg/ml KGF-2 significantly accelerated corneal epithelial wound healing when compared with controls. After 24 hours,epithelial healing rate of the 100 μg/ml KGF-2 group and the PBS treated group was (74±6)% and (40±8)% (P < 0.05). After 48 hours, the rate of the C group was (94±6)%, whereas in the control group it was (73±12)% (P < 0.05). Epithelial defects were often recurrent, which happened only two times in the 100 μg/ml KGF-2-treated group, but many times in the control group. In the corneal epithelial stem cell analysis, the number of the P63 positive cells was higher in the KGF-2-treated corneal

  18. Oxidative Stress to the Cornea, Changes in Corneal Optical Properties, and Advances in Treatment of Corneal Oxidative Injuries

    Directory of Open Access Journals (Sweden)

    Cestmir Cejka

    2015-01-01

    Full Text Available Oxidative stress is involved in many ocular diseases and injuries. The imbalance between oxidants and antioxidants in favour of oxidants (oxidative stress leads to the damage and may be highly involved in ocular aging processes. The anterior eye segment and mainly the cornea are directly exposed to noxae of external environment, such as air pollution, radiation, cigarette smoke, vapors or gases from household cleaning products, chemical burns from splashes of industrial chemicals, and danger from potential oxidative damage evoked by them. Oxidative stress may initiate or develop ocular injury resulting in decreased visual acuity or even vision loss. The role of oxidative stress in the pathogenesis of ocular diseases with particular attention to oxidative stress in the cornea and changes in corneal optical properties are discussed. Advances in the treatment of corneal oxidative injuries or diseases are shown.

  19. Comment on amniotic membrane covering promotes healing of cornea epithelium and improves visual acuity after debridement for fungal keratitis

    Institute of Scientific and Technical Information of China (English)

    Ahmet; Tas; Abdullah; Ilhan; Umit; Yolcu; Uzeyir; Erdem

    2015-01-01

    <正>Dear Editor,We congratulate Zeng et al[1]for their study entitled"Amniotic membrane covering promotes healing of cornea epithelium and improves visual acuity after debridement for fungal keratitis".The authors endeavored to present an alternative method for ophthalmologists in the treatment of a challenging case.We would like to express our reservations and ask for the attitudes of the authors about

  20. The role of connective tissue growth factor, transforming growth factor β1 and Smad signaling pathway in cornea wound healing

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ The cornea is a highly specialized and unique organ in the human body. Its main function is to project light from the external environment onto the retina, and it has a specific transparency to perform its function properly. The transparency and integrity of the cornea is of vital importance. The corneal wound, especially laceration deep to Bowman's membrane and stroma, which will inevitably cause scar formation, may cause the degeneration or even loss of sight. Injury can activate many biological factors in cornea as a strong stimulating signal. Transforming growth factors (TGF) and connective tissue growth factors (CTGF) are thought to be related to scar formation after injury. TGF can stimulate stroma cells of cornea and promote synthesis of matrix. Over expression of TGF causes scar formation.1,2 CTGF is a 38 kD cysteine-rich protein molecule and belongs to CCN family (CTGF/Fisp12, Cyr 61/CEF-10, Nov). In 1991, CTGF was firstly found in endothelial cells of human umbilical vein cultured in vitro.3,4 CTGF acts as an important molecule that intermediates the processes of fibrosis, scarring, wound repairing, angiogenesis and embryonic development in many cell types. CTGF plays a unique role in proliferation, differentiation and adhesion of fibroblast cells, which in turn produces large amounts of collagen and other extracellular matrix (ECM) proteins.5-8 CTGF is upregulated in fibrotic diseases, including lung-, skin-, pancreas-, liver-and kidney fibrosis.9,10 This study reports the expressions and interactions of TGF-β1 and CTGF in corneal wound in vivo. This study aimed at determining the expressions and interactions of CTGF and TGF-β1 in Smad signaling pathway during the period when corneal wound was healing.

  1. Commercially available rigid gas-permeable contact lens for protecting the cornea from drying during vitrectomy with a wide viewing system

    OpenAIRE

    Kamei M; Matsumura N; Sakaguchi H; Oshima Y; Ikuno Y; Nishida K

    2012-01-01

    Motohiro Kamei, Nagakazu Matsumura, Hirokazu Sakaguchi, Yusuke Oshima, Yasushi Ikuno, Kohji NishidaDepartment of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, JapanPurpose: We evaluated the usefulness of commercially available materials for protecting the cornea from drying during vitrectomy with a wide-angle viewing system.Methods: Three vitreoretinal surgeons evaluated fundus visibility during vitrectomy on the images of five study materials used on the cornea: balance...

  2. Bullous allergic drug eruption with presence of myeloperoxidase and reorganization of the dermal vessels observed by using CD34 and collagen IV antibodies

    Directory of Open Access Journals (Sweden)

    Ana Maria Abreu-Velez

    2011-01-01

    Full Text Available Context: Bullous allergic reactions are inflammatory skin disorders, presenting usually as a result of some type of reaction to medication. Case Report: A 67-year-old female was evaluated for the presence of diffuse patches of erythema, microvesiculation, vesicles, crusts, and oozing of sudden appearance on the extremities and on the rest of the body after taking sulfamethoxazole in combination with trimethoprim. Skin biopsies for hematoxylin and eosin examination, as well as for direct immunofluorescence and immunohistochemistry analysis were performed. H&E staining demonstrated classic features. Direct immunofluorescence revealed strong deposits of fibrinogen in the vessels of the skin. The immunohistochemistry stain showed strong positivity of myeloperoxidase within the blister cavity. The distribution of the vessels around the inflammatory process were noticed by using antibodies to CD34 as well to collagen IV. Conclusions: sulfamethoxazole is catalysed by CYP2C9 and/or myeloperoxidase. Thus, myeloperoxidase appears to be of importance in this disorder.

  3. Effect of In Vitro Transcorneal Approach of Aceclofenac Eye Drops through Excised Goat, Sheep, and Buffalo Corneas

    Directory of Open Access Journals (Sweden)

    Vivek Dave

    2015-01-01

    Full Text Available The current study involves the evaluation of factors that influence the transcorneal permeation of aqueous drops of aceclofenac ophthalmic formulation through freshly excised goat, sheep, and buffalo corneas. Aceclofenac formulation with different concentrations 0.1–0.5% (w/v and with different pH and different preservatives, was taken into account. The amount of drug permeated from different formulations was estimated using an Franz diffusion cell. A linear increase in drug permeation was observed with increase in pH (5.5 to 7.4. The apparent permeability coefficient was found to be maximum 15.01±0.45 on goat cornea and maximum transport of aceclofenac was observed at physiological pH of tears (i.e., 7. The results advocate that aceclofenac 0.5% (w/v ophthalmic solution (pH 7.0 containing BAK (0.01% provides maximum in vitro ocular permeability through goat, sheep, and buffalo corneas.

  4. Birefringence of the central cornea in children assessed with scanning laser polarimetry.

    Science.gov (United States)

    Irsch, Kristina; Shah, Ashesh A

    2012-08-01

    Corneal birefringence is a well-known confounding factor with all polarization-sensitive technology used for retinal scanning and other intraocular assessment. It has been studied extensively in adults, but little is known regarding age-related differences. Specifically, no information is available concerning corneal birefringence in children. For applications that are geared towards children, such as retinal birefringence scanning for strabismus screening purposes, it is important to know the expected range of both corneal retardance and azimuth in pediatric populations. This study investigated central corneal birefringence in children (ages three and above), by means of scanning laser polarimetry (GDx-VCC™, Carl Zeiss Meditec, Inc.). Children's measures of corneal retardance and azimuth were compared with those obtained in adults. As with previous studies in adults, corneal birefringence was found to vary widely in children, with corneal retardance ranging from 10 to 77 nm, and azimuth (slow axis) ranging from -11° to 71° (measured nasally downward). No significant differences in central corneal birefringence were found between children and adults, nor were significant age-related differences found in general. In conclusion, establishing knowledge of the polarization properties of the central cornea in children allows better understanding, exploitation, or bypassing of these effects in new polarization-sensitive pediatric ophthalmic applications.

  5. Corneal biomechanical data and biometric parameters measured with Scheimpflug-based devices on normal corneas

    Science.gov (United States)

    Nemeth, Gabor; Szalai, Eszter; Hassan, Ziad; Lipecz, Agnes; Flasko, Zsuzsa; Modis, Laszlo

    2017-01-01

    AIM To analyze the correlations between ocular biomechanical and biometric data of the eye, measured by Scheimpflug-based devices on healthy subjects. METHODS Three consecutive measurements were carried out using the corneal visualization Scheimpflug technology (CorVis ST) device on healthy eyes and the 10 device-specific parameters were recorded. Pentacam HR-derived parameters (corneal curvature radii on the anterior and posterior surfaces; apical pachymetry; corneal volume; corneal aberration data; depth, volume and angle of the anterior chamber) and axial length (AL) from IOLMaster were correlated with the 10 specific CorVis ST parameters. RESULTS Measurements were conducted in 43 eyes of 43 volunteers (age 61.24±15.72y). The 10 specific CorVis ST data showed significant relationships with corneal curvature radii both on the anterior and posterior surface, pachymetric data, root mean square (RMS) data of lower-order aberrations, and posterior RMS of higher-order aberrations and spherical aberration of the posterior cornea. Anterior chamber depth showed a significant relationship, but there were no significant correlations between corneal volume, anterior chamber volume, mean chamber angle or AL and the 10 specific CorVis ST parameters. CONCLUSIONS CorVis ST-generated parameters are influenced by corneal curvature radii, some corneal RMS data, but corneal volume, anterior chamber volume, chamber angle and AL have no correlation with the biomechanical parameters. The parameters measured by CorVis ST seem to refer mostly to corneal properties of the eye. PMID:28251079

  6. Enrichment of pathogenic alleles in the brittle cornea gene, ZNF469, in keratoconus.

    Science.gov (United States)

    Lechner, Judith; Porter, Louise F; Rice, Aine; Vitart, Veronique; Armstrong, David J; Schorderet, Daniel F; Munier, Francis L; Wright, Alan F; Inglehearn, Chris F; Black, Graeme C; Simpson, David A; Manson, Forbes; Willoughby, Colin E

    2014-10-15

    Keratoconus, a common inherited ocular disorder resulting in progressive corneal thinning, is the leading indication for corneal transplantation in the developed world. Genome-wide association studies have identified common SNPs 100 kb upstream of ZNF469 strongly associated with corneal thickness. Homozygous mutations in ZNF469 and PR domain-containing protein 5 (PRDM5) genes result in brittle cornea syndrome (BCS) Types 1 and 2, respectively. BCS is an autosomal recessive generalized connective tissue disorder associated with extreme corneal thinning and a high risk of corneal rupture. Some individuals with heterozygous PRDM5 mutations demonstrate a carrier ocular phenotype, which includes a mildly reduced corneal thickness, keratoconus and blue sclera. We hypothesized that heterozygous variants in PRDM5 and ZNF469 predispose to the development of isolated keratoconus. We found a significant enrichment of potentially pathologic heterozygous alleles in ZNF469 associated with the development of keratoconus (P = 0.00102) resulting in a relative risk of 12.0. This enrichment of rare potentially pathogenic alleles in ZNF469 in 12.5% of keratoconus patients represents a significant mutational load and highlights ZNF469 as the most significant genetic factor responsible for keratoconus identified to date.

  7. Precut cornea for Descemet's stripping endothelial keratoplasty: experience at a single eye bank.

    Science.gov (United States)

    Mohamed, Ashik; Chaurasia, Sunita; Chandragiri, Venkataswamy; Kandhibanda, Srinivas; Gunnam, Srinivas; Garg, Prashant

    2016-07-20

    The aim of the study is to describe the experience with precut facility for endothelial keratoplasty at a single eye bank affiliated to a tertiary eye care center in India. Data on precut tissues from Nov 2012 to Dec 2014 were retrospectively reviewed from the electronic database of the eye bank of a tertiary eye care center in South India. Donor characteristic data including donor age, precut and postcut endothelial cell density (ECD), recipient age, and thickness of graft were collected. The number of precuts increased from 42 in 2012 (Nov and Dec) and 422 in 2013 to 584 in 2014. Of the total of 1048 precuts, seven (0.67 %) were miscut and could not be utilized for transplants. The donor age ranged from 2 to 89 years. A mean change of 43.6 ± 325.2 cells/mm(2) in ECD was noted after cut, proportional increase in mean being 1.9 %. The change in ECD after cut was negatively correlated with ECD before cut. The recipient age ranged from 1 to 89 years. The median thickness of donor lenticule after cut was 148 µm (interquartile range 131-166 µm). Analysis of precut donor corneas from a single eye bank shows that the ECD of the processed tissues was excellent for transplantation. The tissue wastage in the hands of eye bank personal was minimal.

  8. Q pili enhance the attachment of Moraxella bovis to bovine corneas in vitro.

    Science.gov (United States)

    Ruehl, W W; Marrs, C; Beard, M K; Shokooki, V; Hinojoza, J R; Banks, S; Bieber, D; Mattick, J S

    1993-01-01

    Moraxella bovis, the causative agent of infectious bovine keratoconjunctivitis, exhibits several virulence factors, including pili, haemolysin, leukotoxin, and proteases. The pili are filamentous appendages which mediate bacterial adherence. Prior studies have shown that Q-piliated M. bovis Epp63 are more infectious and more pathogenic than I-piliated and non-piliated isogenic variants, suggesting that Q pili per se, or traits associated with Q-pilin expression, promote the early association of Q-piliated bacteria with bovine corneal tissue. In order to better evaluate the role of Q pili in M. bovis attachment, several M. bovis strains and a recombinant P. aeruginosa strain which elaborates M. bovis Q pili but not P. aeruginosa PAK pili, were evaluated using an in vitro corneal attachment assay. For each strain tested, piliated organisms attached better than non-piliated bacteria. M. bovis Epp63 Q-piliated bacteria adhered better than either the I-piliated or non-piliated isogenic variants. Finally, recombinant P. aeruginosa organisms elaborating M. bovis Q pili adhered better than the parent P. aeruginosa strain which did not produce M. bovis pili. These results indicate that the presence of pili, especially Q pili, enhances the attachment of bacteria to bovine cornea in vitro.

  9. Examination of tear film smoothness on corneae after refractive surgeries using a noninvasive interferometric method

    Science.gov (United States)

    Szczesna, Dorota H.; Kulas, Zbigniew; Kasprzak, Henryk T.; Stenevi, Ulf

    2009-11-01

    A lateral shearing interferometer was used to examine the smoothness of the tear film. The information about the distribution and stability of the precorneal tear film is carried out by the wavefront reflected from the surface of tears and coded in interference fringes. Smooth and regular fringes indicate a smooth tear film surface. On corneae after laser in situ keratomileusis (LASIK) or radial keratotomy (RK) surgery, the interference fringes are seldom regular. The fringes are bent on bright lines, which are interpreted as tear film breakups. The high-intensity pattern seems to appear in similar location on the corneal surface after refractive surgery. Our purpose was to extract information about the pattern existing under the interference fringes and calculate its shape reproducibility over time and following eye blinks. A low-pass filter was applied and correlation coefficient was calculated to compare a selected fragment of the template image to each of the following frames in the recorded sequence. High values of the correlation coefficient suggest that irregularities of the corneal epithelium might influence tear film instability and that tear film breakup may be associated with local irregularities of the corneal topography created after the LASIK and RK surgeries.

  10. A short-term study of corneal collagen cross-linking with hypo-osmolar riboflavin solution in keratoconic corneas

    Institute of Scientific and Technical Information of China (English)

    Shao-Feng; Gu; Zhao-Shan; Fan; Li-Hua; Wang; Xiang-Chen; Tao; Yong; Zhang; Chun-Qin; Wang; Ya; Wang; Guo-Ying; Mu

    2015-01-01

    AIM: To report the 3mo outcomes of collagen crosslinking(CXL) with a hypo-osmolar riboflavin in thin corneas with the thinnest thickness less than 400 μm without epithelium.METHODS: Eight eyes in 6 patients with age 26.2±4.8y were included in the study. All patients underwent CXL using a hypo-osmolar riboflavin solution after its de-epithelization. Best corrected visual acuity, manifest refraction, the thinnest corneal thickness, and endothelial cell density were evaluated before and 3mo after the procedure.RESULTS: The mean thinnest thickness of the cornea was 408.5 ±29.0 μm before treatment and reduced to369.8 ±24.8 μm after the removal of epithelium. With the application of the hypo-osmolar riboflavin solution, the thickness increased to 445.0 ±26.5 μm before CXL and recover to 412.5 ±22.7 μm at 3mo after treatment, P =0.659). Before surgery, the mean K-value of the apex of the keratoconus corneas was 57.6 ±4.0 diopters, and slightly decreased(54.7±4.9 diopters) after surgery(P =0.085). Mean best-corrected visual acuity was 0.55 ±0.23 logarithm of the minimal angle of resolution, and increased to 0.53±0.26 logarithm after surgery(P =0.879).The endothelial cell density was 2706.4 ±201.6 cells/mm2 before treatment, and slightly decreased( 2641. 2 ±218.2 cells/mm2) at last fellow up(P =0.002).CONCLUSION: Corneal collagen cross-linking with a hypo-osmolar riboflavin in thin corneas seems to be a promising treatment. Further study should be done to evaluate the safety and efficiency of CXL in thin corneas for the long-term.

  11. Antinociceptive and anti-inflammatory activities of sulphated polysaccharides from the red seaweed Gracilaria cornea.

    Science.gov (United States)

    Coura, Chistiane O; de Araújo, Ianna W F; Vanderlei, Edfranck S O; Rodrigues, José A G; Quinderé, Ana L G; Fontes, Bruno P; de Queiroz, Ismael N L; de Menezes, Dalgimar B; Bezerra, Mirna M; e Silva, Antonio A R; Chaves, Hellíada V; Jorge, Roberta J B; Evangelista, Janaina S A M; Benevides, Norma M B

    2012-04-01

    Seaweeds have attracted special interest as good sources of sulphated polysaccharides (SP) for use in pharmaceutical industries and biotechnology. In this study, we evaluated the effects of SP from the red seaweed Gracilaria cornea (Gc-TSP) in nociceptive and inflammatory models. In mice, Gc-TSP (3, 9 or 27 mg/kg) significantly reduced nociceptive responses, as measured by the number of writhes, at all tested doses. In a formalin test, Gc-TSP significantly reduced licking time in both phases of the test at a dose of 27 mg/kg. In a hot-plate test, the antinociceptive effect was observed only in animals treated with 27 mg/kg of Gc-TSP, suggesting that the analgesic effect occurs through a central action mechanism at the highest dose. Gc-TSP (3, 9 or 27 mg/kg) caused only a slight reduction in neutrophil migration in the rat peritoneal cavity. However, lower doses of Gc-TSP (3 and 9 mg/kg) significantly inhibited paw oedema induced by carrageenan, especially at 3 hr after treatment. Reduction in oedema was confirmed by myeloperoxidase activity in the affected paw tissue. In addition, treatment (s.c.) of animals with different doses of Gc-TSP inhibited paw oedema induced by dextran within the first hour in all doses tested. After 14 consecutive days of intraperitoneal administration of Gc-TSP (9 mg/kg), we measured the wet weight of the liver, kidney, heart, spleen and thymus and performed biochemical, haematological and histopathological evaluations. No systemic damage was found. These results indicate that Gc-TSP possesses analgesic and anti-inflammatory effects and is a potentially important tool worthy of further study.

  12. Visual pigments, oil droplets, lens, and cornea characterization in the whooping crane (Grus americana)

    Science.gov (United States)

    Porter, Megan L.; Kingston, Alexandra C. N.; McCready, Robert; Cameron, Evan G.; Hofmann, Christopher M.; Suarez, Lauren; Olsen, Glenn H.; Cronin, Thomas W.; Robinson, Phyllis R.

    2014-01-01

    Vision has been investigated in many species of birds, but few studies have considered the visual systems of large birds and the particular implications of large eyes and long-life spans on visual system capabilities. To address these issues we investigated the visual system of the whooping crane, Grus americana (Gruiformes: Gruidae). G. americana (an endangered species) is one of only two North American crane species and represents a large, long-lived bird where ultraviolet sensitivity may be degraded by chromatic aberrations and entrance of ultraviolet light into the eye could be detrimental to retinal tissues. To investigate the whooping crane visual system we used microspectrophotometry to determine the absorbance spectra of retinal oil droplets and to investigate if the ocular media (i.e., the lens and cornea) absorbs UV light. In vitro expression and reconstitution was used to determine the absorbance spectra of rod and cone visual pigments. The rod visual pigments had wavelengths of peak absorbance (λmax) at 500 nm, while the cone visual pigments λmax values were determined to be 404 nm (SWS1), 450 nm (SWS2), 499 nm (RH2), and 561 nm (LWS), similar to other characterized bird visual pigment absorbance values. The oil droplet cutoff wavelength (λcut) values similarly fell within ranges recorded from other avian species: 576 nm (R-type), 522 nm (Y-type), 506 nm (P-type), and 448 nm (C-type). We confirm that G. americana has a violet-sensitive visual system, although based on the λmax of the SWS1 visual pigment (404 nm) may also have some ability for UV sensitivity.

  13. Bullous impetigo in children infected with methicillin-resistant Staphylococcus aureus alone or in combination with methicillin-susceptible S. aureus: analysis of genetic characteristics, including assessment of exfoliative toxin gene carriage.

    Science.gov (United States)

    Shi, Da; Higuchi, Wataru; Takano, Tomomi; Saito, Kohei; Ozaki, Kyoko; Takano, Misao; Nitahara, Yoshiyuki; Yamamoto, Tatsuo

    2011-05-01

    Among bullous impetigo isolates, exfoliative toxin (ET) gene carriage was found in 61.5% of methicillin-resistant Staphylococcus aureus (MRSA) isolates versus 90.6% of methicillin-susceptible S. aureus (MSSA) isolates. MRSA-only cases were ETB or ETA positive, while MRSA/MSSA coinfection cases were ET negative for MRSA but ETA positive for MSSA. Collagen adhesin may facilitate some MRSA infections.

  14. A necessidade da imunofluorescência direta no diagnóstico da dermatose bolhosa por IgA The need for direct immunofluorescence in the diagnosis of IgA bullous dermatosis

    Directory of Open Access Journals (Sweden)

    Daniel Chang

    2012-02-01

    Full Text Available A dermatose bolhosa por imunoglobulina da classe A linear (DbIgA do adulto é uma doença autoimune rara caracterizada por formação de bolhas subepidérmicas e depósito linear de imunoglobulina da classe A (IgA na zona da membrana basal (ZMB. Por possuir aspectos clínicos e histológicos semelhantes a outras dermatoses bolhosas, principalmente a dermatite herpetiforme e o penfigoide bolhoso, faz-se necessária a realização de imunofluorescência direta para confirmação diagnóstica. Apresenta-se então, neste artigo, relato de caso ilustrando essa necessidade.Linear immunoglobulin A bullous dermatosis (DbIgA of adults is a rare autoimmune disease characterized by subepidermal blistering and linear deposits of immunoglobulin A (IgA in the basement membrane zone (BMZ. Owing to the fact it presents clinical and histological aspects similar to other bullous dermatosis, mainly dermatitis herpetiformis and bullous pemphigoid, direct immunofluorescence is required to confirm diagnosis. In this article, we describe a case that illustrates this need.

  15. T-style keratoprosthesis based on surface-modified poly (2-hydroxyethyl methacrylate) hydrogel for cornea repairs

    Energy Technology Data Exchange (ETDEWEB)

    Xiang, Jun [Department of Ophthalmology, Eye & ENT Hospital, Shanghai Medical College, Fudan University (China); Key Laboratory of Myopia, Ministry of Health, Fudan University (China); Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University (China); Sun, Jianguo [Research Center, Eye & ENT Hospital, Shanghai Medical College, Fudan University (China); Key Laboratory of Myopia, Ministry of Health, Fudan University (China); Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University (China); State Key Laboratory of Molecular Engineering of Polymers, Fudan University (China); Hong, Jiaxu [Department of Ophthalmology, Eye & ENT Hospital, Shanghai Medical College, Fudan University (China); Key Laboratory of Myopia, Ministry of Health, Fudan University (China); Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University (China); Wang, Wentao [Research Center, Eye & ENT Hospital, Shanghai Medical College, Fudan University (China); Key Laboratory of Myopia, Ministry of Health, Fudan University (China); Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University (China); Wei, Anji [Department of Ophthalmology, Eye & ENT Hospital, Shanghai Medical College, Fudan University (China); Key Laboratory of Myopia, Ministry of Health, Fudan University (China); Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University (China); Le, Qihua [Research Center, Eye & ENT Hospital, Shanghai Medical College, Fudan University (China); Key Laboratory of Myopia, Ministry of Health, Fudan University (China); Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University (China); Xu, Jianjiang, E-mail: jianjiang-xu@163.com [Department of Ophthalmology, Eye & ENT Hospital, Shanghai Medical College, Fudan University (China); Key Laboratory of Myopia, Ministry of Health, Fudan University (China); Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University (China)

    2015-05-01

    Corneal disease is a common cause of blindness, and keratoplasty is considered as an effective treatment method. However, there is a severe shortage of donor corneas worldwide. This paper presents a novel T-style design of a keratoprosthesis and its preparation methods, in which a mechanically and structurally effective artificial cornea is made based on a poly(2-hydroxyethyl methacrylate) hydrogel. The porous skirt was modified with hyaluronic acid and cationized gelatin, and the bottom of the optical column was coated with poly(ethylene glycol). The physical properties of the T-style Kpro were analyzed using ultraviolet and visible spectrophotometry and electron scanning microscopy. The surface chemical properties were characterized using Fourier transform infrared spectroscopy and X-ray photoelectron spectroscopy. The surface modification in the spongy skirt promoted cell adhesion and produced a firm bond between the corneal tissue and the implant device, while the surface modification in the optic column resisted cell adhesion and prevented retroprosthetic membrane formation. Through improved surgical techniques, the novel T-style keratoprosthesis provides enough mechanical stability to facilitate long-term biointegration with the host environment. In vivo implantation experiments showed that the T-style keratoprosthesis is a promising cornea alternative for patients with severe limbal stem cell deficiency and corneal opacity. - Highlights: • T-style keratoprosthesis was designed and prepared based on a PHEMA hydrogel. • Selective surface modifications effectively regulated cells' selective adhesion. • T-style keratoprosthesis provides enough mechanical stability to facilitate long-term biointegration with host tissues.

  16. Artificial cornea: surface modification of silicone rubber membrane by graft polymerization of pHEMA via glow discharge.

    Science.gov (United States)

    Lee, S D; Hsiue, G H; Kao, C Y; Chang, P C

    1996-03-01

    A method for producing various surfaces of silicone rubber membrane (SR) was developed in this study by grafting various amounts of poly(2-hydroxy ethyl methacrylate) (pHEMA) onto SR by plasma-induced grafted polymerization (PIP) as a homobifunctional membrane. The elemental composition and different carbon bindings on the surface of SR were examined by electron spectroscopy for chemical analysis with the amount of O1s/C1s being approximately 0.7 at 1 min, 60 W, 200 mTorr of Ar-plasma treatment. The peroxide group introduced on SR was measured via 1,1-diphenyl-2-picrylhydrazyl (DPPH) and the amount of 6.85 x 10(-8) mol cm-2 reached optimum value at 1 min of Ar-plasma treatment. After Ar-plasma treated SR, the peroxide group (33D peak) was introduced on the surface of SR by negative spectra of secondary ion mass spectroscopy analysis, whereas ester groups (72D peak) were observed for pHEMA-grafted SR. For the in vitro test, the influence of various surfaces of SR on attachment and growth of rabbit corneal epithelial cells (CEC) was studied by cell culture assay. These results indicated that 56-150 micrograms cm-2 of pHEMA grafted onto SR were suitable values for attachment and growth of CEC. On the contrary, the large grafted amounts (500-1650 micrograms cm-2) of pHEMA on SR were insufficient for attachment and growth of CEC. For the in vivo test, the migration of CEC from host cornea to implant was investigated by slit lamp microscopy. The experimental results indicated that SRs grafted with pHEMA were completely covered with CEC 3 weeks after implantation of the membranes into the host cornea. These results provide a valuable reference for developing an artificial cornea.

  17. Innervation of TRPV1-, PGP-, and CGRP-immunoreactive nerve fibers in the subepithelial layer of a whole mount preparation of the rat cornea.

    Science.gov (United States)

    Hiura, Akio; Nakagawa, Hiroshi

    2012-01-01

    The pattern of innervation of capsaicin receptor, TRPV1-(transient receptor protein vanilloid 1), PGP 9.5-(protein gene product, a marker of peripheral nerve fibers)-, and CGRP (calcitonin gene-related peptide)-immunoreactive (IR) nerve fibers was examined by immunohistological staining of whole mount preparations of the adult rat cornea. The outer corneoscleral limbus toward the central cornea in the subepithelial (stromal) layer was richly innervated by a meshwork of PGP- and CGRP-IR nerve fibers. Sparse innervation was observed in the central cornea, presumably owing to insufficient staining. Dense innervation of TRPV1-IR nerve fibers were demonstrated in addition to innervation of PGP- and CGRP-IR nerve fibers, running from the corneoscleral margin to the central cornea. Although the density of TRPV1-IR nerve fibers appeared to gradually diminish, immunostaining of TRPV1-IR nerve fibers was not as clear as that of PGP- and CGRP-IR nerve fibers. The TRPV1-IR nerve fibers appeared to be thinner than the PGP- and CGRP-IR nerve fibers. The TRPV1-IR leash fibers were observed in the basal epithelial layer, presumably ensuring effective corneal reflex, response to noxious stimuli, and repair of cornea injury.

  18. Lymphatic vessels growing apart from blood vessels in transplanted corneas after the blockade of vascular endothelial growth factor C

    Institute of Scientific and Technical Information of China (English)

    Ye Hui; Yan Hao; Zhong Lei; Wang Tao; Deng Juan; Ling Shi-qi

    2016-01-01

    BACKGROUND:Corneal lymphangiogenesis is beneficial to the transport of corneal antigenic materials, and accelerates the process of antigen presentation, thereby playing an important role in corneal immunity. However, due to the paral el outgrowth of corneal blood and lymphatic vessels in transplanted corneas, it is often difficult to accurately evaluate the role of corneal lymphatic vessels in allograft rejection. OBJECTIVE:To explore the development of corneal lymphangiogenesis and angiogenesis in transplanted rat corneas after the blockade of vascular endothelial growth factor C (VEGF-C). METHODS:130 rats used to establish corneal al ogenic transplantation models were equally randomized into two groups:the anti-VEGF-C group and the control group. VEGF-C was blocked in the anti-VEGF-C group by intraperitoneal injection of neutralizing monoclonal anti-VEGF-C antibody every other day for 2 consecutive weeks. Meanwhile, rats in control groups received intraperitoneal injections of saline. Corneal angiogenesis and lymphangiogenesis were characterized using whole mount immunofluorescence, and the immune rejection of the grafts was evaluated by scoring the rejection index (RI). In addition, the expression of VEGF-C was examined by real-time PCR. The relationship of corneal lymphangiogenesis and angiogenesis to RI in transplanted corneas was also characterized. RESULTS AND CONCLUSION:VEGF-C expression was markedly downregulated after VEGF-C blockade. Corneal lymphangiogenesis developed in parallel with corneal angiogenesis in the control group. While there was a mild reduction in blood vessel area (BVA) and a significant decrease in lymphatic vessel area (LVA) in the anti-VEGF-C group (P0.05). the graft survival time in the anti-VEGF-C group was significantly increased compared with that in the control group (P<0.05). Our results show that the outgrowth of lymphatic vessels is separated from that of blood vessels in transplanted corneas by blocking VEGF-C. The blockade

  19. Analysis of two precipitation methods on the yield, structural features and activity of sulfated polysaccharides from Gracilaria cornea (Rhodophyta

    Directory of Open Access Journals (Sweden)

    Ricardo Basto Souza

    2015-03-01

    Full Text Available The global demand for natural products from seaweeds has increased worldwide; however, no description of the use of isoamly alcohol (IAA for obtaining of sulfated polysaccharides (SPs has been reported. We investigated the efficiency of two precipitation methods (M in obtaining SPs from the red seaweed Gracilaria cornea. SPs enzymatically isolated were concentrated with cetylpyridinium chloride (M I or IAA (M II and extracts were examined with regard to their yield, structural features and in vitro effects on the activated partial thromboplastin time (APTT using normal human plasma and standard heparin (193 IU mg-1. Yield difference reached 12.99%. Quantitative determination of sulfate was similar between the two methods (̴ 26%, but extracts revealed different pattern on charge density by agarose gel electrophoresis. Whereas both extracts revealed as agarocolloids, alternative M II was also efficient for lipids, proteins and nucleic acids according to the infrared analysis. Extracts had virtually no effect on APPT (1.95 and 2 IU mg-1 for M I and M II, respectively. The results revealed IAA as an alternative solvent for obtaining SPs from the red seaweed G. cornea, depending on the industry’ usage criterion.

  20. The short-term effects of PMMA contact lens wear on keratometric behaviour: results for a single keratoconic cornea*

    Directory of Open Access Journals (Sweden)

    E. Chetty

    2010-12-01

    Full Text Available Keratometric behaviour is a multifaceted issue that many researchers have investigated for years. Many internal and external influences can have an effect on the cornea’s keratometric behaviour. This investigation forms a small part of a larger study that aims at determining the effects that rigid contact lenses might have on keratometric behaviour. This pilot study examined the keratometric behaviour of a single, mildly keratoconic cornea that was fitted with a polymethyl methacrylate (PMMA contact lens. Sixty successive auto-keratometric measurements were taken immediately before and immediately after three hours of contact lens wear. The data obtained was transformed to dioptric power matrices and were analysed using multivariate statistical methods. This study showed that, at least in one keratoconic cornea, there appeared to be a statistically significant change in corneal curvature under the influence of a PMMA contact lens. The contact lens had also appeared to decrease variation in corneal curvature. There was no control study done on this eye therefore the effects of diurnal variation, if any, could not be established. (S Afr Optom 2010 69(2 69-76

  1. Visual outcomes after deep anterior lamellar keratoplasty using donor corneas without removal of Descemet membrane and endothelium

    Directory of Open Access Journals (Sweden)

    Tatiana Moura Bastos Prazeres

    Full Text Available ABSTRACT Purpose: The optical quality of the interface after deep anterior lamellar keratoplasty (DALK using the big-bubble technique has been shown to be excellent, leading to results comparable to penetrating keratoplasty. However, there is little in the literature with respect to the controversy surrounding the preparation of the donor cornea. The purpose of this study was to evaluate visual acuity (VA in patients with keratoconus who underwent DALK without removal of the donor graft endothelium. Methods: The records of 90 patients who underwent DALK without the removal of the Descemet membrane (DM and endothelium were retrospectively reviewed. Data collected included uncorrected VA (UCVA and spectacle-corrected VA (SCVA at 7, 30, 180 days, and 1 year postoperatively. Contact lens-corrected visual acuity (CLVA was evaluated after 1 year of the procedure. Results: UCVA was significantly better than preoperative values at 7 days (p<0.001, 30 days (p<0.001, 180 days (p<0.001, and 1 year (p<0.001 after surgery. The 1-year postoperative mean SCVA and CLVA also improved when compared with preoperative SCVA (p<0.001 for both. Conclusions: DALK utilizing donor corneas with attached Descemet membrane and endothelium results in satisfactory VA in patients with keratoconus.

  2. Common genetic variants near the Brittle Cornea Syndrome locus ZNF469 influence the blinding disease risk factor central corneal thickness.

    Directory of Open Access Journals (Sweden)

    Yi Lu

    2010-05-01

    Full Text Available Central corneal thickness (CCT, one of the most highly heritable human traits (h(2 typically>0.9, is important for the diagnosis of glaucoma and a potential risk factor for glaucoma susceptibility. We conducted genome-wide association studies in five cohorts from Australia and the United Kingdom (total N = 5058. Three cohorts were based on individually genotyped twin collections, with the remaining two cohorts genotyped on pooled samples from singletons with extreme trait values. The pooled sample findings were validated by individual genotyping the pooled samples together with additional samples also within extreme quantiles. We describe methods for efficient combined analysis of the results from these different study designs. We have identified and replicated quantitative trait loci on chromosomes 13 and 16 for association with CCT. The locus on chromosome 13 (nearest gene FOXO1 had an overall meta-analysis p-value for all the individually genotyped samples of 4.6x10(-10. The locus on chromosome 16 was associated with CCT with p = 8.95x10(-11. The nearest gene to the associated chromosome 16 SNPs was ZNF469, a locus recently implicated in Brittle Cornea Syndrome (BCS, a very rare disorder characterized by abnormal thin corneas. Our findings suggest that in addition to rare variants in ZNF469 underlying CCT variation in BCS patients, more common variants near this gene may contribute to CCT variation in the general population.

  3. In vitro evaluation of the permeation enhancing effect of polycarbophil-cysteine conjugates on the cornea of rabbits.

    Science.gov (United States)

    Hornof, Margit D; Bernkop-Schnürch, Andreas

    2002-12-01

    It was the aim of this study to investigate the permeation enhancing effect of thiolated polycarbophil on the cornea of rabbits in vitro. The proposed reaction mechanism involves the opening of the tight junctions in the corneal epithelium. The modification of polycarbophil was achieved via covalent attachment of L-cysteine mediated by a carbodiimide. Transcorneal permeation studies were performed in Ussing-type diffusion chambers. As model compounds, sodium fluorescein, as a marker for paracellular transport, and dexamethasone phosphate were used. To evaluate potential corneal damage the corneal hydration level of each cornea was determined. Polycarbophil-cysteine was found to increase the permeation of sodium fluorescein 2.2-fold and that of dexamethasone phosphate 2.4-fold in comparison to the unmodified polymer. The concentration of dexamethasone in the acceptor medium was 1.5-fold increased. As evidenced by the corneal hydration level, polycarbophil-cysteine did not damage the corneal tissues. Therefore, polycarbophil-cysteine conjugates seem to be promising excipients for ocular drug delivery systems where they might be used as safe permeation enhancers.

  4. Differentiating untreated and cross-linked porcine corneas of the same measured stiffness with optical coherence elastography

    Science.gov (United States)

    Li, Jiasong; Han, Zhaolong; Singh, Manmohan; Twa, Michael D.; Larin, Kirill V.

    2014-11-01

    Structurally degenerative diseases, such as keratoconus, can significantly alter the stiffness of the cornea, directly affecting the quality of vision. Ultraviolet-induced collagen cross-linking (CXL) effectively increases corneal stiffness and is applied clinically to treat keratoconus. However, measured corneal stiffness is also influenced by intraocular pressure (IOP). Therefore, experimentally measured changes in corneal stiffness may be attributable to the effects of CXL, changes in IOP, or both. We present a noninvasive measurement method using phase-stabilized swept-source optical coherence elastography to distinguish between CXL and IOP effects on measured corneal stiffness. This method compared the displacement amplitude attenuation of a focused air-pulse-induced elastic wave. The damping speed of the displacement amplitudes at each measurement position along the wave propagation were compared for different materials. This method was initially tested on gelatin and agar phantoms of the same stiffness for validation. Consequently, untreated and CXL-treated porcine corneas of the same measured stiffness, but at different IOPs, were also evaluated. The results suggest that this noninvasive method may have the potential to detect the early stages of ocular diseases such as keratoconus or may be applied during CLX procedures by factoring in the effects of IOP on the measured corneal stiffness.

  5. Research progress in scaffolds of tissue engineered cornea%组织工程化角膜支架的研究进展

    Institute of Scientific and Technical Information of China (English)

    张凯

    2012-01-01

    近20年来,应用组织工程技术构建角膜组织——组织工程化角膜的构建取得了较大的进展.然而,能够广泛应用于临床的组织工程化角膜的构建仍不够完善.组织工程化角膜支架是构建组织工程化角膜的重要组成部分之一.探寻生物相容性好、可降解并具有足够生物力学强度的支架材料是组织工程化角膜研究领域亟待解决的课题.就组织工程化角膜支架的发展历程进行概括总结,评价不同支架材料的优缺点,拓展理想支架材料的研发视野,为可广泛用于临床的组织工程化角膜的研制提供信息.%Great progress has been made in tissue engineering cornea construction (i.c.constructing human corneal equivalence by using tissue engineering technique) during the past 20 years.However,a kind of tissue engineering cornea which can be applied to corneal transplantation as human cornea equivalent is yet to be availablc.Scaffold is an indispensable part of tissue engineering cornea.Searching for some kinds of scaffolds with good biocompability,some extent of biodegradation and euough biomechanics property are the issue needing to be resolved immediately in the tissue engineering cornea filed.This article reviewed the development of tissue engineering cornea scaffolds,represented the merits and defects of different scaffolds in order to optimize the project of choosing scaffolds and furthermore lay the foundation for constructing a kind of tissue engineering cornea which may be applied to corneal transplantation as human cornea equivalent in the future.

  6. Microbiological profile of donor corneas stored for tectonic transplantation purposes in rabbits Microbiologia de amostras de bancos de córneas destinadas a transplantes, em coelhos

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    K.K. Kobashigawa

    2013-02-01

    Full Text Available This study aimed to evaluate the microbiota of donor rabbit corneas stored for tectonic transplantation purposes. Swabs from both corneas of 20 rabbits were carefully collected and submitted to microorganism isolation and identification. After this first swab collection, rabbits were euthanized for reasons other than this project and the eyes were enucleated. The corneas were collected and stored to compose the cornea tissue bank. Corneas were stored in a 0.3% tobramycin solution at -20ºC. After 30 days, the corneas were thawed at room temperature and removed from the antibiotic. New swabs were obtained from the corneas and submitted to microorganism isolation and identification. Gram positive organisms were predominant in the rabbit corneal flora before storage and the Staphylococcus sp. was the most common microorganism isolated from those samples. No growth was observed on the samples collected after storage. The methods used for collection and storage of the corneas were efficient to constitute a sterile donor corneal tissue bank.Analisaram-se córneas armazenadas para transplantes tectônicos usando-se suabes coletados de 20 coelhos, visando ao isolamento e à identificação de microrganismos. Após a coleta das amostras, os coelhos foram submetidos à eutanásia, por razões alheias ao estudo, e enucleados. As córneas foram coletadas e armazenadas a fim de se constituir o banco de córneas. O armazenamento deu-se em solução de tobramicina 0,3% a -20ºC, por 30 dias. Após esse período, as córneas foram descongeladas à temperatura ambiente e removidas da solução de antibiótico. Novos suabes foram coletados e submetidos ao isolamento e à identificação dos microrganismos. A flora corneal mostrou-se predominantemente composta por bactérias Gram positivas, sendo o Staphylococcus sp. o mais identificado. Não se verificou crescimento de colônias bacterianas ou fúngicas nas amostras após o armazenamento. Considerando-se a

  7. Two-photon spectral fluorescence lifetime and second-harmonic generation imaging of the porcine cornea with a 12-femtosecond laser microscope

    Science.gov (United States)

    Batista, Ana; Breunig, Hans Georg; Uchugonova, Aisada; Morgado, António Miguel; König, Karsten

    2016-03-01

    Five dimensional microscopy with a 12-fs laser scanning microscope based on spectrally resolved two-photon autofluorescence lifetime and second-harmonic generation (SHG) imaging was used to characterize all layers of the porcine cornea. This setup allowed the simultaneous excitation of both metabolic cofactors, NAD(P)H and flavins, and their discrimination based on their spectral emission properties and fluorescence decay characteristics. Furthermore, the architecture of the stromal collagen fibrils was assessed by SHG imaging in both forward and backward directions. Information on the metabolic state and the tissue architecture of the porcine cornea were obtained with subcellular resolution, and high temporal and spectral resolutions.

  8. Liquen escleroso extragenital ampollar y hemorrágico: a propósito de un caso Extra-genital bullous and haemorrhagic lichen sclerosus: a case report

    Directory of Open Access Journals (Sweden)

    JM López Bertrán

    2010-06-01

    Full Text Available El liquen escleroso (LE es una enfermedad inflamatoria, crónica y benigna. De etiología desconocida, se ha vinculado con diversos factores autoinmunológicos, genéticos, hormonales, infecciosos y traumáticos. Hay dos variedades clínicas de esta enfermedad: genital y extra-genital. La localización más frecuente en ambos sexos es la genital. Se presenta un caso clínico de LE extra-genital, con lesiones cutáneas poco frecuentes, ampollares y hemorrágicas, que coexistían con placas atróficas de larga evolución, no diagnosticadas previamente.Lichen sclerosus is an inflammatory disease, benign, chronic, of unknown aetiology. It has been linked with many factors such as autoimmune, genetic, hormonal and infectious diseases, as well as trauma. There are two clinical types of this disease: genital and extra-genital. The most frequent in both sexes is the genital form. We present a rare case of extra-genital localization with bullous and haemorrhagic manifestations that co-existed with late atrophic plaques, previously undiagnosed.

  9. Outbreak of bullous impetigo caused by Staphylococcus aureus strains of phage type 3C/71 in a maternity ward linked to nasal carriage of a healthcare worker.

    Science.gov (United States)

    Piechowicz, Lidia; Garbacz, Katarzyna; Budzyńska, Anna; Dąbrowska-Szponar, Maria

    2012-01-01

    We describe an outbreak of bullous impetigo (BI) that occurred in a maternity unit and show phenotypic and genotypic properties and relatedness of isolated Staphylococcus aureus strains. Clinical material was obtained from 11 affected neonates. Additionally, nasal swabs from 67 healthy care workers (HCWs) as well as 107 environmental swabs were investigated. All isolates were screened for exfoliative toxin genes (eta, etb), antibiotic susceptibility and phage typed. Chromosomal DNA was genotyped by MLVF method and PCR/RFLP of coagulase gene were tested. Affected neonates were infected by two clusters of eta-positive S. aureus of phage type 3C/71: (1) MLVF type A isolates resistant only to penicillin, and (2) MLVF type B isolates resistant to penicillin and erythromycin/clindamycin. All isolates were susceptible to methicillin. We found 19 of 67 HCWs to be S. aureus nasal carriers. Two nasal isolates from HCWs were related to the outbreak on the basis of phage typing, PCR detection of eta/etb genes, antibiotyping and genotyping. Additionally, environmental swabs from the maternity unit revealed a 3C/71 S. aureus in the mattress of a baby bed. This is the first documented case of an outbreak of BI caused by phage type 3C/71 eta-positive strain of S. aureus.

  10. Linear IgA Bullous Dermatosis in a Patient with Graves' Disease%线状IgA大疱性皮病合并Graves病1例

    Institute of Scientific and Technical Information of China (English)

    黄翀; 陈连军

    2011-01-01

    患者女,28岁.背部反复出现水疱,伴瘙痒5个月,加重并泛发至全身4天,病程中同时出现甲状腺功能亢进.皮损组织病理和直接免疫荧光检查均提示线状IgA大疱性皮病.皮肤病和甲状腺疾病分别经糖皮质激素和同位素治疗得到缓解.%A 28-year-old female had suffered from pruritic vesicles on the back for 5 months, which rapidly progressed to the whole body within 4 days before admission to our hospital. The skin disease was accompanied by hy-perthymidism. Skin biopsy and direct imrnunofluoreseenee proved linear IgA bullous dermatosis. The skin disease and thyroid desease achieved remission with corticosteroid and 131I treatment respectively.

  11. Cloning of the 5' mRNA for the 230-kD bullous pemphigoid antigen by rapid amplification of cDNA ends.

    Science.gov (United States)

    Elgart, G W; Stanley, J R

    1993-08-01

    The 230-kD bullous pemphigoid antigen (BPAG1), defined by autoantibodies in patient sera, is a hemidesmosomal plaque protein in the same gene family as the intracellular proteins desmoplakin I/II and plectin. We had previously isolated, from a lambda gt11 library, overlapping cDNA clones with 6921 bp of mRNA sequence for BPAG1. The coding sequence encoded by these clones included the 3' stop codon but not the 5' coding and non-coding region of the mRNA. To obtain these sequences we used the polymerase chain reaction (PCR) method called rapid amplification of cDNA ends (RACE). The PCR products were cloned into plasmids and sequenced. With five PCR primers we were able to obtain overlapping clones containing the 5' region of the mRNA. An upstream stop codon in frame with the rest of the coding sequence demonstrates that the full 5' coding sequence is obtained. Four different PCR products from two separate reactions had the same 5' end, suggesting that this 5' end is near, or at, the transcription start site. No alternatively spliced clones were found and no transmembrane site was predicted, confirming that BPAG1 is an intracellular hemidesmosomal plaque protein.

  12. Novel feline autoimmune blistering disease resembling bullous pemphigoid in humans: IgG autoantibodies target the NC16A ectodomain of type XVII collagen (BP180/BPAG2).

    Science.gov (United States)

    Olivry, T; Chan, L S; Xu, L; Chace, P; Dunston, S M; Fahey, M; Marinkovich, M P

    1999-07-01

    In humans and dogs, bullous pemphigoid (BP) is an autoimmune blistering disease associated with the production of basement membrane autoantibodies that target the 180-kd type XVII collagen (BP180, BPAG2) and/or the 230-kd plakin epidermal isoform BPAG1e (BP230). In two adult cats, an acquired dermatosis and stomatitis was diagnosed as BP subsequent to the fulfillment of the following criteria: 1) presence of cutaneous vesicles, erosions, and ulcers; 2) histologic demonstration of subepidermal vesiculation with inflammatory cells, including eosinophils; 3) in vivo deposition of IgG autoantibodies at the epidermal basement membrane zone; and 4) serum IgG autoantibodies targeting a 180-kd epidermal protein identified as type XVII collagen. In both cats, the antigenic epitopes targeted by IgG autoantibodies were shown to be situated in the NC16A ectodomain of type XVII collagen, a situation similar to that of humans and dogs with BP. Feline BP therefore can be considered a clinical, histopathologic, and immunologic homologue of BP in humans and dogs.

  13. 人工角膜及其相关材料%Artificial cornea and related materials

    Institute of Scientific and Technical Information of China (English)

    严拓; 敖宁建; 覃百花; 邓华

    2008-01-01

    学术背景:对于同种异体角膜移植失败的患者,人工角膜移植便成了复明的惟一希望.人工角膜的研究虽然已经跨越2个世纪,但由于各种因素限制,角膜植入术仍然只能在少数中心开展.近年来,由于相关学科的飞速发展,人工角膜也进入了快速发展时期.目的:从材料选择、片型设计、材料改性以及临床试验等角度进行叙述,比较不同结构人工角膜各自特点,并指出目前人工角膜所存在的主要问题,对理想的人工角膜提出了新的见解.检索策略:作者应用计算机检索中国全文期刊数据库(CNKI),Springer,EI,Blackwell数据库1993-01/2007-12与人工角膜相关文献.所用中文检索词有"人工角膜、角膜穿透术";英文榆索词包括"artificial cornea,penetrating keratoplasty".纳入标准:文章内容与人工角膜材料、片型设计、临床研究有关.排除标准:较为陈旧,重复性研究.文献评价:共检索到86篇相关文献,68篇文献符合上述要求,其中12篇为综述性文献,37篇为基础性研究文献,19篇为临床研究文献,从中选择30篇进行综述.资料综合:人工角膜材料包括光学镜柱材料(水凝胶、聚甲基丙烯酸甲酯、硅凝胶、玻璃)和支架材料(氟碳聚合物、羟基磷灰石、生物材料).材料改性包括材料化学改性、材料表面处理、材料表面修饰、材料表面等离子处理.不同的角膜片型设计中,较为成功的是AlphaCor和Osteo-Odonto,并获得了美国食品药品管理局批准,进入临床阶段.结论:提高人工角膜与组织黏附度,减少并发症是长期研究的重点领域,而材料选择、材料改性、片型设计等是解决的关键.

  14. A Raman scattering and FT-IR spectroscopic study on the effect of the solar radiation in Antarctica on bovine cornea

    Science.gov (United States)

    Yamamoto, Tatsuyuki; Murakami, Naoki; Yoshikiyo, Keisuke; Takahashi, Tetsuya; Yamamoto, Naoyuki

    2010-01-01

    The Raman scattering and FT-IR spectra of the corneas, transported to the Syowa station in Antarctica and exposed to the solar radiation of the mid-summer for four weeks, were studied to reveal that type IV collagen involved in corneas were fragmented. The amide I and III Raman bands were observed at 1660 and 1245 cm -1, respectively, and the amide I and II infrared bands were observed at 1655 and 1545 cm -1, respectively, for original corneas before exposure. The background of Raman signals prominently increased and the ratio of amide II infrared band versus amide I decreased by the solar radiation in Antarctica. The control experiment using an artificial UV lamp was also performed in laboratory. The decline rate of the amide II/amide I was utilized for estimating the degree of fragmentation of collagen, to reveal that the addition of vitamin C suppressed the reaction while the addition of sugars promoted it. The effect of the solar radiation in Antarctica on the corneas was estimated as the same as the artificial UV lamp of four weeks (Raman) or one week (FT-IR) exposure.

  15. Development of a serum-free human cornea construct for in vitro drug absorption studies: the influence of varying cultivation parameters on barrier characteristics.

    Science.gov (United States)

    Hahne, Matthias; Reichl, Stephan

    2011-09-15

    The increased use of ophthalmic products in recent years has led to an increased demand for in vitro and in vivo transcorneal drug absorption studies. Cell-culture models of the human cornea can avoid several of the disadvantages of widely used animal experimental models, including ethical concerns and poor standardisation. This study describes the development of a serum-free cultivated, three-dimensional human cornea model (Hemicornea, HC) for drug absorption experiments. The impact of varying cultivation conditions on the corneal barrier function was analysed and compared with excised rabbit and porcine corneas. The HC was cultivated on permeable polycarbonate filters using immortalised human keratocytes and a corneal epithelial cell line. The equivalence to native tissue was investigated through absorption studies using model substances with a wide range of molecular characteristics, including hydrophilic sodium fluorescein, lipophilic rhodamine B and fluorescein isothiocyanate (FITC)-labelled macromolecule dextran. To study the intra-laboratory repeatability and construct cultivation, the permeation studies were performed independently by different researchers. The HC exhibited a permeation barrier in the same range as excised animal corneas, high reproducibility and a lower standard deviation. Therefore, the HC could be a promising in vitro alternative to ex vivo corneal tissues in preclinical permeation studies.

  16. Establishment of a new in vitro test method for evaluation of eye irritancy using a reconstructed human corneal epithelial model, LabCyte CORNEA-MODEL.

    Science.gov (United States)

    Katoh, Masakazu; Hamajima, Fumiyasu; Ogasawara, Takahiro; Hata, Ken-ichiro

    2013-12-01

    Finding in vitro eye irritation testing alternatives to animal testing such as the Draize eye test, which uses rabbits, is essential from the standpoint of animal welfare. It has been developed a reconstructed human corneal epithelial model, the LabCyte CORNEA-MODEL, which has a representative corneal epithelium-like structure. Protocol optimization (pre-validation study) was examined in order to establish a new alternative method for eye irritancy evaluation with this model. From the results of the optimization experiments, the application periods for chemicals were set at 1min for liquid chemicals or 24h for solid chemicals, and the post-exposure incubation periods were set at 24h for liquids or zero for solids. If the viability was less than 50%, the chemical was judged to be an eye irritant. Sixty-one chemicals were applied in the optimized protocol using the LabCyte CORNEA-MODEL and these results were evaluated in correlation with in vivo results. The predictions of the optimized LabCyte CORNEA-MODEL eye irritation test methods were highly correlated with in vivo eye irritation (sensitivity 100%, specificity 80.0%, and accuracy 91.8%). These results suggest that the LabCyte CORNEA-MODEL eye irritation test could be useful as an alternative method to the Draize eye test.

  17. Central corneal thickness measurement using ultrasonic pachymetry, rotating scheimpflug camera, and scanning-slit topography exclusively in thin non-keratoconic corneas

    Directory of Open Access Journals (Sweden)

    Mehrdad Mohammadpour

    2016-01-01

    Conclusion: In normal thin corneas, Pentacam demonstrated better agreement with US pachymetry as compared to corrected Orbscan readings. Results achieved by Orbscan were better consistent with US pachymetry using an AF of 0.94. We speculate that a dynamically graded AF in reverse proportion to CCT constitutes a better approach for correcting Orbscan measurements.

  18. Herpes simplex virus-specific T cells infiltrate the cornea of patients with herpetic stromal keratitis: no evidence for autoreactive T cells

    NARCIS (Netherlands)

    L. Remeijer (Lies); C.M. Mooy (Cornelia); A.D.M.E. Osterhaus (Albert); G.M.G.M. Verjans (George)

    2000-01-01

    textabstractPURPOSE: Herpetic stromal keratitis (HSK) is a T-cell-mediated inflammatory disease initiated by a herpes simplex virus (HSV) infection of the cornea. Recently, studies in the HSK mouse model have shown that the immunopathogenic T cells are directed against the HSV prot

  19. Evaluation of Intrastromal Riboflavin Concentration in Human Corneas after Three Corneal Cross-Linking Imbibition Procedures: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Antonella Franch

    2015-01-01

    Full Text Available Purpose. To compare stromal riboflavin concentration after three corneal cross-linking (CXL imbibition procedures: standard (EpiOff, transepithelial corneal (EpiOn, and iontophoresis-assisted technique (Ionto using 0.1% hypotonic riboflavin phosphate. Methods. Randomized open-label pilot clinical study. Twelve corneas/12 patients with advanced keratoconus were randomly divided into 4 groups for CXL (n=3. The corneas underwent imbibition with standard riboflavin EpiOff and with enhanced riboflavin solution (RICROLIN+ EpiOff, EpiOn, and iontophoresis techniques. Thereafter, deep anterior lamellar keratectomy procedure was performed and the obtained debrided corneal tissues were frozen. The maximal intrastromal riboflavin concentration was measured by high-performance liquid chromatography/mass spectrometry (mcg/dg. Results. The mean stromal concentration of riboflavin was 2.02±0.72 mcg/dg in EpiOff group, 4.33±0.12 mcg/g in EpiOff-RICROLIN+ group, 0.63±0.21 mcg/dg in EpiOn-RICROLIN+ group, and 1.15±0.27 mcg/dg in iontophoresis RICROLIN+ group. A 7-fold decrease in intrastromal riboflavin concentration was observed comparing EpiOn-RICROLIN+ and EpiOff-RICROLIN+ groups. Conclusion. The present pilot study indicates that both transepithelial CXL techniques in combination with hypotonic enhanced riboflavin formulation (RICROLIN+ were still inferior to the standard CXL technique; however, larger clinical studies to further validate the results are needed and in progress.

  20. Three dimensional visualization and fractal analysis of mosaic patches in rat chimeras: cell assortment in liver, adrenal cortex and cornea.

    Science.gov (United States)

    Iannaccone, Stephen; Zhou, Yue; Walterhouse, David; Taborn, Greg; Landini, Gabriel; Iannaccone, Philip

    2012-01-01

    The production of organ parenchyma in a rapid and reproducible manner is critical to normal development. In chimeras produced by the combination of genetically distinguishable tissues, mosaic patterns of cells derived from the combined genotypes can be visualized. These patterns comprise patches of contiguously similar genotypes and are different in different organs but similar in a given organ from individual to individual. Thus, the processes that produce the patterns are regulated and conserved. We have previously established that mosaic patches in multiple tissues are fractal, consistent with an iterative, recursive growth model with simple stereotypical division rules. Fractal dimensions of various tissues are consistent with algorithmic models in which changing a single variable (e.g. daughter cell placement after division) switches the mosaic pattern from islands to stripes of cells. Here we show that the spiral pattern previously observed in mouse cornea can also be visualized in rat chimeras. While it is generally held that the pattern is induced by stem cell division dynamics, there is an unexplained discrepancy in the speed of cellular migration and the emergence of the pattern. We demonstrate in chimeric rat corneas both island and striped patterns exist depending on the age of the animal. The patches that comprise the pattern are fractal, and the fractal dimension changes with the age of the animal and indicates the constraint in patch complexity as the spiral pattern emerges. The spiral patterns are consistent with a loxodrome. Such data are likely to be relevant to growth and cell division in organ systems and will help in understanding how organ parenchyma are generated and maintained from multipotent stem cell populations located in specific topographical locations within the organ. Ultimately, understanding algorithmic growth is likely to be essential in achieving organ regeneration in vivo or in vitro from stem cell populations.

  1. Three dimensional visualization and fractal analysis of mosaic patches in rat chimeras: cell assortment in liver, adrenal cortex and cornea.

    Directory of Open Access Journals (Sweden)

    Stephen Iannaccone

    Full Text Available The production of organ parenchyma in a rapid and reproducible manner is critical to normal development. In chimeras produced by the combination of genetically distinguishable tissues, mosaic patterns of cells derived from the combined genotypes can be visualized. These patterns comprise patches of contiguously similar genotypes and are different in different organs but similar in a given organ from individual to individual. Thus, the processes that produce the patterns are regulated and conserved. We have previously established that mosaic patches in multiple tissues are fractal, consistent with an iterative, recursive growth model with simple stereotypical division rules. Fractal dimensions of various tissues are consistent with algorithmic models in which changing a single variable (e.g. daughter cell placement after division switches the mosaic pattern from islands to stripes of cells. Here we show that the spiral pattern previously observed in mouse cornea can also be visualized in rat chimeras. While it is generally held that the pattern is induced by stem cell division dynamics, there is an unexplained discrepancy in the speed of cellular migration and the emergence of the pattern. We demonstrate in chimeric rat corneas both island and striped patterns exist depending on the age of the animal. The patches that comprise the pattern are fractal, and the fractal dimension changes with the age of the animal and indicates the constraint in patch complexity as the spiral pattern emerges. The spiral patterns are consistent with a loxodrome. Such data are likely to be relevant to growth and cell division in organ systems and will help in understanding how organ parenchyma are generated and maintained from multipotent stem cell populations located in specific topographical locations within the organ. Ultimately, understanding algorithmic growth is likely to be essential in achieving organ regeneration in vivo or in vitro from stem cell populations.

  2. Confocal microscopy of epithelial and langerhans cells of the cornea in patients using travoprost drops containing two different preservatives.

    Science.gov (United States)

    Marsovszky, László; Resch, Miklós D; Visontai, Zsuzsanna; Németh, János

    2014-07-01

    The recently developed confocal cornea microscopy offers the opportunity to examine pathologies of the cornea and to gain insight into the activity of innate immunity. We aimed to investigate the corneal epithelial and Langerhans cell (LC) densities along with dry eye parameters in primary open-angle glaucoma (POAG) subjects, treated with either of two commercially available travoprost 0.004 % topical medications containing different preservatives. (1: benzalkonium chloride 0.015 % (TravBAK) and 2: polyquaternium-1 (PQ) 0.001 % (TravPQ). Consecutive case series of nineteen POAG patients on TravBAK (mean age: 64.8 ± 13.6 years), nineteen POAG patients on TravPQ (mean age: 66.8 ± 11.3 years) and nineteen age-matched healthy control subjects (63.8 ± 8.2 years). Ocular surface disease index (OSDI), lid parallel conjunctival folds (LIPCOF), Schirmer test (ST) and tear break up time (TBUT) were assessed, and then corneal epithelial and LC densities were investigated with confocal microscopy. Tear production was significantly reduced in both glaucoma patient groups compared to healthy individuals (p < 0.05). TBUT was significantly reduced and epithelial cell densities were significantly greater in patients treated with TravBAK compared to healthy individuals (p < 0.05 for all). LC densities were greater in both glaucoma groups compared to control subjects (p < 0.05 for all). Travoprost therapy may compromise ocular surface. The limited alertness of the corneal immune system found in patients with TravPQ can be considered as indicators of a less disturbed ocular surface and better controlled corneal homeostasis.

  3. OAS/PKR Pathways and α/β TCR+ T Cells are Required for Ad: IFN-γ Inhibition of HSV-1 in Cornea1

    Science.gov (United States)

    Austin, Bobbie Ann; Halford, William P.; Williams, Bryan R. G.; Carr, Daniel J. J.

    2007-01-01

    An adenoviral vector containing the muIFN-γ transgene (Ad:IFN-γ) was evaluated for its capacity to inhibit HSV-1. To measure effectiveness, viral titers were analyzed in cornea and trigeminal ganglia (TG) during acute ocular HSV-1 infection. Ad: IFN-γ potently suppressed HSV-1 replication in a dose-dependent fashion, requiring IFN-γ R. Moreover, Ad:IFN-γ was effective when delivered -72 and -24 h prior to infection as well as 24 h post infection. Associated with anti-viral opposition, TG from Ad: IFN-γ transduced mice harbored fewer T cells. Also related to T cell involvement, Ad:IFN-γ was effective but attenuated in TG from α/β TCR deficient mice. In corneas, α/β TCR+ T cells were obligatory for protection against viral multiplication. Type I IFN involvement amid anti-viral efficacy of Ad: IFN-γ was further investigated because type I and II IFN pathways have synergistic anti-HSV-1 activity. Ad:IFN-γ inhibited viral reproduction in corneas and TG from IFN-α/β R deficient (CD118 −/−) mice, although viral titers were 2–3 fold higher in cornea and TG, compared to wild type. The absence of IFN-stimulated anti-viral proteins, 2’-5’ oligoadenylate synthetase/RNase L and ds RNA dependent protein kinase R, completely eliminated the anti-viral effectiveness of Ad:IFN-γ. Collectively, the results demonstrate: (1) nonexistence of type I IFN R does not abolish defense of Ad:IFN-γ against HSV-1; (2) anti-viral pathways, OAS/RNase L and PKR are mandatory; and (3) α/β TCR+ T cells are compulsory for Ad: IFN-γ effectiveness against HSV-1 in cornea but not in TG. PMID:17404299

  4. Bullous systemic lupus erythematosus:a case report%大疱性系统性红斑狼疮一例

    Institute of Scientific and Technical Information of China (English)

    闫天萌; 左亚刚; 张舒; 林澜; 刘跃华; 李丽; 张涛; 赖雅敏

    2016-01-01

    患者,女,27岁。咳嗽4个月,躯干、四肢红斑、水疱及脱发2个月。皮肤科情况:头顶发稀疏,面部充血性红斑,双手指腹红斑,躯干四肢可见大小不等水疱、血疱,疱壁紧张,尼氏征阴性。外周血红细胞和血红蛋白下降、补体下降,ANA、抗ds-DNA阳性,血清抗VII胶原抗体阳性。患者疱液免疫检测:ANA、抗ds-DNA、抗SSA、抗SSB、抗组蛋白抗体(+),抗RO 52抗体(+++),抗核小体抗体(++),滴度与血液中滴度平行。诊断为大疱性系统性红斑狼疮。%A 27-years-old female patient presented with cough for 4 months and erythema, vesicle and hair-loss for 2 months. Physical examination revealed sparse hair on the scalp, erythema on the face and fin ̄ger pulp, bullas on the trunk and extremities. The bullas were negative in Nikolsky`s sign. Red blood cells and hemoglobin declined and anti-nuclear antibody, anti-ds DNA, antibody to type VII collagen in peripheral blood were positive. ANA, anti-dsDNA, anti-SSA, anti-SSB, anti-histone, anti-Ro 52 and anti-nucleo ̄some antibodies in blister fluids were positive. The diagnosis of bullous systemic lupus erythematosus was made.

  5. Eosinophil localization to the basement membrane zone is autoantibody- and complement-dependent in a human cryosection model of bullous pemphigoid.

    Science.gov (United States)

    Messingham, Kelly N; Wang, Jeffrey W; Holahan, Heather M; Srikantha, Rupasree; Aust, Samantha C; Fairley, Janet A

    2016-01-01

    Bullous pemphigoid (BP) is an autoimmune blistering disease characterized by antibodies (IgG and IgE) targeting cell-substrate adhesion proteins. A variety of BP models suggest that autoantibody-dependent neutrophil degranulation is essential for blister formation. However, lesional biopsies reveal a predominance of eosinophils and few neutrophils. Our goal was to evaluate the role of antibodies and complement in eosinophil localization, degranulation and split formation at the dermo-epidermal junction (DEJ) utilizing a human skin cryosection model of BP paired with a human eosinophilic cell line, 15HL-60. Expression of receptors for IgG (FcγRII), IgE (FcεRI) and complement (CR1 and CR3) was confirmed on 15HL-60 cells using flow cytometry. 15HL-60 expression of granule protein [eosinophil derived neurotoxin (EDN) and eosinophil peroxidase (EPO)] mRNA and their degranulation in vitro was confirmed using RT-PCR and ELISA, respectively. For cryosection experiments, BP or control sera or IgG and IgE antibodies purified from BP sera were utilized in combination with 15HL-60 cells ± fresh complement. Both BP serum and fresh complement were required for localization of 15-HL60 cells to the DEJ. Interestingly, eosinophil localization to the DEJ was dependent on IgG, but not IgE, and complement. However, no subepidermal split was observed. Additionally, the 15HL-60 cells did not degranulate under any experimental conditions and direct application of cell lysate to cryosections did not result in a split. Our observation that eosinophil localization to the DEJ is dependent on IgG mediated complement fixation provides additional insight into the sequence of events during the development of BP lesions.

  6. Human IgG1 monoclonal antibody against human collagen 17 noncollagenous 16A domain induces blisters via complement activation in experimental bullous pemphigoid model.

    Science.gov (United States)

    Li, Qiang; Ujiie, Hideyuki; Shibaki, Akihiko; Wang, Gang; Moriuchi, Reine; Qiao, Hong-jiang; Morioka, Hiroshi; Shinkuma, Satoru; Natsuga, Ken; Long, Heather A; Nishie, Wataru; Shimizu, Hiroshi

    2010-12-15

    Bullous pemphigoid (BP) is an autoimmune blistering disease caused by IgG autoantibodies targeting the noncollagenous 16A (NC16A) domain of human collagen 17 (hCOL17), which triggers blister formation via complement activation. Previous in vitro analysis demonstrated that IgG1 autoantibodies showed much stronger pathogenic activity than IgG4 autoantibodies; however, the exact pathogenic role of IgG1 autoantibodies has not been fully demonstrated in vivo. We constructed a recombinant IgG1 mAb against hCOL17 NC16A from BP patients. In COL17-humanized mice, this mAb effectively reproduced a BP phenotype that included subepidermal blisters, deposition of IgG1, C1q and C3, neutrophil infiltration, and mast cell degranulation. Subsequently, alanine substitutions at various C1q binding sites were separately introduced to the Fc region of the IgG1 mAb. Among these mutated mAbs, the one that was mutated at the P331 residue completely failed to activate the complement in vitro and drastically lost pathogenic activity in COL17-humanized mice. These findings indicate that P331 is a key residue required for complement activation and that IgG1-dependent complement activation is essential for blister formation in BP. This study is, to our knowledge, the first direct evidence that IgG1 Abs to hCOL17 NC16A can induce blister formation in vivo, and it raises the possibility that IgG1 mAbs with Fc modification may be used to block pathogenic epitopes in autoimmune diseases.

  7. Eritema multiforme ampollar extenso asociado a infección por virus herpes simplex Extended Bullous Erythema Multiforme Associated To Herpes Simplex Virus Infection

    Directory of Open Access Journals (Sweden)

    A Elgueta-Noy

    2009-12-01

    Full Text Available El Eritema Multiforme (EM es una reacción cutánea aguda generalmente benigna y autolimitada, asociada a la infección por Virus Herpes Simplex (HSV. Se caracteriza por lesiones polimorfas y tipo diana en extremidades y mucosas. Presentamos un paciente de 22 años con pápulas, vesículas y ampollas, que evoluciona con un 90% de la superficie corporal comprometida en tres semanas. Se realizó una reacción de polimerasa en cadena para HSV, resultando positiva en una costra. La biopsia de piel y la tinción de inmunohistoquímica positiva para linfocitos T CD4, fueron compatibles con EM ampollar asociado a HSV. Destacamos la importancia de la correlación clínico patológica, apoyada por el estudio virológico, en el diagnóstico de este caso de presentación atípica. Los hallazgos de laboratorio confirmaron lo descrito en la literatura respecto de la patogenia del EM asociado a HSV.Erythema Multiforme (EM is a generally benign and self-limited acute cutaneous reaction, associated with Herpes Simplex Virus (HSV infection. It is characterized by polymorphic "target" lesions in extremities and mucosal tissues. We report a 22-year old patient with papules, vesicles and blisters, which evolved to cover 90% of the body in three weeks. We performed a PCR study for HSV, which was positive in a crust. A skin biopsy and positive immunohistochemical stain for LT CD4+ were compatible with bullous EM associated with HSV. We underline the importance of pathological clinical correlation, reinforced by a virological study, in the diagnosis of this case with atypical symptoms. The laboratory findings confirmed literature descriptions with respect to the pathogenicity of EM associated with HSV.

  8. IgG/IgE bullous pemphigoid with CD45 lymphocytic reactivity to dermal blood vessels, nerves and eccrine sweat glands

    Directory of Open Access Journals (Sweden)

    Ana Maria Abreu-Velez

    2010-01-01

    Full Text Available Context: Bullous pemphigoid (BP, the most common autoimmune blistering disease, is mediated by autoantibodies. BP primarily affects the elderly and is characterized by the development of urticarial plaques surmounted by subepidermal blisters, and the deposition of immunoglobulins and complement at the basement membrane zone (BMZ of the skin. BP is immunologically characterized by the development of autoantibodies targeting two structural proteins of the hemidesmosomes, BP180 (collagen XVII and BP230 (BPAG1. Case Report: A 63 -year-old Caucasian female patient was evaluated for a 4 day history of several itching, erythematous blisters on her extremities. Biopsies for hematoxylin and eosin (H&E examination, as well as Periodic acid-Schiff (PAS, immunohistochemistry (IHC and direct immunofluorescence (DIF analysis were performed. Results: H&E demonstrated a subepidermal blister, with partial re-epithelialization of the blister floor. Within the blister lumen, numerous neutrophils were present, with occasional eosinophils and lymphocytes also noted. Within the dermis, a mild, superficial, perivascular and periadnexal infiltrate of lymphocytes, histiocytes and occasional eosinophils was identified, with mild perivascular leukocytoclastic debris. The PAS stain was positive at the BMZ, and around selected blood vessels, nerves and sweat glands. DIF revealed linear deposits of IgG and Complement/C3 and fibrinogen at the BMZ, and around selected dermal nerves, blood vessels and sweat glands. Strong granular deposits of IgE were also observed, colocalizing with monoclonal antibodies to Collagen IV (CIV. By IHC, positive CD45 staining of lymphocytes was seen surrounding selected dermal blood vessels, eccrine sweat glands, and nerves. Conclusion : The patient displayed IgG, IgE, and fibrinogen autoantibodies against the BMZ, as well as around some dermal nerves and sweat glands; their binding in the skin could trigger complement activation. In addition, the

  9. 自身免疫性大疱性皮肤病评分系统在天疱疮治疗中的应用%The application of autoimmune bullous skin disorders intensity score in the treatment of pemphigus

    Institute of Scientific and Technical Information of China (English)

    阳艺; 郭宜青; 周红梅

    2013-01-01

    Pemphigus is a kind of serious, chronic skin-mucosa bullous disorder. Glucocorticoid, as the first choice drug, could reduce the mortality of the disease largely, while long-term use could lead to fatal adverse reaction. Series of evaluation system have been put forward by foreign scholars, which contribute significantly to disease and drug efficacy assessment and monitoring. Autoimmune bullous skin disorders intensity score system in this paper is a relatively accepted system, and some suggestions for improvement would be put forward according to our clinical practice.%  天疱疮是一类严重的、慢性皮肤-黏膜大疱性疾病,糖皮质激素是其治疗的首选药物,但长期用药可能导致较严重的并发症甚至死亡。近年来,国外学者提出一系列天疱疮评估系统,有助于较准确评估病情、客观评价药物疗效、监测病情转归等。本文将重点介绍较受公认的自身免疫性大疱性皮肤病评分系统,并根据临床实践对其提出思考和改进意见。

  10. Poly (ε-caprolactone nanofibrous ring surrounding a polyvinyl alcohol hydrogel for the development of a biocompatible two-part artificial cornea

    Directory of Open Access Journals (Sweden)

    Bakhshandeh H

    2011-07-01

    Full Text Available Haleh Bakhshandeh1, Masoud Soleimani2, Saied Shah Hosseini3, Hassan Hashemi3, Iman Shabani4, Abbas Shafiee5, Amir Houshang Behesht Nejad6, Mohammad Erfan1, Rassoul Dinarvand7, Fatemeh Atyabi71Department of Pharmaceutics, School of Pharmacy, Shaheed Beheshti Medical University, Tehran, Iran; 2Hematology Department, Faculty of Medical Science, Tarbiat Modares University, Tehran, Iran; 3Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran; 4Nanotechnology and Tissue Engineering Department, Stem Cell Technology Research Center, Tehran, Iran; 5Stem Cell Biology Department, Stem Cell Technology Research Center, Tehran, Iran; 6Ophthalmology Department, Tehran University of Medical Sciences, Tehran, Iran; 7Nanotechnology Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, IranAbstract: The study aimed to fabricate and characterize a 2-part artificial cornea as a substitute for penetrating keratoplasty in patients with corneal blindness. The peripheral part of the artificial cornea consisted of plasma-treated electrospun poly (ε-caprolactone (PCL nanofibers, which were attached to a hydrogel disc of polyvinyl alcohol (PVA as a central optical part. The physical properties of the prepared artificial cornea, including morphology, mechanical properties, light transmittance, and contact angle, were assessed. Cell attachment and proliferation studies were performed on rabbit limbal stem cells. The SEM image of the polymeric system showed that the peripheral part formed a highly porous scaffold that could facilitate tissue biointegration. Assessment of the mechanical properties of the peripheral nanofibrous part and the hydrogel optical part showed suitable elasticity. Young’s modulus values of the electrospun PCL skirt and PVA hydrogel core were 7.5 and 5.3 MPa, respectively, which is in line with the elasticity range of natural human cornea (0.3–7 MPa. The light transmittance of the central part was >85

  11. Estudo comparativo entre duas plataformas para realização de Lasik personalizado para correção de miopia e astigmatismo: Alcon CustomCornea® versus Bausch & Lomb Zyoptix® Wavefront-Guided Lasik for low to moderate myopia: CustomCornea® versus Zyoptix®

    Directory of Open Access Journals (Sweden)

    Telma Pereira Barreiro

    2009-08-01

    Full Text Available OBJETIVO: Comparar os resultados obtidos após o Lasik personalizado utilizando duas plataformas diferentes. MÉTODOS: Estudo prospectivo, randomizado com 50 pacientes míopes submetidos a cirurgia refrativa em ambos os olhos. Foram selecionados para o estudo, pacientes com equivalente esférico semelhante entre os olhos. Todos foram submetidos a Lasik bilateral e simultâneo, sendo que um olho foi operado pela plataforma CustomCornea® e o outro pela Zyoptix®. Acuidade visual sem e com correção, refração dinâmica e estática, medida das aberrações oculares, teste de sensibilidade ao contraste foram realizados no período pré-operatório e pós-operatório de 1, 3 e 6 meses. RESULTADOS: No período pré-operatório a média do equivalente esférico era de -3,29 ± 1,56 D no grupo CustomCornea® e de -3,22 ± 1,50 D no Zyoptix® (p=0,267. No sexto mês de pós-operatório, a média do equivalente esférico no grupo CustomCornea® era de -0,077 ± 0,23 D e -0,282 ± 0,30 D no Zyoptix® (p 20/20 foi alcançada em 86% dos olhos no grupo CustomCornea® e 70% no grupo Zyoptix® (p=0,094. Nenhum paciente perdeu duas ou mais linhas da melhor acuidade visual corrigida. Cem por cento dos olhos CustomCornea® e 88% dos Zyoptix® ficaram entre ± 0,50 D da emetropia (p=0,014*. Melhora da sensibilidade ao contraste em todas as frequências espaciais testadas foi observada em ambos os grupos. A aberração esférica apresentou aumento em ambos os grupos, porém este foi estatisticamente maior na plataforma Zyoptix® (pPURPOSE: To compare the visual and clinical outcomes of Wavefront-guided laser in situ keratomileusis (Lasik with Alcon CustomCornea® and Zyoptix® systems. METHODS: A prospective, randomized, masked and bilateral study was conducted. Fifty patients with preoperative spherical equivalent ranging from -1.00 to -6.50 D were enrolled for customized ablation in both eyes. All of them were submitted to Lasik CustomCornea® treatment in one

  12. Coloured cornea replacements with anti-infective properties: expanding the safe use of silver nanoparticles in regenerative medicine

    Science.gov (United States)

    Alarcon, E. I.; Vulesevic, B.; Argawal, A.; Ross, A.; Bejjani, P.; Podrebarac, J.; Ravichandran, R.; Phopase, J.; Suuronen, E. J.; Griffith, M.

    2016-03-01

    Despite the broad anti-microbial and anti-inflammatory properties of silver nanoparticles (AgNPs), their use in bioengineered corneal replacements or bandage contact lenses has been hindered due to their intense yellow coloration. In this communication, we report the development of a new strategy to pre-stabilize and incorporate AgNPs with different colours into collagen matrices for fabrication of corneal implants and lenses, and assessed their in vitro and in vivo activity.Despite the broad anti-microbial and anti-inflammatory properties of silver nanoparticles (AgNPs), their use in bioengineered corneal replacements or bandage contact lenses has been hindered due to their intense yellow coloration. In this communication, we report the development of a new strategy to pre-stabilize and incorporate AgNPs with different colours into collagen matrices for fabrication of corneal implants and lenses, and assessed their in vitro and in vivo activity. Electronic supplementary information (ESI) available: Collagen hydrogel, moulded as a cornea, prepared containing collagen protected AgNPs and representative images for collagen hydrogels, moulded as corneas, containing Blue AgNPs either unprotected or protected with LL37-SH; representative TEM images for Green-1 AgNPs prepared in this work; changes on surface plasmon band after synthesis for Green-2 AgNPs without LL37-SH; representative picture of the powder obtained for Green-1 AgNPs capped with LL37-SH after 72 h lyophilization, see main text; representative TEM images for Blue and Green-1 AgNPs prepared in this work; absorption spectra for the supernatants for collagen hydrogels containing Blue AgNPs; absorbance at 600 nm of PAO1 cultures prepared in 25% LB media incubated for 14 h at 37 °C in the presence of different concentrations of AgNPs, Green-1 or Blue, or silver nitrate; HECC cell density (cells per cm2) measured on gels with and without silver nitrate after 1 day of cell incubation; total silver concentration

  13. Determining the Depth of Injury in Bioengineered Tissue Models of Cornea and Conjunctiva for the Prediction of All Three Ocular GHS Categories.

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    Michaela Zorn-Kruppa

    Full Text Available The depth of injury (DOI is a mechanistic correlate to the ocular irritation response. Attempts to quantitatively determine the DOI in alternative tests have been limited to ex vivo animal eyes by fluorescent staining for biomarkers of cell death and viability in histological cross sections. It was the purpose of this study to assess whether DOI could also be measured by means of cell viability detected by the MTT assay using 3-dimensional (3D reconstructed models of cornea and conjunctiva. The formazan-free area of metabolically inactive cells in the tissue after topical substance application is used as the visible correlate of the DOI. Areas of metabolically active or inactive cells are quantitatively analyzed on cryosection images with ImageJ software analysis tools. By incorporating the total tissue thickness, the relative MTT-DOI (rMTT-DOI was calculated. Using the rMTT-DOI and human reconstructed cornea equivalents, we developed a prediction model based on suitable viability cut-off values. We tested 25 chemicals that cover the whole range of eye irritation potential based on the globally harmonized system of classification and labelling of chemicals (GHS. Principally, the MTT-DOI test method allows distinguishing between the cytotoxic effects of the different chemicals in accordance with all 3 GHS categories for eye irritation. Although the prediction model is slightly over-predictive with respect to non-irritants, it promises to be highly valuable to discriminate between severe irritants (Cat. 1, and mild to moderate irritants (Cat. 2. We also tested 3D conjunctiva models with the aim to specifically address conjunctiva-damaging substances. Using the MTT-DOI method in this model delivers comparable results as the cornea model, but does not add additional information. However, the MTT-DOI method using reconstructed cornea models already provided good predictability that was superior to the already existing established in vitro/ex vivo

  14. Corneal thickness changes during corneal collagen cross-linking with UV-A irradiation and hypo-osmolar riboflavin in thin corneas

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    Belquiz Amaral Nassaralla

    2013-06-01

    Full Text Available PURPOSE: To evaluate the thinnest corneal thickness changes during and after corneal collagen cross-linking treatment with ultraviolet-A irradiation, using hypo-osmolar riboflavin solution in thin corneas. METHODS: Eighteen eyes of 18 patients were included in this study. After epithelium removal, iso-osmolar 0.1% riboflavin solution was instilled to the cornea every 3 minutes for 30 minutes. Hypo-osmolar 0.1% riboflavin solution was then applied every 20 seconds for 5 minutes or until the thinnest corneal thickness reached 400 µm. Ultraviolet-A irradiation was performed for 30 minutes. During irradiation, iso-osmolar 0.1% riboflavin drops were applied every 5 minutes. Ultrasound pachymetry was performed at approximately the thinnest point of the cornea preoperatively, after epithelial removal, after iso-osmolar riboflavin instillation, after hypo-osmolar riboflavin instillation, after ultraviolet-A irradiation, and at 1, 6 and 12 months after treatment. RESULTS: Mean preoperative thinnest corneal thickness was 380 ± 11 µm. After epithelial removal it decreased to 341 ± 11 µm, and after 30 minutes of iso-osmolar 0.1% riboflavin drops, to 330 ± 7.6 µm. After hypo-osmolar 0.1% riboflavin drops, mean thinnest corneal thickness increased to 418 ± 11 µm. After UVA irradiation, it was 384 ± 10 µm. At 1, 6 and 12 months after treatment, it was 372 ± 10 µm, 381 ± 12.7, and 379 ± 15 µm, respectively. No intraoperative, early postoperative, or late postoperative complications were noted. CONCLUSIONS: Hypo-osmolar 0.1% riboflavin solution seems to be effective for swelling thin corneas. The swelling effect is transient and short acting. Corneal thickness should be monitored throughout the procedure. Larger sample sizes and longer follow-up are required in order to make meaningful conclusions regarding safety.

  15. Simultaneous imaging and measurement of tensile stress on cornea by using a common-path optical coherence tomography system with an external contact reference

    Institute of Scientific and Technical Information of China (English)

    Utkarsh Sharma; Jin U. Kang

    2008-01-01

    The objective of this study is to demonstrate that tensile stress resulting due to applied force on cornea can be accurately measured by using a time-domain common-path optical coherence tomography (OCT) system with an external contact reference. The unique design of the common-path OCT is utilized to set up an imaging system in which a chicken eye is placed adjacent to a glass plate serving as the external reference plane for the imaging system. As the force is applied to the chicken eye, it presses against the reference glass plate. The modified OCT image obtained is used to calculate the size of contact area, which is then used to derive the tensile stress on the cornea. The drop in signal levels upon contact of reference glass plate with the tissue are extremely sharp because of the sharp decline in reference power levels itself, thus providing us with an accurate measurement of contact area. The experimental results were in good agreement with the numerical predictions. The results of this study might be useful in providing new insights and ideas to improve the precision and safety of currently used ophthalmic surgical techniques. This research outlines a method which could be used to provide high resolution OCT images and a precise feedback of the forces applied to the cornea simultaneously.

  16. Expressions of matrix metalloproteinases-1 and -9 and opioid growth factor in rabbit cornea after lamellar keratectomy and treatment with 1% nalbuphine

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    Miguel Ladino Silva

    2015-06-01

    Full Text Available ABSTRACT Purposes: To evaluate the effects of nalbuphine 1% on the expression of metalloproteinase 1 (MMP-1, metalloproteinase 9 (MMP-9, and opioid growth factor (OGF in rabbit corneas after lamellar keratectomy. Methods: The rabbits were assigned to two groups: group nalbuphine (GN, n=30, which received 30 µL of nalbuphine 1% in 4 daily applications at regular intervals until corneal epithelialization, and group control (GC, n=30, which received physiological saline solution under the same conditions adopted in GN. The corneas were collected for immunohistochemistry on days 1, 3, 5, 7, and 9 after lamellar keratectomy, and the expressions of MMP-1, MMP-9, and OGF were analyzed. Results: The expressions of MMP-1 and MMP-9 increased until day 5 of the evaluation, with no differences observed between GN and GC (p>0.05. On days 7 and 9, significant reductions were observed in the expression of MMP-1 (p0.05. The expression of OGF was constant in all periods (p>0.05, restricted to the corneal epithelium, and there was no difference between the groups (p>0.05. Conclusions: The study results showed that nalbuphine 1% did not alter the expression patterns of MMP-1, MMP-9, and OGF in rabbit corneas after lamellar keratectomy.

  17. Effect of a pulsed magnetic field on permeability of the cornea and sorption properties of the tissue structures and refractive media of the eye

    Energy Technology Data Exchange (ETDEWEB)

    Skrinnik, A.V.

    1986-03-01

    The author attempts to obtain direct proof of increased permeability of the cornea and enhanced sorption properties of the tissue structures and refractive media of the eye under the influence of a pulsed magnetic field (MF). In the course of the investigation, the method of radioactive indication of two substances (/sup 35/S-streptomycin and /sup 75/Se-methionine), widely used in opthalmologic practice, was used. The radioactivity of the working solution of the preparations was 300,000 cpm in 0.1 ml. Changes in the permeability of the cornea were assessed on the basis of changes in radioactivity of the aqueous humor. The concentration of /sup 35/S-streptomycin in aqueous humor of the animals immediately after exposure to MF was significantly higher than in the control. Analysis of permeability of the cornea for /sup 75/Se-methionine also showed increased penetration of radioactivity into the aqueous. The results are evidence of the greater penetrating power of /sup 75/Se-methionine.

  18. Chronic Electromagnetic Exposure at Occupational Safety Level Does Not Affect the Metabolic Profile nor Cornea Healing after LASIK Surgery.

    Science.gov (United States)

    Crouzier, David; Dabouis, Vincent; Gentilhomme, Edgar; Vignal, Rodolphe; Bourbon, Fréderic; Fauvelle, Florence; Debouzy, Jean-Claude

    2014-01-01

    LASIK eye surgery has become a very common practice for myopic people, especially those in the military. Sometimes undertaken by people who need to keep a specific medical aptitude, this surgery could be performed in secret from the hierarchy and from the institute medical staff. However, even though the eyes have been previously described as one of the most sensitive organs to electromagnetic fields in the human body, no data exist on the potential deleterious effects of electromagnetic fields on the healing eye. The consequences of chronic long-lasting radar exposures at power density, in accordance with the occupational safety standards (9.71 GHz, 50 W/m(2)), were investigated on cornea healing. The metabolic and clinical statuses after experimental LASIK keratotomy were assessed on the different eye segments in a New Zealand rabbit model. The analysis methods were performed after 5 months of exposure (1 hour/day, 3 times/week). Neither clinical or histological examinations, nor experimental data, such as light scattering, (1)H-NMR HRMAS metabolomics, (13)C-NMR spectra of lipidic extracts, and antioxidant status, evidenced significant modifications. It was concluded that withdrawing the medical aptitude of people working in electromagnetic field environments (i.e., radar operators in the navy) after eye surgery was not justified.

  19. Effect of the Multiglycoside of Tripterygium Wilfordii Hookf.(Tii)on Cornea Allograft Rejection Model in Rabbit

    Institute of Scientific and Technical Information of China (English)

    ZhijieLi; ChenLi

    1995-01-01

    Purpose:Toexamine the effect of Tii treatment of cornea graft survival in a rab-bit model.Methods:Tii was administrated orally after eccentrical corneal transplantation.Survival times were determined by biomicroscopy.Cytotoxic T lymphocytes(CTL)and delayed-type hypersensitivity(DTH)responses to donor alloantigens were assessed at ady 16after heterotopic corneal grafts.Results:Administration of Tii reduced the incidence and prologed the graft sur-vival time.Both CTLand DTH responses to donor alloantigens were severely ed-pressed in hosts treated with Tii.However,combination of Tii and cyclosporine further enhanced the immunosuppressive effects described above.Conclusions:Tii is a potent immunosuppressant with the ability to prolong allo-graft survival in the rabbit penetrating keratoplasty model and may have coordi-native effects with CsA through different mechanisms.Further studies are neces-sary to define any potentially coordinative role in the prevention of allograft rejec-tion in human keratoplasty.Eye Science 1995;11:168-172.

  20. KTCNlncDB—a first platform to investigate lncRNAs expressed in human keratoconus and non-keratoconus corneas

    Science.gov (United States)

    Szcześniak, Michał W.; Kabza, Michal; Karolak, Justyna A.; Rydzanicz, Malgorzata; Nowak, Dorota M.; Ginter-Matuszewska, Barbara; Polakowski, Piotr; Ploski, Rafal; Szaflik, Jacek P.; Gajecka, Marzena

    2017-01-01

    Keratoconus (KTCN, OMIM 148300) is a degenerative eye disorder characterized by progressive stromal thinning that leads to a conical shape of the cornea, resulting in optical aberrations and even loss of visual function. The biochemical background of the disease is poorly understood, which motivated us to perform RNA-Seq experiment, aimed at better characterizing the KTCN transcriptome and identification of long non-coding RNAs (lncRNAs) that might be involved in KTCN etiology. The in silico functional studies based on predicted lncRNA:RNA base-pairings led us to recognition of a number of lncRNAs possibly regulating genes with known or plausible links to KTCN. The lncRNA sequences and data regarding their predicted functions in controlling the RNA processing and stability are available for browse, search and download in KTCNlncDB (http://rhesus.amu.edu.pl/KTCNlncDB/), the first online platform devoted to KTCN transcriptome. Database URL: http://rhesus.amu.edu.pl/KTCNlncDB/ PMID:28077570

  1. Dr John Nottingham's 1854 Landmark Treatise on Conical Cornea Considered in the Context of the Current Knowledge of Keratoconus.

    Science.gov (United States)

    Gokul, Akilesh; Patel, Dipika V; McGhee, Charles N J

    2016-05-01

    John Nottingham has been widely credited with the first accurate description of keratoconus in his treatise on conical cornea, published in 1854. Contained within the 270-page treatise are accounts and theories of keratoconus postulated by authors such as Scarpa, von Carion, von Ammon, and Mackenzie, synthesized by Nottingham in a treatise containing his own original observations. Nottingham's work delves deeply into keratoconus, with coverage reminiscent of a modern review, albeit in a far less succinct manner. He extensively describes the epidemiology, clinical presentation, underlying cause, and treatment of keratoconus. However, the concepts put forth are limited largely by the contemporary lack of understanding of the underlying anatomy and physiology of the eye, and the observations, by technological limitations. He postulates a similar treatment algorithm to that used today; optical devices being the management option of choice in the mild stages with surgery being a last resort. None of the surgical methods discussed are used in the modern era, but he does make reference to the possible efficacy of corneal transplantation. Nottingham's treatise was published over 160 years ago, yet his ideas and observations are surprisingly accurate. It is very possible that he was the first person to publish an accurate, comprehensive description of keratoconus.

  2. Late Stage of Corneal Decompensation Caused by Progressive Keratoconus: Can We Treat It and Save the Cornea?

    Directory of Open Access Journals (Sweden)

    Igor Knezović

    2015-01-01

    Full Text Available Aim. To report a case of 40-year-old male with progressive bilateral keratoconus who had undergone transepithelial phototherapeutic keratectomy (TE-PTK and corneal collagen cross-linking (CXL using hypoosmolar riboflavin solution in a same day procedure. Methods. Eye examination showed that UCDVA on both eyes was 0,01 according to Snellen charts, and slit lamp biomicroscopy showed paracentral diffuse intrastromal corneal haze. Anterior OCT marked stromal hyperreflective zones and localized paracentral thinning of the cornea. Scheimpflug tomography noted keratoconus stages III-IV on both eyes. After 40/35 microns TE-PTK, a CXL was performed for 30 minutes using hypoosmolar riboflavin solution. The left eye was treated first and the right eye 1 month after. Follow-up period was 10 months. Results. One month after the treatment both eyes showed improvement in corneal topography and the UCDVA was better. Eight months after the treatment BSCVA improved to 0,6 in both eyes using Rose K2 contact lenses and remained stable. Conclusion. TE-PTK and CXL using hypotonic riboflavin solution as a same day procedure have been shown to be a safe and promising method in this case of progressive keratoconus. It was necessary to consider certain parameters that could influence the safety and the final outcome of this combined protocol.

  3. Combined use of borneol or menthol with labrasol promotes penetration of baicalin through rabbit cornea in vitro.

    Science.gov (United States)

    Huang, Lei; Bai, Jianhai; Yang, Hongbin; Liu, Jingjing; Cui, Hao

    2015-01-01

    The permeability of most drugs through the eyes is very limited, so finding safe and effective penetration enhancers is of high importance in current ophthalmology research. In this paper, we use a new approach that integrates Chinese and Western medicine to improve the corneal permeability of baicalin, a water- and fat-insoluble target drug, in vitro. Rabbits were divided into three groups. The first group was dosed with borneol (0.05%, 0.1%). menthol (0.1%, 0.2%), or Labrasol (1%, 2%) individually, the second was dosed with a combination of Labrasol with either borneol or menthol, and the third group received a control treatment. Compared with the control treatment, borneol, menthol, or Labrasol alone clearly improved the permeability of baicalin in vitro. Furthermore, the penetrating effects were significantly increased by combining the application of Labrasol with menthol or borneol. Among the various combined penetration enhancers, 0.1% borneol with 2% Labrasol achieved the best apparent permeability, approximately 16.35 times that of the control. Additionally, the calculation of corneal hydration level and the Draize test demonstrated the safety of these penetration enhancers to the rabbit corneas in vivo. This study confirms that the combined use of borneol or menthol, compounds both derived from Chinese herbs, with Labrasol can improve the corneal permeability of water- and fat-insoluble drugs.

  4. Chronic Electromagnetic Exposure at Occupational Safety Level Does Not Affect the Metabolic Profile nor Cornea Healing after LASIK Surgery

    Directory of Open Access Journals (Sweden)

    David Crouzier

    2014-01-01

    Full Text Available LASIK eye surgery has become a very common practice for myopic people, especially those in the military. Sometimes undertaken by people who need to keep a specific medical aptitude, this surgery could be performed in secret from the hierarchy and from the institute medical staff. However, even though the eyes have been previously described as one of the most sensitive organs to electromagnetic fields in the human body, no data exist on the potential deleterious effects of electromagnetic fields on the healing eye. The consequences of chronic long-lasting radar exposures at power density, in accordance with the occupational safety standards (9.71 GHz, 50 W/m2, were investigated on cornea healing. The metabolic and clinical statuses after experimental LASIK keratotomy were assessed on the different eye segments in a New Zealand rabbit model. The analysis methods were performed after 5 months of exposure (1 hour/day, 3 times/week. Neither clinical or histological examinations, nor experimental data, such as light scattering, 1H-NMR HRMAS metabolomics, 13C-NMR spectra of lipidic extracts, and antioxidant status, evidenced significant modifications. It was concluded that withdrawing the medical aptitude of people working in electromagnetic field environments (i.e., radar operators in the navy after eye surgery was not justified.

  5. Label-free SHG imaging and spectral FLIM of corneas using a sub-15 fs laser microscope

    Science.gov (United States)

    Batista, Ana; Breunig, Hans Georg; Uchugonova, Aisada; Seitz, Berthold; Morgado, António Miguel; König, Karsten

    2014-02-01

    Alterations to the corneal cell metabolism or to the structural organization of collagen fibrils occur in several corneal and systemic pathologies. In this work we resort to multiphoton microscopy corneal imaging to achieve a characterization of the corneal state. Using fluorescence lifetime imaging microscopy (FLIM) the assessment of the metabolic state of corneal cells is possible, whereas second harmonic generation (SHG) imaging can be used to assess corneal structural alterations. A sub-15 fs near-infrared laser source with a broad excitation spectrum was used for SHG imaging and FLIM. The broad spectrum allows simultaneous excitation of both metabolic co-factors. The signals were collected by a photomultiplier tubes (PMT) detector with 16 simultaneous recording channels, which allowed the separation of fluorophores autofluorescence based on their emission wavelengths. We were able to successfully image ex-vivo human and porcine cornea at multiple depths. Simultaneous NADH and flavin autofluorescence, SHG of collagen fibrils, and stroma autofluorescence imaging was performed which may in future allow an improved characterization of the metabolic and structural alterations of the corneal tissue due to pathophysiological conditions. This would be an important step towards a better understanding of corneal dystrophies and systemic metabolic disorders.

  6. Distribution of Young's modulus in porcine corneas after riboflavin/UVA-induced collagen cross-linking as measured by atomic force microscopy.

    Directory of Open Access Journals (Sweden)

    Jan Seifert

    Full Text Available Riboflavin/UVA-induced corneal collagen cross-linking has become an effective clinical application to treat keratoconus and other ectatic disorders of the cornea. Its beneficial effects are attributed to a marked stiffening of the unphysiologically weak stroma. Previous studies located the stiffening effect predominantly within the anterior cornea. In this study, we present an atomic force microscopy-derived analysis of the depth-dependent distribution of the Young's modulus with a depth resolution of 5 µm in 8 cross-linked porcine corneas and 8 contralateral controls. Sagittal cryosections were fabricated from every specimen and subjected to force mapping. The mean stromal depth of the zone with effective cross-linking was found to be 219 ± 67 µm. Within this cross-linked zone, the mean Young's modulus declined from 49 ± 18 kPa at the corneal surface to 46 ± 17 kPa, 33 ± 11 kPa, 17 ± 5 kPa, 10 ± 4 kPa and 10 ± 4 kPa at stromal depth intervals of 0-50 µm, 50-100 µm, 100-150 µm, 150-200 µm and 200-250 µm, respectively. This corresponded to a stiffening by a factor of 8.1 (corneal surface, 7.6 (0-50 µm, 5.4 (50-100 µm, 3.0 (100-150 µm, 1.6 (150-200 µm, and 1.5 (200-250 µm, when compared to the Young's modulus of the posterior 100 µm. The mean Young's modulus within the cross-linked zone was 20 ± 8 kPa (2.9-fold stiffening, while it was 11 ± 4 kPa (1.7-fold stiffening for the entire stroma. Both values were significantly distinct from the mean Young's modulus obtained from the posterior 100 µm of the cross-linked corneas and from the contralateral controls. In conclusion, we were able to specify the depth-dependent distribution of the stiffening effect elicited by standard collagen cross-linking in porcine corneas. Apart from determining the depth of the zone with effective corneal cross-linking, we also developed a method that allows for atomic force microscopy-based measurements of gradients of Young's modulus in soft

  7. The non-surgical therapy of fungal cornea ulcer%真菌性角膜溃疡药物治疗体会

    Institute of Scientific and Technical Information of China (English)

    程昕; 谷树严

    2008-01-01

    Objective To summarize curative effect of the non-surgical operations cured the fungal cornea ulcer.Methods 68 inpatients (68 eyes) of the fungal cornea ulcer were treated with medicine locally and systemically.To analyze the curative effect of medication in fungal cornea ulcer.Result The cure rate of non-surgical operation treatment was 36.76%,the improvement rate is 27.94%,the inefficacious rate is 35.29%,2 cases were relapsed.Conclusions The non-surgical operation treatment is the effective method of cure the fungal cornea ulcer.Broad spectrum antifungal agents,especially the polyene and triazole,is efficacious drug to fungal cornea ulcer.The curative effect is conspicuous to the low-grade cases.The refractory cases should be treated with surgical operation.%目的 评价真菌性角膜溃疡非手术治疗的效果.方法 对68例68眼真菌性角膜溃疡患者,采用局部、全身药物治疗等方法的疗效进行回顾性分析,总结非手术方法治疗真菌性角膜溃疡的效果.结果 68例真菌性角膜溃疡患者经非手术治疗,治愈25只眼,好转19只眼,无效24只眼,复发2只眼.结论 非手术治疗方法是治疗真菌性角膜溃疡的一种有效的方法.广谱抗真菌药物多烯类与三唑类药物局部及全身联合治疗真菌性角膜溃疡有效,尤其对溃疡面积小、浸润浅者效果好,复发率低.对于非手术治疗无效的重症患者需行穿透性角膜移植手术治疗.

  8. LASIK后角膜瓣皱褶和折叠的处理%Management of folds and striae in the cornea flap after laser in situ keratomileusis,

    Institute of Scientific and Technical Information of China (English)

    刘云川; 吴欣怡; 张丽; 马蓉; 崔迎春; 王洪娟

    2008-01-01

    目的 探讨准分子激光原位角膜磨镶术(laser in situ keratomileusis,LASIK)后早期角膜瓣皱褶和折叠的有效处理方法.方法 对LASIK术后11例角膜瓣皱褶的原因及处理进行回顾性分析.所有的患者需经手术重新复位,在显微镜下采用去离子水冲洗角膜瓣加戴角膜接触镜24 h.术后观察角膜瓣状况、屈光变化、裸眼视力和最佳矫正视力.结果 经过处理的所有患者裸眼视力均达到或超过术前最佳矫正视力.角膜透明,未见明显皱褶,角膜瓣位置正常,无上皮植入.结论 角膜瓣皱褶和折叠是LASIK术后较严重的并发症.早期诊断和正确快速的处理是获得最佳视力的关键.用去离子水重新复位角膜瓣并佩戴角膜接触镜治疗LASIK术后早期角膜瓣皱褶和折叠是安全简单有效的方法.%Objective To investigate the efficient treatment of cornea flap folds and striae after laser in situ keratomileusis (LASIK).To review the management and results of cases with severe flap wrinkling or dislodgment after LASIK.Methods Eleven patients with cornea flap folds and striae after LASIK are described.To make retrospective analysis of etiology and treatment in 11 cases who had cornea flap folds and striae after LASIK.Surgical repositioning of the flap was performed in all cases.Under the operating microscope the flap was refloated and hydrated with sterile deionized water for 2 minutes without stretching or ironing the flap.A bandage contact lens was then applied for 24 hours.Flap status,refractive changes,and final uncorrected and best corrected visual acuities were used to evaluate the outcome of flap repositioning.Results Relocation flap and bandage contact lens were used in such cases.Scraping epithelial and hydrating the cornea flap with sterile deionized water were used under operation.Twenty-four hours after treatment with sterile deionized water and a bandage contact lens,the cornea was smooth and wrinkle free.All patients

  9. Microbiota bacteriana aeróbia da conjuntiva de doadores de córnea Aerobic bacterial microbiota of the conjunctiva of cornea donors

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    Paula Fontana Lorenzini

    2007-03-01

    Full Text Available OBJETIVOS: Determinar a microbiota bacteriana aeróbia da conjuntiva de doadores de córnea e seu padrão de suscetibilidade a antibióticos; verificar o número de córneas utilizadas para transplante e a média de tempo de preservação em solução preservante com gentamicina e estreptomicina; traçar o perfil dos doadores e receptores de córnea. MÉTODOS: Espécimes clínicos foram colhidos de saco inferior da conjuntiva de ambos os olhos, de 40 doadores de córnea. As amostras foram inoculadas em ágar sangue azida, ágar chocolate e ágar MacConkey e o antibiograma foi realizado pelo método de Kirby-Bauer. RESULTADOS: A freqüência de cultura positiva da conjuntiva de doadores de córnea foi de 72,5%, sendo que Gram-positivos totalizaram 81,6% e apenas 18,4% das amostras foram identificadas como Gram-negativos. Vancomicina inibiu 100% dos Gram-positivos, ao passo que a sensibilidade dos Gram-negativos à gentamicina foi de 53,8% e à estreptomicina foi de 30%. O sexo masculino predominou entre os doadores e receptores, a média de tempo entre o óbito e a enucleação foi de 2h e a de preservação em solução preservante com gentamicina e estreptomicina foi de 7 dias. Neoplasia e mais de uma causa associada foram as causas de óbito mais freqüentes. O ceratocone foi a principal indicação para transplante (51,7%. CONCLUSÕES: Staphylococcus coagulase negativo foi o microrganismo com o maior número de isolamentos, apresentando sensibilidade variada aos antimicrobianos. A quantidade de córneas utilizadas para transplante foi bastante inferior em relação ao total de captações. O perfil dos doadores e receptores de córnea mostrou-se heterogêneo para grande parte das variáveis analisadas.PURPOSE: To determine aerobic bacterial microbiota of the conjunctiva of cornea donors and its patterns of susceptibility to antibiotics; verify the number of corneas used for transplant and the average time of preservation in solutions with

  10. Mechanisms involved in the anti-inflammatory action of a polysulfated fraction from Gracilaria cornea in rats.

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    Chistiane Oliveira Coura

    Full Text Available The anti-inflammatory mechanisms of the sulfated polysaccharidic fraction obtained from red marine alga Gracilaria cornea (Gc-FI were investigated using a paw edema model induced in rats by different inflammatory agents (carrageenan, dextran, serotonin, bradykinin, compound 48/80 or L-arginine. Gc-FI at the doses of 3, 9 or 27 mg/kg, subcutaneously--s.c., significantly inhibited rat paw edema induced by carrageenan and dextran, as confirmed by myeloperoxidase and Evans' blue assessments, respectively. Gc-FI (9 mg/kg, s.c. inhibited rat paw edema induced by histamine, compound 48/80 and L-arginine. Additionally, Gc-FI (9 mg/kg, s.c. inhibited Cg-induced edema in animals with intact mast cells but did not inhibit that with degranulated mast cells by compound 48/80, revealing a protective role on mast cell membranes. Gc-FI down-regulated the IL-1β, TNF-α and COX-2 mRNA and protein levels compared with those of the carrageenan group, based on qRT-PCR and immunohistochemistry analyses. After inhibition with ZnPP IX, a specific heme oxygenase-1 (HO-1 inhibitor, the anti-inflammatory effect of Gc-FI was not observed in Cg-induced paw edema, suggesting that the anti-inflammatory effect of Gc-FI is, in part, dependent on the integrity of the HO-1 pathway. Gc-FI can target a combination of multiple points involved in inflammatory phenomena.

  11. Mechanisms involved in the anti-inflammatory action of a polysulfated fraction from Gracilaria cornea in rats.

    Science.gov (United States)

    Coura, Chistiane Oliveira; Souza, Ricardo Basto; Rodrigues, José Ariévilo Gurgel; Vanderlei, Edfranck de Sousa Oliveira; de Araújo, Ianna Wivianne Fernandes; Ribeiro, Natássia Albuquerque; Frota, Annyta Fernandes; Ribeiro, Kátia Alves; Chaves, Hellíada Vasconcelos; Pereira, Karuza Maria Alves; da Cunha, Rodrigo Maranguape Silva; Bezerra, Mirna Marques; Benevides, Norma Maria Barros

    2015-01-01

    The anti-inflammatory mechanisms of the sulfated polysaccharidic fraction obtained from red marine alga Gracilaria cornea (Gc-FI) were investigated using a paw edema model induced in rats by different inflammatory agents (carrageenan, dextran, serotonin, bradykinin, compound 48/80 or L-arginine). Gc-FI at the doses of 3, 9 or 27 mg/kg, subcutaneously--s.c., significantly inhibited rat paw edema induced by carrageenan and dextran, as confirmed by myeloperoxidase and Evans' blue assessments, respectively. Gc-FI (9 mg/kg, s.c.) inhibited rat paw edema induced by histamine, compound 48/80 and L-arginine. Additionally, Gc-FI (9 mg/kg, s.c.) inhibited Cg-induced edema in animals with intact mast cells but did not inhibit that with degranulated mast cells by compound 48/80, revealing a protective role on mast cell membranes. Gc-FI down-regulated the IL-1β, TNF-α and COX-2 mRNA and protein levels compared with those of the carrageenan group, based on qRT-PCR and immunohistochemistry analyses. After inhibition with ZnPP IX, a specific heme oxygenase-1 (HO-1) inhibitor, the anti-inflammatory effect of Gc-FI was not observed in Cg-induced paw edema, suggesting that the anti-inflammatory effect of Gc-FI is, in part, dependent on the integrity of the HO-1 pathway. Gc-FI can target a combination of multiple points involved in inflammatory phenomena.

  12. Evaluation of the HB&L System for the Microbiological Screening of Storage Medium for Organ-Cultured Corneas

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    D. Camposampiero

    2013-01-01

    Full Text Available Aims. To compare HB&L and BACTEC systems for detecting the microorganisms contaminating the corneal storage liquid preserved at 31°C. Methods. Human donor corneas were stored at 4°C followed by preservation at 31°C. Samples of the storage medium were inoculated in BACTEC Peds Plus/F (aerobic microorganisms, BACTEC Plus Anaerobic/F (anaerobic microorganisms, and HB&L bottles. The tests were performed (a after six days of storage, (b end of storage, and (c after 24 hours of preservation in deturgescent liquid sequentially. 10,655 storage and deturgescent media samples were subjected to microbiological control using BACTEC (6-day incubation and HB&L (24-hour incubation systems simultaneously. BACTEC positive/negative refers to both/either aerobic and anaerobic positives/negatives, whereas HB&L can only detect the aerobic microbes, and therefore the positives/negatives depend on the presence/absence of aerobic microorganisms. Results. 147 (1.38% samples were identified positive with at least one of the two methods. 127 samples (134 identified microorganisms were positive with both HB&L and BACTEC. 14 HB&L+/BACTEC− and 6 BACTEC+/HB&L− were identified. Sensitivity (95.5%, specificity (99.8%, and positive (90.1% and negative predictive values (99.9% were high with HB&L considering a 3.5% annual contamination rate. Conclusion. HB&L is a rapid system for detecting microorganisms in corneal storage medium in addition to the existing methods.

  13. Effect of Biometric Characteristics on the Change of Biomechanical Properties of the Human Cornea due to Cataract Surgery

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    Xuefei Song

    2014-01-01

    Full Text Available Purpose. To determine the impact of biometric characteristics on changes of biomechanical properties of the human cornea due to standard cataract surgery using biomechanical analysis. Patients and Methods. This prospective consecutive cross-sectional study comprised 54 eyes with cataract in stages I or II that underwent phacoemulsification and IOL implantation. CH, CRF, IOPg, and IOPcc intraocular pressure were measured by biomechanical analysis preoperatively and at 1 month postoperatively. Changes (Δ were calculated as preoperative value versus postoperative value. Biometrical data were extracted from TMS-5 (CSI and SAI, IOLMaster (AL, and EM-3000 (CCT and ECC preoperatively. Results. The average values of the changes were ΔCH=-0.45±1.27 mmHg, ΔCRF=-0.88±1.1 mmHg, ΔIOPg=-1.58±3.15 mmHg, and ΔIOPcc=-1.45±3.93 mmHg. The higher the CSI the smaller the decrease in CH (r=0.302, P=0.028. The higher the CCT the larger the decrease in CRF (r=-0.371, P=0.013. The higher the AL the smaller the decrease in IOPg (r=0.417, P=0.005. The higher the AL, SAI, and EEC the smaller the decrease in IOPcc (r=0.351, P=0.001; r=-0.478, P<0.001; r=0.339, P=0.013. Conclusions. Corneal biomechanical properties were affected by comprehensive factors after cataract surgery, including corneal endothelium properties, biometry, and geometrical characteristics.

  14. 真菌毒素与角膜真菌感染%Mycotoxins and fungal infection of cornea

    Institute of Scientific and Technical Information of China (English)

    吴福进; 胡建章; 韩晓丽

    2013-01-01

    Mycotoxins are secondary metabolites produced by the toxigenic fungi in suitable environmental conditions,the main toxicity of which are carcinogenesis,genotoxicity,teratogenesis,hepatotoxicity and immunosuppression.After fungal infects the cornea,it may release mycotoxins to cause corneal damage.However what roles do the mycotoxins play in fungal keratitis is still unclear.The biosynthesis of mycotoxinis is regulated by a series of related function genes ; in addition,pH value,carbon nitrogen ratio and other environmental conditions are the influence factors as well.This article reviews the common harms,regulatory factors and their possible roles in the occurrence and development of keratomycosis.%真菌毒素(Mycotoxin)是由产毒真菌在适宜的环境条件下产生的具有毒性的次级代谢产物,主要毒性有致癌作用、遗传毒性、致畸作用、肝细胞毒性和免疫抑制等.真菌感染角膜后可能释放真菌毒素导致角膜损害,但至今对真菌毒素在真菌性角膜炎中究竟扮演什么角色,仍不明确.真菌毒素的生物合成受到一系列相关功能基因的调控;此外,pH值、碳氮比等环境条件也能影响其产量.本文就常见的真菌毒素的危害、调控因素及其可能在真菌性角膜炎发生发展中的作用进行综述.

  15. Microbiota bacteriana da conjuntiva de doadores de córnea Bacterial microbiota of the conjunctiva of donor corneas

    Directory of Open Access Journals (Sweden)

    Maria Emília Xavier dos Santos Araújo

    2004-12-01

    Full Text Available OBJETIVOS: Quantificar e qualificar a microbiota aeróbia da conjuntiva de doadores de córnea segundo a interferência do intervalo de tempo entre o óbito e a colheita do espécime conjuntival, a causa do óbito e a idade do doador e avaliar a atividade biocida de determinados antibióticos aos microrganismos isolados. MÉTODOS: Entre janeiro e março de 1994 foram colhidos espécimes da conjuntiva de 242 olhos de doadores de córnea. O material transportado em meio de Stuart foi semeado em ágares sangue, chocolate, sangue azida, MacConkey e caldo tioglicolato. Foi registrada a idade do doador, hora e causa do óbito. A atividade biocida dos antibióticos foi avaliada pela metodologia de Kirby e Bauer. A análise estatística utilizou os testes do qui-quadrado, exato de Fisher e Mann-Whitney. RESULTADOS: A freqüência de cultura positiva da conjuntiva de doadores de córnea foi de 91,7%. A mediana da idade dos doadores foi de 62 anos e do intervalo de tempo entre o óbito e a colheita do espécime foi de 4,2 horas. A causa mais freqüente de óbito foi doença cardiovascular (26,4%. Não houve diferença significante entre a cultura positiva e as variáveis estudadas. A vancomicina inibiu 100% das cepas de bactérias Gram-positivas e a sensibilidade dos bacilos Gram-negativos à gentamicina variou de 36,7% a 92,3%. CONCLUSÕES: O estudo revelou freqüência elevada de cultura positiva da conjuntiva de doadores de córneas. Staphylococcus coagulase negativo foi a espécie com maior número de isolamentos positivos. Não foi encontrada associação entre os fatores de risco avaliados e cultura positiva. Os antibióticos tiveram atividade biocida variável sobre os Gram-negativos e 100% dos Gram-positivos foram sensíveis à vancomicina.PURPOSE: To identify and qualify bacterial organisms in conjunctival tissue of donor corneas. To correlate the frequency of positive cultures with donor age, cause of death, and time from death to collection of

  16. 线状IgA大疱性皮病15例分析%Analysis of 15 Cases of Linear IgA Bullous Dermatosis

    Institute of Scientific and Technical Information of China (English)

    郭生红; Sanjaya Shakya; 李薇; 王琳; 杜晓萍

    2012-01-01

    目的 分析线状IgA大疱性皮病的临床特点、治疗及预后,提高临床医生对本病的认识.方法 回顾性分析本科2004年1月-2011年12月诊治的15例线状IgA大疱性皮病的临床资料.结果 男6例,女9例;儿童型5例,成人型10例;皮损初始部位:面部4例,口腔黏膜及双下肢各3例;累及躯干和四肢12例,14例临床表现为红斑或正常皮肤上出现水疱,6例水疱呈环形或半环形排列.皮损组织病理均见表皮及复层鳞状上皮下水疱或裂隙,直接免疫荧光均表现为基底膜带线状IgA沉积.13例予糖皮质激素治疗,皮损均控制;2例子氨苯砜治疗,均发生不良反应.结论 线状IgA大疱性皮病的皮损以口腔黏膜、面部及下肢首发居多,好发于躯干和四肢,临床表现为红斑或正常皮肤上出现水疱,呈孤立、环形和/或半环形排列;组织病理可见表皮或复层鳞状上皮下水疱或裂隙,直接免疫荧光示基底膜带线状IgA沉积是诊断的主要依据.治疗上可选用氨苯砜、糖皮质激素和磺胺类药物等.%Objective To analyze the clinical features of linear IgA bullous dermatosis (LABD) and have a better understanding of this disease to clinicians. Methods Clinical data of 15 cases with LABD were analyzed retrospectively. Results Among 15 cases, 6 were males and 9 were females, 10 were adults and 5 were children. The onsets of lesions were respectively faces (4/15) , oral mueosa(3/15) and lower limbs (3/15). Twelve cases were involved in trunks and extremities, blisters of 14 cases arose from the erythema or normal skin and 6 of them were annular or semicircular. Histopathologic examinations showed subepidermal/subepi- thelial blisters or fissures in 15 cases. Direct immunofluorescence( DIF) showed continuous linear deposition of IgA at the basement membrane zone (BMZ) . Thirteen cases were cured by corticosteroid, 2 cases had side effects of dapsone( DDS), Conclusion The onsets of LABD mostly occur on faces

  17. Corneal collagen crosslinking for keratoconus. A review

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    M. M. Bikbov

    2014-10-01

    C, and collagen fiber diameter increase by 12.2 % (anterior stroma and 4.6 % (posterior stroma. In mild bullous keratopathy, corneal crosslinking provides antimicrobial effect. In moderate and severe keratopathy, crosslinking reduces pain and corneal edema and improves visual acuity immediately after the procedure. A case of HSV keratitis exacerbation was described. Amongst the complications, infection, halos, and posterior segment damage should be mentioned. Poor refractive results can be improved by the implantation of intrastromal corneal ring segments.

  18. Corneal collagen crosslinking for keratoconus. A review

    Directory of Open Access Journals (Sweden)

    M. M. Bikbov

    2014-01-01

    C, and collagen fiber diameter increase by 12.2 % (anterior stroma and 4.6 % (posterior stroma. In mild bullous keratopathy, corneal crosslinking provides antimicrobial effect. In moderate and severe keratopathy, crosslinking reduces pain and corneal edema and improves visual acuity immediately after the procedure. A case of HSV keratitis exacerbation was described. Amongst the complications, infection, halos, and posterior segment damage should be mentioned. Poor refractive results can be improved by the implantation of intrastromal corneal ring segments.

  19. Conhecimento de estudantes de medicina sobre o processo de doação de córneas The knowledge of medical students about cornea donation

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    Rodrigo França de Espíndola

    2007-08-01

    Full Text Available OBJETIVO: Avaliar o conhecimento de estudantes de medicina sobre o processo de doação de córneas, comparando-o entre aqueles que já cursaram a disciplina de Oftalmologia com os demais. MÉTODOS: Foi aplicado um questionário a estudantes de medicina do interior de São Paulo, contendo dados como: idade, sexo, ano de graduação e 10 perguntas de múltipla escolha sobre o tema. As questões abordaram o limite de idade para doação, contra-indicações para o transplante, tempo para retirada das córneas, dentre outras. Foi comparado o conhecimento (% de acertos entre aqueles que haviam cursado a disciplina de Oftalmologia (Grupo A com os demais (Grupo B. RESULTADOS: Foram entrevistados 402 estudantes. Destes, 140 eram do grupo A e 262 do grupo B. Não houve diferença estatisticamente significante entre os dois grupos (p=0,8328. CONCLUSÃO: O conhecimento sobre o processo de doação de córneas mostrou-se insuficiente entre os alunos entrevistados, mesmo para aqueles que haviam cursado a disciplina de Oftalmologia, apontando a necessidade de aperfeiçoamento do conhecimento divulgado nas escolas médicas.PURPOSE: To compare knowledge of medical students about the cornea donation process among those who already studied Ophthalmology and the others. METHODOS: A questionnaire containing data as: age, sex, graduation year, and 10 multiple-choice questions about the subject was applied to medical students from the interior of São Paulo state, Brazil. The questions were: age for donation, contraindication for transplants, the time limit to remove the cornea, among others. The knowledge regarding cornea donation was compared between the two groups: students who already studied Ophthalmology (Group A and the others (Group B. RESULTS: The study group was composed of 402 students, of whom 140 were of group A and 262 of group B. Knowledge between the two groups was different, but not statistically significant (p=0.8328. CONCLUSION: Knowledge about

  20. Introduction of quantitative and qualitative cornea optical coherence tomography findings induced by collagen cross-linking for keratoconus: a novel effect measurement benchmark

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    Kanellopoulos AJ

    2013-02-01

    Full Text Available A John Kanellopoulos1,2 George Asimellis11Laservision.gr Institute, Athens, Greece; 2New York University Medical School, New York, NY, USAPurpose: To introduce a novel, noninvasive technique to determine the depth and extent of anterior corneal stroma changes induced by collagen cross-linking (CXL using quantitative analysis of high-resolution anterior-segment optical coherence tomography (OCT post-operative images.Setting: Private clinical ophthalmology practice.Patients and methods: Two groups of corneal cross-sectional images obtained with the OptoVue RTVue anterior-segment OCT system were studied: group A (control consisted of unoperated, healthy corneas, with the exception of possible refractive errors. The second group consisted of keratoconic corneas with CXL that were previously operated on. The two groups were investigated for possible quantitative evidence of changes induced by the CXL, and specifically, the depth, horizontal extent, as well as the cross-sectional area of intrastromal hyper-reflective areas (defined in our study as the area consisting of pixels with luminosity greater than the mean +2 × standard deviation of the entire stromal cross section within the corneal stroma.Results: In all images of the second group (keratoconus patients treated with CXL there was evidence of intrastromal hyper-reflective areas. The hyper-reflective areas ranged from 0.2% to 8.8% of the cross-sectional area (mean ± standard deviation; 3.46% ± 1.92%. The extent of the horizontal hyper-reflective area ranged from 4.42% to 99.2% (56.2% ± 23.35% of the cornea image, while the axial extent (the vertical extent in the image ranged from 40.00% to 86.67% (70.98% ± 7.85%. There was significant statistical difference (P < 0.02 in these values compared to the control group, in which, by application of the same criteria, the same hyper-reflective area (owing to signal noise ranged from 0.00% to 2.51% (0.74% ± 0.63%.Conclusion: Herein, we introduce a

  1. Boston type I keratoprosthesis-donor cornea interface evaluated by high-definition spectral-domain anterior segment optical coherence tomography

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    Alzaga Fernandez AG

    2012-08-01

    Full Text Available Ana G Alzaga Fernandez,* Nathan M Radcliffe,* Kimberly C Sippel, Mark I Rosenblatt, Priyanka Sood, Christopher E Starr, Jessica B Ciralsky, Donald J D'Amico, Szilárd KissDepartment of Ophthalmology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA*These authors contributed equally to this work and both are considered principal authorsBackground: The purpose of this study was to assess whether the resolution offered by two different, recently commercially available high-resolution, spectral-domain anterior segment optical coherence tomography (AS-OCT instruments allows for detailed anatomic characterization of the critical device-donor cornea interface in eyes implanted with the Boston type I permanent keratoprosthesis.Methods: Eighteen eyes of 17 patients implanted with the Boston type I keratoprosthesis were included in this retrospective case series. All eyes were quantitatively evaluated using the Cirrus HD-OCT while a subset (five eyes was also qualitatively imaged using the Spectralis Anterior Segment Module. Images from these instruments were analyzed for evidence of epithelial migration onto the anterior surface of the keratoprosthesis front plate, and presence of a vertical gap between the posterior surface of the front plate and the underlying carrier donor corneal tissue. Quantitative data was obtained utilizing the caliper function on the Cirrus HD-OCT.Results: The mean duration between AS-OCT imaging and keratoprosthesis placement was 29 months. As assessed by the Cirrus HD-OCT, 83% of eyes exhibited epithelial migration over the edge of the front plate. Fifty-six percent of the keratoprosthesis devices displayed good apposition of the device with the carrier corneal donor tissue. When a vertical gap was present (44% of eyes, the mean gap was 40 (range 8–104 microns. The Spectralis Anterior Segment Module also displayed sufficient resolution to allow for similar characterization of the device

  2. Research progress of correction of cornea astigmatism after cataract extraction%白内障术后角膜散光矫正的研究进展

    Institute of Scientific and Technical Information of China (English)

    杨宁

    2012-01-01

    随着白内障手术由复明手术向屈光手术的转变,角膜散光已成为影响白内障术后裸眼视力的主要因素之一.矫正术前存在的角膜散光,控制手术源性散光,是解决白内障术后因散光导致的术后视力不佳的有效方法.本文将对控制和矫正白内障术后散光的治疗进展进行综述.%Cataract operation has evolved from pure vision improvement toward the optics for reducing refractive errors. The main factor affecting naked vision of postoperative cataract surgery is cornea astigmatism . To correct cornea astigmatism and decrease surgically induced astigmatism are required for resolving problems of post cataract operative refraction and improving visual acuity. The research progress of reducing and correcting astigmatism after cataract extraction was summarized in this paper.

  3. Corneal Cross-Linking with Riboflavin and UV-A in the Mouse Cornea in Vivo: Morphological, Biochemical, and Physiological Analysis

    Science.gov (United States)

    Kling, Sabine; Hammer, Arthur; Conti, Alain; Hafezi, Farhad

    2017-01-01

    Purpose To morphologically, biochemically, and physiologically characterize corneal cross-linking with riboflavin and UV-A light (CXL) in a newly established in vivo murine model. Methods C57BL/6 wild-type mice (N = 67) were treated with various CXL protocols, with modification of the following parameters: total energy (fluence) used, duration of UV-A irradiation, continuous versus pulsed irradiation, and CXL under hypoxic conditions (contact lens). Corneas were evaluated biomicroscopically, histologically, and using optical coherence tomography. Conformational collagen changes were evaluated via changes in the speed of enzymatic digestion. Results A fluence of 5.4 J/cm2 induced scar formation, while fluences of scar formation. Changes in the speed of enzymatic digestion suggest that CXL in mice, when compared to humans, requires less UV-A energy than the difference in corneal thickness between the species would suggest. Conclusions We demonstrated the in vivo response of very strong and very weak CXL and identified the best suited range of UV fluence in murine corneas. The presented murine CXL model may be helpful in future research addressing cellular and molecular pathways associated to CXL treatment. Translational Relevance Adverse tissue reactions following CXL treatment were observed, if the administered UV energy was out of the treatment window—raising concern about novel CXL treatment protocols that have not been previously validated in an experimental setting. PMID:28149672

  4. Corneal Melting after Collagen Cross-Linking for Keratoconus in a Thin Cornea of a Diabetic Patient Treated with Topical Nepafenac: A Case Report with a Literature Review

    Directory of Open Access Journals (Sweden)

    Karim Mohamed-Noriega

    2016-02-01

    Full Text Available Purpose: To report the case of a 50-year-old woman with diabetes that presented with corneal melting and perforation 6 weeks after collagen cross-linking (CxL for keratoconus (KC and postoperative use of nepafenac eye drops, a nonsteroidal anti-inflammatory drug (NSAID. Methods: This is a case report of a patient with diabetes, KC and a thin cornea that had undergone left eye corneal CxL at a different hospital followed by postoperative use of nepafenac eye drops for 6 weeks. Results: The patient presented for the first time to our clinic with left corneal melting, perforation and iris prolapse 6 weeks after corneal CxL and topical nepafenac use. She was treated with a left eye tectonic penetrating keratoplasty, extracapsular cataract extraction, intraocular lens implantation and pupilloplasty. Conclusions: The corneal melting and perforation in this patient was associated with multiple risk factors: (1 nepafenac eye drop use, (2 CxL in a cornea thinner than 400 µm and (3 diabetes. The recommended corneal thickness limits should be respected. Topical NSAIDs should be used with caution if used as postoperative treatment after corneal CxL and in patients with diabetes, epithelial defect or delayed healing, because of the possible increased risk for corneal melting when multiple risk factors are observed.

  5. Biofiltration of fishpond effluents and accumulation of N-compounds (phycobiliproteins and mycosporine-like amino acids) versus C-compounds (polysaccharides) in Hydropuntia cornea (Rhodophyta).

    Science.gov (United States)

    Figueroa, Félix L; Korbee, Nathalie; Abdala, Roberto; Jerez, Celia G; López-de la Torre, Mayra; Güenaga, Leire; Larrubia, María A; Gómez-Pinchetti, Juan L

    2012-02-01

    The biofiltration capacity, biomass-yield and accumulation of N- and C-compounds of Hydropuntia cornea were analyzed. Algae were grown in different conditions for 28 d: outdoor and indoor, with or without fishpond effluents. N-uptake efficiency of these effluents was higher than 95% after 7 d both outdoors and indoors. N-enriched conditions reduced the extent of photoinhibition and increased the maximal quantum yield in H. cornea. The biomass-yield was higher in outdoor grown-algae after 7 d and decreased independently of the treatment after 28 d. N, acid polysaccharide (AP) and mycosporine-like amino acid (MAA)-yields decreased throughout the experiment in all conditions. The highest MAA-yield was observed in fishpond effluent outdoor-grown algae, indicating a positive effect of increased radiation on MAA accumulation. However, APs were higher under N-depleted conditions. The use of MAAs as UV-screening and antioxidants, and the use of AP as immunostimulants are discussed.

  6. Commercially available rigid gas-permeable contact lens for protecting the cornea from drying during vitrectomy with a wide viewing system

    Directory of Open Access Journals (Sweden)

    Kamei M

    2012-08-01

    Full Text Available Motohiro Kamei, Nagakazu Matsumura, Hirokazu Sakaguchi, Yusuke Oshima, Yasushi Ikuno, Kohji NishidaDepartment of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, JapanPurpose: We evaluated the usefulness of commercially available materials for protecting the cornea from drying during vitrectomy with a wide-angle viewing system.Methods: Three vitreoretinal surgeons evaluated fundus visibility during vitrectomy on the images of five study materials used on the cornea: balanced saline solution, a viscoelastic agent, a vitrectomy contact lens, a rigid gas permeable (RGP contact lens, and a soft contact lens. Fundus visibility was graded using the following scale: grade 1, unclear; grade 2, slightly unclear; grade 3, clear; and grade 4, very clear.Results: Respective scores for each material used during core vitrectomy and membrane removal were: balanced saline solution, 3.3/3.3; viscoelastic agent, 3.8/3.3; vitrectomy contact lens, 3.3/4.0; RGP contact lens, 4.0/3.9; soft contact lens, 1.1/not applicable.Conclusion: The RGP contact lens provided visibility similar to or clearer than that obtained with other methods. Because of its ease of use and lower cost, use of the RGP contact lens is ideal during vitrectomy performed with a wide-angle viewing system.Keywords: contact lens, RGP, viscoelastic agent, vitrectomy, wide viewing system

  7. A comparative clinical study of Solcoseryl Eye-Gel and Cysteine Eye-Gel 2.4% in the treatment of foreign-body injuries of the cornea.

    Science.gov (United States)

    Studer, O

    1984-01-01

    Solcoseryl, a protein-free haemodialysate, promotes tissue regeneration and improves utilization of oxygen in the cell. In a randomized, double-blind, clinical study, Solcoseryl Eye-Gel was compared with Cysteine Eye-Gel in the treatment of foreign-body injuries of the cornea in a total of 99 eyes. In order to facilitate objective evaluation of the effects of the treatment, the area of the lesion before the start of treatment and on the following day was determined by means of slit-lamp photographs. Healing of the lesion and relative reduction of the area of the wound were observed much more frequently in the group treated with Solcoseryl Eye-Gel than in the reference group. Maculae corneae after the end of the treatment were significantly less frequent under Solcoseryl Eye-Gel than under Cysteine Eye-Gel. Teh tolerability of the test preparation was good; an itching sensation was reported in only 2 cases. Under Cysteine Eye-Gel, on the other hand, a burning sensation was reported by a number of patients and very fine deposits in the epithelium were also observed in a few cases. Thus complete closure of the epithelium over the lesion after 1 day was observed much more frequently in the group of patients treated with Solcoseryl Eye-Gel than in the reference group (63 vs. 53%).

  8. 准分子激光角膜屈光术后角膜感染诊断与治疗回顾%Review the diagnosis and treatment of infection of the cornea after excimer laser cornea refractive surgery

    Institute of Scientific and Technical Information of China (English)

    李韵秋; 李静; 王梦雅; 李从心; 李素霞; 史伟云; 王婷

    2015-01-01

    目的:回顾性分析准分子激光角膜屈光术后早期角膜感染的诊断与治疗策略及视力转归。方法对2008年1月至2014年3月我院收治的因准分子激光术后早期角膜感染患者7例(8只眼)进行回顾性分析。根据患者病史、共焦显微镜或角膜病灶组织刮片等检查明确其感染类型,对症采用局部及全身药物治疗,对药物不能控制的感染采取手术治疗,并观察视力转归情况。结果患者8只眼全部诊断为细菌性角膜溃疡,其中8只眼病灶组织刮片检查为阳性,5只眼细菌培养阳性。4只眼(50.0%)经抗菌药物治疗达到溃疡愈合,4只眼(50.0%)行板层性角膜移植术治愈。治愈病例至溃疡愈合时,8只眼视力均较治疗前提高。结论感染性角膜炎是准分子激光术后早期发生的严重并发症,尽早明确诊断并积极治疗是控制感染、保存视力的关键。%Objective Retrospective analysis of diagnosis and treatment strategies and visual acuity outcomes of the early corneal infection after excimer laser cornea refractive surgery.Methods Retrospective analysis 7 patients 8 eyes early postoperative corneal infection after excimer laser who treated in our hospital in 2008 January to 2014 March.Confirm the type of infection according to patient history, confocal microscopy or corneal tissue scraping test , using local and sys-temic drug treatment, take the operation if drug can not control the infection, and observe the visual prognosis.Results All patients with 8 eyes diagnosed as bacterial corneal ulcer, 8 eyes Lesions tissue smear examination, 5 eyes of bacterial culture were positive.4 eyes (50%) after anti bacteria drug treatment to the healing of ulcer, 4 eyes (50%) taking lamel-lar keratoplasty to cure.To the healing of ulcers, visual acuity of 8 eyes was improved compared with those before treat-ment.Conclusion Infective keratitis is a severe complication occ-urred after

  9. The management of cornea blindness from severe corneal scarring, with the Athens Protocol (transepithelial topography-guided PRK therapeutic remodeling, combined with same-day, collagen cross-linking

    Directory of Open Access Journals (Sweden)

    Kanellopoulos AJ

    2012-02-01

    Full Text Available Anastasios John KanellopoulosLaservision.gr Institute, Athens, Greece; Manhattan Eye, Ear and Throat Hospital, New York, NY, USA; New York University Medical School, New York, NY, USAPurpose: To evaluate the safety and efficacy of combined transepithelial topography-guided photorefractive keratectomy (PRK therapeutic remodeling, combined with same-day, collagen cross-linking (CXL. This protocol was used for the management of cornea blindness due to severe corneal scarring.Methods: A 57-year-old man had severe corneal blindness in both eyes. Both corneas had significant central scars attributed to a firework explosion 45 years ago, when the patient was 12 years old. Corrected distance visual acuity (CDVA was 20/100 both eyes (OU with refraction: +4.00, –4.50 at 135° in the right eye and +3.50, –1.00 at 55° in the left. Respective keratometries were: 42.3, 60.4 at 17° and 35.8, 39.1 at 151.3°. Cornea transplantation was the recommendation by multiple cornea specialists as the treatment of choice. We decided prior to considering a transplant to employ the Athens Protocol (combined topography-guided partial PRK and CXL in the right eye in February 2010 and in the left eye in September 2010. The treatment plan for both eyes was designed on the topography-guided wavelight excimer laser platform.Results: Fifteen months after the right eye treatment, the right cornea had improved translucency and was topographically stable with uncorrected distance visual acuity (UDVA 20/50 and CDVA 20/40 with refraction +0.50, –2.00 at 5°. We noted a similar outcome after similar treatment applied in the left eye with UDVA 20/50 and CDVA 20/40 with –0.50, –2.00 at 170° at the 8-month follow-up.Conclusion: In this case, the introduction of successful management of severe cornea abnormalities and scarring with the Athens Protocol may provide an effective alternative to other existing surgical or medical options.Keywords: Athens Protocol, collagen cross

  10. Clinical analysis on 11 patients with psoriasis vulgaris coexisted with autoimmune bullous diseases%银屑病并发免疫性大疱性皮肤病11例临床分析

    Institute of Scientific and Technical Information of China (English)

    董娟; 吴桂菊; 郑捷; 潘萌

    2012-01-01

    Objective: To analyze the clinical features, relevant factors of the patients with psoriasis vulgaris coexisted with autoimmune bullous disease. Methods: 11 patients with psoriasis vulgaris coexisted with autoimmune bullous disease were collected, and retrospectively analyzed on clinical manifestations, triggering factors, pathological features and the treatment of them. The specific antibodies were also detected. Results: Among the patients, the ratio of male to female was 10:1. The average age was 70.55±11.08 years old. The average disease duration of psoriasis was 15.36±9.19 years. Four patients had a definite NB-U-VB therapy before. Seven patients were diagnosed as pemphigus, among which four showed positive IF, two negative but had high titers of anti-Dsgl antibody. Four patients were diagnosed as pemphigoid, among which three showed positive IF, two had high titers of anti-BP180 antibody. Low-dose glucocorticoids combined with immunosuppressive agents were used for the treatment. Conclusions; It is not common for the patients with psoriasis coexsisted with autoimmune bullous disease. We should make the diagnosis earlier and provide a proper treatment for these patients.%目的:对银屑病并发免疫性大疱性皮肤病患者的临床相关因素及其临床特征进行回顾性分析.方法:收集11例银屑病并发免疫性大疱性皮肤病患者资料,对其临床特征、大疱病的诱发因素、免疫病理以及治疗等方面进行回顾性分析;并对部分患者的特异性致病性抗体进行检测.结果:11例患者中1例为女性,10例为男性,平均年龄(70.55±11.08)岁.患者在银屑病发生后平均(15.36±9.19)年出现大疱性皮肤病;4例患者在出现大疱病前有明确的窄谱中波紫外线(NB-UVB)照射史.7例患者并发天疱疮,4例并发类天疱疮.7例天疱疮患者中4例免疫荧光检查阳性,而阴性的2例患者中外周血检出高滴度抗Dsg1抗体,另有1例结果不详;4

  11. One Case Report of Linear IgA Bullous Dermatosis and Literature Review%线状 IgA 大疱性皮肤病1例报道并文献复习

    Institute of Scientific and Technical Information of China (English)

    乔丽; 杨志勇; 田蓉

    2015-01-01

    目的:探讨线状 IgA 大疱性皮肤病(LABD)的病因、诊断和鉴别诊断、治疗及预后,以提高对该病的认识。方法对1例 LABD 患者的临床资料、组织病理、免疫荧光进行分析,并对相关文献进行分析。结果患者表现在红斑基础上的水疱,或外观正常皮肤上出现的水疱,病理组织活检和免疫荧光确诊为 LABD。结论 LABD 是一种少见的自身免疫性表皮下大疱病,确切的发病机制还不清楚。常见的靶抗原有 LAD97,LAD -1,BP180,BP230和 LAD285等,其中 BP180抗原可能在发病中起作用。特征性的基底膜带线状 IgA 抗体沉积为确诊本病的主要依据。氨苯砜是治疗 LABD 的首选药物。%Objective To investigate the etiology, diagnosis and differential diagnosis, treatment and prognosis of linear IgA bullous der-matosis(LABD) for improving the cognition on this disease. Methods The clinical, histopathological and immunofluorescence data in one case of LABD were analyzed and the relevant literature was analyzed. Results The patient with LABD showed blisters on the basis of erythema or blisters appeared on the skin with normal appearance. The histopathological and immunofluorescence biopsy diagnosed as LABD. Conclusion LABD is a rare autoimmune subepidermal bullous disease. The common target antigens are LAD97, LAD - 1, BP180, BP230, LAD285, etc.,in which BP180 antigen may play a role in the pathogenesis. The characteristic basement membrane linear IgA an-tibody deposition is the main basis for diagnosing LABD. Dapsone is the drug of first choice for treating LABD.

  12. Histogenesis and cellular apoptosis of the mouse cornea%小鼠角膜的发生与细胞凋亡

    Institute of Scientific and Technical Information of China (English)

    李雪; 王强; 陈文静; 刘彬; 邓锦波

    2013-01-01

    目的 通过观察小鼠角膜的发生过程,探讨角膜细胞的增殖与凋亡对角膜结构修复与塑形的作用.方法 各日龄共计120只小鼠,用HE染色或4’,6-二脒基-2-苯基吲哚(DAPI)染色对小鼠角膜的一般结构进行观察;用5’-溴脱氧尿嘧啶核苷(BrdU)技术标记角膜增殖细胞和免疫荧光法标记干细胞和凋亡细胞.结果 胚胎发育及出生后早期,角膜以实质层的发育为主.出生14d(P14)左右,角膜上皮细胞层开始增殖分化为两层细胞,同时内皮细胞也开始分化.至P30时,我们可以辨别出角膜的6层结构.BrdU阳性细胞主要存在实质层中的成纤维细胞,出生以后也可见于角膜上皮细胞层和内皮细胞层.随着角膜发育,P10左右,其他层的BrdU阳性细胞都消失,仅存在于角膜上皮细胞层.增殖细胞核抗原(PCNA)阳性细胞在发育早期散在分布于角膜的各层,P14以后PCNA阳性细胞均匀的分布于角膜上皮细胞的基底层,并维持在稳定状态.在角膜发育早期,在各层可见许多细胞凋亡.结论 角膜的发育与其感光功能形成的过程相一致,角膜干细胞的增殖与其修复有关;有大量的凋亡细胞参与角膜结构的塑形.%Objective Our aim was to observe the histogenesis, cellular proliferation and apoptosis of the mouse cornea. Methods A total of 120 mice were used in the study. HE staining and DAPI staining were used to observe the general structure of the mouse cornea. Brdu detetion and immunofluorescent labeling were carried out to study corned proliferating cell, stem cells apoptic cells. Caspase-8 immunofluorescent staining was uesd to detect corneal apoptotic cells. Results During embryonic development and early postnatal stage, the stroma layer was observed in the developing cornea. About P14, the corneal epithelial cell layer began to proliferate and differentiate into two layers, with differentiation of endothelial cells. At P30 the six-layer structure of the

  13. Investigation of Cornea Donation Cognition and Willing of College Students, Daqing%大庆市大学生对角膜捐献的认知及捐献意愿调查

    Institute of Scientific and Technical Information of China (English)

    赵楠; 王彩霞

    2015-01-01

    目的:了解大学生角膜捐献知识及捐献意愿现状,探讨相关影响因素.方法:分层整群抽取大庆市3所高校1040名在校大学生,以问卷调查形式对角膜捐献知识及捐献意愿现状进行调查.结果:不同特征大学生对角膜捐献知晓情况不同,差异有统计学意义;整体上看,大学生关于角膜捐献具体知识了解较少,医学生与非医学生的认知差异有统计学意义.64.5%的大学生愿意捐献角膜,35.5%的大学生暂时不愿意捐献角膜,性别、年级、是否听说过角膜捐献、是否知道角膜供体紧缺、是否了解医学伦理学知识及社会对角膜捐献的支持与鼓励力度与身后捐献角膜意愿有关.结论:高校大学生对角膜捐献知识了解较少,但捐献意愿较高,应该有针对性地进行角膜捐献知识的宣传普及,完善角膜捐献渠道及相关法律法规.%Objective: To understand the current status of knowledge and willingness of cornea donation of college students, and to analyze its influencing factors.Methods:1040 students from 3 universities were selected with stratified cluster sampling method, and the questionnaires were used to analyze their knowledge and willingness of cornea donation .Results: Different students had different cognition on cornea donation with statistical significance (P <0.05).The overall respondents had a poor knowledge on cornea donation, with statistically significant differences between medical and non-medical students (P <0.05), and 64.5% of them were willing to donate cornea donation with 35.5% not.The students'gender, grade, whether knowing the cornea donation and the shortage of donor, and medical ethics knowledge and the social support and encourage on cornea donation were related to their donation willingness.Conclusion: College students'cornea donation knowledge is not enough but their donation willingness is high.Strategies such as promoting and popularizing knowledge of cornea donation, and

  14. Central Corneal Thickness Measurement Using Ultrasonic Pachymetry, Rotating Scheimpflug Camera, and Scanning-slit Topography Exclusively in Thin Non-keratoconic Corneas

    Science.gov (United States)

    Mohammadpour, Mehrdad; Mohammad, Kazem; Karimi, Nasser

    2016-01-01

    Purpose: To evaluate the agreement among Pentacam, Orbscan and ultrasound (US) pachymetry for measurement of central corneal thickness (CCT) in thin corneas with normal topographic pattern. Methods: We included 88 eyes of 44 refractive surgery candidates with thinnest pachymetric readings of 500 micrometers (μm) or less on Orbscan, a normal topographic pattern, no sign of keratoconus, and best corrected visual acuity (BCVA) of 20/20. Pentacam, Orbscan and US were performed in one session by the same examiner. Exclusion criteria were history of ocular surgery, topographic abnormalities suggesting forme fruste keratoconus or keratectasia, and recent contact lens wear. Results: The difference in CCT measurements by US pachymetry and Orbscan II [using an acoustic factor (AF) of 0.92] ranged from −34 to +34 μm. The difference between the thinnest point and central readings measured by US reached 16 μm with Orbscan II (AF: 0.92) and 2 μm with Pentacam. Mean differences between the employed devices were 0.2 μm for Pentacam versus US (P = 0.727), 30.1 μm for uncorrected Orbscan versus US (P < 0.001), 10.4 μm for Orbscan II (AF = 0.92) versus US (P < 0.001), and 0.2 μm for Orbscan II (AF = 0.94) versus US (P = 0.851). Conclusion: In normal thin corneas, Pentacam demonstrated better agreement with US pachymetry as compared to corrected Orbscan readings. Results achieved by Orbscan were better consistent with US pachymetry using an AF of 0.94. We speculate that a dynamically graded AF in reverse proportion to CCT constitutes a better approach for correcting Orbscan measurements. PMID:27621779

  15. Eye Gaze Tracking Method Based on Pupil Center Cornea Reflection Technique%基于瞳孔-角膜反射技术的视线跟踪方法

    Institute of Scientific and Technical Information of China (English)

    吴广发; 宋鸿陟; 黄生辉

    2014-01-01

    视线跟踪是基于多通道的人机交互技术的重要研究内容,而基于瞳孔-角膜反射技术的视线方向是目前应用最广泛的视线跟踪技术之一。瞳孔-角膜反射技术的主要目的是提取人眼图像中瞳孔-角膜反射向量作为视线方向计算模型所需的视觉信息,通过搭建红外光源设备提取瞳孔-角膜反射向量构建基于瞳孔-角膜反射技术的视线跟踪系统,为面向人机交互的视线跟踪研究提供可行的低成本解决方案。%Eye gaze tracking is an important research content of human-computer interaction technology based on multiple channels, and the gaze estimation based on pupil center cornea reflection technique is one of eye gaze tracking technologies with the widest application. The pri-mary purpose of pupil center cornea reflection technique is to extract the pupil center cornea reflection vector in human eye image as the vision information of gaze estimation model. Constructs an infrared light device to extract the pupil center cornea reflection vector and builds up an eye gaze tracking system based on pupil center cornea reflection technique, provides a feasible and low-cost solution for the eye gaze tracking research of human-computer interaction.

  16. 不同受者同期分别接受同者的角膜移植五例%Two corneal donor tissues for 5 different recipients

    Institute of Scientific and Technical Information of China (English)

    吴护平; 谢素贞; 刘昭升; 董诺

    2008-01-01

    Objective To evaluate the feasibility and to discuss the methods of using two donor corneal tissue in multiple patients. Methods One donor corneal tissue was divided into 3 parts: The anterior lamellar part were transplanted into a patient with corneo-conjunctival malignant melanoma and a patient with corneal perforation of Mooren's ulcer using lamellar keratoplasty technique; The posterior part was transplanted into a patient with bullous keratopathy using deep lamellar endothelial keratoplasty technique. The other donor corneal tissue was divided into 2 parts: The anterior part was transplanted into a patient with severe symblepharon after ocular surface thermal burn using full bed lamellar keratoplasty. The posterior part was transplanted into another patient with bullous keratopathy using deep lamellar endothelial keratoplasty technique. Results All surgical procedures were performed successfully. At 1 month after surgery, the grafts were transparent in both of the eyes with bullous keratopathy. Epithelial bulla disappeared and cornea edema relieved in both cornea. The best corrected visual acuity of the patient with corneo-conjunctival malignant melanoma improved from 0.3 preoperatively to 0.6 postoperatively. The graft remained transparent and no pigment remained in the conjunctiva and graft bed of recipient. The patient with corneal perforation of Mooren's ulcer were cured after amniotic membrane transplantation combined with partial lamellar keratoplasty. At 1 month, the best corrected visual acuity was improved from 0.1 preoperetively to 0.3 postoperatively in the patient with severe symblepharon. The graft remained transparent and the symblepharon was relieved. Conclusion To make good use of donor cornea, we can use one donor cornea to treat multiple patients.%目的 为提高角膜材料的利用率,探讨将同一噶供者的二个角膜同期移植给不同受者的可行性及手术方法.方法 供者的其中一个角膜材料分别为1

  17. Phototherapeutic keratectomy

    Directory of Open Access Journals (Sweden)

    Varsha M Rathi

    2012-01-01

    Full Text Available Phototherapeutic keratectomy (PTK is done regularly for anterior corneal diseases such as corneal dystrophies, corneal degenerations, scars, and band-shaped keratopathy. The various indications include both therapeutic and visual. The aim of this article is to discuss the therapeutic indications for PTK, the specific technique pertaining to a specific etiology, the various other procedures like amniotic membrane graft combined with PTK or PTK being done for recurrences in the grafts, and PTK done before cataract surgery when the anterior corneal pathology coexists with the cataract. Post PTK management such as healing of an epithelial defect, use of steroids in the post PTK period, recurrences of primary disease pathology, and infections, will be discussed. Methods of literature search: A Medline search was carried out for articles in the English language, with the keywords, phototherapeutic keratectomy, band-shaped keratopathy, spheroidal degeneration, scars, bullous keratopathy, and corneal dystrophy. The relevant references are mentioned here.

  18. Phototherapeutic keratectomy.

    Science.gov (United States)

    Rathi, Varsha M; Vyas, Sharadini P; Sangwan, Virender S

    2012-01-01

    Phototherapeutic keratectomy (PTK) is done regularly for anterior corneal diseases such as corneal dystrophies, corneal degenerations, scars, and band-shaped keratopathy. The various indications include both therapeutic and visual. The aim of this article is to discuss the therapeutic indications for PTK, the specific technique pertaining to a specific etiology, the various other procedures like amniotic membrane graft combined with PTK or PTK being done for recurrences in the grafts, and PTK done before cataract surgery when the anterior corneal pathology coexists with the cataract. Post PTK management such as healing of an epithelial defect, use of steroids in the post PTK period, recurrences of primary disease pathology, and infections, will be discussed. Methods of literature search: A Medline search was carried out for articles in the English language, with the keywords, phototherapeutic keratectomy, band-shaped keratopathy, spheroidal degeneration, scars, bullous keratopathy, and corneal dystrophy. The relevant references are mentioned here.

  19. Corneal Decompensation after Selective Laser Trabeculoplasty

    Directory of Open Access Journals (Sweden)

    Ahmet Ozkok

    2014-01-01

    Full Text Available A 64-year-old Caucasian man referred for decreased vision after selective laser trabeculoplasty (SLT. Slit lamp examination revealed diffuse corneal edema. Despite intensive topical treatment including steroids, corneal edema did not resolve; on the contrary, it advanced to bullous keratopathy. Corneal edema after SLT is an exceptionally rare complication and in all of the previous reports edema resolved with medical treatment. To the best of our knowledge, this is the first report presenting persistent corneal edema after SLT.

  20. 辅助角膜移植显微手术机器人系统的实验性应用研究%Operation of cornea grafting micro-surgery robot system

    Institute of Scientific and Technical Information of China (English)

    梁庆丰; 李大寨; 胡一达; 魏东; 邓世靖; 孙旭光

    2009-01-01

    目的 探讨辅助角膜移植显微手术机器人系统的实验性应用效果.方法 实验研究.采用人机协同手术方式,建立具有6个子系统的角膜移植显微手术机器人系统,并对20只兔眼角膜进行钻切、缝合实验;观察手术目标定位误差、切口圆周对称性、角膜钻切深度及缝合跨距等指标.结果 20只角膜钻切、缝合手术操作均按照机器人及计算机导航系统的预定程序完成,其手术钻切中心定位误差为(0.356±0.040)mm,切口横纵跨度比为(0.855±0.040),角膜圆周不同位置钻切深度误差小于10 μm,病理组织切片可见角膜切缘整齐,角膜切口附近各层组织结构及厚度无明显变化;缝合装置的缝合跨距(2.15±0.09)mm,与目标跨距2.00 mm误差(0.15±0.02)mm.结论 辅助角膜移植显微手术机器人系统设计合理;系统的基本功能可满足角膜移植手术的要求;在实验动物的角膜钻切、缝合过程中具有较好的稳定性和准确性.%Objective To design the robotic mechanism of the cornea grafting micro-surgery system and evaluate its experimental feasibility and efficacy. Methods It was an experimental study. Based on computer assisted cornea grafting surgery ( CACGS), the prototype about cornea grafting robot, which consists of six subsystems, was developed. The system was used for looping incision and suturing for 20 rabbit corneas. Experimental data were studied including the error of target incision position, the actual cutting depth and the cutting edge span in order to evaluate the system's clinical value. All above statistical descriptions were performed using SPSS software version 11.5. Results 20 corneas were looping incised and sutured by the robot-assisted cornea grafting micro-surgery system successfully. The error of target incision position was (0.356±0.040)mm. With CACGS, the cutting edge span (A) was (0.855±0.040) and the actual cutting depth error was less than 10 p,m. Corneal structure

  1. Confocal microscopy findings in deep anterior lamellar keratoplasty performed after Descemet's stripping automated endothelial keratoplasty

    Directory of Open Access Journals (Sweden)

    Pang A

    2014-01-01

    Full Text Available Audrey Pang,1,2 Karim Mohamed-Noriega,1 Anita S Chan,1,3–5 Jodbhir S Mehta1,3 1Singapore National Eye Centre, 2Department of Ophthalmology, Tan Tock Seng Hospital, 3Singapore Eye Research Institute, 4Department of Histopathology, Pathology, Singapore General Hospital, 5Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Background: This study describes the in vivo confocal microscopy findings in two patients who had deep anterior lamellar keratoplasty (DALK following Descemet's stripping automated endothelial keratoplasty (DSAEK. Methods: The study reviewed the cases of two patients who first underwent DSAEK followed by DALK when their vision failed to improve due to residual stromal scarring. In the first case, a DSAEK was performed for a patient with pseudophakic bullous keratopathy. After surgery, the patient's vision failed to improve satisfactorily due to residual anterior stromal opacity and irregularity. Subsequently, the patient underwent a DALK. The same two consecutive operations were performed for a second patient with keratoconus whose previous penetrating keratoplasty had failed and had secondary graft ectasia. In vivo confocal microscopy was performed 2 months after the DALK surgery in both cases. Results: At 3 months after DALK, the best-corrected visual acuity was 6/30 in case 1 and 6/24 in case 2. In vivo confocal microscopy in both cases revealed the presence of quiescent keratocytes in the stroma layers of the DSAEK and DALK grafts, which was similar in the central and peripheral cornea. There was no activated keratocytes or haze noted in the interface between the grafts. Conclusion: Our short-term results show that performing a DALK after a DSAEK is an effective way of restoring cornea clarity in patients with residual anterior stromal opacity. In vivo confocal microscopy showed that there were no activated keratocytes seen in the interface of the grafts, which suggests

  2. 正常与病态眼角膜蠕变特性的对比分析%Comparative Analysis of the Creep Mechanical Characteristic of the Normal and the Morbid Cornea

    Institute of Scientific and Technical Information of China (English)

    李爽; 袁毅

    2012-01-01

    To compare the creep mechanical characteristics of the normal cornea and the morbid cornea and provide the biome-chanical parameter for the clinical medicine. 20 corneas were divided into two groups. 10 corneas (the rest part of the cornea after transplantation) belonged to the normal group and the other 10 ones (the abandoned part of the severe ulcer corneal after operation) belonged to the morbid group. The creep experiment was done with the electronic universal testing machine, increasing the stress at the speed of 0. 1 MPa per second. The data with the normalized analysis method was analyzed. The creep quantity of the normal group in 7 200 s was 0. 16% . The creep quantity of the morbid one in 7 200 s was 0. 12%. The creep quantity of the normal group was more than the morbid one and the differences were significant (P < 0. 05). The creep curves of the normal group and the morbid one change exponentially. The creep characteristics of the cornea in the morbid group has changed.%比较正常和病态眼角膜的蠕变力学特性为临床提供生物力学参数.采用人工捐献角膜,角膜移植后的10个眼角膜剩余部分、严重角膜溃疡术后严重并发症行角膜移植患者的病态眼角膜遗弃部分10个,在电子万能试验机上以0.1 Mpa/s的应力增加速度进行蠕变实验.以归一化分析的方法处理蠕变实验数据.正常对照组眼角膜7 200s蠕变量为0.16%,病态组眼角膜7 200s蠕变量为0.12%,正常对照组7 200s蠕变量大于病态组,差异显著(P<0.05).蠕变曲线是以指数关系变化的,病态组眼角膜蠕变特性发生改变.

  3. Tarsorrafia: aplicações em um Serviço de Córnea Tarsorrhaphy: applications in a Cornea Service

    Directory of Open Access Journals (Sweden)

    Patrick Frensel de Moraes Tzelikis

    2005-02-01

    were evaluated retrospectively. Reviewed data included patient's sex and age, indication for tarsorrhaphy, duration of signs and symptoms before tarsorrhaphy, time for epithelial healing after tarsorrhaphy, type of tarsorrhaphy, complications, follow-up time. RESULTS: Eighteen patients underwent tarsorrhaphy. The indications for a tarsorrhaphy were exposure keratopathy (27.8%, persistent epithelial defect associated with penetrating keratoplasty (38.8%, neurotrophic ulcer (11.1%, dry eye syndrome (5.6%, Stevens-Johnson syndrome (11.1%, and chemical burn (5.6%. The epithelial defect resolved completely in 15 patients (83.3%. Mean duration of signs and symptoms before tarsorrhaphy was 98.7±48.6 days, and time to heal after tarsorrhaphy was 53.2±22.8 days. Of the 18 procedures, two (11.1% were temporary and 16 (88.9% permanent. Complications after tarsorrhaphy were premature opening of the tarsorrhaphy, trichiasis and pyogenic granuloma. CONCLUSION: Tarsorrhaphy is a simple procedure, being also very safe and effective in the management of nonhealing epithelial defects, with a success rate of 83.3% and with minor complications.

  4. Discovery of molecular markers to discriminate corneal endothelial cells in the human body.

    Directory of Open Access Journals (Sweden)

    Masahito Yoshihara

    Full Text Available The corneal endothelium is a monolayer of hexagonal corneal endothelial cells (CECs on the inner surface of the cornea. CECs are critical in maintaining corneal transparency through their barrier and pump functions. CECs in vivo have a limited capacity in proliferation, and loss of a significant number of CECs results in corneal edema called bullous keratopathy which can lead to severe visual loss. Corneal transplantation is the most effective method to treat corneal endothelial dysfunction, where it suffers from donor shortage. Therefore, regeneration of CECs from other cell types attracts increasing interests, and specific markers of CECs are crucial to identify actual CECs. However, the currently used markers are far from satisfactory because of their non-specific expression in other cell types. Here, we explored molecular markers to discriminate CECs from other cell types in the human body by integrating the published RNA-seq data of CECs and the FANTOM5 atlas representing diverse range of cell types based on expression patterns. We identified five genes, CLRN1, MRGPRX3, HTR1D, GRIP1 and ZP4 as novel markers of CECs, and the specificities of these genes were successfully confirmed by independent experiments at both the RNA and protein levels. Notably none of them have been documented in the context of CEC function. These markers could be useful for the purification of actual CECs, and also available for the evaluation of the products derived from other cell types. Our results demonstrate an effective approach to identify molecular markers for CECs and open the door for the regeneration of CECs in vitro.

  5. Discovery of molecular markers to discriminate corneal endothelial cells in the human body.

    Science.gov (United States)

    Yoshihara, Masahito; Ohmiya, Hiroko; Hara, Susumu; Kawasaki, Satoshi; Hayashizaki, Yoshihide; Itoh, Masayoshi; Kawaji, Hideya; Tsujikawa, Motokazu; Nishida, Kohji

    2015-01-01

    The corneal endothelium is a monolayer of hexagonal corneal endothelial cells (CECs) on the inner surface of the cornea. CECs are critical in maintaining corneal transparency through their barrier and pump functions. CECs in vivo have a limited capacity in proliferation, and loss of a significant number of CECs results in corneal edema called bullous keratopathy which can lead to severe visual loss. Corneal transplantation is the most effective method to treat corneal endothelial dysfunction, where it suffers from donor shortage. Therefore, regeneration of CECs from other cell types attracts increasing interests, and specific markers of CECs are crucial to identify actual CECs. However, the currently used markers are far from satisfactory because of their non-specific expression in other cell types. Here, we explored molecular markers to discriminate CECs from other cell types in the human body by integrating the published RNA-seq data of CECs and the FANTOM5 atlas representing diverse range of cell types based on expression patterns. We identified five genes, CLRN1, MRGPRX3, HTR1D, GRIP1 and ZP4 as novel markers of CECs, and the specificities of these genes were successfully confirmed by independent experiments at both the RNA and protein levels. Notably none of them have been documented in the context of CEC function. These markers could be useful for the purification of actual CECs, and also available for the evaluation of the products derived from other cell types. Our results demonstrate an effective approach to identify molecular markers for CECs and open the door for the regeneration of CECs in vitro.

  6. The generation of 4-hydroxynonenal, an electrophilic lipid peroxidation end product, in rabbit cornea organ cultures treated with UVB light and nitrogen mustard

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Ruijin; Po, Iris; Mishin, Vladimir; Black, Adrienne T. [Pharmacology and Toxicology, Rutgers University, Piscataway, NJ (United States); Heck, Diane E. [Environmental Science, New York Medical College, Valhalla, NY (United States); Laskin, Debra L. [Pharmacology and Toxicology, Rutgers University, Piscataway, NJ (United States); Sinko, Patrick J. [Pharmaceutics, Rutgers University, Piscataway, NJ (United States); Gerecke, Donald R.; Gordon, Marion K. [Pharmacology and Toxicology, Rutgers University, Piscataway, NJ (United States); Laskin, Jeffrey D., E-mail: jlaskin@eohsi.rutgers.edu [Environmental and Occupational Medicine, UMDNJ-Robert Wood Johnson Medical School, Piscataway, NJ (United States)

    2013-10-15

    The cornea is highly sensitive to oxidative stress, a process that can lead to lipid peroxidation. Ultraviolet light B (UVB) and nitrogen mustard (mechlorethamine) are corneal toxicants known to induce oxidative stress. Using a rabbit air-lifted corneal organ culture model, the oxidative stress responses to these toxicants in the corneal epithelium was characterized. Treatment of the cornea with UVB (0.5 J/cm{sup 2}) or nitrogen mustard (100 nmol) resulted in the generation of 4-hydroxynonenal (4-HNE), a reactive lipid peroxidation end product. This was associated with increased expression of the antioxidant, heme oxygenase-1 (HO-1). In human corneal epithelial cells in culture, addition of 4-HNE or 9-nitrooleic acid, a reactive nitrolipid formed during nitrosative stress, caused a time-dependent induction of HO-1 mRNA and protein; maximal responses were evident after 10 h with 30 μM 4-HNE or 6 h with 10 μM 9-nitrooleic acid. 4-HNE and 9-nitrooleic acid were also found to activate Erk1/2, JNK and p38 MAP kinases, as well as phosphoinositide-3-kinase (PI3)/Akt. Inhibition of p38 blocked 4-HNE- and 9-nitrooleic acid-induced HO-1 expression. Inhibition of Erk1/2, and to a lesser extent, JNK and PI3K/Akt, suppressed only 4-HNE-induced HO-1, while inhibition of JNK and PI3K/Akt, but not Erk1/2, partly reduced 9-nitrooleic acid-induced HO-1. These data indicate that the actions of 4-HNE and 9-nitrooleic acid on corneal epithelial cells are distinct. The sensitivity of corneal epithelial cells to oxidative stress may be an important mechanism mediating tissue injury induced by UVB or nitrogen mustard. - Highlights: • UVB or nitrogen mustard causes rabbit corneal epithelial injury. • 4-Hydroxynonenal (4-HNE) was formed and heme oxygenase-1 (HO-1) was increased. • 4-HNE induced HO-1 mRNA and protein expression in human corneal epithelial cells. • The induction of HO-1 by 4-HNE was through MAP kinase activation.

  7. 正常与病态眼角膜应力松弛力学特性的对比分析%The Comparative Analysis of Stress Relaxation Characteristics of Normal and Pothologycal Cornea

    Institute of Scientific and Technical Information of China (English)

    李爽; 李鹏; 袁毅

    2013-01-01

    通过建立正常与病态眼角膜的应力松弛函数方程、应力松弛曲线,比较正常和病态眼角膜的应力松弛力学为临床提供生物力学参数。正常人尸体眼角膜和病态(眼角膜移植患者的眼角膜)眼角膜各10个,在电子万能试验机上进行应力松弛实验。模拟人体温在36.5±0.5℃的温度下,以0.1%/s的应变增加速度对试样施加拉应变,采集100个数据,以归一化分析的方法处理应力松弛数据,拟合应力松弛曲线。正常对照组眼角膜7200 s应力松弛量为0.61 MPa,病态组眼角膜7200 s应力松弛量为0.46 MPa,正常对照组7200 s应力松弛量大于病态组,差异显著(P<0.05)。应力松弛曲线是以对数关系变化的,病态组眼角膜应力松弛特性发生改变。%To compare the stress relaxation mechanics of normal and morbid state corneas by establishing normal and the morbid state cornea stress relaxation functional equation and the stress relaxation curve,and to provide the biological mechanical parameters for clinical.10 corneas of the normal persons′corpse cornea and the morbid state (the corneas of patients with transplanted corneas) corneas were taken respectively,and then the stress relaxation experiment was conducted with electronic universal testing machine.We simulated human body temperature at a temperature of 36.5 ±0.5 ℃,and then applied a tensile strain in the sample 0.1%/state of increase of the strain,and collected 100 data,then the stress relaxation data were dealed with normalized analysis method,and finally the stress relaxation curve was fitted.The stress relaxation quantity of the coreas of the normal control group at 7 200 s was 0.61 MPa, the stress relaxation quantity of the corneas of the morbid state group at 7 200 s was 0.46 MPa,the stress relaxation quantity of normal control group at 7 200 s was more than that of the morbid state group,and the differences were obviously (P<0

  8. Controlled reshaping of the front surface of the cornea through its full-area ablation outside of the optical zone with a Gaussian ArF excimer laser beam

    Science.gov (United States)

    Semchishen, A. V.; Semchishen, V. A.

    2014-01-01

    We studied in vitro the response of the topography of the cornea to its full-area laser ablation (the laser beam spot diameter is commensurable with the size of the interface) outside of the central zone with an excimer laser having a Gaussian fluence distribution across the beam. Subject to investigation were the topographically controlled surface changes of the anterior cornea in 60 porcine eyes with a 5 ± 1.25-diopter artificially induced astigmatism, the changes being caused by laser ablation of the stromal collagen in two 3.5-mm-dia. circular areas along the weaker astigmatism axis. Experimental relationships are presented between the actual astigmatism correction and the expected correction for the intact optical zones 1, 2, 3, and 4 mm in diameter. The data for each zone were approximated by the least-squares method with the function d = a + bx. The coefficient b is given with the root-mean-square error. The statistical processing of the data yielded the following results: d = (0.14 ± 0.037)x for the 1-mm-dia. optical zone, (1.10 ± 0.036)x for the 2-mm-dia. optical zone, (1.04 ± 0.020)x for the 3-mm-dia. optical zone, and (0.55 ± 0.04)x for the 4-mm-dia. optical zone. Full astigmatism correction was achieved with ablation effected outside of the 3-mm-dia. optical zone. The surface changes of the cornea are shown to be due not only to the removal of the corneal tissue, but also to the biomechanical topographic response of the cornea to its strain caused by the formation of a dense pseudomembrane in the ablation area.

  9. 准分子激光原位角膜磨镶术不同厚度角膜瓣的临床评估%Clinical evaluation on the cornea flap with different thickness after LASIK

    Institute of Scientific and Technical Information of China (English)

    张丰菊; 陈丽娜; 郭宁; 于芳蕾; 鲁智莉

    2009-01-01

    目的 利用共焦显微镜观察厚、薄角膜瓣各层组织在形态学方面改变的区别,同时比较准分子激光原位角膜磨镶术(LASIK)后厚、薄角膜瓣的视功能差异,以期为临床合理化手术提供客观依据.方法 病例对照研究.收集行LASIK手术的患者70例(70只眼),平均年龄(23±5)岁.按照角膜瓣厚度分为两组:薄角膜瓣组(A组,36只眼)和厚角膜瓣组(B组,34只眼),术前平均等值球镜屈光度数分别为(-4.76±2.30)和(-3.03±2.20)D.术前术后均进行视力、屈光度、波阵面像差、对比敏感度等视功能检查,同时应用共焦显微镜(海德堡视网膜断层扫描仪角膜模块,HRTⅢ)检测角膜中央各层组织.数据应用配对t检验进行统计学分析,以P0.05).IASIK术后两组角膜瓣厚度分别为(107.37±20.5)和(149±25.2)μm,皱褶厚度分别为(63.71±15.8)和(48.16±20.7)μm,无细胞区厚度分别为(69.93±15.8)和(55.63±23.7)μm,激活角膜细胞区厚度分别为(60.15±30.9)和(51.86±27.9)μm;前基质细胞密度分别为(825.14±156.9)和(853.54±126.8)个/mm2;各项差异均有统计学意义(t=2.679,1.974,3.051,2.196,3.146;P0.05).术前及术后不同时间两组的各阶像差及对比敏感度差异均无统计学意义(P>0.05).结论 准分子激光原位角膜磨镶术中采用的角膜瓣厚度不同,术后虽然其临床视功能比较并无明显差异,但是厚、薄角膜瓣愈合时在细胞水平存在较大差异,角膜瓣与基质之间是非瘢痕性愈合.角膜薄瓣在细胞水平对角膜组织损伤的程度重于角膜厚瓣.(中华眼科杂志,2009,45:587-593)%Objective To investigate morphologically the different changes of cornea tissue between thick and thin cornea flap with confocal microscope, and to compare visual function between thick and thin cornea flap after LASIK Methods 70 eases (70 eyes) who had received LASIK were divided into the thin cornea flap group (36eyes, group A) and the thick cornea flap group

  10. 人角膜接触镜材料生物相容性的研究%Studies on biocompatibility of contact lens material for human cornea

    Institute of Scientific and Technical Information of China (English)

    朱文渊; 刘正堂; 崔英德; 黎新明

    2007-01-01

    Objective To study the biocompatibility of contact lens material for human cornea prepared in our department. Methods Biological properties of the material were assessed by cytotoxicity,haemolysis and protein aggradation. Results The material had no toxicity for HEFC. The haemolysis rate was eligibility(1.62%). Anti-protein-aggradation was quite good. Conclusion The contact lens material by our department possesses quite good biological properties.%目的 研究本室制备的人角膜接触镜材料的生物性能.方法 采用细胞毒性试验、红细胞溶血试验以及蛋白质沉积试验方法.结果 所制备的人角膜接触镜材料对人胚肺纤维细胞(HEFC)毒性评价为1级无毒性;红细胞溶血率为1.62%合格;在体温范围内抗蛋白质沉积作用较好.结论 本室制备的人角膜接触镜材料具有较好的生物相容性.

  11. Neuroprotective Effects of Sulphated Agaran from Marine Alga Gracilaria cornea in Rat 6-Hydroxydopamine Parkinson's Disease Model: Behavioural, Neurochemical and Transcriptional Alterations.

    Science.gov (United States)

    Souza, Ricardo Basto; Frota, Annyta Fernandes; Sousa, Rayane Siqueira; Cezario, Nayara Araújo; Santos, Tarcizio Brito; Souza, Luziana Mara Frota; Coura, Chistiane Oliveira; Monteiro, Valdécio Silvano; Cristino Filho, Gerardo; Vasconcelos, Silvânia Maria Mendes; da Cunha, Rodrigo Maranguape Silva; Aguiar, Lissiana Magna Vasconcelos; Benevides, Norma Maria Barros

    2017-02-01

    Parkinson's disease (PD) is a multifactorial disease associated with the degeneration of dopaminergic neurons and behavioural alterations. Natural bioactive compounds may provide new therapeutic alternatives for neurodegenerative disorders, such as PD. The sulphated polysaccharides isolated from marine algae are heterogenic molecules that show different biological activities. The red marine alga Gracilaria cornea has a sulphated polysaccharide (SA-Gc) with structure and anti-inflammatory and antinociceptive activities reported in the literature. Therefore, this study aimed to evaluate the neuroprotective effects of SA-Gc in rat model PD induced by 6-hydroxydopamine (6-OHDA). Firstly, we established the PD model in rats, induced by an intrastriatal injection (int.) of 6-OHDA, followed by a single administration of SA-Gc (15, 30 or 60 μg; int.). On the 14th day, behavioural tests were performed. After killing, brain areas were dissected and used for neurochemical and/or transcriptional analyses. The results showed that SA-Gc (60 μg, int.) promoted neuroprotective effects in vivo through reducing the oxidative/nitroactive stress and through alterations in the monoamine contents induced by 6-OHDA. Furthermore, SA-Gc modulated the transcription of neuroprotective and inflammatory genes, as well as returning behavioural activities and weight gain to normal conditions. Thus, this study reports the neuroprotective effects of SA-Gc against 6-OHDA in rats.

  12. 改良结膜筋膜覆盖角膜术在眼球萎缩整形中的应用%Application of improved conjunctival and balbar fascia flap cornea coverlaying in traumatic atrophic eyeball for anaplasty

    Institute of Scientific and Technical Information of China (English)

    刘凤霞; 张松; 王彦; 刘德成

    2016-01-01

    目的 探讨保留外伤性萎缩眼球配戴薄型义眼的方法与临床效果.方法 轻中度外伤眼球萎缩32例(32眼).术中将萎缩眼球的角膜浅层基质和角膜缘上皮组织彻底清除,将上方球结膜和眼球筋膜同时向下滑行,覆盖整个角膜并固定于下方角膜缘,与下方眼球筋膜及结膜缝合.术后1个月定做义眼片佩戴,随访6 ~ 24个月,观察其效果.结果 32例结膜筋膜覆盖良好,无角膜暴露,患者无异物感,双侧睑裂对称,外观改善满意.结论 轻中度外伤性眼球萎缩采用改良结膜眼球筋膜瓣覆盖角膜,术后愈合良好,角膜不暴露,结膜囊成形好,佩戴个性化义眼片,可达到美容效果.%Objective To investigate the method and clinical effect of wearing thin-walled ocular prosthesis after conjunctival and bulbar fascia flap coverlaying surgery of traumatic atrophic eyeball.Methods Total 32 eyes of 32 patients with mild-to-moderate traumatic atrophic eyeball were treated.In the operation,the superficial parenchyma of cornea and limbus epithelial tissue of atrophic eyeball were thoroughly removed,the above bulbar conjunctiva and bulbar fascia flap were slid downward to cover the whole cornea and fixed in the inferior limbus,and sutured with fascia and conjunctiva below.At 1 month postoperatively,customized personalized ocular prosthesis was used.The follow-up time was 6-24 months and the curative effect was observed.Results The conjunctiva fascia coverage of 32 patients were good without corneal exposure or foreign body sensation.The improved appearance was satisfactory.Conclusion Applying complete conjunctiva fascia flap to cover cornea in mild-to-moderate traumatic atrophic eyeball is effective.The healing of postoperative fascia and cornea is good,and the cornea is not exposed.The cosmetic effect of wearing personalized ocular prosthesis is good.

  13. Pharmaceutical Care of Ciclosporine for Patient with Bullous Pemphigoid by Clinical Pharmacists%临床药师参与环孢素治疗大疱性类天疱疮患者的药学监护

    Institute of Scientific and Technical Information of China (English)

    费龙; 郭珩; 张耕; 刘杨从

    2016-01-01

    目的:为临床药师融入临床实现个体化用药提供思路。方法:分享临床药师对1例环孢素治疗大疱性类天疱疮患者的药学监护,为患者提供个体化用药方案的成功案例。结果:医师接受建议,调整环孢素用药方案,治疗4日后少见新发红斑水疱,症状改善明显,同时临床药师对合并用药(糖皮质激素、人免疫球蛋白、环孢素等)进行药学监护,未见明显不良反应( adverse drug reaction,ADR),患者好转出院。结论:使用环孢素治疗皮肤系统疾病,监测血药浓度可能具有一定的临床意义,但尚需进一步经过临床实践研究。%OBJECTIVE:To provide ideas for the participation of clinical pharmacists in clinical individualized medication.METHODS: By sharing the pharmaceutical care participated by the clinical pharmacists in the drug therapy of a patient with bullous pemphigoid , the successful example of individualized medication was provided . RESULTS:The clinician accepted the proposal and adjusted the therapeutic regimen .The symptoms of the patient had been improved significantly and new erythema blister were rare after four days of treatment .Meanwhile , the clinical pharmacists provided pharmaceutical care for the drug combination ( corticosteroids , gamma globulin , cyclosporine , etc) , with no significant adverse drug reactions , the patient was discharged with a better health condition . CONCLUSIONS:The application of ciclosporine in treatment of skin diseases and monitor the blood concentration may have clinical significance , yet it still needs to be further researched in clinical practice .

  14. Normal X-inactivation mosaicism in corneas of heterozygous FlnaDilp2/+ female mice--a model of human Filamin A (FLNA diseases

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    Douvaras Panagiotis

    2012-02-01

    Full Text Available Abstract Background Some abnormalities of mouse corneal epithelial maintenance can be identified by the atypical mosaic patterns they produce in X-chromosome inactivation mosaics and chimeras. Human FLNA/+ females, heterozygous for X-linked, filamin A gene (FLNA mutations, display a range of disorders and X-inactivation mosaicism is sometimes quantitatively unbalanced. FlnaDilp2/+ mice, heterozygous for an X-linked filamin A (Flna nonsense mutation have variable eye, skeletal and other abnormalities, but X-inactivation mosaicism has not been investigated. The aim of this study was to determine whether X-inactivation mosaicism in the corneal epithelia of FlnaDilp2/+ mice was affected in any way that might predict abnormal corneal epithelial maintenance. Results X-chromosome inactivation mosaicism was studied in the corneal epithelium and a control tissue (liver of FlnaDilp2/+ and wild-type (WT female X-inactivation mosaics, hemizygous for the X-linked, LacZ reporter H253 transgene, using β-galactosidase histochemical staining. The corneal epithelia of FlnaDilp2/+ and WT X-inactivation mosaics showed similar radial, striped patterns, implying epithelial cell movement was not disrupted in FlnaDilp2/+ corneas. Corrected stripe numbers declined with age overall (but not significantly for either genotype individually, consistent with previous reports suggesting an age-related reduction in stem cell function. Corrected stripe numbers were not reduced in FlnaDilp2/+ compared with WT X-inactivation mosaics and mosaicism was not significantly more unbalanced in the corneal epithelia or livers of FlnaDilp2/+ than wild-type Flna+/+ X-inactivation mosaics. Conclusions Mosaic analysis identified no major effect of the mouse FlnaDilp2 mutation on corneal epithelial maintenance or the balance of X-inactivation mosaicism in the corneal epithelium or liver.

  15. Clinical Outcomes of Small Incision Lenticule Extraction with Accelerated Cross-Linking (ReLEx SMILE Xtra in Patients with Thin Corneas and Borderline Topography

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    Sri Ganesh

    2015-01-01

    Full Text Available Purpose. To study the safety and clinical outcomes of ReLEx SMILE with accelerated cross-linking in individuals with thinner corneas, borderline topography, and higher refractive errors. Methods. Eligible patients first underwent SMILE procedure for correction of myopic refractive error. Following the removal of lenticule, 0.25% riboflavin in saline was injected into the interface and allowed to diffuse for 60 seconds. Finally, eye was exposed to UV-A radiation of 45 mW/cm2 for 75 seconds through the cap. Total energy delivered was 3.4 J/cm2. Results. 40 eyes of 20 patients with mean age of 26.75 ± 5.99 years were treated. Mean follow-up was 12 months ± 28.12 days. Mean spherical equivalent (SE was −5.02 ± 2.06 D preoperatively and −0.24 ± 0.18 D postoperatively. The mean central corneal thickness (CCT and keratometry changed from 501 ± 25.90 µm to 415 ± 42.26 µm and 45.40 ± 1.40 D to 41.2 ± 2.75 D, respectively. Mean uncorrected visual acuity (UCVA was 20/25 or better in all eyes. No eyes lost lines of corrected distant visual acuity (CDVA. There were no complications like haze, keratitis, ectasia, or regression. Conclusion. Based on the initial clinical outcome it appears that SMILE Xtra may be a safe and feasible modality to prevent corneal ectasia in susceptible individuals.

  16. The Changes of TGF-α, TGF-β1 and Basic FGF Messenger RNA Expression in Rabbit Cornea after Photorefractive Keratectomy

    Institute of Scientific and Technical Information of China (English)

    Yisheng Zhong; Yingrning Zhou; Jingcai Lian; Wen Ye; Kangsun Wang; Feng Cheng

    2000-01-01

    Objective: To study the mechanism of haze formation and investigate the expression changes of transforming growth factor-αα(TGF-αα), transforming growth factor-β1 (TGF-β1)and basic fibroblast growth factor (bFGF) mRNA in corneal epithelium and stroma after photorefractive keratectomy (PRK).Methods: Sixteen white rabbits were randomly divided into 4 groups, and PRK was performed on each eye of 12 rabbits. The haze formation was examined under a slit-lamp microscope at the 1st, 2na and 3ra month after PRK, and the expressions of TGF-αα , TGF-βi and bFGF mRNA were detected with in situ hybridization.Results: The corneal haze formed at the 1st month after PRK. The most prominent haze formation was observed at the 2nd month, and declined gradually at the 3ra month after ablation. TGF-αα mRNA expression was presented on the normal corneal epithelium and not on the corneal stroma. TGF-βl and bGFG mRNA were expressed by both corneal epitheliurn and stroma. The capacities for cornea tissue expression of three growth factors mRNA increased after PRK, and the peaks appeared on the 1s, 2na month. The extent for expressions of three growth factors related proportionally to the haze formation.Conclusion: Three growth factors took part in promoting corneal wound healing after PRK, and might contribute to corneal haze formation and development.

  17. Motivos do descarte de córneas captadas pelo banco de olhos do Hospital São Paulo em dois anos Discarding causes of cornea collected by eye bank of São Paulo hospital in two years

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    Carla Galluzzi dos Santos

    2010-02-01

    Full Text Available OBJETIVO: Analisar os motivos do descarte ou não utilização de córneas doadas, cujos tecidos foram captados, preservados e avaliados pelo Banco de Olhos do Hospital São Paulo no período de outubro de 2002 a setembro de 2004. MÉTODOS: Estudo retrospectivo analisando os prontuários com as seguintes informações sobre as doações: história clínica e ocular do doador, idade, causa mortis, resultados de exames sorológicos, avaliação do corpo do doador, avaliação biomicroscópica da morfologia do globo ocular e da córnea e contagem celular endotelial. RESULTADOS: De 1.116 córneas doadas no período, 518 (46,41% foram descartadas antes de serem preservadas, sendo 288 (25,80% devido à causa mortis, 56 (5,01% pelo histórico clínico do doador e 174 (15,59% pela avaliação do tecido. Das 598 córneas preservadas, 317 (28,40% foram destinadas ao transplante óptico e 168 (15,05% indicadas para transplantes tectônicos. CONCLUSÃO: A análise do prontuário hospitalar e história clínica do doador foi um importante fator de descarte de córneas antes da preservação. Já a avaliação biomicroscópica realizada na lâmpada de fenda é uma etapa fundamental para qualificação e classificação do tecido adequando-o para o paciente e garantindo um bom resultado cirúrgico.PURPOSE: To analyze causes of discarded donor corneas which were collected and preserved by São Paulo Hospital Eye Bank in a period of two years. METHODS: Retrospective study based in the investigation of donor's medical records, for clinical and ocular factors, age, death cause, serology results, body conditions, slit lamp corneal examination and endothelial cells counting. RESULTS: 1,116 corneas were donated and included in the study, 518 (46.41% were discarded before preservation, 168 (15.05% were not transplanted for optical purpose, but used for tectonic indication. The main reason of cornea discard was the cause of death in 288 (25.80% corneas, second the slit

  18. Study on penetration behavior of mitomycin in isolated cornea of rabbits%丝裂霉素在兔离体角膜中的渗透特性研究

    Institute of Scientific and Technical Information of China (English)

    王石健; 应苗法

    2014-01-01

    目的:考察丝裂霉素在兔离体角膜中的渗透特性。方法以谷胱甘肽缓冲液为接收液,使用水平式扩散仪考察丝裂霉素在离体兔角膜中的渗透特性;样品使用HPLC测定,采用Agilent Zorbax C18柱(150 mm ×4.6 mm,5μm),流动相为甲醇∶水(70∶30,v/v),流速为1 mL/min,检测波长为365 nm。结果建立的丝裂霉素HPLC测定方法专属性、线性、精密度等均良好,丝裂霉素在兔角膜中的渗透按照一级动力学拟合时相关系数最高。结论丝裂霉素在兔离体角膜中的渗透符合一级动力学过程。%Objective To investigate the penetration behavior of mitomycin in isolated cornea of rabbits. Methods The penetration behavior of mitomycin in isolated rabbit cornea was investigated on horizontal diffusion cells using glutathione buffer as receptor medium. The samples were determined by HPLC and separation was achieved on an Agilent Zorbax C18 column. The mobile phase consisted of methanol/water (70/30,v/v) and delivered at a flow rate of 1 mL/min. The detective wavelength was set at 365 nm. Results The established HPLC method had shown good selectivity,linearity and precision. The correlation index was the highest when the penetration profile of mitomycin in isolated rabbit cornea was fitted by first order kinetic equation. Conclusion The penetration behavior of mitomycin in isolated rabbit cornea accords to first order kinetics.

  19. Indications and Outcomes of Amniotic Membrane Transplantation

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    Alime Güneş

    2014-03-01

    Full Text Available Objectives: To investigate the indications and outcomes of amniotic membrane transplantation (AMT. Materials and Methods: A total of 87 eyes who underwent amnion membrane transplantation in our clinic between February 2010 and April 2013 were included in this study. Mean follow-up period was 7.49±7.84 months (range 1-29 months. Amnion membrane defrosted at room temperature and washed three times with saline covered all over the cornea independent of the position and size of the lesion and was sutured to the peripheral cornea circumferentially by 10/0 monofilament suture. At the end of the operation, therapeutic contact lens was placed. All cases were evaluated with respect to duration of surface epithelial healing, visual acuity, presence of recurrence, and infection. Results: Forty-six of the 87 patients (52.8% were men and 41 (47.1% were women. The mean age was 57.02±19.74 years (range 31-89 years in men and 66.69±16.56 years (range 8-88 years in women. The indications were: ulcers in 27 eyes, keratitis in 24 eyes, topical anesthetic abuse in 10 eyes, bullous keratopathy in 7 eyes, conjunctival mass in 7 eyes, symblepharon in 3 eyes, chemical burns in 3 eyes, pterygium in 2 eyes, endophthalmitis in 2 eyes, dellen in 1 eye, and conjunctival laceration in 1 eye. After AMT, 12 patients required second AMT, and 2 cases required third AMT. 2 eyes were eviscerated, 1 eye was exenterated. At the final follow-up visit, except for patients who underwent evisceration and exenteration, improved visual acuity was observed in 45 of the 84 eyes (53.5%. The average of healing time was between 4 and 6 weeks. No infectious, inflammatory, immunologic, or toxic/allergic reactions related to AMT was observed. Conclusion: Amniotic membrane transplantation is a safe and effective technique in ocular surface diseases. (Turk J Ophthalmol 2014; 44: 123-6

  20. Dendritic immune cell densities in the central cornea associated with soft contact lens types and lens care solution types: a pilot study

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    Sindt CW

    2012-03-01

    Full Text Available Christine W Sindt1, Trudy K Grout1, D Brice Critser1, Jami R Kern2, David L Meadows21University of Iowa Hospitals and Clinics, Iowa City, IA; 2Alcon Research Ltd, Fort Worth, TX, USABackground: The purpose of this study was to assess whether differences in central corneal dendritic immune cell densities associated with combinations of soft contact lenses and lens care solutions could be detected by in vivo confocal microscopy.Methods: Participants were adults naïve to contact lens wear (n = 10 or who wore soft contact lenses habitually on a daily-wear schedule (n = 38 or on a study-assigned schedule for 30 days with daily disposable silicone hydrogel lenses (n = 15. Central corneas were scanned using an in vivo confocal microscope. Cell densities were compared among groups by demographic parameters, lens materials, and lens care solutions (polyhexamethylene biguanide [PHMB], polyquaternium-1 and myristamidopropyl dimethylamine [PQ/MAPD], peroxide, or blister pack solution [for daily disposable lenses].Results: Among lens wearers, no associations were observed between immune cell densities and age, gender, or years of lens-wearing experience. Mean cell density was significantly lower (P < 0.01 in nonwearers (29 ± 23 cells/mm2, n = 10 than in lens wearers (64 ± 71 cells/mm2, n = 53. Mean cell density was lower (P = 0.21 with traditional polymer lenses (47 ± 44 cells/mm2, n = 12 than with silicone hydrogel lenses (69 ± 77 cells/mm2, n = 41. Lowest to highest mean density of immune cells among lens wearers was as follows: PQ/MAPD solution (49 ± 28 cells/mm2, blister pack solution (63 ± 81 cells/mm2, PHMB solution (66 ± 44 cells/mm2, and peroxide solution (85 ± 112 cells/mm2.Conclusion: In this pilot study, in vivo confocal microscopy was useful for detecting an elevated immune response associated with soft contact lenses, and for identifying lens-related and solution-related immune responses that merit further research.Keywords: Clear Care