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JAMA ophthalmology. 04/2013;
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ABSTRACT: PURPOSE:: To report a case of spontaneous bleb formation in a presumed pellucid marginal corneal degeneration with acute hydrops. METHODS:: A 51-year-old man reported sudden ocular pain with a lower conjunctival mass in his left eye. A clinical examination was performed to investigate this lesion. RESULTS:: The intraocular pressure in the left eye was markedly lower compared with that in the opposite eye. Slit-lamp examination of the left eye showed a conjunctival mass inferior to the corneoscleral limbus adjacent to corneal epithelial and stromal edema without perforation. Corneal topography showed the typical bow tie appearance of corneal steepening rotated 120 degrees clockwise. The right eye was totally normal. Fourier-domain optical coherence tomography with a corneal anterior module adaptor clearly showed a break in Descemet membrane and a ruptured corneal stromal cleft under the conjunctiva near the corneal limbus that resulted in spontaneous bleb formation. The cornea gradually healed after bandage treatment; the spontaneous bleb became smaller and the corneal stromal cleft and edema regressed at 3 months with corneal scarring. The intraocular pressure in the left eye recovered to the same level as that in the opposite eye in association with the decreased bleb size. CONCLUSIONS:: This case indicated that spontaneous bleb formation in a pellucid marginal corneal degeneration should be included in the differential diagnosis of a conjunctival mass of unknown origin.
Cornea 02/2013; · 1.73 Impact Factor
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ABSTRACT: Abstract Purpose: The development of endophthalmitis after cataract surgery often results in a significant vision loss. Inhibition of bacterial proliferation in the anterior chamber using antibiotic eye drops is important to prevent endophthalmitis after cataract surgery. We aimed to determine the sensitivity of fluoroquinolones against Enterococcus faecalis ocular isolates and the efficacy of fluoroquinolones to prevent E. faecalis-induced endophthalmitis in aphakic rabbits. Methods: The minimum inhibitory concentrations (MICs) of moxifloxacin (MFLX) and levofloxacin (LVFX) used in ophthalmic solutions for 13 E. faecalis isolates obtained from the conjunctival sac or endophthalmitis cases were determined. Eye drops containing MFLX (0.5%), LVFX (0.5%), or saline were administered to aphakic rabbits with endophthalmitis induced by E. faecalis. The eye drops were administered immediately after lensectomy and at 3 and 6 h after cataract surgery (early instillation group) or immediately after lensectomy and at 12 and 15 h after cataract surgery (delayed instillation group). Bacterial growth, electroretinography (ERG), and slit-lamp examination (SLE) were determined throughout the course of infection. Results: In vitro susceptibility testing revealed that the MICs of MFLX for E. faecalis isolates were lower than those of LVFX. In the early ocular instillation groups, MFLX significantly improved SLE scores, ERG, and viable bacterial counts compared with LVFX and saline (all, P<0.05). There were no significant differences in any parameter between MFLX and saline in the delayed ocular instillation groups. Conclusions: Early ocular instillation of MFLX delays retinal damage compared with LVFX when used to treat E. faecalis-induced endophthalmitis after cataract surgery.
Journal of ocular pharmacology and therapeutics: the official journal of the Association for Ocular Pharmacology and Therapeutics 12/2012; · 1.46 Impact Factor
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ABSTRACT: Because human corneal endothelial cells do not proliferate once the endothelial monolayer is formed, corneal wound healing is thought to be mediated by cell enlargement or migration rather than proliferation. However, the cellular mechanisms involved in corneal wound healing have not been fully determined. Because transforming growth factor-β(2) (TGF-β(2)) isoform is present in high concentrations in normal human aqueous humor, it may play a role in human corneal endothelial cell wound healing. The purpose of this study was to determine the effect of TGF-β(2) on the proliferation and migration of cultured human corneal endothelial cells (HCECs). To achieve this, we first examined the effect of TGF-β(2) on the wound closure rate in an in vitro HCEC wound healing model. However, unexpectedly TGF-β(2) had no effect on the wound closure rate in this model. Therefore, a real-time cell electronic sensing (RT-CES) system and the BrdU incorporation assay were used to determine the effect of recombinant TGF-β(2) (0.1-10 ng/ml) on cultured HCEC proliferation during in vitro wound healing. The specificity of this effect was confirmed by adding the TGF-β receptor I kinase inhibitor. TGF-β(2) inhibited the proliferation of HCECs in a dose dependent way and was blocked by TGF-β receptor I kinase inhibitor. Next, the Boyden chamber assay was used to determine how TGF-β(2) (10 ng/ml) affect HCEC migration. Exposure to TGF-β(2) increased cell migration, and a synergistic effect was observed when FGF-2 was added. To determine whether the mitogen-activated protein kinase (MAPK) signaling pathway is involved in the migration of HCECs, western blot analysis and Bio-Plex(TM) suspension array were used to detect phosphorylation of Erk1/2, p38, and JNK in HCECs stimulated by TGF-β(2) and/or FGF-2. The effect of the p38 MAPK inhibitor, SB239063 (10 μM), on TGF-β(2) and/or FGF-2 induced cellular migration was determined by the Boyden chamber assay. Both TGF-β(2) and FGF-2 induced p38 phosphorylation, and a synergistic effect was observed with exposure to both growth factors. SB 239063 inhibited TGF-β(2) and FGF-2-induced migration of HCECs. These results indicate that TGF-β(2) reduces proliferation but stimulates migration of cultured HCECs. In addition, TGF-β(2) and FGF-2 may have synergistic effects on the migration of HCECs mediated by p38 MAPK phosphorylation.
Experimental Eye Research 12/2012; · 3.26 Impact Factor
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ABSTRACT: : Previous studies have shown that the stem cells of corneal epithelia are located at the limbal basal layer. Limbal stem cells are believed to be the source of corneal epithelial cell proliferation and differentiation. This study tested the replacement hypothesis, which suggests that corneal stem cell origin epithelia may be replaced by limbal stem cell origin epithelia after 2 weeks of age in mice.
: The cytokeratin 12 expression pattern in the cornea was examined using K12 IRES-Cre and Cre reporter mice.
: Before 2 weeks of age, K12 expression in corneal epithelia showed a mosaic pattern. After 2 weeks of age, centripetal K12 expression gradually elongated from the limbal area. Around 12 weeks of age, the mosaic expression pattern disappeared from the center of the cornea. Temporal and spatial observations of K12 expression patterns suggested that the mosaic pattern cells proliferated and amassed at the same position from day 15.5 of the embryonic stage at the latest.
: Therefore, these cells were considered corneal stem cell origin epithelia. In contrast, centripetal pattern cell populations were considered limbal stem cell origin epithelia because they originated from the limbal area and moved to the center of the cornea. These observations suggest that corneal stem cell origin epithelia are replaced by limbal stem cell origin epithelia after 2 weeks of age in mice.
Cornea 11/2012; 31 Suppl 1:S68-73. · 1.73 Impact Factor
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Yoshitsugu Inoue,
Yoshikazu Shimomura,
Masahiko Fukuda,
Dai Miyazaki, Yuichi Ohashi,
Hiroshi Sasaki,
Yoshitsugu Tagawa,
Hiroshi Shiota,
Noriko Inada,
Shigeki Okamoto,
Kaoru Araki-Sasaki,
Tairo Kimura,
Hiroshi Hatano,
Hisashi Nakagawa,
Satoshi Nakamura,
Atsuko Hirahara,
Kazumi Tanaka,
Hirofumi Sakuma
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ABSTRACT: BACKGROUND/AIMS: The novel immunochromatographic assay (ICGA) kit was recently developed to diagnose herpes simplex virus (HSV) infection. This multicentre study aimed to evaluate the value of the ICGA kit for the diagnosis of herpetic epithelial keratitis by comparing it with immunofluorescence assay (IFA) and real-time PCR. METHODS: Corneal scrapings were collected from 117 patients, including 77 with herpetic keratitis as their final clinical diagnosis as well as 40 others at 21 facilities. These samples were tested by the ICGA kit, IFA and real-time PCR. RESULTS: The positive concordance between final clinical diagnosis and ICGA was 46.7% (35/75 cases) and the negative concordance was 100% (39/39). The positive and negative concordance between real-time PCR and ICGA were 57.4% (35/61 cases) and 100% (53/53), respectively. The positive and negative concordance between IFA and ICGA were 61.1% (22/36 cases) and 83.3% (55/66), respectively. In 92 cases where anti-HSV drugs were not prescribed prior to corneal scraping, the positive and negative concordance between final clinical diagnosis and ICGA were 55.0% (33/60 cases) and 100% (32/32), respectively. CONCLUSIONS: The ICGA kit has moderate sensitivity and high specificity, indicating clinical utility in the diagnosis of herpetic epithelial keratitis.
The British journal of ophthalmology 10/2012; · 2.92 Impact Factor
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ABSTRACT: To describe the case of a 74-year-old man who developed cytomegalovirus (CMV) retinitis after multiple ocular surgeries.
Observational case report.
A 74-year-old man who had a history of multiple ocular surgeries developed unilateral retinitis with whitening of the entire peripheral retina. A presumptive diagnosis of viral retinitis was considered, and polymerase chain reaction of the aqueous fluid was positive for CMV DNA. Laboratory examination revealed that the patient was completely immunocompetent. Moreover, the patient did not have any subtenon or intravitreal injection of triamcinolone acetonide (TA). The patient responded well to intravenous ganciclovir and oral valganciclovir.
CMV retinitis can occur to immunocompetent patients without local immunosuppression with TA injection.
Case reports in ophthalmology. 09/2012; 3(3):356-9.
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ABSTRACT: Purpose. To evaluate the disinfectant effect of methylene blue (MB)-mediated photodynamic therapy (PDT) on a pathogenic strain of Acanthamoeba. Methods. Acanthamoeba castellanii (ATCC 50370) used in this study were treated under one of four experimental conditions: light irradiation and incubation in MB (L+M+), light irradiation and incubation in physiologic solution (L+M-), incubation in MB only (L-M+), and incubation in physiologic solution (L-M-). M+ trophozoites were incubated in either 0.25 or 0.5 mM MB for 10 minutes. L+ organisms were irradiated for 30 minutes following incubation in solution. A halogen lamp (660 ± 10 nm) with a maximum output of 6 mW/cm(2) was used as the PDT light source. After treatment, antiacanthamoeba activity was evaluated by checking the respiratory activity of the amoeba with 5-cyano-2,3-tetrazolium chloride (CTC) staining. We also determined whether the effect of PDT with MB had been retained or augmented when it was performed in combination with conventional antiamoebic agents. Results. MB-PDT suppressed the respiratory activity of trophozoites in an MB-concentration-dependent manner at total light doses of 10.8 J/cm(2). The respiratory activity of each group as a percentage of that of L-M- is as follows: L+M+ 11.6% (0.5 mM), 60.9% (0.25 mM); L-M+ 116.5% (0.5 mM), 105.5% (0.25 mM); L+M- 107.6%; and L-M- 106.3%. (L+M+ versus L-M- P < 0.05). MB-PDT had a synergistic effect when used in combination with polyhexamethylene biguanide (PHMB) or amphotericin B, but not with voriconazole. Conclusions. MB-PDT is effective against Acanthamoeba in vitro and has synergistic effects with PHMB and amphotericin B.
Investigative ophthalmology & visual science 08/2012; 53(10):6305-13. · 3.43 Impact Factor
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ABSTRACT: AIMS: To compare the efficacy and safety of 3% diquafosol ophthalmic solution with those of 0.1% sodium hyaluronate ophthalmic solution in dry eye patients, using mean changes in fluorescein and rose bengal staining scores as endpoints. TRIAL DESIGN AND METHODS: In this multicenter, randomised, double-masked, parallel study of 286 dry eye patients with fluorescein and rose bengal staining scores of ≥3 were randomised to the treatment groups in a 1 : 1 ratio. Efficacy and safety were evaluated after drop-wise instillation of the study drug, six times daily for 4 weeks. RESULTS: After 4 weeks, the intergroup difference in the mean change from baseline in fluorescein staining score was -0.03; this verified the non-inferiority of diquafosol. The mean change from baseline in rose bengal staining score was significantly lower in the diquafosol group (p=0.010), thus verifying its superiority. The incidence of adverse events was 26.4% and 18.9% in the diquafosol and sodium hyaluronate groups, respectively, with no significant difference. CONCLUSIONS: Diquafosol (3%) and sodium hyaluronate (0.1%) exhibit similar efficacy in improving fluorescein staining scores of dry eye patients, whereas, diquafosol exhibits superior efficacy in improving rose bengal staining scores. Diquafosol has high clinical efficacy and is well tolerated with a good safety profile.
The British journal of ophthalmology 08/2012; 96(10):1310-1315. · 2.92 Impact Factor
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ABSTRACT: To assess a newly developed eyelid pressure measurement system called a blepharo-tensiometer that uses a tactile pressure sensor.
The tactile sensor was 10 mm in diameter and approximately 0.4 mm thick. The sensor was covered with silicon rubber and was placed between a soft contact lens on the cornea and the inner surface of the eyelid. Under these conditions, the sensor measured the pressure of the eyelid on the ocular surface. The pressure of the upper and lower eyelids were measured separately while the eyelids were closed for at least 5 seconds in 34 eyes of 34 normal volunteers. To determine the reliability of the blepharo-tensiometer, the pressures of the upper and lower eyelids were measured on 3 separate days in both eyes of 12 normal volunteers. The correlation between the age and the eyelid pressure was calculated.
The intraclass correlation coefficients for the 3 measurements ranged from 0.675 to 0.911 for the upper eyelid and 0.663 to 0.925 for the lower eyelid. The mean eyelid pressure was 16.95±6.08 mm Hg for the upper lid and 16.11±7.27 mm Hg for the lower lid. The eyelid pressure decreased with increasing age, and both the upper and lower eyelid pressures were significantly and negatively correlated with age (upper eyelid pressures, P<0.0001; lower eyelid pressures, P=0.000432). No complication was detected after the measurements in all of the subjects.
Our blepahro-tensiometer can obtain repeatable measurements of the eyelid pressure and can be used to evaluate the pressure of the eyelids on the ocular surface in normal and diseased eyes.
Eye & contact lens 08/2012; 38(5):326-30.
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Yoshimasa Takano,
Dong Shi,
Ai Shimizu,
Tomoyo Funayama,
Yukihiko Mashima,
Noriko Yasuda,
Takeo Fukuchi,
Haruki Abe,
Hidenao Ideta,
Xiaodong Zheng,
Atsushi Shiraishi, Yuichi Ohashi,
Kohji Nishida,
Toru Nakazawa,
Nobuo Fuse
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ABSTRACT: To determine whether polymorphisms in the Toll-like receptor 4 (TLR4) gene are associated with primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), and exfoliation glaucoma (XFG) in Japanese individuals.
Genetic association study.
Setting: Multicenter study. Study population: One hundred eighty-four unrelated Japanese patients with POAG, 365 unrelated patients with NTG, and 109 unrelated patients with XFG from 5 hospitals. Procedures: Genomic DNA was extracted from leukocytes of the peripheral blood, and 8 polymorphisms in the TLR4 genes were amplified by polymerase chain reaction (PCR) and directly sequenced. Allele and genotype frequencies and the inferred haplotypes were estimated. Main outcome measures: Differences in allele and genotype frequencies and haplotypes between subjects with POAG, NTG, and XFG.
The allele frequency of rs2149356 of the TLR4 gene in the POAG, NTG, and XFG groups was the most significantly different from that of the control group (minor allele frequency 0.446, 0.395, 0.404, vs 0.308; P = .000058, P = .0030, and P = .015). The allele frequencies of the 5 TLR4 SNPs were higher in all of the glaucoma groups than that in the control group. The statistics of genotypes of TLR4 were approximately the same for all allele frequencies. The haplotypic frequencies with Tag SNPs studied earlier showed that only POAG was statistically significant. Other haplotypes, such as rs10759930, rs1927914, rs1927911, and rs2149356, had higher statistical significance (overall P = .00078 in POAG, overall P = .018 in NTG, and overall P = .014 in XFG).
This study demonstrated that TLR4 polymorphisms are associated with NTG in the Japanese, and they also play a role in the pathogenesis of POAG and XFG.
American journal of ophthalmology 07/2012; 154(5):825-832.e1. · 3.83 Impact Factor
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ABSTRACT: To investigate the dose-dependent efficacy and safety of diquafosol ophthalmic solution for the treatment of dry eye syndrome.
Randomized, double-masked, multicenter, parallel-group, placebo-controlled trial.
A total of 286 Japanese patients with dry eye who were prescribed topical diquafosol (1%, n = 96; 3%, n = 96) or placebo ophthalmic solution (n = 94).
After a washout period of 2 weeks, qualified subjects were randomized to receive a single drop of 1% or 3% diquafosol or placebo ophthalmic solutions 6 times per day for 6 weeks.
The primary outcome measure was fluorescein corneal staining score assessment. The secondary outcome measures were Rose Bengal corneal and conjunctival staining scores, tear break-up time (BUT), and subjective symptom assessment. Safety measures were clinical blood and urine examination and recording of adverse events.
Fluorescein corneal staining scores significantly improved with both 1% and 3% topical diquafosol compared with placebo at 4 weeks, respectively (P = 0.037, P = 0.002). There was a dose-dependent effect among the groups. Rose Bengal corneal and conjunctival staining scores also improved significantly with both 1% and 3% diquafosol compared with placebo (P = 0.007 and P = 0.004, respectively). Subjective dry eye symptom scores significantly improved with both diquafosol ophthalmic solutions (P ≤ 0.033), although there were no significant differences in BUT compared with placebo. No significant differences between the treatment groups were observed in relation to the occurrence of adverse events.
Both 1% and 3% diquafosol ophthalmic solutions are considered effective and safe for the treatment of dry eye syndrome.
Proprietary or commercial disclosure may be found after the references.
Ophthalmology 06/2012; 119(10):1954-60. · 5.45 Impact Factor
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ABSTRACT: BACKGROUND: Bullous keratopathy (BK), a severe sight-threatening disorder can have a variety of etiologiessuch as prophylactic laser iridotomy, intraocular surgery, trauma, and other ocular disorders.However, there are cases of unknown origins, among which a unique clinical entity namelypseudoexfoliation syndrome (PEX) is having increased importance. CASE PRESENTATION: In this case note, we report the clinical features and in vivo confocal microscopic andpathological findings of two BK cases of unknown cause. CONCLUSIONS: Our findings suggest that the BK was caused by the corneal endotheliopathy of PEX, acommon disease that could affect up to 30% of people over 60 years old and is moreprevalent than we have believed.
BMC Ophthalmology 06/2012; 12(1):17. · 1.00 Impact Factor
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ABSTRACT: : To evaluate the effect of 7 multipurpose contact lens care solutions (MPSs) on the adhesion of Acanthamoeba (AC) to 5 silicone hydrogel contact lenses (SHCLs).
: Acanthamoeba castellanii (ATCC50370) trophozoites were inoculated onto disks trimmed from SHCLs, Asmofilcon A, Galyfilcon A, Senofilcon A, Lotrafilcon B, and Balafilcon A. After 4-hour incubation, the number of adherent AC trophozoites on SHCL was counted under phase contrast microscopy. AC trophozoites mixed with 7 MPSs were inoculated onto Balafilcon A and incubated for 24 hours followed by direct counting, phase contrast microscopy, and scanning electron microscopy. AC cysts were also inoculated onto Balafilcon A followed by counting using phase contrast microscopy.
: Adhesion of AC trophozoites to Lotrafilcon B and Balafilcon A was 10 times higher in comparison with the other 3 SHCLs. Twenty four-hour treatment of AC trophozoites with Epica Cold, Epica Cold Aquamore, ReNu MultiPlus, OptiFree Plus, and Complete DoubleMoist reduced the numbers of adherent AC to less than 25% of control, whereas the numbers of AC treated with Complete AminoMoist and C3 SoftOne Moist was about 50% and 75% of control, respectively. Normal AC trophozoites without any treatments showed 25 times higher adhesion rates compared with normal AC cysts.
: The adhesion rates of AC trophozoites to SHCL varied depending on the type of MPSs used. Appropriate uses of MPS could reduce adhesion rates of AC to SHCL and potentially decrease clinical rates of Acanthamoeba keratitis.
Cornea 06/2012; 31(10):1170-5. · 1.73 Impact Factor
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ABSTRACT: PURPOSE:: The aim of this study was to simulate the biofilm formation in contact lens (CL) case under poor hygiene behaviors; antimicrobial efficacies of multipurpose solutions (MPSs) against biofilm on the lens case were evaluated. METHODS:: Five MPSs (Epica Cold, Complete 10 min, ReNu MultiPlus, SoftOne Mois, and OPTI-FREE Plus) were tested. Lens cases containing ACUVUE2 were inoculated with 1×10, 10, or 10 colony-forming units (CFUs) of Staphylococcus epidermidis (SE). Each lens case was treated with 1 MPS for 4 hrs followed by the estimation of the number of SE by the CFU method. Disinfection efficacies of MPSs against SE biofilm were evaluated by biomicroscopy with safranin staining and scanning electron microscopy. RESULTS:: Lens cases, inoculated with 1×10 CFU, were disinfected by all MPSs. Epica Cold, Complete 10 min, ReNu MultiPlus, and OPTI-FREE showed almost a 2-log reduction of the CFU, whereas SoftOne Mois effect was almost a 1 log reduction, significantly lower than other MPSs (P<0.05). No biofilm formations were observed in Epica Cold, Complete 10 min, ReNu MultiPlus, and OPTI-FREE Plus-treated groups unlike significant biofilm formation in the SoftOne Mois-treated group (P<0.01). CONCLUSIONS:: Greater efforts to educate patients regarding compliant lens care behavior are needed to reduce the incidence of CL-associated microbial keratitis.
Eye & contact lens 06/2012;
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Kazumi Fukagawa,
Hiroshi Fujishima,
Atsuki Fukushima,
Tamaki Sumi,
Shigeki Okamoto,
Jun Shoji,
Yoshiyuki Satake,
Shigeaki Ohno,
Kenichi Namba,
Nobuyoshi Kitaichi, [......],
Naoki Kumagai,
Yuichi Uchino,
Miki Uchino,
Koichi Murayama,
Miki Sakata,
Eiichi Uchio,
Etsuko Takamura, Yuichi Ohashi,
Kimihiro Ohkubo,
Toshihiko Satoh
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ABSTRACT: To establish a specific quality of life (QOL) questionnaire for Japanese allergic conjunctival disease (ACD) (Japanese allergic conjunctival disease QOL questionnaire: JACQLQ).
A multicenter study was conducted in 521 patients with ACD and 127 healthy volunteers (total 648 cases). The JACQLQ ver. 0 was developed by modifying the Japanese rhino-conjunctivitis QOL questionnaire (JRQLQ). The participants were asked to complete the questionnaire, and objective scores were determined by an ophthalmologist using a slit lamp. To confirm validity, item and factor analyses were conducted and correlation coefficients were calculated.
The items were grouped into four subscales (Daily activity, Psychological well-being, Eye symptoms, Nasal symptoms) after factor analysis. The JACQLQ had good item-internal consistency (Cronbach's alpha: 0.846-0.934). QOL scores were correlated with eye itching, eye irritation and tearing. Objective scores were correlated with eye redness, eye itching and eye irritation. Face scores were correlated with eye itching, eye irritation and eye redness.
The JACQLQ is a useful tool for assessing disease specific QOL in ACD.
Nippon Ganka Gakkai zasshi 05/2012; 116(5):494-502.
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Jun Shojio,
Eiichi Uchio,
Nobuyuki Ebihara, Yuichi Ohashi,
Shigeaki Ohno,
Shigeki Okamoto,
Naoki Kumagai,
Yoshiyuki Satake,
Kenichi Namba,
Kazumi Fukagawa,
Atsuki Fukushima,
Hiroshi Fujishima,
Etsuko Takamura
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ABSTRACT: To evaluate the efficacy of subjective symptoms, objective findings, and of a total tear IgE test kit in the diagnosis of allergic conjunctival diseases (ACD).
The subjects were 223 patients with ACD, diagnosed according to the clinical practice guidelines for allergic conjunctival diseases in 28 medical facilities in Japan. The ACD patients were divided into the following five groups: 84 patients with seasonal allergic conjunctivitis (SAC), 52 patients with perennial allergic conjunctivitis (PAC), 41 patients with atopic keratoconjunctivitis (AKC), 38 patients with vernal keratoconjunctivitis (VKC) and 8 patients with giant papillary conjunctivitis (GPC). All cases were examined for clinical ACD, subjective symptoms, objective findings by the clinical score and by a total tear IgE test. An eosinophil examination by conjunctival smear was also performed in 87 ACD patients.
The most prevalent subjective symptoms were itching (81.6%) and hyperemia (77.6%). The clinical scores of the objective findings in the patients with SAC, PAC, AKC, VKC and GPC were 16.3 +/- 3.8 (mean +/- SD) points, 16.2 +/- 2.8, 19.8 +/- 6.5, 23.1 +/- 5.3, and 21.4 +/- 3.9, respectively. In the total tear IgE test 72.2% of the ACD patients were positive; i.e., the ratios were 61.9% in SAC, 65.4% in PAC, 80.5% in AKC, 94.7% in VKC, and 75.0% in GPC. In the examination of eosinophils in the 87 ACD patients, 42.5% (37 eyes) were positive, i.e., the ratio was 20.0% in SAC, 36.8% in PAC, 53.3% in AKC, 75.0% in VKC and 33.3% in GPC. The rate of agreement between the total tear IgE test and the examination of eosinophils was kappa = 0.28 (Cohen kappa coefficient).
Because of the high positive ratio in patients quasi-definitively diagnosed with ACD, we conclude that the total tear IgE test is useful as an auxiliary method for diagnosing ACD.
Nippon Ganka Gakkai zasshi 05/2012; 116(5):485-93.
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ABSTRACT: To compare disinfection by povidone-iodine (PI) solution with that by polyvinyl alcohol-iodine (PAI) solution in preoperative eyewash and to assess the optimal duration of the preoperative application of 0.5% levofloxacin (LVFX) ophthalmic solution.
Two-hundred-seventy-two elderly cataract patients who had undergone phacoemulsification aspiration with intraocular lens insertion at 12 clinical facilities in Japan were randomized into three groups: 3-day, 1-day, and 1-h preoperative application of 0.5% LVFX ophthalmic solution. Each LVFX group was further divided into two subgroups; the patients in one subgroup were treated with diluted PI eyewash, and those in the second subgroup with diluted PAI eyewash, immediately before the surgery. Thus, a total of six groups were studied. Conjunctival scrapings were collected four times: before LVFX application, after LVFX application, after the eyewash with iodine compounds, and after the surgery. Samples of the aqueous humor were collected immediately after the surgery. All samples were cultured aerobically and anaerobically.
The 3-day application of LVFX had a significantly higher disinfection rate than the 1-day or 1-h applications (P<0.05). The disinfection rate of PI was 78.0%, and that of PAI was 79.4%; PAI was not inferior to PI as a preoperative disinfectant. However, new isolates, mainly Propionibacterium acnes and Staphylococcus epidermidis, were detected after LVFX application and even after use of the eyewash with iodine compounds.
Three-day administration of LVFX ophthalmic solution and use of an eyewash with diluted iodine compounds is effective for preoperative disinfection. However, complete elimination of bacteria from the conjunctival sac is difficult.
Japanese Journal of Ophthalmology 04/2012; 52(3):151-61. · 0.92 Impact Factor
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Masahiko Fukuda,
Masakazu Yamada,
Shigeru Kinoshita,
Tsutomu Inatomi, Yuichi Ohashi,
Toshihiko Uno,
Jun Shimazaki,
Yoshiyuki Satake,
Naoyuki Maeda,
Yuichi Hori,
Kohji Nishida,
Akira Kubota,
Toru Nakazawa,
Yoshikazu Shimomura
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ABSTRACT: Achieving high antibiotic concentrations is important for preventing and treating postoperative infections. However, no study has simultaneously compared the achieved concentrations of moxifloxacin, gatifloxacin, and levofloxacin in the human cornea and aqueous humor. The authors therefore performed a randomized study to determine the concentrations of 0.5% moxifloxacin, 0.3% gatifloxacin, and 0.5% levofloxacin in the corneal tissue and aqueous humor after topical instillation in patients undergoing penetrating keratoplasty.
Patients who required penetrating keratoplasty were eligible for this study. The topical preparations of 0.5% moxifloxacin, 0.3% gatifloxacin, and 0.5% levofloxacin used in the study were preservative free (Japanese formulations). Patients were randomly assigned to one of three sequential drug groups, in which each drug was administered three times before surgery. In each administration cycle, the patients received two drops of each drug at 2-minute intervals. Samples of corneal tissue and aqueous humor were collected during surgery. The concentrations of each drug in the samples were determined by high-performance liquid chromatography.
A total of 63 patients across eight centers in Japan were enrolled in the study. Overall, 61 corneal and 58 aqueous humor samples were evaluated. The concentration (mean±standard deviation) of moxifloxacin in corneal tissues was 12.66±8.93 μg/g, which was significantly higher than that of gatifloxacin (4.71±3.39 μg/g; P<0.0001) and levofloxacin (5.95±4.02 μg/g; P<0.0001). The mean concentration of moxifloxacin in aqueous humor samples was 1.40±1.17 μg/mL, which was significantly higher than that of gatifloxacin (0.65±0.80 μg/mL; P=0.0001) and levofloxacin (0.89±0.86 μg/mL; P<0.05). The sequence of drug administration did not significantly affect the results.
These results show that 0.5% moxifloxacin achieved superior ocular concentration than both 0.3% gatifloxacin and 0.5% levofloxacin.
Advances in Therapy 04/2012; 29(4):339-49. · 2.11 Impact Factor
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ABSTRACT: To investigate the role played by epiregulin in corneal epithelial wound healing in vivo in epiregulin-knockout (KO) mice and cultured mouse corneal epithelial cells (MCECs).
A 2-mm diameter central epithelial wound was created in epiregulin-KO and wild-type (WT) mouse corneas. The size of the unhealed area and the epithelial cell proliferation and migration were examined. Myeloperoxidase assay was performed to determine the number of polymorphonuclear (PMN) cells infiltrating corneal stroma. Real-time PCR was used to determine expression of the mRNA of inflammatory cytokines in the corneal epithelial cells. Expression of chemokine (C-X-C motif) ligand 2 (CXCL2) response to IL-1β was examined in MCECs with or without recombinant mouse epiregulin. Repetitive injuries were created to determine the effect of inflammation in healing in epiregulin-KO mice.
After a single injury, corneal epithelial wound healing and cell migration and proliferation were unimpaired. However, corneal opacities and a larger number of infiltrating PMN cells were observed in epiregulin-KO mice. Expression levels of IL-1β, IL-6, CXCL1, and CXCL2 were higher in epiregulin-KO than in WT corneal epithelia cells. The addition of epiregulin significantly reduced the expression of CXCL2 in response to IL-1β in MCECs. In response to repetitive injuries, a significant delay in healing and more severe opacities were observed in epiregulin-KO mice than in WT mice.
Our results indicate that during wound healing, epiregulin may regulate the expression of cytokines and chemokines to reduce an excessive accumulation of PMN cells, which will cause corneal opacity and persistent epithelial defects.
Investigative ophthalmology & visual science 03/2012; 53(4):2414-23. · 3.43 Impact Factor
