Organ donation from intensive care units.
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Cornea↗
Biomedical subjects
A B Tullo
Publications and source records attributed to A B Tullo.
Corneal autoimmunity in patients with peripheral ulcerative keratitis (PUK) in association with rheumatoid arthritis and Wegener's granulomatosis.
Serum antibodies to the cornea were investigated in patients with peripheral ulcerative keratitis (PUK) in isolation or in association with a systemic disease (rheumatoid arthritis or Wegener's granulomatosis). Indirect immunofluorescence on bovine corneal sections demonstrated that antibodies bound to epithelial antigens in two distinct patterns: a lattice-like pattern, probably staining intercellular membrane antigens, and a diffuse pattern covering the entire surface of the epithelium. Both patterns were associated with PUK rather than systemic disease whilst the presence of the lattice pattern was more associated with the onset of the PUK. Immunoblotting of sera to corneal epithelial protein extracts demonstrated that a number of corneal antigens were targeted by antibodies. Two antigens, 54 kDa and 70 kDa, were of particular interest. Antibodies to the 54 kDa antigen, the major corneal-specific antigen, were also detected by enzyme-linked immunosorbent assay (ELISA). Longitudinal studies showed that these antibodies often first occurred after an episode of PUK. Antibodies to the 70 kDa antigen were related to the Wegener's granulomatosis rather than the PUK.
Adult↗
An immune dot-blot test for the diagnosis of ocular infection with Chlamydia trachomatis.
We report a new simple non culture technique for the diagnosis of chlamydial eye disease. The immune dot-blot test (IDBT) detects chlamydial lipopolysaccharide (LPS) antigen which, after being trapped on nitrocellulose membrane, is detected by autoradiography with 125I-labelled genus specific monoclonal antibody. This test was evaluated over a two year period in adults and neonates, by comparing it to culture, serological detection of chlamydial antibodies and clinical features. We demonstrate that the IDBT is more than twice as sensitive as culture, and suggest that in order to achieve a reliable diagnosis of chlamydial eye infection an immunological test for chlamydial antigen should be used in preference to tests which detect the organisms themselves.
Adolescent↗
Herpes virus in a corneal donor.
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Adult↗
Macular corneal dystrophy: the macromolecular structure of the stroma observed using electron microscopy and synchrotron X-ray diffraction.
The distribution of sulphated proteoglycans within the stromas of three patients (A,B,C) suffering from macular corneal dystrophy was studied using the specific dye Cuprolinic Blue in a 'critical electrolyte concentration' method. The corneas were examined using transmission electron microscopy and A and C were further studied by low-angle synchroton X-ray diffraction. Sera from all three patients were analyzed for the presence of keratan sulphate using a monoclonal antibody in an enzyme-linked immunosorbent assay. The serum from Patient A contained keratan sulphate, but the chains were thought to be shorter or less sulphate in their sera. Electron microscopy showed many electron-transparent lacunae randomly distributed throughout the specimens. The average collagen fibril diameter was normal but there were differences in packing between the specimens. Specimen A was closely-packed with most collagen fibrils in contact with their neighbours. Specimens B and C showed fewer regions of close packing; in most of the tissue the interfibrillar spacing appeared normal. Staining with Cuprolinic Blue revealed an unusual distribution of proteoglycans in some parts of the interfibrillar matrix, particularly in A, with 'small' proteoglycans running exclusively parallel to the collagen fibrils. Furthermore in A, and to a lesser extent in B and C, some lacunae were filled with clusters of abnormal sulphated proteoglycan filaments (of various sizes) which were chondroitinase ABC susceptible. Clearly defined regions, both within the lacunae and elsewhere, failed to stain with Cuprolinic Blue; this suggests an absence of sulphated proteoglycans within these areas. Equatorial X-ray diffraction of the wet tissues (A and C) gave values for the mean interfibrillar centre-to-centre separation of 43 +/- 2 nm in Specimen A and 52 +/- 3 nm in Specimen C. The differences observed in the serum keratan sulphate levels, the packing of the collagen fibrils and the distribution of chondroitin/dermatan sulphate proteoglycans confirm the heterogeneity that exists within the macular corneal dystrophies.
Chondroitin Sulfates↗
Arborescent bacterial keratopathy (infectious crystalline keratopathy).
Bacterial colonisation of the cornea is described in two cases, one bilateral. Discreet, white, branching opacities are produced without associated inflammation. It is suggested that due to its aetiology "arborescent bacterial keratopathy" is a better name for this condition than "infectious crystalline keratopathy".
Administration, Topical↗
Secondary lens implantation: incidence, indications and complications.
A retrospective study of 79 secondary intraocular lens implants performed during 1984-87 in a large teaching hospital is reported. The period of follow-up ranged from 6 months to 3.9 years (mean 16.6 months). The principal indication for surgery was contact lens intolerance. Thirty-four per cent of the patients had previously undergone cataract surgery with implantation of the other eye. Eighty-three per cent of the patients achieved a visual acuity within one Snellen line of best-corrected preoperative visual acuity. A further 2.5% lost two lines of Snellen chart acuity, and 14.5% had a substantial reduction in visual acuity. We conclude that in carefully selected patients secondary intraocular lens implantation is an acceptable and often highly successful way of treating monocular aphakia and we discuss the selection and preoperative investigation of such patients.
Adolescent↗
Corneal sensation in acute angle closure glaucoma.
Corneal sensation was found to be decreased in eyes affected by acute angle closure glaucoma. In those patients with a short history (less than four days) the difference in sensation between the two eyes was only detectable using the Cochet-Bonnet aesthesiometer and not by using cotton wool. Patients with a longer history had a more marked decrease in corneal sensation that was detectable by both methods. Corneal sensation in both groups tended to recover partially on normalization of the intraocular pressure.
Acute Disease↗
Lamellar macular hole associated with idiopathic juxtafoveolar telangiectasia.
A case of juxtafoveolar telangiectasia complicated by lamellar, retinal hole is reported and the pathogenesis discussed. This association is not commonly recognised.
Adult↗
Histopathology of adenovirus type 8 keratitis.
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Adenoviridae Infections↗
Traumatic myopia; an ultrasonographic and clinical study.
Three patients with transient myopia following blunt injury are described with the aid of serial ultrasonography. The cause of refractive change is an increase in the anteroposterior thickness of the crystalline lens, which probably results from oedema of the ciliary body.
Adolescent↗
Analysis of glycoproteins expressed by isolates of herpes simplex virus causing different forms of keratitis in man.
An in vitro analysis of glycoprotein produced by nine human ocular isolates of HSV-1 is reported. The source of the isolates was; three patients with recurrent dendritic keratitis, three with chronic stromal disease and three with primary keratoconjunctivitis. Virus strains were labelled with the radioactive precursors (35S) methionine and (14C) glucosamine. Radiolabelled viral glycoproteins were subsequently analysed by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE), followed by autoradiography. Viral glycoproteins were further characterised by immuno-precipitation with polyclonal and monoclonal antibodies to HSV. The stromal isolates excrete larger amounts of 'soluble' precursor glycoprotein D than those in the other two disease categories. It is possible that the immune response to glycoprotein D is in part responsible for the severity of stromal disease.
Electrophoresis, Polyacrylamide Gel↗
Severe eye injuries in cricket.
We report five cases of severe eye injury sustained in cricket, including retinal detachment and rupture of the globe. The eye is at particular risk from a rising ball. We comment on the need for appropriate facial protection for batsmen and close fielders.
Adolescent↗
Herpesvirus simplex in chronic human stromal keratitis.
A method is described for the isolation of Herpesvirus simplex (HSV) from corneal discs of patients suffering from chronic stromal keratitis. The discs were removed during penetrating keratoplasty. Virus was successfully isolated from 2 out of 8 discs maintained in vitro.
Cornea↗
Endophthalmitis and bacterial endocarditis.
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Adult↗
More corneal grafts.
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Corneal Transplantation↗