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Biomedical subjects

I Claerhout

Publications and source records attributed to I Claerhout.

9 recordsLinked to original sources
PubMed2004

Delay in diagnosis and outcome of Acanthamoeba keratitis.

PURPOSE: To evaluate the outcome of Acanthamoeba keratitis with respect to the delay in diagnosis. METHODS: A retrospective review of the records of 14 patients treated for Acanthamoeba keratitis was carried out. Delay in diagnosis was correlated with risk factors, clinical presentation, method of diagnosis, final visual acuity and need for penetrating keratoplasty. RESULTS: Based on the time interval between the first symptoms and the diagnosis of Acanthamoeba keratitis, it appeared that patients could be divided into two groups: an early treatment group (group I), consisting of six patients treated within 18 days of onset of symptoms, and a late treatment group (group II), composed of eight patients treated beyond that time. There were no statistically significant differences between the two groups as far as risk factors, clinical presentation, accuracy of diagnosis and method of diagnosis were concerned, although more extensive and deeper corneal involvement was noted in group II. Improvement in visual acuity following medical therapy was seen in all six patients in the early group and in three (37%) of the eight patients in the late group. One patient in group I needed urgent penetrating keratoplasty for corneal necrosis. In group II, two patients underwent penetrating keratoplasty à chaud to prevent corneal perforation and three patients needed penetrating keratoplasty to restore functional visual acuity. CONCLUSION: A diagnostic delay of less than 18 days between onset of symptoms and start of anti-amoebic treatment results in a better final VA after medical treatment and obviates the need for urgent and elective penetrating keratoplasty.

Acanthamoeba Keratitis↗
PubMed2004

[Results of penetrating keratoplasty in syphilitic interstitial keratitis].

PURPOSE: To compare the results in our patient series after penetrating keratoplasty (PKP) for syphilitic interstitial keratitis (IK) with those described in the literature. METHODS: Retrospective case series in which visual acuity (VA), graft clarity, rejection episodes, intraocular pressure and endothelial cell density (ECD) were examined postoperatively. RESULTS: Postoperative VA improved in all cases. There was no evidence of wound dehiscense or occurrence of retrocorneal membrane formation in any case. Postoperative inflammation was not more severe in our patients with syphilitic IK compared to patients undergoing PKP for other reasons. A normal decline in ECD proved that there was no subclinical inflammation as well. CONCLUSION: PKP for syphilitic IK has a good prognosis in our case series as far as graft survival is concerned. Improvement in VA was present in all cases, though sometimes limited. In our case series, we experienced less postoperative complications than described in the older literature, which is probably due to better microsurgical techniques used nowadays.

Adult↗
PubMed2003

Results of penetrating keratoplasty in syphilitic interstitial keratitis.

PURPOSE: To compare the results in our patient series after penetrating keratoplasty (PKP) for syphilitic interstitial keratitis (IK) with those described in the literature. METHODS: Retrospective case series in which visual acuity (VA), graft clarity, rejection episodes, intraocular pressure and endothelial cell density (ECD) were examined postoperatively. RESULTS: Postoperative VA improved in all cases. There was no evidence of wound dehiscense or occurrence of retrocorneal membrane formation in any case. Postoperative inflammation was not more severe in our patients with syphilitic IK compared to patients undergoing PKP for other reasons. A normal decline in ECD proved that there was no subclinical inflammation as well. CONCLUSION: PKP for syphilitic IK has a good prognosis in our case series as far as graft survival is concerned. Improvement in VA was present in all cases, though sometimes limited. In our case series, we experienced less postoperative complications than described in the older literature, which is probably due to better microsurgical techniques used nowadays.

Adult↗
PubMed2001

The effect of duration and timing of systemic cyclosporine therapy on corneal allograft survival in a rat model.

BACKGROUND: Systemic cyclosporine A (CsA) remains a valuable treatment option in the prevention of corneal graft rejection, but the question of timing and duration of this systemic therapy remains unresolved. The effect of a pre- and postoperative dosing schedule, related to the expected moment of rejection, was examined in a rat model. METHODS: All AO (strain) recipients of PVG grafts were assigned to the following treatment groups: Group 1 (controls), groups 2-5 (a postoperative treatment regimen of CsA for 5, 10, 15 and 30 days respectively) and groups 6 and 7 (CsA preoperatively for 5 days and postoperatively for another 5 or 10 days respectively). Corneal allografts were clinically evaluated and blood CsA levels were measured at various time points. RESULTS: Untreated controls rejected their allografts after 13 days. Regression analysis showed a strongly significant positive correlation between graft survival time and duration of cyclosporine therapy. There was no difference in graft survival between groups 3 (CsA 10 days) and 4 (CsA 15 days). A pre-operative dosing schedule of CsA followed by postoperative treatment had no advantage over a solely postoperative treatment regimen. The moment of rejection was characterized by a low to undetectable CsA concentration. CONCLUSION: The present study demonstrates a significant influence of the duration of systemic CsA administration on allograft survival time. However, preoperative administration of CsA does not seem to have an additional influence on graft survival, which is in line with the biological evidence of the mechanism of action of CsA on the efferent arm of graft rejection.

Animals↗
PubMed2001

Bilateral corneal melting in a patient with paraneoplastic pemphigus.

An 80-year-old man, with a solid abdominal tumor and multiple skin lesions, was admitted to the hospital because of a perforated right cornea and an impending perforation of the left. The clinical, histological, immunohistological and immunoprecipitation findings of the skin lesions were consistent with Anhalt's criteria for paraneoplastic pemphigus (PNP). The underlying malignancy proved to be an incurable peripheral neuronal shaft tumor. Both conjunctivae appeared normal. The right eye revealed a flat anterior chamber, due to a spontaneous, central corneal perforation. The central part of the left cornea had severely thinned, resulting in a descemetocele, which eventually perforated. Multiple surgical interventions were needed to restore the anterior chamber in both eyes. Although a causative association between PNP and corneal perforation could not be demonstrated, we think that corneal melting should be added to the list of ocular complications in patients with PNP.

Abdominal Neoplasms↗
PubMed1999

Acanthamoeba keratitis: a review.

Acanthamoeba keratitis is caused by protozoa and characterised by a protracted course. All patients presenting with a therapy-resistant keratitis, even non-contact lens wearers, should be examined for the presence of Acanthamoeba by means of specific cultures, histopathological stainings and--if necessary--a corneal biopsy. The combination of clinical signs, such as excessive pain, a radial keratoneuritis and in a later phase a stromal ring infiltrate, together with a suggestive history (contact lenses, polluted water) is an important factor for the early diagnosis. Because of improved clinical detection and earlier diagnosis, the infection can often be controlled with a combination therapy of polyhexamethylene biguanide or chlorhexidine with propamidine and neomycine. This results in a better visual prognosis and a decreased need for therapeutic keratoplasty.

Acanthamoeba Keratitis↗