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Biomedical subjects

L M Collum

Publications and source records attributed to L M Collum.

At least 19 recordsLinked to original sources

Quantification of the ultraviolet radiation (UVR) field in the human eye in vivo using novel instrumentation and the potential benefits of UVR blocking hydrogel contact lens.

BACKGROUND/AIMS: Certain degenerative eye conditions occur predominantly nasally, at the limbal region, and are associated with solar ultraviolet radiation (UVR) induced damage. The relative contribution to the in vivo ocular flux of (a) the reflection of UVR incident on the skin of the nose onto the nasal limbus, and (b) the focusing of UVR incident on the temporal side of the cornea onto the nasal limbus were examined. METHODS: A novel photodiode sensor array was used to measure the UVR field across the eye. In addition, a novel spectrometer set-up was used to measure the spectrum of radiation refracted across the cornea. The efficacy of UVR blocking hydrogel contact lenses in filtering incident UVR was assessed in vivo. RESULTS: Qualitative and quantitative data indicated an increase nasally of UVR. Photodiode readings showed a net UVR increase from the temporal to the nasal side. Transmission curves showed that most UVR incident on the limbal region is either absorbed by, or transmitted through, the ocular tissues. This radiation is filtered by UVR blocking soft contact lens. CONCLUSIONS: An increased UVR flux on the nasal side of the eye, due to reflection off the nasal skin, was identified in vivo. Any UVR passing through the cornea is either absorbed by the conjunctiva and/or transmitted through it onto the sclera where it is absorbed. UVR blocking hydrogel contact lenses can eliminate these sources of UVR.

Contact Lenses, Hydrophilic↗

Immune-mediated corneal melting disease.

Corneal melting disease is, as illustrated, a very severe problem for patients. Correct diagnosis and aggressive management is critical. Help from general physicians and rheumatologists as required is essential, given that the medications used have significant toxic effects.

Arthritis, Rheumatoid↗

Localization of the gene for autosomal recessive congenital hereditary endothelial dystrophy (CHED2) to chromosome 20 by homozygosity mapping.

Congenital hereditary endothelial dystrophy (CHED) is a corneal disorder that presents with diffuse bilateral corneal clouding. Vision may be severely impaired, and many patients require corneal transplantation. Both autosomal dominant (AD) and autosomal recessive (AR) forms of the disorder have been described. The gene responsible for AD CHED (HGMW-approved symbol CHED1) has been mapped to the pericentromeric region of chromosome 20. Investigating a large, consanguineous Irish pedigree with autosomal recessive CHED, we have previously excluded linkage to this AD CHED locus. We now describe a genome-wide search using homozygosity mapping and DNA pooling. Evidence of linkage to chromosome 20p was demonstrated with a maximum lod score of 9.30 at a recombination fraction of 0.0 using microsatellite marker D20S482. A region of homozygosity in all affected individuals was identified, narrowing the disease gene locus to an 8-cM region flanked by markers D20S113 and D20S882. This AR CHED (HGMW-approved symbol CHED2) disease gene locus is physically and genetically distinct from the AD CHED locus.

Chromosome Mapping↗

Vernal keratoconjunctivitis.

Vernal keratoconjunctivitis therefore, if managed properly, can be controlled. Inaccurate diagnosis or staging of the disease, together with inaccurate treatment will however, result in changes which can jeopardize sight and may even necessitate corneal surgery at a later date.

Conjunctivitis, Allergic↗

Homozygosity mapping and linkage analysis demonstrate that autosomal recessive congenital hereditary endothelial dystrophy (CHED) and autosomal dominant CHED are genetically distinct.

BACKGROUND: Congenital hereditary endothelial dystrophy (CHED) is a corneal dystrophy characterised by diffuse bilateral corneal clouding resulting in impaired vision. It is inherited in either an autosomal dominant (AD) or autosomal recessive (AR) manner. The AD form of CHED has been mapped to the pericentromeric region of chromosome 20. Another endothelial dystrophy, posterior polymorphous dystrophy (PPM), has been linked to a larger but overlapping region on chromosome 20. A large, Irish, consanguineous family with AR CHED was investigated to determine if there was linkage to this region. METHODS: The technique of linkage analysis with polymorphic microsatellite markers amplified by polymerase chain reaction (PCR) was used. In addition, a DNA pooling approach to homozygosity mapping was employed to demonstrate the efficiency of this method. RESULTS: Conventional genetic analysis in addition to a pooled DNA strategy excludes linkage of AR CHED to the AD CHED and larger PPMD loci. CONCLUSION: This demonstrates that AR CHED is genetically distinct from AD CHED and PPMD.

Chromosome Mapping↗

Randomised trial of ganciclovir and acyclovir in the treatment of herpes simplex dendritic keratitis: a multicentre study.

AIMS: This study was designed to assess the relative efficacy of topical ganciclovir 0.15% gel and acyclovir 3% ointment in the treatment of herpes simplex dendritic keratitis. METHODS: Both treatment modalities were administered on a five times daily basis to patients suffering from herpes simplex keratitis. Patients were assigned randomly to one of the two treatment groups for the purpose of the trial. They were then examined on days 2, 7, 10, and 14 to assess the rate of healing of the dendritic ulceration. RESULTS: There was no statistically significant difference detected in the rate of healing between the two treatment groups over the course of the trial. CONCLUSIONS: Review of the relative efficacy of topical ganciclovir and acyclovir in the treatment of herpes simplex dendritic keratitis showed that both treatment modalities were equally effective in their ability to heal the viral induced corneal ulceration. There were no significant side effects or adverse effects reported for either treatment modality.

Acyclovir↗

Association of HLA type with pseudoexfoliation of the lens capsule.

AIMS/BACKGROUND: To identify an HLA association with pseudoexfoliation of the lens capsule to support the hypothesis that there is a genetic predisposition to pseudoexfoliation. A randomised trial would be ideal for establishing a relation but is more costly and time consuming to conduct. Case-control studies provide an alternative method of establishing a relation. METHODS: The study group comprised 128 subjects who presented to a major eye centre with pseudoexfoliation. Data from blood donors representative of the population of Ireland were used to form a control group. RESULTS: An HLA association with pseudoexfoliation is identified for 14 antigens. Eleven antigens (HLA A1, A33, B8, B47, B51, B53, B57, B62, DR3, DR12, and DR13) are significantly more common in the pseudoexfoliation group while three antigens (HLA B12, B17, and DR2) are significantly less common. Four HLA antigens are strongly associated, with odds ratios of over 7.5. CONCLUSION: The strength of this HLA association is supportive evidence for a genetic component to the development of pseudoexfoliation of the lens capsule.

Adolescent↗

Adherence of human lens epithelial cells to conventional poly(methyl methacrylate), heparin-surface-modified, and polyHema lenses.

We developed an in vitro model to assess the adherence of human lens epithelial cells to three types of intraocular lenses: poly(methyl methacrylate) (PMMA), heparin-surface-modified PMMA (HSM-PMMA), and polyHema. Lenses were incubated with a fixed number of human lens epithelial cells. Adherent cells were counted after 72 hours in culture. Scanning electron microscopy showed significantly fewer cells adhering to the HSM-PMMA and polyHema lenses than to the PMMA lenses (P < .01). Repeat experiments on cell lines established from different donors confirmed these findings.

Cell Adhesion↗

Daunomycin as an inhibitor of human lens epithelial cell proliferation in culture.

Posterior capsule opacification is still a major complication of both extracapsular cataract extraction and phacoemulsification. We evaluated the effects of the anti-proliferative agent daunomycin on cultured human and bovine lens epithelial cell viability and proliferation. After ten minutes of exposure, low concentrations of the agent markedly inhibited the proliferation of both cell types. The calculated LD50 for the drug against human cells was 2.20 micrograms/ml and against the bovine cells was 0.38 microgram/ml. The bovine cells appeared to be slightly more susceptible to the drug's effects, although this difference was not marked. Our results indicate that daunomycin is a potent inhibitor of both human and bovine lens epithelial cells in the laboratory.

Animals↗

Effect of topical cyclosporin A on conjunctival T cells in patients with secondary Sjögren's syndrome.

The effect of topical cyclosporin A on conjunctival T cells was studied in nine patients with secondary Sjögren's disease. Patients had conjunctival biopsies performed before and after a 6-week course of topical cyclosporin. Epithelium and substantia propria in the Sjögren's patients before treatment showed significantly more CD4+ cells than specimens taken from nine age- and sex-matched controls. Following treatment with topical cyclosporin, there was a significant reduction in the number of CD4+ cells in both the conjunctival epithelium and substantia propria. Despite the fact that the treatment resulted in immunopathological improvement, the clinical benefit was not as favorable. Our results suggest that topical cyclosporin may have a local immunosuppressive effect on the conjunctiva in patients with Sjögren's disease.

Administration, Topical↗

Twice daily 4% Sodium Cromoglycate vs. 2% Sodium Cromoglycate used four times daily in seasonal (grass pollen) allergic conjunctivitis.

It is well established that 2% Sodium Cromoglycate is an effective treatment for a number of allergic eye diseases. It has been shown to be non-toxic. It can be used longterm and in serious allergic problems it is a useful adjunctive therapy to steroids. The main problem with Sodium Cromoglycate is that the recommended dosage is a four times daily application and patient non-compliance is common. One of the main objectives of any therapy is to reduce the frequency of dosage and the current study has been designed to investigate the efficacy of a 4% solution of Sodium Cromoglycate, used twice daily, versus a 2% solution used four times daily in seasonal allergic conjunctivitis. A multicentre study, therefore, was carried out to assess the efficacy of both drugs and to assess any possibility of side effects. In addition, a unit dose was used, thus eliminating preservatives and it was used specifically in seasonal allergic conjunctivitis in the pollen season. This study showed that 4% Sodium Cromoglycate used twice daily was at least as affective as 2% Sodium Cromoglycate used four times daily.

Adolescent↗

The current management of herpetic eye disease.

Herpes simplex disciform keratitis is a difficult condition. The general feeling is that it is an immune disease, mediated by the virus, possibly located in the endothelial cells. It is frequently combined with inflammation in the trabecular meshwork and with uveitis. There is some controversy in relation to treatment and it has been suggested that anti-virals will control herpetic disciform keratitis, particularly if the patient has never had steroids previously. The authors of this paper have, in the past, published data which showed that Acyclovir, with corticosteroid, was necessary in the management of disciform keratitis. The data suggested that Acyclovir on its own was not effective. It remained to be answered whether Acyclovir on its own would be effective in patients who never had steroids for any reason previously. This paper demonstrates clearly that it is necessary, irrespective of whether patients have had steroids in the past or not, to combine corticosteroids with Acyclovir in the management of herpetic disciform keratitis. Acyclovir, on its own, is shown to be ineffective. It has also been suggested that Acyclovir is non-toxic. In a general way this is true, but the authors suggest that Acyclovir ointment does produce a punctate keratitis in patients with tear film disease, and that oral Acyclovir is preferable in such patients.

Acyclovir↗

Acyclovir ointment plus topical betamethasone or placebo in first episode disciform keratitis.

Thirty patients with first episode disciform keratitis and with no previous steroid exposure were randomly assigned to double blind treatment with 3% acyclovir ointment and 0.1% betamethasone (Betnesol) drops or acyclovir ointment and matching placebo. In the steroid group 14 of the 15 patients healed in a mean time of 21.8 days. In the placebo group eight of the 13 patients healed in a mean time of 34.5 days. The difference in mean healing time between the two groups was significant (p < 0.05). The cumulative rate of healing was also quicker in the steroid group when compared with the placebo group (p < 0.001). Other clinical parameters improved more favourably in the combination treatment group. Four patients, two in either group, experienced a mild transient punctate epitheliopathy, but no other serious adverse effects were noted. There has been no significant difference in the recurrence rate between the two groups after a mean follow-up period of approximately 3 years.

Acyclovir↗

Electron microscopic appearances of human corneal endothelium following Nd:YAG laser iridotomy.

We looked at the electron microscopic appearances of the corneal endothelium following neodymium:YAG (Nd:YAG) laser iridotomy in a patient with a shallow anterior chamber. An area of denuded endothelial cells approximately 500 microns in diameter was produced when no contact lens was used. The area of cell loss was reduced by approximately 50% when an Abraham YAG goniolens was used. We conclude that the use of a positive plus contact lens can help minimize cell loss following Nd:YAG laser iridotomy.

Adult↗

Randomised double-blind trial of bromovinyldeoxyuridine (BVDU) and trifluorothymidine (TFT) in dendritic corneal ulceration.

The results of a randomised double-blind clinical trial of 0.1% bromovinyldeoxyuridine (BVDU) and 1% trifluorothymidine (TFT) in 60 patients with corneal dendritic ulceration are presented. There was no significant difference between BVDU and TFT in terms of numbers of ulcers healed (p = 0.61), mean healing time (p = 0.065), and cumulative healing rate (p = 0.058). No serious side effects were observed, though transient stinging was recorded in five patients receiving TFT and in three patients receiving BVDU. One patient in the group treated with TFT developed a punctate epitheliopathy.

Adolescent↗

Bromovinyldeoxyuridine (BVDU) and trifluorothymidine (TFT) in dendritic corneal ulceration: a double blind controlled study.

Fifty patients with corneal dendritic ulceration were randomly entered into a double blind clinical trial comparing BVDU eyedrops with TFT eyedrops. Of those receiving TFT 100% healed in a mean time of 6.7 days, while 92% of those receiving BVDU healed in a mean time of 8.7 days. There was no statistical difference between the two groups in terms of numbers healed, but BVDU was significantly slower in terms of days to heal. After a mean follow-up period of 7.5 months there has been one recurrence in each group.

Administration, Topical↗