Severe keratopathy in paediatric Cogan's syndrome.
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Autoimmune Diseases↗
Biomedical subjects
M Calonge
Publications and source records attributed to M Calonge.
[Ocular Behçet disease. Retrospective study].
OBJECTIVE: To study clinical features, visual prognosis and response to immunosuppressive drugs in patients with ocular Behçet Disease (BD). PATIENTS AND METHODS: clinical data of 17 patients (33 eyes) were retrospectively reviewed from May 1996 to May 2003. RESULTS: The male/female ratio was 12/5. The commonest manifestations were oral ulceration (100%) and skin lesions (88%). Anterior uveitis was present in 59%, posterior uveitis was in 76% and panuveitis was in 88.1%. Visual acuity improved in 11 (33.3%) eyes, remind stable in 18 (54.5%) eyes and four (12.1%) eyes lost two or more lines. Main drug therapy consisted of colchicine and cyclosporine (59%). Seven patients had received three drugs simultaneously. CONCLUSIONS: BD can lead to an irreversible visual loss; however, the visual prognosis is good (85%) if immunosuppressor treatment is implemented.
Adolescent↗
Levels of mucin gene expression in normal human conjunctival epithelium in vivo.
PURPOSE: Conjunctival impression cytology (CIC) samples were used to determine the mean and normal range of mRNA levels of human MUC1, MUC2, MUC4, MUC5AC, and MUC7 mucin genes. METHODS: Real time PCR was performed to determine normal mRNA levels in CIC samples of 24 male and 19 female healthy donors. Correlation coefficients between gene expression levels were obtained. RESULTS: All five mucin genes were expressed in the CIC samples. MUC1 and MUC4 were present at the highest level and MUC2 was at the lowest. There were no gender differences. Significant positive correlations existed between MUC2 and MUC4 and between MUC2 and MUC7 levels. CONCLUSIONS: Normal levels and ranges of mRNAs for MUC1, MUC2, MUC4, MUC5AC and MUC7 conjunctival mucin genes have been established for the first time. These data may serve as the normal threshold values for future comparisons in different experimental and pathological conditions involving the ocular surface.
Adult↗
[Normal human conjunctival epithelium expresses MUC13, MUC15, MUC16 and MUC17 mucin genes].
PURPOSE: The ocular surface epithelia express at least five mucin genes of the total of 17 human mucin genes that have been identified so far. This study was designed to determine the expression profile of mucin genes in conjunctival impression cytology (CIC) samples from healthy subjects. METHODS: Two polyethersulfone filters were applied to the superior conjunctiva of both eyes from eight healthy donors. Polymerase chain reaction (PCR) was performed using isolated and retrotranscripted total RNA obtained from the CIC samples to study the expression of all known human mucin genes. Following amplification, PCR products were electrophoresed on 1.5% agarose gel and stained with ethidium bromide to confirm that only a single band was obtained when amplifying all cDNAs with the convenient primers. RESULTS: Transcripts of the previously reported conjunctival mucin genes MUC1, MUC2, MUC4, MUC5AC, and MUC7 were detected in all samples. In addition, transcripts of MUC13, MUC15, MUC16 and MUC17 mucin genes also were detected. Amplified products by conventional PCR showed the expected amplicon size. Transcripts of MUC3A, MUC3B, MUC5B, MUC6, MUC8, MUC11, and MUC12 mucin genes were not detected. CONCLUSION: The expression of four additional mucin mRNA (MUC13, MUC15, MUC16, and MUC17) has been proved in human conjunctival epithelium from healthy donors for the first time. The function of these genes remains to be further elucidated.
Adolescent↗
[Dry eye syndrome: is there any hope for a curative therapy?].
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Anti-Inflammatory Agents↗
The treatment of dry eye.
The most widely used therapy for dry eye disease is tear replacement by topical artificial tears. Punctal occlusion to prevent the drainage of natural or artificial tears is the most common non-pharmacological treatment. These and other traditional therapies for dry eye disease are only palliative, however, as they replace or conserve the tears without necessarily correcting the underlying disease process. As our understanding of the pathology of dry eye disease improves, new treatment strategies are being developed. Topical anti-inflammatory and immunomodulatory agents, such as cyclosporin A, are under investigation in the treatment of dry eye, as it is anticipated that they will correct the vicious cycle of inflammation and cell damage on the ocular surface and lacrimal glands.
Dry Eye Syndromes↗
Pars planitis: epidemiology, treatment, and association with multiple sclerosis.
During retrospective and prospective studies, we attempted to determine the clinical characteristics, treatment, and visual outcome of patients with pars planitis and to evaluate the association between pars planitis and multiple sclerosis (MS). The retrospective study included 44 patients with pars planitis, who had been examined between October 1986 and January 1999. We analyzed age, sex, visual acuity (VA), median follow-up time, and medical and surgical treatments. The prospective study, which included 21 consecutive patients with pars planitis, was performed to determine the presence of MS. In the retrospective study, the mean patient age was 22.4 years (SD +/- 11.5) and the median follow-up was 34.9 months (SD +/- 27.2). Complications included macular edema (47.7%), vitreous opacities (38.6%), papillitis (38.6%), vasculitis (36.4%), and cataract (20.5%). Forty patients (90.9%) had a final bilateral VA better than 20/40. In the prospective study, magnetic resonance imaging (MRI) was performed. Demyelinating lesions were found in 10 (47.6%) of the 21 patients and relapsing-remitting clinically definite MS was diagnosed in seven (33.3%). With the exception of age, no significantly statistical differences were observed when the visual prognosis and the clinical and epidemiologic characteristics were compared between the two groups of patients with and without associated MS; a diagnosis of MS was more frequently made in patients over 25 years of age. With appropriate treatment, patients with pars planitis have a good visual prognosis. Because the presence of demyelinating lesions seems to be high among patients with pars planitis, MRI should be considered, especially in patients over 25 years of age.
Adolescent↗
Fuchs' heterochromic iridocyclitis: a review of 26 cases.
UNLABELLED: Fuchs' heterochromic iridocyclitis (FHI), an unusual form of uveitis of unknown etiology, is frequently misdiagnosed. PURPOSE: To report the analysis of 26 patients (27 eyes) with FHI who were diagnosed and observed over a period of 1-7 years (mean: 3.42 +/- 2.2 years). METHODS: Ocular and systemic examinations were performed on all patients. RESULTS: The most common presenting symptom was visual deterioration (42.3%); one patient was affected bilaterally. Characteristic keratic precipitates (100%), cataracts (77.8%), and heterochromia (70.4%) were the major signs. Eleven eyes (40.7%) required cataract surgery. At the initial examination, four eyes (14.8%) had glaucoma, and no new cases of glaucoma developed during the follow-up period. One eye required filtration surgery. Vitrectomy was performed in two eyes (7.4%) because of vitreous opacities. Most patients (73.0%) did not require active treatment; pre- and postoperative anti-inflammatory treatment for cataract extraction was performed successfully to minimize the risk of inflammation. No severe uveitis was seen in any patient after surgery, but visual acuity did not improve greatly after cataract extraction; 54.5% eyes had visual acuity better than 20/40 before surgery, and 45.4% postoperatively. CONCLUSION: Posterior capsule opacification, glaucoma, and vitreous opacity were the major obstacles to visual rehabilitation after cataract surgery in patients with this type of uveitis.
Adolescent↗
[Usefulness of conjunctival biopsy as diagnostic technique].
PURPOSE: The conjuctival biopsy is described as a useful technique in the diagnosis of some chronic conjunctivitis, with low specific signs and with poor response to the conventional treatment. Furthermore it is quite important in the diagnosis of conjunctival diseases with potential dangerous treatment. PATIENTS AND METHODS: Three clinical cases are described. Case 1: A 37 years old woman with a chronic lesion of conjuctiva and the suspicion of blepharoconjunctivitis. There was no improvement with treatment. Case 2: A 58 years old woman with a chronic conjunctivitis and follicular reaction. Case 3: A 66 years old man who suffers from a cicatricial conjunctivis in both eyes with corneal lesion in one eye. A conjunctival biopsy was perfomed and studied under light microscopy and immunohistochemistry. There is a description of the technique. RESULTS: The results of every clinical case are described. In the first case the biopsy established the diagnosis of conjunctival lymphoma. In the second, the biopsy showed the appearance of granulomas and a diagnosis of conjunctival sarcoidosis was performed. In the third case a diagnosis of ocular cicatricial pemphigoid was established. CONCLUSION: Conjunctival biopsy is a useful and effective technique in the diagnosis of chronic conjunctivitis.
Adult↗
[Acute macular neuroretinopathy: a case report].
CASE REPORT: A 68 year old woman developed a sudden decrease in her visual acuity in both eyes with several central scotomas. Funduscopy demonstrated a motted alteration of the retinal pigment epithelium in both maculae. The fluorescein angiography showed a choroidal ischemia at the macular level in both eyes. DISCUSSION: The patient was diagnosed of acute macular neuroretinopathy. This entity is included among the so-called < >. However, it is important to determine which of these diseases each patient suffers in order to determine if treatment is necessary, the visual prognosis and the possibility of recurrences.
Acute Disease↗
[In vitro toxicity of non-preserved artificial-tear formulations].
PURPOSE: To analyse the putative toxic effect of three commercially available non-preserved artificial tear formulations on in vitro human conjunctival cells. MATERIAL AND METHOD: A conjunctival human epithelial cell line was exposed to Cellufresh, Oculotect and Acuolens formulations during 1, 3 and 24 hours. Cytotoxicity was measured by calculating the percentage of cell viability examination and scanning electron microscopy (SEM). Controls underwent exposure to supplement free DMEM-F12 (negative control) and exposure to 0.005% benzalkonium chloride solution (positive control). RESULTS: Cell viability after 1 or 3 hours incubation with Cellufresh and Oculotect was similar to that obtained for negative controls. With Acuolens incubation however, cell viability showed significant reduction after 3 and 24 hours compared to control. SEM showed that Cellufresh and Oculotect exposed cells presented similar behavior to control cells. All three cell lines presented evidence of cellular surface alteration after incubation for 1 or 3 hours compared to controls, Acuolens showing the highest rate of alterations in exposed cells and an additional increment in cell loss was observed. CONCLUSION: In the present study, non preserved artificial tears formulations showed a different degree in their in vitro toxicity, Acuolens being more toxic than Cellufresh or Oculotect.
Cell Survival↗
Ocular allergies: association with immune dermatitis.
PURPOSE: To describe the type of skin involvement that patients with ocular allergies are prone to suffer due to the atopic association of the condition. METHODS: Review of the published literature and retrospective data from our patient series. RESULTS: Patients with ocular allergies may have skin affected with one or several combinations of the following dermatologic problems: contact dermatitis, urticaria/angioedema, and atopic dermatitis, with secondary infections as a possible consequence of this later disorder. Other rare skin disorders have been occasionally reported in association with ocular atopy. CONCLUSION: Patients with ocular allergies may have a spectrum of 'allergic' skin problems, the most severe of which is atopic dermatitis. Ocular surface involvement in atopic dermatitis should be diagnosed as atopic keratoconjunctivitis, a sight-threatening disorder, until proven otherwise.
Angioedema↗
Classification of ocular atopic/allergic disorders and conditions: an unsolved problem.
PURPOSE: To review the different classifications of ocular allergic diseases and to define the most suitable one according to the current understanding of the pathophysiology and clinical course of these disorders. METHODS: Review of the major published ocular allergy classifications. RESULTS: Based on past and present classifications, the author proposes the following classification: 1. allergic conjunctivitis (acute and chronic); 2. giant papillary conjunctivitis; 3. vernal keratoconjunctivitis; and 4. atopic keratoconjunctivitis. In addition, use of the term "allergic conjunctivitis" as a synonym for all ocular allergic disease is discouraged. CONCLUSION: The proposed classification for ocular allergic disorders intends to unify the present criteria and to serve as an initial forum of discussion. This should enhance a common understanding among and between ophthalmologists and other allergy specialists. Constructive criticism of this classification system is required for further improvement.
Conjunctivitis, Allergic↗
Efficacy of topical cyclosporine-loaded nanocapsules on keratoplasty rejection in the rat.
PURPOSE: To evaluate the efficacy of a topical formulation of nanocapsules loaded with 1% cyclosporine A (CsA), which has been previously demonstrated to enhance CsA corneal penetration, compared to 1% CsA in migliol oil on a penetrating keratoplasty rejection model in the rat. METHODS: Lewis rats received orthotopic corneal allografts from inbred Fisher donors. Rats were treated with 10 microliters of the following topical solutions four times daily for 30 days, starting one day before surgery: Group 1 (n = 9), 1% CsA-loaded nanocapsules; group 2 (n = 13), 1% CsA dissolved in migliol oil; group 3 (n = 12), migliol oil; group 4 (n = 13), no treatment. Rejection index, mean survival time and rejection percentage were calculated for each group, and CsA levels in blood were measured. RESULTS: The rejection percentage was 84.6% for group 2, 91.7% for group 3, and 100% for groups 1 and 4, with no significant differences among groups. Mean graft survival time was 7.3 days for group 1, 15.5 days for group 2, 8.36 days for group 3, and 7.69 days for group 4, with significant differences between group 2 and the other groups. Systemic CsA levels were only detectable in group 2. CONCLUSIONS: CsA formulated in migliol oil delayed corneal rejection onset, but blood levels were evident in this group. CsA loaded-nanocapsules showed no effect on rejection and the drug was not detectable in blood. These data, along with the current concepts on corneal graft rejection immunology, suggest that the immunomodulatory effect of topical CsA in the prevention of corneal graft rejection may be systemically-mediated.
Administration, Topical↗
Expression of ICAM-1 and HLA-DR by human conjunctival epithelial cultured cells and modulation by nedocromil sodium.
It is unclear whether conjunctival epithelial cells participate in the development of immune-mediated events. Using a previously reported in vitro system of human conjunctival epithelium, we determined whether conjunctival epithelial cells express two relevant markers in the antigenic presentation process. Moreover, the potential capability of nedocromil sodium, an antiallergic and antiinflammatory drug, to modulate such expression was investigated. Primary cultures of human conjunctival epithelium and Chang conjunctival cells, incubated with or without 100 U/ml IL-1beta and/or IFNgamma for 1, 3 or 6 h, were simultaneously exposed to 10(-5) M nedocromil sodium. The expression of the intercellular adhesion molecule-1 (ICAM-1) and the human leukocyte antigen-DR (HLA-DR) was determined immunocytochemically. Constitutive expression of ICAM-1 and HLA-DR was observed in primary cultures and Chang cells and was minimally affected by incubation with IL-1beta and/or IFNgamma. The addition of nedocromil sodium resulted in complete abolition of HLA-DR expression and a notable reduction in ICAM-1 expression in primary cultures and Chang cells. These results suggest that epithelial cells from human conjunctiva constitutively express ICAM-1 and HLA-DR in vitro and that such expression is downregulated by nedocromil sodium. This may indicate that conjunctival epithelial cells may be another target for this drug.
Anti-Allergic Agents↗
Analysis of human ocular mucus: effects of neuraminidase and chitinase enzymes.
PURPOSE: Our goal was to establish the characteristic migration pattern on sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of high molecular weight mucins from human ocular mucus and the effects of treatment with exo- and endoglycosidases. METHODS: Chromatography by gel filtration with Sepharose CL-4B was performed on samples collected from normal subjects. Human ocular mucins from the high molecular weight fraction were digested with exoglycosidases (neuraminidase, N-acetyl-beta-D-glucosaminidase, beta-D-glucosidase) and endoglycosidases (chitinase, lysozyme); and the resulting products were analyzed by electrophoresis. Carbohydrate identification was performed using lectin probes. RESULTS: The migration of the ocular mucins on SDS-PAGE stopped after treatment with neuraminidase, which removes the terminal negatively charged sialic acid residues from mucin. Chitinase (beta(1-4)N-acetylglucosaminidase) treatment increased the electrophoretic migration of mucins. Staining with wheat germ agglutinin and Maackia amurensis agglutinin lectins showed that these mucins contain beta(1-4)NAcGlc and SAa(2-3)Gal linkages. CONCLUSIONS: These studies demonstrate that the mobility of human ocular mucins on SDS-PAGE is determined by their intrinsic total negative charge and is not dependent on SDS treatment. It is interesting to note that human ocular mucus contains chitinous material resistant to lacrimal lysozyme, which is accessible to chitinase, an enzyme now found to degrade human ocular mucins. These chitinous linkages could be in part responsible for the mucus resistance.
Adolescent↗
Carbomer- versus cellulose-based artificial-tear formulations: morphologic and toxicologic effects on a corneal cell line.
PURPOSE: Frequent instillation of artificial tears is the primary disadvantage of the treatment for dry-eye syndrome. Recently gel formulations have been proposed as an alternative to classic cellulose formulations. The higher viscosity of these gels presumably prolongs tear-retention time in the eye and results in fewer daily applications. However, no toxicologic studies with gel formulations have been performed. Our aim was to study the toxic effects of these formulations on corneal cells. METHODS: SIRC cells from rabbit cornea were exposed for 30 min, and 1, 3, and 6 h to five commercially available artificial tears, three of them carbomer gel formulations (Lacrivisc, Lacrivisc unit-doses, and Viscotears) and two carboxymethylcellulose (CMC) formulations (Celluvisc and Cellufresh). A cytotoxicity assay and a scanning electron microscopy (SEM) study were used to analyze the putative toxic effects of the formulations. The preservatives of the gel formulations also were tested. RESULTS: Carbomer gel formulations, both with and without preservatives, caused more in vitro toxic effects in the corneal cells than did CMC formulations and caused severe damage even after 30 min of exposure. SEM revealed dramatic cell-surface alterations. Preservatives added to Lacrivisc and Viscotears also had toxic effects on cells, whose effects were not significantly different from those of the commercial preparations. CONCLUSION: These results demonstrate that in the in vitro study, CMC artificial tears are less toxic than carbomer gel formulations. Questions about the benefits of using high-viscosity gels in the treatment of dry-eye syndrome still remain.
Animals↗
Characterization of epithelial primary cultures from human conjunctiva.
Primary cultures of human epithelial cells from normal conjunctiva were developed and characterized to determine whether they retained epithelial characteristics. Conjunctival explants were obtained from the upper fornix of healthy donors and cultured in supplemented DMEM/F-12 medium for 5 days. The epithelial outgrowth was maintained for an additional 10 days. Primary cultures were then processed for light microscopy, transmission and scanning electron microscopy (TEM, SEM), and immunocytochemistry. They exhibited typical features of conjunctival epithelium on light microscopy (polygonal morphology, intimate cohesion, production of mucins), TEM (abundant desmosomes, keratin bundles, granules, microvilli), SEM (polygonal shape, microvilli, intimate cohesion), and immunocytochemistry (positivity for the receptor of epidermal growth factor, desmosomal proteins, and cytokeratins). In conclusion, primary cultures developed from normal human conjunctiva maintained the epithelial characteristics in vitro. Because the conjunctiva is a major component of the anterior ocular surface, we propose this in vitro system as suitable for physiopathologic and toxicologic studies.
Antibodies, Monoclonal↗