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Results for “ocular surface disease”

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At least 325 records · Page 18Linked to original sources

PubMed2000

Suppression of TGF-beta signaling in both normal conjunctival fibroblasts and pterygial body fibroblasts by amniotic membrane.

PURPOSE: When used as an alternative substrate following bare sclera removal of pterygium and other ocular surface diseases, amniotic membrane transplantation can reduce scarring on the reconstructed conjunctival surface. This study was carried out to determine if the amniotic membrane (AM) suppresses the expression of the TGFb signaling system in cultured normal conjunctival (HCF) and pterygial body fibroblasts (PBF). METHODS: HCF and PBF were cultured on AM and plastic wells in serum-containing and serum-free DMEM with or without TGF-beta1. Total RNA was extracted and subjected to Northern hybridization with probes of TGF-beta1, b2 and b3; TGF-beta receptors (TGF- beta R) type I, II and III; a-smooth muscle actin (alpha-SM), b1-integrin, CD44, fibroblast growth factor receptor 1 (FGF-R1/ flg) and platelet-derived growth factor receptor b (PDGFR-beta); and GAPDH as a loading control. MTT assay was used for cell proliferation. RESULTS: Amniotic membrane markedly suppressed the transcript expression of TGF-beta2, b3 and all three types of TGF-beta receptors by both fibroblasts as compared to their cultures on plastic surface. In addition, expression of CD44 transcript was also markedly suppressed while that of b1 integrin, a-SM actin, and FGFR1/flg was mildly suppressed. In contrast, expression of TGF-beta1 and PDGFR-beta remained largely unchanged. The cell proliferation of HCF and PBF grown on AM was also significantly suppressed. CONCLUSIONS: Amniotic membrane matrix uniquely suppresses TGF- beta signaling in both types of fibroblasts. It may also suppress signaling via CD44, b1 integrin and FGFR1/flg. As a result, the phenotype may become less mitogenic, contractile and fibrogenic. These data support in part why amniotic membrane transplantation has an anti-scarring effect for conjunctival surface reconstruction.

Actins↗

PubMed2000

[Technique of harvesting and preparation of amniotic membranes].

Amniotic membrane transplantation is a promising surgical technique for clinical management of ocular surface diseases. According to the first published results, the ease with which this highly available tissue can be prepared and preserved makes this technique very attractive. The aim of our study is to report procurement procedures and the preparation technique for amniotic membrane in accordance with the French tissue transplantation legislation.

Amnion↗

PubMed2000

Further analysis of the size and shape of cells obtained by impression cytology from the exposed portion of the human bulbar conjunctiva.

PURPOSE: To assess whether the size of the cells obtained by conjunctival impression cytology can be quantitatively assessed by measurement of the longest dimension of the cells. METHODS: Under topical benoxinate anaesthesia, cells were removed from the normally exposed nasal bulbar conjunctival surface using a 0.4 micron pore diameter filter (Biopore filter; type Millcell-CM). The filters were stained with haematoxylin after ethanol denaturation, photographed at 40 x magnification, and 35 mm slides prepared. An optical overlay method was used to outline the borders of sets of 30-35 contiguous cells on each image. The cell area, longest and shortest dimensions were measured by planimetry to an accuracy of +/- 3%. RESULTS: Analyses of 20 sets of samples, from individuals aged 21 to 48 years and without clinically significant ocular surface disease, revealed a median cell area of 133 micron 2 (n = 621, range 46-1602 micron 2; average 212 micron 2), a median longest dimension of 13.9 microns (range 6.6-68.8 microns; average 16.9 microns) and a shorter dimension of 10.0 microns (range 4.7-43.0 microns; average 11.9 microns); the distributions of values indicated bimodality. Most cells had a long:short ratio (L:S ratio) value between 1.00 and 1.80, but 11.9 +/- 6.1% of the cells had L:S ratios between 1.80 and 4.60. The overall relationship between the longest dimension and the area of the cells was nonlinear, with cells having larger L:S ratios having disproportionately smaller areas. CONCLUSIONS: The superficial conjunctival cells are small, and their longest dimensions are systematically related to area. Analyses of cell shape indicate further possible ways of identifying different cells on the bulbar conjunctiva. Compared to literature values, there is a substantial overlap in longest dimensions of the conjunctival cells with those of cells that can be collected off the corneal surface. This means that superficial conjunctival and corneal cells cannot be distinguished simply on the basis of measurements of the long dimension.

Adult↗

PubMed2002

Preparation of amniotic membrane for ocular surface reconstruction.

We describe the preparation and preservation of human amniotic membrane required for transplantation in the management of ocular surface diseases. Informed consent is obtained and the donor is screened to exclude risk of transmissible infections such as human immunodeficiency virus (HIV), hepatitis B virus, hepatitis C virus, and Treponema pallidum infections. Ideally, the media and washing solutions needed for the preparation of amniotic membrane are prepared only a week to 10 days prior to use and not stored in the freezer weeks ahead. The AM obtained under sterile conditions after elective caesarian section is washed free of blood clots and chorion. With the epithelial surface up, amniotic membrane is spread uniformly without folds or tears on individually sterilized 0.22 micron nitrocellulose membranes of the required sizes. The prepared filter membrane with the adherent amniotic membrane is placed in the preservative medium and stored at -80 degrees C. The membranes are released when the repeat serology for HIV after the window period has excluded virus infection in the donor. Depending on consumption they may be used up to 6 months after preparation, though many have recommended storage for an indefinite period. Since the amniotic membrane has only incomplete expression of HLA antigens and amniotic epithelial cells do not express them, it is not rejected after transplantation. The presence of several cytokines in the amniotic membrane promotes epithelialization with reduction of fibrosis during healing.

Amnion↗

PubMed2002

Amniotic membrane transplantation for ocular surface reconstruction.

The purpose of this study is to analyze the clinical experience and the effect of human amniotic membrane transplantation on pterygium excision and bullous keratopathy. From January 1999 to January 2001 at University Hospital "Sestre milosrdnice" amniotic membrane transplantation was performed consecutively in 21 eyes: 11 eyes with bullous keratopathy and 10 with recurrent pterygia. In the group with bullous keratopathy epithelization took place in 19.6 days in 72.7% and the reduction of pain was satisfactory. Recurrence rate in group with recurrent pterygia was 20%. Based on the presented results it could be concluded that amniotic membrane transplantation can be considered as an effective alternative for treating severe ocular surface diseases and as an alternative for penetrating keratoplasty if there is a lack of grafts.

Adult↗

PubMed2000

[Application of cellulose acetate membrane with the technique of impression cytology combined with immunohistochemical staining for detection of dry eye].

PURPOSE: To evaluate the conjunctival cells by impression cytology with cellulose acetate membrane. METHODS: The expression of the TGF-beta 1 in conjunctival epithelium of 24 patients with dry eye were studied by impression cytology combined with immunohistochemical staining and observed by microscope. RESULT: The cellulose acetate membrane is very transparent under the microscope. Cell's membrane by TGF-beta 1 staining is clear, cytoplasm brown and nuclei blue. CONCLUSION: The method of impression cytology with cellulose acetate membrane is simple and has no injury to the ocular surface. Combined with immunohistochemistry staining, it is suitable to observe the conjunctival cells by this technique which has an important value for the examination of the ocular surface disease.

Aged↗

PubMed2001

New perspectives in ocular surface disorders. An integrated approach for diagnosis and management.

The cornea, conjuctiva and the limbus comprise the tissues at the ocular surface. All of them are covered by stratified, squamous, non-keratinizing epithelium and a stable tear film. The ocular surface health is ensured by intimate relationship between ocular surface epithelia and the preocular team film. There are two types of ocular surface failure. The first one is characterized by squamous metaplasia and loss of goblet cells and mucin expression. This is consistent with unstable tear film which is the hallmark of various dry-eye disorders. The second type of ocular surface failure is characterized by the replacement of the normal corneal epithelium in a process called limbal stem cell deficiency. It is essential to establish accurate diagnosis for appropriate management of complex ocular surface disorders. There has been considerable advancement in the understanding of the pathophysiology of ocular surface disease. Management has improved with introduction of the limbal stem cell concept and use of amniotic membrane transplantation.

Amnion↗

PubMedDate not supplied

Suspension made with amniotic membrane: clinical trial.

PURPOSE: To investigate if a suspension made with amniotic membrane could have a beneficial effect on ocular surface diseases. METHODS: In the Imola branch of the Eye Bank of Emilia Romagna, the authors prepared a suspension containing homogenized amniotic membrane previously conserved at -80 degrees Celsius. Subsequently, the authors gave this preparation to 21 patients: 8 had undergone lamellar keratoplasty, 4 had undergone penetrating keratoplasty, 2 had undergone photorefractive keratectomy with a delay of epithelialization, 3 had neurotrophic corneal ulcers, 2 had corneal burning, 1 had torpid corneal ulcer, and 1 had Sjogren syndrome. Each patient had been treated with conventional therapy for at least, 4 months without any clinical improvement. In this sample of eyes the authors evaluated the transparency and integrity of epithelium before and after the therapy by means of a fluorescein staining test, examining the area of epithelial defect as well as the phlogistic situation and the symptoms referred by patients. Nine eyes from this group of patients were studied by impression cytology before and after 3 months of use of suspension. The follow-up was 5 months of once-weekly visits. RESULTS: In all patients, after 15 to 30 days the corneas became negative to fluorescein staining test and the epithelium seemed more complete and regular, there was an evident decrease of phlogistic situation in the conjunctiva, and an improvement of symptoms was referred by patients. The situation was stable during the whole follow-up. No side effects were noted. The impression cytology repeated 3 months after the treatment showed a significant corneal recovery of the cytologic situation with an important decrease of CK19+ cells on the corneal surface. CONCLUSIONS: This new therapy, which is less traumatic than an implant of amniotic membrane, is safe, and can be repeated for a long period, could help patients with corneal superficial defects.

Amnion↗

PubMedDate not supplied

[Non-viral infectious keratitis: predisposing factors, etiologic agents and laboratory diagnosis].

Infectious keratitis cause significant morbidity and, if it is not promptly and appropriately treated, can lead to severe ocular disability. Almost all cases of keratitis are associated to predisposing conditions. In occident, the main risk factor is contact lens wear, but previous ocular surgery or trauma are also important, as well as various ocular surface diseases. An enormous diversity of etiologic agents for infectious keratitis exist, including virus, bacteria, mycobacteria, fungi and parasites. This review provides literature and personal based information about main predisposing factors, etiologic agents and pathophysiology of infectious keratitis, excluding those of viral origin. Focus is made on microbiologic procedures, describing stains and media that should be used, and highlighting their utility. A special mention on particular situations is made, including laboratory diagnosis of Acanthamoeba keratitis, utility of lens cases analysis, keratitis in patients with previous treatment, as well as molecular biology techniques described in ophthalmology.

Acanthamoeba Keratitis↗

PubMed2006

[Study of limbal stem cells and related problems].

Basic and clinical research of limbal stem cells has enhanced the understanding of ocular surface diseases. This article analyzes the value and problems existing in the identification of limbal stem cells by anatomical location, proliferation capacity and the use of differentiating surface markers. The clinical methods for the diagnosis of limbal stem cell deficiency and the effects of limbal epithelial cell transplantation are reviewed. Some key problems that must be solved in the future such as the identification marker of limbal stem cells and the final outcome of transplanted cells are presented.

Corneal Diseases↗

PubMed1990

Salzmann's nodular degeneration.

Fifteen eyes in 12 patients with Salzmann's nodular corneal degeneration developed symptoms of recurrent erosion, decreased vision, or both. A history or evidence of ocular surface disease was present in 14 of 15 eyes. Removal of the nodule and accompanying pannus or corneal epithelial basement membrane degeneration, provided symptomatic improvement in all patients.

Adult↗

PubMed1985

Topical retinoid treatment for dry eye disorders.

We have demonstrated the clinical efficacy of topical all-trans retinoic acid ointment in the treatment of four severe cases of the following dry eye disorders: Keratoconjunctivitis sicca, Stevens-Johnson syndrome, drug-induced pseudopemphigoid, surgery-induced dry eye. In all four cases, impression cytology confirmed that improvements in symptoms, visual acuity, keratopathy, and Schirmer test resulted from reversal of the process of squamous metaplasia. This treatment represents the first nonsurgical approach with action directed specifically at the diseased ocular surface epithelia.

Administration, Topical↗

PubMed1984

Histology of human conjunctival transplantation.

The technique of conjunctival transplantation has proven very successful in reestablishing an intact ocular surface in patients with severe ocular surface disease in whom conventional treatment has failed. We present follow-up on the histology of the transplanted conjunctival tissue in four alkali-burned patients who underwent penetrating keratoplasty 3-28 months following conjunctival transplantation. The corneal button was re-epithelialized in all patients. The fate of the transplanted tissue agreed with experimental observations made in the rabbit model, i.e., under areas of vascularization and inflammation, the transplanted tissue resembled conjunctiva with numerous goblet cells and 3-4 cell layers of nonkeratinized, stratified epithelium. In one patient, a definite "transition zone" from conjunctival to corneal appearing epithelium was seen in an area with minimal inflammation and vascularization, again confirming the animal results showing that transdifferentiation of conjunctival to corneal epithelium can occur.

Adult↗

PubMed1995

Clinical evaluation of corneal epithelial barrier function with the slit-lamp fluorophotometer.

We designed a simple and quantitative method for the clinical evaluation of corneal epithelial barrier function using a slit-lamp fluorophotometer and applied it to healthy volunteers and dry-eye patients. The fluorophotometric method used was as follows: Three microliter of 0.5% fluorescein solution was applied to the cornea in the untouched fashion. Ten minutes after instillation, the ocular surface was washed. Twenty minutes afterward, corneal fluorescence intensity was measured and converted into fluorescein concentration. Corneal condition was classified into four grades: no superficial punctate keratopathy (SPK) anywhere on the cornea (grade 0); no SPK at the central cornea (grade 1), mild SPK at the central cornea (grade 2), and severe SPK at the central cornea (grade 3). In the volunteers, corneal condition was classified as grade 0 and fluorescein uptake (ng/ml) was 22.4 +/- 16.9 (mean +/- SD, n = 86). In dry eye, fluorescein uptakes showed significant increase in accordance with SPK severity: grade 1: 96.4 +/- 51.2 (n = 13); grade 2: 318.6 +/- 146.0 (n = 11); and grade 3: 1479.1 +/- 671.9 (n = 10) (each p < 0.0005). This simple method with the slit-lamp fluorophotometer can be used for the clinical grading of SPK in dry eye or other ocular surface diseases.

Adolescent↗

PubMed1987

A new rabbit model for keratoconjunctivitis sicca.

The authors created a new rabbit model for keratoconjunctivitis sicca by cauterizing the lacrimal gland excretory duct and surgically removing the nictitating membrane and harderian gland. Although the slit-lamp examination findings remained normal for the first 8 wk postoperatively, tear-film osmolarity was elevated by postoperative day 1. Corneal epithelial glycogen levels declined progressively, and conjunctival goblet cell density remained decreased. Multiple controls indicated that closure of the lacrimal gland excretory duct was required for elevation of tear film osmolarity, which, in turn, was required for persistent ocular surface disease.

Animals↗

PubMed1996

Conjunctival transplantation for corneal surface reconstruction--case reports and review of literature.

Corneal persistent epithelial defects (PED) can occur due to various causes. In diffuse ocular surface disease, they often occur secondary to depletion of limbal stem cells. A number of complications occur secondary to PED and successful treatment usually requires conjunctival surgeries for corneal surface reconstruction. We report two cases of chemical injury successfully treated by two such procedures. This report highlights the encouraging results of limbal transplantation and reviews the literature in the management of PED with limbal stem cell loss.

Adult↗

PubMed1997

A novel method of tear collection: comparison of glass capillary micropipettes with porous polyester rods.

PURPOSE: To develop a rapid, user-friendly method of tear collection to facilitate tear-protein analysis. METHODS: Tears were collected from a total of 19 normal volunteers without evidence of ocular-surface disease with either porous polyester rods or glass-capillary micropipettes. Tear-collection rate and recovery of two tear proteins, epidermal growth factor (EGF, low abundance) and lactoferrin (LFR, high abundance) were compared between polyester rods and glass-capillary micropipettes. The recovery of LFR and EGF and the stability of these proteins after storage at -70 degrees C were quantitated by specific monoclonal enzyme-linked immunosorbent assay (ELISA). RESULTS: Polyester rods collected tears an average of 3.9-fold faster than glass-capillary micropipettes (p < 0.001). Both methods were comparable in efficacy of protein recovery. The polyester rods demonstrated a trend toward enhanced recovery, but this difference was not statistically significant (p = 0.12, LFR; p = 0.055, EGF). Analysis of the reliability and reproducibility of the tear-collection assay system revealed that ELISA analysis is highly reproducible, but there is significant day-to-day variation in tear-protein levels of both LFR and EGF for a given volunteer. Both LFR and EGF displayed a trend toward enhanced detection by ELISA shortly after freezing at -70 degrees C and slow decay after storage at -70 degrees C for up to 72 and 105 days, respectively. After stimulation of reflex tearing via the nasolacrimal reflex, LFR levels remained relatively constant, whereas EGF levels for most patients declined and then plateaued. CONCLUSIONS: Polyester rods provide a more rapid, user-friendly alternative to glass-capillary micropipettes for the collection and analysis of tear fluid and tear proteins. Polyester rods may have greater clinical utility, facilitating routine analysis of the preocular tear film.

Enzyme-Linked Immunosorbent Assay↗

PubMed1997

A study of 530 patients referred for rigid gas permeable scleral contact lens assessment.

PURPOSE: The purpose of this study was to analyse the current application of scleral contact lenses in two specialist centres. METHODS: The case notes of 530 patients assessed for fitting or refitting with rigid gas permeable (RGP) scleral lenses were retrospectively analysed to determine the indication for contact lenses and the outcome. Scleral lenses had been offered as a conservative management option in suitable cases for a variety of visual and medical indications. RESULTS: Various types of primary corneal ectasia, ranging from low grade to advanced, including keratoconus, keratoglobus, and pellucid marginal degeneration, formed 53.0% of the total referred for assessment. The other principal indications for contact lenses were corneal transplant (15.8%), aphakia (10.3%), high myopia (8.9%), and various ocular surface disorders (8.2%). Sixty percent continued to use scleral lenses, 42.9% RGP, and 17.1% polymethylmethacrylate lenses. Twenty-two percent discontinued scleral lens wear or failed a trial of scleral lenses, with 9.3% in progress at the time of assessment and 8.7% lost to follow-up. CONCLUSIONS: In the authors' opinion, scleral lenses have retained their traditional role in the management of complex ametropia and ocular surface disease. That role has been further enhanced by the application of gas permeable materials.

Adolescent↗