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PubMed1997

[Echographic diagnosis of efferent lacrimal ducts with contrast media].

BACKGROUND: Affections of the lacrimal drainage system are often seen by ophthalmologists. Inspection, palpation, diagnostic rinsing and sounding can distinguish anatomical stops before or after tear sac. For final diagnostics however more apparative examinations are necessary. The ultrasonic examination with contrast media is a simple method for diagnostics of affections of the lacrimal drainage system besides the dacryocystography, the scintigraphy and other ones. PATIENTS AND METHODS: On 12 patients with a dysfunctional lacrimal drainage system and 12 normal controls the ultrasonic examination with instillation of contrast media: silicon oil, glycerine, dispersions of almond oil and viscoelastic substances was performed. All examinations were performed with the 13 B-scan. RESULTS: The lacrimal drainage way was detectable from the canaliculus to the middle nasolacrimal duc CONCLUSION: An additional advantage of the ultrasonic examination with contrast-media is the neglect of radiation, the simple and often repeatable examination method, especially the enhancement of the contrast of different valves and stenoses and mucinous deposits in stationary anatomical variations and dynamic defects.

Contrast Media↗
PubMed1992

[Value of dacryocystography in diagnosis of lacrimal duct diseases].

The paper compares the preoperative localization of stenosis in the lacrimal passage after digital dacryocystography with the operative findings in 23 eyes of 22 patients in the years 1988 to 1991 at the Munich University Eye Hospital. In a very high percentage (95.6%) there is a positive correlation. The discussion shows the advantages of the method and includes a review of relevant literature.

Adolescent↗
PubMed1987

[Digital dacryocystography].

The technique of conventional dacryocystography has recently been improved and extended by utilizing new technological developments. Digital dacryocystography, performed with computer-controlled X-ray equipment with a C-arc, and coupled to an image intensifier-TV system, enables the passage of the contrast medium to be observed, the image to be enlarged to any desired size, and also offers the advantages of digital subtraction angiography. A great deal of diagnostic information is thus obtained, making precise localization of stenoses of the lacrimal pathways possible. The method is especially useful for localizing stenoses of the lacrimal pathways, presaccal, intrasaccal and postsaccal stenoses which are difficult to demonstrate by conventional methods; and combined stenoses of the efferent lacrimal pathways. Exact localization is an essential prerequisite for choosing an appropriate surgical procedure.

Adolescent↗
PubMed1987

[The tearing eye in newborn infants and young children: good results with short-term conservative therapy].

In this article the authors communicate the results of a short-term conservative treatment for lacrimation in infants with presumed dacryostenosis. The results so far are encouraging and in most cases enable probing of the lacrimal duct to be dispensed with. If the patient fails to respond to the treatment the delay thus caused until probing can be performed is only brief.

Child, Preschool↗
PubMed1985

[Eye changes following bone marrow transplantation].

Blood diseases such as acute leukemia can now be cured by bone marrow transplants. Complications such as a chronic host-versus-graft reaction lead to typical conjunctival changes, as described for Sjögren's syndrome and ocular pemphigoid. A patient with typical eye complications is described and the probable immunological course discussed.

Adult↗
PubMed1985

[Drug treatment of inflammatory and infectious endogenous inflammations of the eye].

In many cases antibiotic treatment is indicated; steroids are not always needed. In special cases of uveitis (Behcet's syndrome, sympathetic ophthalmia, anterior uveitis in children with JRA) cytostatic treatment seems justified. Inflammations of the optic disk and nerve require very extensive diagnostic evaluation. Medical treatment is usually limited to steroids, administered systemically and locally; however, its efficacy is still a matter of debate.

Adult↗
PubMed1985

[Pathology of the lacrimal apparatus].

Following a brief survey of the subjects covered in this paper the author discusses the problem of lacrimal gland tumefactions. These can be divided into five groups: malignant lymphoma and leukemias, proliferative reactions of the lymphatic tissues, dacryoadenitis, secondary and metastatic tumors, and finally miscellaneous conditions; the main nosological characteristics are described.

Dacryocystitis↗
PubMed2002

Initial nasolacrimal duct probing in children under age 5: cure rate and factors affecting success.

AIMS: To evaluate the success rate of initial probing and the factors affecting the success rate for congenital nasolacrimal duct obstruction (CNLDO)in children under the age of 5 years. METHODS: In a prospective uncontrolled interventional case series, 207 eyes from 161 consecutive patients with CNLDO underwent nasolacrimal duct probing under brief general anesthesia. Based on exclusion criteria, 180 eyes from 139 patients were included in the study. Diagnoses were made according to the patients' histories, clinical examinations, and modified dye disappearance tests. The state of the punctum, the canaliculus, the sac, and the nasolacrimal duct were recorded. The main outcome measure was the complete disappearance of tearing and discharge in the affected eye. The patients were followed at 1 week, 1 month, and 3 months postoperatively. RESULTS: The age range was 5 to 60 months (mean, 19.1 +/- 11.2 months). The cure rates were 92% in the first year, 84.5% in the second year, 65% in the third year, and 63.5 in the fourth and fifth years of age. The patient's age, nonmemberanous CNLDO, and canalicular stenosis were correlated with the success of initial nasolacrimal duct probing (P <.05). CONCLUSIONS: Based on the results, simplicity of probing, and absence of significant complications, initial nasolacrimal duct probing is advised up to the age of 5 years. Increasing age, nonmembranous CNLDO, and canalicular stenosis increase the failure rate (P <.05).

Age Factors↗
PubMed2004

Canaliculitis: the incidence of long-term epiphora following canaliculotomy.

PURPOSE: To review the long-term outcome following surgical treatment for canaliculitis. METHODS: All cases of canaliculitis treated surgically from January 1995 to December 2001 were identified from theatre records. Case notes were reviewed retrospectively looking specifically for delay in diagnosis (defined as two or more visits prior to diagnosis), culture results and outcome following surgical treatment. Telephonic questionnaires were used to assess the incidence of post-treatment epiphora. Symptomatic patients were offered clinic appointments for further assessment and management. RESULTS: Fifteen eyes of 15 patients were identified, 13 were females and 2 males. Mean age was 69.6 years (range 45-87 years). One patient had both upper and lower canaliculitis. The remaining 14 (93.3%) had lower canaliculitis. Diagnosis was delayed in 7 of the 15 patients (46.6%). Culture results were positive in 66.6% with Staphylocococcus spp. being the most common isolate (26.6%). Actinomyces was isolated in only 2 of the 15 cases (13.3%). Conservative treatment had been tried in 5 cases (33.3%). All patients had resolution of symptoms following canaliculotomy. Epiphora was identified in four of the treated eyes on telephonic questionnaires. Of these, three eyes had preexisting lacrimal pathology. Average follow-up was 26 months (range 6-83 months). CONCLUSION: Canaliculotomy is safe and efficacious in the treatment of lacrimal canaliculitis with no demonstrable risk of posttreatment epiphora.

Aged↗
PubMed2003

Disorders associated with osteopoikilosis: 5 different lesions in a family.

Although osteopoikilosis is generally considered an accidental finding, several developmental dysplasias coexisting with this disorder have been reported. However, all authors have mentioned only one coexisting finding, and most of them are case reports. We report a family in whom various members had osteopoikilosis with 5 different associated lesions. We suggest that osteopoikilosis is a bone manifestation of a generalized fibroproliferative or stenosing disease.

Adolescent↗
PubMed2004

Clinical and cytopathologic correlation in chronic inflammations of the orbit and ocular adnexa: a review of 55 cases.

Fine-needle aspiration cytology has been used for the diagnosis of neoplastic lesions of the orbit and ocular adnexa with some success. However, inflammatory conditions have not received much attention. This is a retrospective study of fine-needle aspirations of chronic inflammations of the orbit and ocular adnexa over a 15-year period from January 1988 through December 2002. Clinical records and stained smears were reviewed. There were 55 chronic inflammations, presenting as masses, cysts, abscesses, discharging sinuses and dermal plaques and nodules. Forty-two were granulomatous inflammations comprising chalazion (18), tuberculosis (5), Cysticercus cellulosae (3), ruptured epidermal cysts (2), actinomycosis (1) and leprosy (13). Thirteen patients had chronic non-specific inflammations. Fine-needle aspiration cytology is a useful diagnostic procedure in chronic inflammations of the ocular adnexa. Specific diagnosis is possible in many granulomatous inflammations, allowing appropriate, individualized therapy to be initiated.

Biopsy, Fine-Needle↗
PubMed2005

A case series on chronic canaliculitis.

INTRODUCTION: Primary chronic canaliculitis is an uncommon disease, which is often misdiagnosed and insufficiently treated. We present two cases of canaliculitis caused by two different organisms, Actinomycetes spp. and Arcanobacterium haemolyticum. To the best of our knowledge, canaliculitis due to Arcanobacterium haemolyticum has not been reported before. PATIENTS AND METHODS: The two cases described in this series show typical clinical features of canaliculitis with an inflamed upper canaliculus, not responsive to topical antibiotics. Appropriate treatment was delayed as they were initially treated for conjunctivitis. Both patients were treated with a canaliculotomy, with curettage and subsequent treatment with topical and systemic penicillin. The contents were sent for microbiological examination. RESULTS: There was complete resolution following treatment. Actinomyces spp. was grown from one patient as expected. However, in the second patient, Arcanobacterium haemolyticum was isolated. Although this organism was not expected, the patient did respond to similar, conventional treatment. DISCUSSION: Actinomyces spp. is a cast-forming Gram-positive anaerobe. They are difficult to isolate and identify and can cause infections of hollow spaces with formation of canaliculiths. Arcanobacterium (Corynebacterium) haemolyticum closely resembles Actinomyces (Corynebacterium) pyogenes. Ocular infections reported with this organism include orbital cellulitis and subperiosteal abscesses. The difficulty encountered in the isolation and identification of these organisms is discussed and the need for thorough curettage in the treatment of persistent or recurrent canaliculitis is emphasised. CONCLUSION: Chronic canaliculitis should be considered in any patient who presents with chronic or recurrent conjunctivitis. Definitive cure will not be affected until all concretions are removed, either at surgery or by mechanical expression.

Actinomycetales Infections↗
PubMed2005

Dacryoadenitis associated with subcutaneous Sweet's syndrome in a patient with acute myeloid leukemia.

A 26-year-old woman presented with a painful skin eruption which led to the diagnosis of acute myeloid leukemia. During chemotherapy, she developed an unusual orbital inflammation. Careful observation of the clinical course, computed tomography, and orbital biopsy were necessary to establish the diagnosis of dacryoadenitis associated with subcutaneous Sweet's syndrome. The skin eruption and the dacryoadenitis resolved rapidly with corticosteroid therapy. This is the first report of dacryoadenitis in the course of subcutaneous Sweet's syndrome.

Adrenal Cortex Hormones↗
PubMed2005

Preservation of tear film integrity and inhibition of corneal injury by dexamethasone in a rabbit model of lacrimal gland inflammation-induced dry eye.

PURPOSE: The aim of this study was to establish a clinically relevant short-term animal model of dry eye with utility in identifying compounds with potential therapeutic efficacy. METHODS: Rabbit lacrimal glands were injected with the T-cell mitogen Concanavalin A (Con A) and inflammation, tear function, and corneal epithelial cell integrity were subsequently assessed. The inflammatory response was characterized by quantifying biochemical markers of inflammation ex vivo and by confirming inflammatory cell influx by histology. Matrix metalloproteinase-9 (MMP-9) and proinflammatory cytokines IL-1beta, IL-8, and TGF-beta1 were quantified in tissue extracts. Tear function was monitored by measuring tear fluorescein clearance and tear breakup time (TBUT). Corneal epithelial cell integrity was determined by quantifying the uptake of methylene blue dye following the exposure of rabbits to a low-humidity environment. The anti-inflammatory corticosteroid, dexamethasone, was administered topically as indicated for each study. RESULTS: Histopathologic evaluation of lacrimal glands injected with Con A revealed a pronounced inflammatory process characterized by lymphocytic infiltration, multifocal necrosis, and fibroplasia. Elevated levels of MMP-9 and cytokines IL-1beta, IL-8, and TGF-beta1 were detected in the lacrimal gland and cornea. Inflammation of the rabbit lacrimal gland following an injection of Con A significantly reduced tear clearance and TBUT and increased susceptibility to desiccation-induced corneal damage. Dexamethasone was prophylactically and therapeutically effective in this inflammation model of dry eye, restoring tear function and inhibiting corneal injury following topical ocular application. CONCLUSIONS: Characteristics of this rabbit lacrimal gland inflammation model of dry eye are consistent with the current understanding of dry eye as a local ocular surface inflammatory response to abnormal tear volume and composition. These results suggest that this rabbit model of dry eye may be employed to assess the therapeutic efficacy of mechanistically diverse agents on clinically relevant signs of ocular surface disease. These methods were strategically developed to be applicable for advancing drug discovery for a broad spectrum of dry eye patients.

Animals↗