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At least 19 recordsLinked to original sources
PubMed1992

Topical fibronectin in the treatment of keratoconjunctivitis sicca. Chiron Keratoconjunctivitis Sicca Study Group.

Topical fibronectin was evaluated for the treatment of keratoconjunctivitis sicca in a multicenter, double-masked, controlled study in which 272 patients were randomly assigned to treatment. Patients with documented clinical evidence of keratoconjunctivitis sicca received either fibronectin, a vehicle alone, or a commercially available artificial tear. Evaluation at baseline, 21, 42, and 63 days consisted of patient self-evaluation of symptoms, rose bengal and fluorescein staining, tear breakup time, Schirmer's testing, and conjunctival impression cytology. Although all groups showed improvements in most study variables during the course of the study, there were no statistically significant differences found between any of the groups. Topical fibronectin does not appear to be more effective than artificial tears in the treatment of keratoconjunctivitis sicca.

Aged↗
PubMed1989

[Tear lactoferrin in keratoconjunctivitis sicca].

Keratoconjunctivitis sicca is a commonly encountered disease with decreased lacrimal gland activity. There are several tests to determine the lacrimal gland function, but all have limitations in accuracy, sensitivity or technical difficulty. At present, there is no reliable objective test to render a firm diagnosis of dry eye. Lactoferrin is one of the major proteins secreted by the lacrimal gland. Its concentration was found to correlate well to lacrimal gland activity. In this study we tried to evaluate the diagnostic value of lactoferrin measurement in comparison with other tests for keratoconjunctivitis sicca. Tests including the measurement of tear lactoferrin, Schirmer's-1 test, Schirmer's basal test, tear film break-up time, and rose bengal stain of the cornea were done on 60 healthy eyes and 56 eyes with keratoconjunctivitis sicca. The lactoferrin level was measured by a commercially available "Lactoplate" (Eagle Vision, U.S.A.). It is a plate containing gel loaded with rabbit anti-human-lactoferrin antiserum. Tear-moistened filter paper discs containing lactoferrin were placed on the gel. The lactoferrin concentration could be determined by measuring the concentric ring of precipitate after 72 hours incubation at room temperature. The average concentration of lactoferrin was 1.9 +/- 0.51 mg/ml in the normal group and 1.4 +/- 0.93 mg/ml in the keratoconjunctivitis sicca group. They were significantly different from each other (t-test: p less than 0.05). The results of the other 4 tests also showed a significant difference between the normal and keratoconjunctivitis sicca group, but the lactoferrin measurement had the highest specificity among these 5 tests. Because of the technical simplicity of measurement and its high specificity, lactoferrin measurement could be a valuable tool for the early and accurate diagnosis of keratoconjunctivitis sicca.

Adult↗
PubMed1991

Sjogren's syndrome and keratoconjunctivitis sicca.

Keratoconjunctivitis sicca patients diagnosed on the basis of a history, dry-eye symptoms, and definite clinical signs of keratoconjunctivitis sicca, with the associated symptoms of dry mouth and/or arthritis, had measurements of tear osmolarity, Schirmer tear test without anesthetic, stimulated parotid salivary flow, and serum analysis for the presence of autoantibodies associated with Sjogren's Syndrome. In contrast to previous studies, a lower incidence of SS-A or SS-B (1-3%), ANA (41-47%), DNA (11-16%), and RF (9-12%) serum antibodies was detected. Salivary-stimulated parotid flow was abnormally decreased in 59% of the patients. Sjogren's syndrome, as indicated by the presence of serum antibodies, appears to have a lower incidence in keratoconjunctivitis sicca than considered previously.

Adult↗
PubMed1998

Advances in the diagnosis and management of keratoconjunctivitis sicca.

Keratoconjunctivitis sicca is a common ocular surface disease that develops in patients with aqueous tear deficiency. Recent advances have been made in diagnosis, pathogenesis, and therapy of this condition. Advances in diagnosis include improved understanding of the specificity of the tests used for diagnosis, elucidation of the mechanism of the ocular surface rose bengal and fluorescein staining that occurs in this condition, and the expanded use of impression cytology. Advances in pathogenesis include the concept that keratoconjunctivitis sicca is a condition of abnormal growth and differentiation and immune activation of the ocular surface epithelium. These findings indicate that keratoconjunctivitis sicca may represent a chronic wound-healing response to a poorly lubricated and inflamed ocular surface. Advances in therapy include improved nonpreserved artificial tears and therapies targeted at decreasing ocular surface inflammation.

Animals↗
PubMed1991

Keratoconjunctivitis sicca.

Keratoconjunctivitis sicca (KCS) is one of the dry eye syndromes characterized by a deficiency of the aqueous layer of the tear film. The disorder may occur as an isolated entity or in association with a variety of local and systemic conditions affecting aqueous production. Often it follows a mild course but in severe cases, complications resulting in blindness may occur. In this paper, the clinical features, diagnostic strategies, and current treatment of KCS will be covered. Etiologies, including a discussion of the Sjögren syndrome, will also be presented.

Diagnosis, Differential↗
PubMed1989

Spontaneous canine keratoconjunctivitis sicca. A useful model for human keratoconjunctivitis sicca: treatment with cyclosporine eye drops.

Thirty-six sequential cases of canine keratoconjunctivitis sicca (KCS) were treated with ophthalmic cyclosporine. The effects of topical cyclosporine were twofold: (1) cyclosporine increased tear production by 5 mm/min or greater in all cases of spontaneous KCS having an initial Schirmer's Tear Test value greater than 2 mm/min and in 59% of eyes with an initial Schirmer's Tear Test value of 0 to 2 mm/min, and (2) cyclosporine caused marked regression of chronic corneal neovascularization and granulation even in eyes in which lacrimation failed to improve. Additional benefits of topical cyclosporine were reduced mucopurulent conjunctivitis, rapid healing of nonhealing corneal ulcers, and reduced dependence on frequent topical treatments of KCS. Twelve normal beagles treated with topical cyclosporine also had a reversible increase in lacrimation compared with baseline or placebo control-treated dogs.

Animals↗
PubMed1978

Sterile corneal ulcers after cataract surgery in keratoconjunctivitis sicca.

Mild keratoconjunctivitis sicca can become dramatically worse after cataract extraction and result in corneal thinning and perforation. Anticipation of this problem can prevent it, but lack of recognition may result in permanent central scarring from ulceration, which responds slowly to treatment.

Bandages↗
PubMed2006

Sjögren's syndrome-like disease of C57BL/6.NOD-Aec1 Aec2 mice: gender differences in keratoconjunctivitis sicca defined by a cross-over in the chromosome 3 Aec1 locus.

Sjögren's syndrome (SjS) is a systemic autoimmune disease in which an immunological attack primarily against the salivary and lacrimal glands results in loss of acinar cell tissue and function leading to stomatitis sicca and keratoconjunctivitis sicca. In recent years, the NOD mouse has become an accepted model of SjS, exhibiting a spontaneously developing disease that strongly mimics the human condition. Two genetic regions, one on chromosome 1 (designated Aec2) and the second on chromosome 3 (designated Aec1) of NOD mice, have been shown to be necessary and sufficient to recapitulate SjS-like disease in non-susceptible C57BL/6 mice. Here we describe a newly derived strain, C57BL/6.NOD-Aec1R1Aec2, in which a recombination in Aec1 has resulted in reducing this genetic region to less than 20 cM from 48.5 cM. Profiling of this recombinant inbred strain has revealed that male mice maintain a full SjS-like disease, whereas female mice exhibit stomatitis sicca in the absence of detectable keratoconjunctivitis sicca. These data suggest SjS-like disease in the NOD mouse shows gender-specific regulation determined by autosomal genes.

Animals↗
PubMed1998

Keratoconjunctivitis sicca associated with achalasia of the cardia, adrenocortical insufficiency, and lacrimal gland degeneration: Keratoconjunctivitis sicca secondary to lacrimal gland degeneration may parallel degenerative changes in esophageal and adrenocortical function.

OBJECTIVE/DESIGN: This study aimed to examine and describe three siblings with alacrima, the eldest of whom had associated achalasia and adrenocortical insufficiency. PARTICIPANTS: Three affected siblings and four age-matched control subjects participated. INTERVENTION/MAIN OUTCOME MEASURES: The three children underwent complete ophthalmologic examinations; computed tomographic scanning of brain, orbit, chest, and abdomen; and measurement of serum cortisol. All three were subjected to a short synacthen challenge. Lacrimal gland biopsies were performed on the two younger subjects, and specimens were studied by light and electron microscopy. RESULTS: All three children showed virtually absent tear secretion as tested by the Schirmer test. The resulting keratopathy was most severe in the oldest child, who developed bilateral corneal melting. The two younger children showed interpalpebral corneal staining with rose bengal. All three children improved after punctal occlusion. Addison's disease was present in the oldest child. Computed tomographic scanning showed absent lacrimal and shrunken adrenal glands in association with achalasia of the cardia in the oldest child. The lacrimal glands were found to be reduced in size in the next eldest child. When evaluated by electron microscopy, the lacrimal gland biopsy specimens from the two younger children showed neuronal degeneration associated with depletion of secretory granules in the acinar cells. CONCLUSION: In this disease, radiologic evidence of reducing lacrimal gland size with increasing age could represent a degenerative process. This may be paralleled by other signs and the possibility of adrenocortical insufficiency and achalasia of the cardia should be investigated in all children presenting with dry eyes. These children appear to have a progressive neuronal disease.

Adrenal Cortex↗
PubMed1991

Clinical evaluation of 1% cyclosporine for topical treatment of keratoconjunctivitis sicca in dogs.

Keratoconjunctivitis sicca (KCS) is a prevalent and often vision-threatening condition in dogs. In several reports, 2% cyclosporine (cyclosporin A, CsA) was described as effective in modulating the clinical signs of KCS. This study was designed to compare the efficacy of 1% CsA vs a placebo, using a randomized double-blind clinical trial. Topical administration of 1% CsA significantly improved Schirmer wetting values and subjective markers of corneal health as compared with the placebo. In the dogs treated with topical administration of 1% CsA, the clinical signs of KCS were improved in 81.8% of cases.

Administration, Topical↗
PubMed1992

Keratoconjunctivitis sicca and diabetes mellitus in a dog.

Diabetes mellitus and keratoconjunctivitis sicca were diagnosed in a female Poodle. The dog was treated for diabetes and keratoconjunctivitis sicca until blood glucose concentrations were within normal limits. Treatment for keratoconjunctivitis sicca was suspended then, and signs of this disorder did not appear again. Most of the factors known to predispose to keratoconjunctivitis sicca were not applicable to this dog. On the basis of observations made in this dog, we suggest that diabetes mellitus and keratoconjunctivitis sicca may be linked. Clinical signs of the disorders developed simultaneously and resolved when diabetes mellitus was controlled with insulin.

Animals↗
PubMed1995

[Significance of subjective sensitivity in evaluation of keratoconjunctivitis sicca].

In patients with keratoconjunctivitis sicca (KCS) frequently a mismatch between the symptoms and clinical signs of impaired tear film is found. Thus, we conducted a study to determine whether tests can be found that provide information on increased sensitivity in KCS patients. Thirty patients with and without KCS were investigated by the following methods: a specific anamnestic questionnaire, esthesiometry and provocation of ocular pain by instillation of a local anesthetic eye drop. Esthesiometry only showed a shift towards higher sensitivity, but the other tests indicated significantly increased ocular sensitivity in KCS patients. These very simple methods permit better understanding of the specific situation in the individual patient.

Humans↗
PubMed1987

Diagnosis and treatment of keratoconjunctivitis sicca in the dog.

Keratoconjunctivitis sicca (KCS) is a relatively common eye disease in the dog. The diagnosis is discussed, particularly of the early or mild case. The various types of medical treatment are described, including replacement therapy with artificial tears and ocular inserts, as well as other preparations; lacrimogenics; and other forms of medical treatment, including antibiotics, corticosteroids, mucolytics and hormones. Contraindicated drugs and agents are listed. Surgical treatments, including punctal occlusion, tarsorrhaphy, conjunctival flaps, contact lenses, superficial keratectomy, as well as parotid duct transposition, are discussed and the procedure indicated which is best suited to the case. The choice of treatment according to the severity of the KCS is also given.

Animals↗
PubMed2005

Topical 0.1% prednisolone lowers nerve growth factor expression in keratoconjunctivitis sicca patients.

PURPOSE: To compare nerve growth factor (NGF) levels in tears and on the ocular surfaces of normal control and non-Sjögren's type keratoconjunctivitis sicca subjects, and to investigate the effect of 0.1% prednisolone eyedrops on NGF levels in keratoconjunctivitis sicca patients. DESIGN: Prospective, double-masked, randomized, comparative clinical trial. PARTICIPANTS: Forty-one keratoconjunctivitis sicca patients and 23 age- and gender-matched healthy subjects. METHODS: Baseline tear NGF levels were measured in keratoconjunctivitis sicca patients and healthy control subjects using enzyme-linked immunosorbent assays. Keratoconjunctivitis sicca patients received 0.1% prednisolone drops in one eye and 0.1% hyaluronic acid drops in the other, 3 times a day for 28 days. Also, impression cytology (IC) and immunostaining for NGF on conjunctival epithelium were performed on both groups. MAIN OUTCOME MEASURES: Tear NGF/total tear protein (TP) concentration ratio, IC and NGF immunocytologic staining, subjective symptom scale, tear breakup time, and Schirmer values. RESULTS: Keratoconjunctivitis sicca patients were found to have baseline tear NGF concentrations higher than those of age- and gender-matched healthy control subjects (65.9+/-14.5 vs. 122.1+/-45.3 pg/mug, P<0.0001). In keratoconjunctivitis sicca patients, prednisolone treatment for 28 days resulted in a decrease in tear NGF levels, symptom scores, and IC scores, whereas hyaluronic acid treatment had no such effect (68.2+/-25.0 pg/mug vs. 108.0+/-43.4 pg/mug, P<0.0001 for tear NGF/TP ratio; 2.16+/-1.01 vs. 3.39+/-1.50, P = 0.0014 for symptom scale; 1.05+/-0.67 vs. 1.61+/-0.86, P = 0.0317 for IC). Measurements taken at both 14 and 28 days indicated that neither prednisolone nor hyaluronic acid treatment affected breakup time or Schirmer values. CONCLUSION: Keratoconjunctivitis sicca patients showed elevated levels of tear NGF, which were decreased by treatment with 0.1% prednisolone. These data suggest that ocular surface NGF may play an important role in ocular surface inflammation processes associated with dry eyes.

Administration, Topical↗
PubMed2000

Increased expression of the type 1 growth factor receptor family in the conjunctival epithelium of patients with keratoconjunctivitis sicca.

PURPOSE: To investigate the expression of type 1 growth factor receptors (epidermal growth factor receptor, ErbB2, and ErbB3) in the conjunctival epithelium of patients with keratoconjunctivitis sicca. METHODS: Immunofluorescent staining and Western blotting were performed to grade the level of expression of the epidermal growth factor receptor ErbB2, and ErbB3 in conjunctival epithelial impression cytologies taken from both eyes of seven normal subjects and 22 patients with keratoconjunctivitis sicca. RESULTS: Epidermal growth factor receptor staining was observed in a greater percentage of keratoconjunctivitis sicca than normal samples (P <.05). ErbB2 and ErB3 staining in the apical conjunctival epithelium was observed in both groups, but stronger ErbB2 and ErbB3 staining was noted in keratoconjunctivitis sicca conjunctival samples (P <.05). The relative levels of expression of these receptor proteins on immunoblots were consistent with immunofluorescent staining. On immunoblots, epidermal growth factor receptor protein was detected in 50% of keratoconjunctivitis sicca samples, but none of the normal samples (P <.025). The expression of ErbB2 and ErbB3 on immunoblots was also greater in the keratoconjunctivitis sicca samples (P <.05). Immunofluorescent staining scores for these receptors were correlated with conjunctival lissamine green staining scores (r =. 574, P <.01 for epidermal growth factor receptor; r =.620, P <.0025 for ErbB2; r =.502, P <.025 for ErbB3) and with corneal fluorescein staining (r =.409, P <.05 for ErbB2; r =.588, P <.005 for ErbB3). CONCLUSION: The expression of the type 1 growth factor receptors is significantly greater in the conjunctival epithelium of eyes with keratoconjunctivitis sicca than normal eyes. The increased expression of these receptors was positively correlated with ocular surface dye staining. The increased expression of these receptors may contribute to the abnormal growth and differentiation of the conjunctival epithelium that occurs in keratoconjunctivitis sicca.

Adult↗
PubMed1994

Treatment of keratoconjunctivitis sicca in rabbits with 3-isobutyl-1-methylxanthine.

OBJECTIVE: To examine the effects of topical 3-isobutyl-1-methylxanthine treatment on tear-film osmolarity, conjunctival goblet-cell densities, and corneal epithelial glycogen levels in a rabbit model for keratoconjunctivitis sicca. METHODS: Keratoconjunctivitis sicca was surgically induced in the right eyes of 16 rabbits. In a masked protocol, eight of these operated-on eyes underwent treatment for 12 weeks with a 3.0-mmol solution of 3-isobutyl-1-methylxanthine. The remaining eight operated-on eyes were left untreated and served as controls. RESULTS: The 3-isobutyl-1-methylxanthine treatment resulted in a rapid and significant decrease in tear osmolarity and sodium (P < .5) and potassium levels (P < .05) and a significant increase in conjunctival goblet-cell densities and corneal epithelial glycogen levels compared with untreated and operated-on controls (P < .001). CONCLUSIONS: 3-Isobutyl-1-methylxanthine rapidly and significantly decreased tear-film osmolarity in this rabbit model for keratoconjunctivitis sicca and restored conjunctival goblet-cell densities and corneal glycogen levels, thus reversing the disease process.

1-Methyl-3-isobutylxanthine↗
PubMed1988

Scanning electron microscopy of experimental keratoconjunctivitis sicca in dogs: cornea and bulbar conjunctiva.

Keratoconjunctivitis sicca was produced experimentally in 16 beagles by bilateral surgical removal of the lacrimal and nictitans glands; four dogs were not treated, and 12 received tear-replacement therapy on post-operative days 7 through 28. Keratoconjunctivitis sicca was verified by reduction in Schirmer tear test values by post-operative day 6, and there was no response on day 28 to tear-replacement therapy. Corneas of both normal and tear-deficient dogs had polygonal squamous epithelial cells of light and dark electron density by scanning electron microscopy. Light cells had more microvilli and microplicae than dark cells. Conjunctivae were similar to corneas, except for numerous goblet cells on the surface. Corneal dark-cell density and goblet cell density were not different between groups. Goblet cells most often occurred singly in normal dogs, while they were in clusters in tear-deficient dogs. A hypothesis that petrolatum/mineral oil ointment should provide more effective artificial tear replacement than hydroxymethylcellulose drops for tear-deficient dogs could not be confirmed by objective analysis of corneal dark-cell density or conjunctival goblet cell density.

Animals↗