Conjunctival DiseasesPost-Exposure Prophylaxis: The prevention of infection or disease following exposure to a pathogen.Limbus Corneae: An annular transitional zone, approximately 1 mm wide, between the cornea and the bulbar conjunctiva and sclera. It is highly vascular and is involved in the metabolism of the cornea. It is ophthalmologically significant in that it appears on the outer surface of the eyeball as a slight furrow, marking the line between the clear cornea and the sclera. (Dictionary of Visual Science, 3d ed)Corneal Diseases: Diseases of the cornea.Conjunctiva: The mucous membrane that covers the posterior surface of the eyelids and the anterior pericorneal surface of the eyeball.Epithelium, Corneal: Stratified squamous epithelium that covers the outer surface of the CORNEA. It is smooth and contains many free nerve endings.Amnion: The innermost membranous sac that surrounds and protects the developing embryo which is bathed in the AMNIOTIC FLUID. Amnion cells are secretory EPITHELIAL CELLS and contribute to the amniotic fluid.Stem Cells: Relatively undifferentiated cells that retain the ability to divide and proliferate throughout postnatal life to provide progenitor cells that can differentiate into specialized cells.Dry Eye Syndromes: Corneal and conjunctival dryness due to deficient tear production, predominantly in menopausal and post-menopausal women. Filamentary keratitis or erosion of the conjunctival and corneal epithelium may be caused by these disorders. Sensation of the presence of a foreign body in the eye and burning of the eyes may occur.Diagnostic Errors: Incorrect diagnoses after clinical examination or technical diagnostic procedures.Stress Disorders, Post-Traumatic: A class of traumatic stress disorders with symptoms that last more than one month. There are various forms of post-traumatic stress disorder, depending on the time of onset and the duration of these stress symptoms. In the acute form, the duration of the symptoms is between 1 to 3 months. In the chronic form, symptoms last more than 3 months. With delayed onset, symptoms develop more than 6 months after the traumatic event.Eating Disorders: A group of disorders characterized by physiological and psychological disturbances in appetite or food intake.Prognosis: A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.Bipolar Disorder: A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence.Attention Deficit Disorder with Hyperactivity: A behavior disorder originating in childhood in which the essential features are signs of developmentally inappropriate inattention, impulsivity, and hyperactivity. Although most individuals have symptoms of both inattention and hyperactivity-impulsivity, one or the other pattern may be predominant. The disorder is more frequent in males than females. Onset is in childhood. Symptoms often attenuate during late adolescence although a minority experience the full complement of symptoms into mid-adulthood. (From DSM-V)Anxiety Disorders: Persistent and disabling ANXIETY.Hydrocortisone: The main glucocorticoid secreted by the ADRENAL CORTEX. Its synthetic counterpart is used, either as an injection or topically, in the treatment of inflammation, allergy, collagen diseases, asthma, adrenocortical deficiency, shock, and some neoplastic conditions.Conjunctivitis, Allergic: Conjunctivitis due to hypersensitivity to various allergens.Phosphates: Inorganic salts of phosphoric acid.Prednisolone: A glucocorticoid with the general properties of the corticosteroids. It is the drug of choice for all conditions in which routine systemic corticosteroid therapy is indicated, except adrenal deficiency states.Cathartics: Agents that are used to stimulate evacuation of the bowels.Dexamethasone: An anti-inflammatory 9-fluoro-glucocorticoid.Conjunctivitis

Epithelial hyperproliferation and transglutaminase 1 gene expression in Stevens-Johnson syndrome conjunctiva. (1/208)

In Stevens-Johnson syndrome, pathological keratinization of the ordinarily nonkeratinized corneal and conjunctival mucosal epithelia results in severe visual loss. We examined conjunctiva covering cornea in five eyes in the chronic cicatricial phase of Stevens-Johnson syndrome. Normal conjunctiva from five age-matched individuals was studied also. The number of epithelial cells in Stevens-Johnson syndrome conjunctiva that were immunoreactive with a monoclonal antibody, Ki-67, to a nuclear antigen found only in proliferating cells was greater than normal (93.8+/-19.8 cells above 100 basal cells versus 12.8+/-0.5 cells above 100 basal cells; P = 0.009). In addition, although clinical inflammation was mild, massive lymphocytic infiltration was seen in the substantia propria of conjunctiva covering cornea. In situ hybridization documented transglutaminase 1 (keratinocyte transglutaminase) mRNA in suprabasal cells of the abnormally thickened conjunctival epithelium in all Stevens-Johnson syndrome patients. In contrast, no message was detected in normal conjunctival or corneal epithelia. Transglutaminase 1 is expressed during the terminal differentiation of keratinocytes where it helps synthesize cornified cell envelopes. We speculate that in Stevens-Johnson syndrome, epithelial hyperproliferation, and transglutaminase 1 gene expression lead to the pathological keratinization of ocular surface mucosal epithelia.  (+info)

Ocular ochronosis in alkaptonuria patients carrying mutations in the homogentisate 1,2-dioxygenase gene. (2/208)

AIMS: To assess the involvement of the recently identified human homogentisate 1,2-dioxygenase gene (HGO) in alkaptonuria (AKU) in two unrelated patients with ochronosis of the conjunctiva, sclera, and cornea. METHODS: A mutation screen of the entire coding region of the HGO gene was performed using single stranded conformational analysis after polymerase chain reaction with oligonucleotide primers flanking all 14 exons of the HGO gene. Fragments showing aberrant mobility were directly sequenced. RESULTS: Two homozygous missense mutations, L25P and M368V, were identified, each of which leads to the replacement of a highly conserved amino acid in the HGO protein. CONCLUSIONS: The authors describe a novel mutation, L25P, in the German population and bring to 18 the total number of known HGO mutations.  (+info)

Combined effect of Interceed and 5-fluorouracil on delayed adjustable strabismus surgery. (3/208)

AIMS/BACKGROUND: To discover a more reliable method of performing delayed suture adjustment as a basis to investigate whether delayed adjustment actually provides more stable results. In order to prevent the formation of postoperative adhesions and delay the time of adjustment, an animal study was performed to determine the combined effect of physical barriers, Viscoat and Interceed, and a pharmacological agent, 5-fluorouracil (5-FU). METHODS: 38 rabbit eyes were divided into three groups. After recession of the superior rectus muscle (SRM), 5-FU was applied beneath and over the SRM in group 5-FU. Group I-f had Interceed and 5-FU and group I-fv, Interceed, 5-FU, and Viscoat. Delayed adjustment was performed once on each SRM at 1, 2, and 3 weeks postoperatively. The possible length and the necessary force to adjust as well as the degree of adhesions were recorded. RESULTS: 5-FU delayed the adjustment for up to 1 week after surgery in three out of four eyes. Combined use of Interceed and 5-FU could delay the adjustment for up to 1 week after surgery in three out of five eyes. Addition of Viscoat could delay the adjustment for up to 1 week after surgery in four out of five eyes. Adjustment was possible on only one of four eyes thereafter. CONCLUSIONS: Combined use of Interceed, 5-FU, and Viscoat could delay the adjustment in rabbits until 1 week postoperatively.  (+info)

Transforming growth factor-beta1, -beta2, and -beta3 in vivo: effects on normal and mitomycin C-modulated conjunctival scarring. (4/208)

PURPOSE: To compare the effects of the three human isoforms of transforming growth factor (TGF)-beta in vivo using a mouse model of conjunctival scarring, both in normal eyes and after treatment with MMC, with a view to delineating the role of this growth factor in glaucoma filtration surgery. METHODS: Application of recombinant human TGF-beta was assessed in a prospective, randomized study of mouse conjunctival scarring, in which subconjunctival TGF-beta1, -beta2, and -beta3 (all 10(-9) M) were compared with control (phosphate-buffered saline [PBS] carrier) and mitomycin C (MMC; 0.4 mg/ml) treatment at 6 hours, and 1, 3, and 7 days after surgery (six eyes/treatment/time point). Effects of TGF-beta2 on eyes previously treated with MMC were also assessed. Histologic studies of enucleated eyes were performed to analyze development of the scarring response, extracellular matrix deposition, and the inflammatory cell profile. RESULTS: All three isoforms of TGF-beta behaved in a similar manner in vivo, being associated with a rapid-onset and exaggerated scarring response compared with control and MMC treatment. TGF-beta-treated eyes showed evidence of an earlier peak in inflammatory cell activity (P < 0.05) and increased collagen type III deposition (P < 0.05). TGF-beta2 treatment significantly stimulated scarring after MMC application (P < 0.05). CONCLUSIONS: TGF-beta1, -beta2, and -beta3 appear to have similar actions in vivo and stimulate the conjunctival scarring response. Application of TGF-beta2 modified the effects of MMC. All TGF-beta isoforms may be potent modulators of the conjunctival scarring response. These studies indicate that TGF-beta2 may naturally modify the antiscarring effects of antimetabolites such as MMC in glaucoma filtration surgery.  (+info)

Human anti-transforming growth factor-beta2 antibody: a new glaucoma anti-scarring agent. (5/208)

PURPOSE: Currently available anti-scarring regimens for glaucoma filtration surgery have potentially blinding complications and thus the need for alternative and safer agents. The effects of a new antibody to transforming growth factor (TGF)-beta2 on in vitro and in vivo conjunctival scarring and after glaucoma filtration surgery were investigated. METHODS: The activity of a novel recombinant monoclonal neutralizing antibody (mAb) to human TGF-2 (rhAnti-TGF-beta2 mAb) was studied in conjunctival fibroblast-mediated proliferation, migration, and collagen contraction. Its safety in subconjunctival administration was assessed in vivo, and, in a rabbit model of glaucoma filtration surgery, its effects on conjunctival scarring and filtration surgery outcome were investigated. RESULTS: The rhAnti-TGF-beta2 mAb effectively inhibited TGF-beta2-mediated conjunctival scarring activity in vitro, at 50% inhibitory concentrations (IC50) of less than 1 nM. It significantly improved glaucoma filtration surgery outcome in an animal model of aggressive conjunctival scarring compared with control (P = 0.0291) and was clinically safe, nontoxic, and well tolerated after subconjunctival administration. CONCLUSIONS: Subconjunctival rhAnti-TGF-beta2 mAb treatment significantly affects surgical outcome and effectively reduces conjunctival scarring both in vitro and in vivo. It appears safe for subconjunctival administration and when compared with mitomycin-C treatment histologically, much less destructive to local tissue. rhAnti-TGF-beta2 mAb may have potential as a new anti-scarring agent for use in glaucoma filtration surgery.  (+info)

Tear fluid gelatinase B activity correlates with IL-1alpha concentration and fluorescein clearance in ocular rosacea. (6/208)

PURPOSE: To correlate tear fluorescein clearance with interleukin-1alpha (IL-1alpha) concentration and gelatinase B (matrix metalloproteinase [MMP]-9) activity in the tear fluid of patients with ocular rosacea and normal control subjects. METHODS: Gelatinase activity was evaluated by gelatin zymography in tear fluid obtained from 13 patients with ocular rosacea (including 1 patient with recurrent epithelial erosion, 2 with recurrent peripheral corneal infiltrates and vascularization, and 2 patients with epithelial basement membrane dystrophy) and 13 normal subjects with normal aqueous tear production and no irritation symptoms. Tear fluorescein clearance was evaluated by measuring fluorescence in tear fluid collected from the inferior meniscus 15 minutes after instillation of 5 microl of 2% Na-fluorescein with a CytoFluor II fluorometer. Pro-MMP-9 and IL-1alpha concentrations in the tear fluid were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: Compared with normal control subjects, patients with ocular rosacea had a greater delay of tear fluorescein clearance (P < 0.001), a higher tear IL-1alpha concentration (P < 0.001), and a greater pro-gelatinase B (92 kDa) activity (P < 0.001) in their tear fluid. The 84-kDa active form of gelatinase B was observed in 46% of the rosacea tear samples and none of the controls. The zymographic results were confirmed by ELISA that showed a significantly greater concentration of pro-MMP-9 (92 kDa) in the tear fluid of rosacea patients than controls. Delayed tear clearance was correlated with elevated tear IL-1alpha concentration (p=0.67, P < 0.001) and increased tear gelatinase B activity (p=0.84, P < 0.001). Tear IL-1alpha concentration was correlated with tear gelatinase B activity (p=0.58, P < 0.002). CONCLUSIONS: Gelatinase B (MMP-9) activity is greater in patients with ocular rosacea than in normal eyes. The majority of this activity is due to 92-kDa proform of this enzyme. This activity is correlated with delayed tear clearance and tear fluid concentration of interleukin-1alpha, a proinflammatory cytokine that has been reported to stimulate gelatinase B production. Elevated gelatinase B activity in ocular rosacea may be involved in the pathogenesis of the irritation symptoms, recurrent epithelial erosions, vascularization, and epithelial basement membrane dystrophy that develops in the corneas of patients with this condition.  (+info)

Overexpression of MMP-1 and MMP-3 by cultured conjunctivochalasis fibroblasts. (7/208)

PURPOSE: To determine whether conjunctivochalasis, denoting redundant, loose, nonedematous inferior bulbar conjunctiva, is associated with increased expression and activity of matrix metalloproteinases (MMPS) over their tissue inhibitors (TIMPs). METHODS: Expression of transcripts and proteins of MMPs, TIMPs, and urokinase plasminogen activator (uPA) by cultured normal human conjunctival and conjunctivochalasis fibroblasts was determined by Northern hybridization, enzyme-linked immunosorbent assay (ELISA), and Western blot analysis, respectively. Gelatin and casein zymography and quantitative collagenase activity assay were performed in the serum-free conditioned media. RESULTS: Compared with normal conjunctival fibroblasts from six subjects, conjunctivochalasis fibroblasts from eight patients showed markedly increased transcript expression of MMP-1 (5- to 32-fold) and MMP-3 (4 to 30-fold), whereas that of MMP-2, TIMP-1, TIMP-2, and uPA was similar between the two groups. Protein levels were increased in the serum-free conditioned media of conjunctivochalasis fibroblasts for MMP-1 (3.5- to 7.6-fold) and MMP-3 (2.3- to 13-fold), determined by ELISA and Western blot analysis. There was increased caseinolytic activity of MMP-3 and collagenolytic activity of MMP-1 (2.2-fold) by conjunctivochalasis fibroblasts, whereas no difference was noted between these two types of fibroblasts in the protein and gelatinolytic activity of MMP-2 or expression of TIMP-1 and TIMP-2 proteins, although that of TIMP-1 transcript was slightly higher in some conjunctivochalasis fibroblasts. No expression of MMP-9 was detected. CONCLUSIONS: Overexpression of MMP-1 and MMP-3 mRNA by conjunctivochalasis fibroblasts is correlated with their increased protein levels and proteolytic activities. Collectively, these data help explain how conjunctivochalasis manifests excessive degradation of the conjunctival matrix and Tenon's capsule.  (+info)

Key factors in the subjective and objective assessment of conjunctival erythema. (8/208)

PURPOSE: To establish objectively measurable characteristics of the conjunctival vasculature that correspond with the judgment of erythema by human observers. METHODS: Color images of bulbar conjunctiva from 21 subjects were digitally analyzed to extract the following variables characteristic of the scene: vessel width (W), number of vessels (V), proportion of area occupied by vessels (PA), relative redness both in vessels (RRV) and in the whole image (RRI), red-green difference both in vessels (RGV) and in the whole image (RGI), red-blue difference both in vessels (RBV) and in the whole image (RBI), and red hue value (RHV). These data were compared with subjective judgments by a panel of seven trained observers who independently rated erythema in the same images, using a 0 to 4 scale with decimal interpolation between grades. RESULTS: Correlation analysis indicated significant associations (P<0.05) between the mean response of the human observers and all the objective variables except RHV. Associations with the morphometric variables PA (R2 = 0.93) and V(R2 = 0.90) were markedly stronger than for the best colorimetric variable RBV (R2 = 0.62). CONCLUSIONS: Judgments of erythema made by human observers do not rely primarily on color but can be closely approximated by a univariate, linear model involving only the proportion of the scene occupied by vessels. Under the conditions of this study, grading of erythema by trained observers can be considered to constitute measurement to at least an interval level.  (+info)

  • Methods: Nine dogs (12 eyes) diagnosed with progressive corneal edema underwent superficial keratectomy followed by placement of conjunctival advancement hood flaps. (
  • After use for hematologic analysis, samples and edema of the conjunctival mucosae (Figure 2), sore were stored at -30°C until virologic and serologic tests muzzle, hyperemia of the teats and udder, hemorrhage, de- could be performed. (
  • Purpose: Dry eye symptoms greatly impact patients' quality of life in ocular graft-versus-host disease (oGVHD). (
  • The Ocular Surface Disease Index (OSDI) is a 12-question validated questionnaire used to measure ocular symptoms, visual function, and environmental factors that may affect a patient's vision. (
  • Monarch's tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. (
  • Dry eye is a complex disease that may result in symptoms like discomfort, visual disturbance, and dryness. (
  • Lifitegrast is an investigational treatment for dry eye disease in adults and, if approved, has the potential to be the first treatment indicated to address both signs and symptoms of the disease. (
  • As defined by the 2007 Dry Eye WorkShop ("DEWS"), sponsored by the Tear Film & Ocular Surface Society (TFOS), dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. (
  • Lexington, Mass. - March 2, 2015 - Shire plc (LSE: SHP, NASDAQ: SHPG) announced today that the company has submitted a New Drug Application (NDA) with the U. S. Food and Drug Administration for its investigational compound lifitegrast for the treatment of signs and symptoms of dry eye disease in adults. (
  • Lifitegrast has potential to be the first treatment indicated to address both the signs and symptoms of dry eye disease, a chronic inflammatory condition which affects millions of people,' said Philip J. Vickers, Ph.D., Head of Research and Development, Shire. (
  • Ocular inserts reduce symptoms resulting from moderate to severe dry eye disease. (
  • It is indicated for treatment of the signs and symptoms of dry eye disease in adults. (
  • We summarize up-to-date literature on conjunctival intraepithelial neoplasia and invasive squamous cell carcinoma and present some own cases. (
  • Progressive motor impairment from a critically located lesion in highly restricted CNS-demyelinating disease. (
  • An important gene associated with Conjunctival Nevus is MLANA (Melan-A), and among its related pathways/superpathways are Development Angiotensin activation of ERK and Development Endothelin-1/EDNRA signaling . (
  • Primary acquired melanosis is now differentiated histologically into hypermelanosis and conjunctival melanocytic intra-epithelial neoplasia, for which an objective reproducible scoring system has been developed. (
  • 5 We have also devised a system for histological scoring for conjunctival melanocytic intra-epithelial neoplasia (C-MIN), which in our institution has replaced the term primary acquired melanosis (PAM) with varying (subjectively evaluated) degrees of atypia. (
  • Histologically, conjunctival melanosis is divided into two groups according to the pathological processes involved: 'hypermelanosis' and 'melanocytic neoplasia' ( Table 2 and Figure 3 ). (
  • Sjögren's syndrome (SjS) is a human autoimmune disease characterized by exocrine dysfunction resulting from chronic autoimmune attack primarily against the lacrimal and/or salivary glands. (
  • Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and multiple evanescent white dot syndrome (MEWDS) are self-limited, spontaneously-remitting diseases for which treatment typically is not needed. (
  • Genetic analyses have identified BRAF and other mutations, which may predict responsiveness to new chemotherapeutic agents, for example Vemurafenib, should metastatic disease develop. (
  • log-rank P = .02) were improved when all known sites of metastatic disease were consolidated with SBRT compared with partial consolidation. (
  • With this technique, researchers could potentially identify occult metastatic disease which would otherwise go unnoticed until it was too advanced. (
  • abstract = "Purpose: To evaluate the efficacy of superficial keratectomy and conjunctival advancement hood flap (SKCAHF) for the treatment of bullous keratopathy in canine patients. (