Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The eye has a special relationship with the immune system; normally, there appears to be intraocular suppression of inflammatory responses. Studies of the immunological principles of intraocular inflammation (uveitis) are mostly done in animal models. Although very complicated, uveitis appears in any case to be T-cell mediated. Uveitis is classified according to anatomical location as anterior, intermediate, posterior and pan-uveitis. Other immunological disorders are the sicca syndrome, keratitis and scleritis. All these disorders may or may not be associated with systemic autoimmune diseases. The chronic and recurring characteristics make uveitis a serious threat to vision. A rapid diagnosis and adequate treatment are therefore very important.
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PMID:[Immunology in clinical practice. XIII. Immune diseases of the eye]. 956 56

A 50-year-old diabetic man developed necrotizing scleritis with adjacent keratitis 4 weeks after uncomplicated cataract extraction and intraocular lens implantation through a scleral tunnel incision. Cultures of the necrotic sclera grew Rizopus species. Severe destruction of the globe ensued despite topical, subconjunctival, and intravenous amphotericin B, in combination with hyperbaric oxygen therapy. Histopathological examination of the enucleated globe was consistent with Rhizopus infection. One year later, the patient was well without signs of recurrence.
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PMID:Postoperative Rhizopus scleritis in a diabetic man. 958 56

Acanthamoeba species are an important cause of microbial keratitis that may cause severe ocular inflammation and visual loss. The first cases were recognized in 1973, but the disease remained very rare until the 1980s, when an increase in incidence mainly associated with contact lens wear was reported. There is an increased risk when contact lens rinsing and soaking solutions are prepared with nonsterile water and salt tablets. The clinical picture is often characterized by severe pain with an early superficial keratitis that is often treated as herpes simplex infection. Subsequently a characteristic radial perineural infiltration may be seen, and ring infiltration is common. Limbitis and scleritis are frequent. Laboratory diagnosis is primarily by culture of epithelial samples inoculated onto agar plates spread with bacteria. Direct microscopy of samples using stains for the cyst wall or immunostaining may also be employed. A variety of topically applied therapeutic agents are thought to be effective, including propamidine isethionate, clotrimazole, polyhexamethylene biguanide, and chlorhexidine. Various combinations of these and other agents have been employed, often resulting in medical cure, especially if treatment is commenced early in the course of the disease. Penetrating keratoplasty is preferably avoided in inflamed eyes, but may be necessary in severe cases to preserve the globe or, when the infection has resolved, to restore corneal clarity for optical reasons.
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PMID:Acanthamoeba keratitis. 963

Wegener's granulomatosis is a necrotizing, granulomatous vasculitis. It usually causes sinusitis, pneumonitis and glomerulonephritis. The common ocular manifestations include conjunctivitis, scleritis, peripheral keratitis and orbital inflammation. We report the case of a 50-year-old woman with Wegener's granulomatosis and very severe ocular complications who underwent bilateral enucleation. The pathologic findings of the eyeballs revealed granulomatous necrotizing scleritis, perivasculitis and granulomatous choroiditis. The last, as far as we know, has not yet been reported.
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PMID:Choroidal involvement in Wegener's granulomatosis: a case report. 974 68

The frequency of tuberculous uveitis has extremely decreased in Japan. Anterior granulomatous or non-granulomatous uveitis, chorioretinitis and retinal vasculitis are common ocular manifestations, while tuberculoma, scleritis, keratitis and orbital tuberculosis are rare. The diagnosis of ocular tuberculosis is extremely difficult because ocular tuberculosis tends to be negative in chest x-ray or tuberclin skin test. To diagnose ocular tuberculosis clinically some ophthalmologists recommend subconjunctival tuberculin test or therapeutic isoniazide (INH) test. Recently, for confirmed diagnosis, polymerase chain reaction (PCR) technique has been used to detect mycobacterium in intraocular samples such as aqueous or vitreous humor. The mainstay of treatment is antituberculosis agents. Active retinal vasculitis or tuberculoma are generally responsive to corticosteroid therapy. Although ocular tuberculosis is rare, it must be considered as one of the possible causes of uveitis.
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PMID:[Ocular tuberculosis]. 988 31

Varicella zoster virus (VZV) infection is a frequent complication following bone marrow transplantation (BMT). Involvement of the ophthalmic division of the trigeminal nerve, herpes zoster ophthalmicus (HZO), can result in significant and potentially vision-threatening ocular complications. We report the frequency and characteristics of HZO following BMT, including the timing of infection, treatment, ocular complications, and visual outcome. Between 1983 and 1997, 572 patients underwent BMT and seven children developed HZO at a median of 150 days following transplantation. All but one of the children had undergone allogeneic BMT. All of the children were treated with acyclovir after onset of the rash but none had received prophylactic therapy. All seven children developed ocular complications within the first 4 weeks following the onset of the dermatomal rash but none reported any symptoms during this period. Complications included keratitis in six, anterior uveitis in three and scleritis in one. Keratitis was an early complication developing within the first 4 weeks, while anterior uveitis and scleritis occurred later in the course of the disease. The high frequency of ocular complications and lack of symptoms in children with HZO following BMT suggests that early ophthalmologic evaluation is warranted in this group of patients. Prompt diagnosis and treatment of ocular complications is essential in the prevention of acute and long-term ocular sequelae in these children.
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PMID:Herpes zoster ophthalmicus following bone marrow transplantation in children. 1041 22

Changes in the levels of natural antibodies in the lacrimal fluid, saliva, and blood immunoglobulin concentrations were studied in patients with ocular injuries, inflammatory (keratitis, scleritis, uveitis) and noninflammatory diseases of the eyes. These values can be used as additional parameters for the diagnosis and prediction of the treatment efficiency. The immune system functions as a universal system with different compartments, and therefore mathematical relationships between these parameters were studied. Positive linear regression and correlation relationships were detected between -log2 antibody titers in the serum and lacrimal fluid, antibody titers in the saliva and serum, and negative relationships between antibody titers in the lacrimal fluid and IgA concentration and between lacrimal antibody titers and IgA level.
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PMID:[Regularities of changes in parameters of humoral immunity in patients with eye diseases]. 1103 71

AIM. To investigate whether the extent of ocular morbidity had de-creased as a result of improved diagnosis, awareness and treatment of Wegener 's granulomatosis (WG). MATERIALS AND METHODS. A retrospective study of all patients with ophthalmic involvement due to WG over an 8-year period. RESULTS. Forty-nine patients were diagnosed to have WG. Of these, 28 had ocular involvement: 21 patients had focal ocular involvement (conjunctivitis, episcleritis, scleritis, keratitis, iritis, retinitis)and 7 had orbital involvement. Permanent visual loss occurred in three patients with orbital involvement, but in no patients with focal ocular disease. Up to 90% of patients had systemic involvement. Three deaths oc- curred among those with ocular involvement. CONCLUSIONS. Patients with WG have a much improved visual prog- nosis as a result of early diagnosis and intervention with systemic im- munosuppression. A combination of assays for ANCA and tissue biop-sies were needed to establish the diagnosis of WG. Treatment with immunosuppressive agents (usually prednisolone and cyclophospha- mide)led to a good response in the majority of cases.
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PMID:Wegener's granulomatosis: The ocular manifestations revisited. 1204 40

Keratoconjonctivitis sicca, scleritis and keratitis remain the major ocular manifestation, associated with rheumatoid arthritis. Corneal ulcers are a rare complication but can lead to perforation. Unstable epithelial barrier and immune disorders play a key role in the pathophysiology of such corneal melting. Moreover the association with systemic vasculitis reveals the need for an appropriate immunosuppressive treatment. New surgical approaches and early immunotherapy allow to maintain ocular integrity even if the visual prognosis is poor.
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PMID:[Corneal ulcers associated with rheumatoid arthritis]. 1207 96

Fungi may infect the cornea, orbit and other ocular structures. Species of Fusarium, Aspergillus, Candida, dematiaceous fungi, and Scedosporium predominate. Diagnosis is aided by recognition of typical clinical features and by direct microscopic detection of fungi in scrapes, biopsy specimens, and other samples. Culture confirms the diagnosis. Histopathological, immunohistochemical, or DNA-based tests may also be needed. Pathogenesis involves agent (invasiveness, toxigenicity) and host factors. Specific antifungal therapy is instituted as soon as the diagnosis is made. Amphotericin B by various routes is the mainstay of treatment for life-threatening and severe ophthalmic mycoses. Topical natamycin is usually the first choice for filamentous fungal keratitis, and topical amphotericin B is the first choice for yeast keratitis. Increasingly, the triazoles itraconazole and fluconazole are being evaluated as therapeutic options in ophthalmic mycoses. Medical therapy alone does not usually suffice for invasive fungal orbital infections, scleritis, and keratitis due to Fusarium spp., Lasiodiplodia theobromae, and Pythium insidiosum. Surgical debridement is essential in orbital infections, while various surgical procedures may be required for other infections not responding to medical therapy. Corticosteroids are contraindicated in most ophthalmic mycoses; therefore, other methods are being sought to control inflammatory tissue damage. Fungal infections following ophthalmic surgical procedures, in patients with AIDS, and due to use of various ocular biomaterials are unique subsets of ophthalmic mycoses. Future research needs to focus on the development of rapid, species-specific diagnostic aids, broad-spectrum fungicidal compounds that are active by various routes, and therapeutic modalities which curtail the harmful effects of fungus- and host tissue-derived factors.
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PMID:Current perspectives on ophthalmic mycoses. 1455 97


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