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)

A CLINICAL ASPECT DEPENDING ON THE PHYSIOPATHOGENESIS: Ocular infections are a frequent motive for ophthalmological consultations in geriatric settings because of the mechanical factors related to age (modifications in palpebral dynamics and lacrymal function) and in local and general immune factors leading to the rapid and/or more severe development of infections. The mechanism of microbial contamination of the eye also determines the clinical damage: predominantly local (dirty hands, traumas) with involvement of the surface tissues (conjunctive and cornea) or general, hematogenic or neurogenic, frequently at the origin of more internal infections (iris, choroid, retina, optical nerve). CONJUNCTIVITIS AND KERATITIS: These provoke reddening of the eyes, tears and above all pain when the corneal epithelium is involved. Microbiological samples are useful in cases of severe, presumably infectious keratitis or conjunctivitis. Two emergency situations must be distinguished: any suspicion of herpes for which local corticosteroids are contraindicated and keratitis or conjunctivitis with the use of lenses, often due to Gram negative bacilli, amoeba or fungus, the treatment of which is intensive and the prognosis often severe. OPHTHALMOLOGICAL HERPES ZOSTER: The rapid diagnosis and introduction of efficient doses of antivirals reduces the initial pain, the ocular complications of herpes zoster and post-zoster pain. The latter, when it exists, requires specialized management. ACUTE UVEITIS: A context of intra-ocular inflammation in an elderly patient must always evoke a pseudo-uveitis syndrome, the principle cause of which is lymphoma. Conversely, an uveitis occurring in the days or weeks following ocular surgery, including cataract, must be considered as suggestive of a post-surgical infection and rapidly referred to a specialist. ACUTE DACRYOCYSTITIS: Is manifested by a hard and painful tumefaction below the internal angle of the eye. Following collection, it requires draining through an in incision in the skin, washing and packing of the sac, and systemic antibiotherapy. The preventive treatment of recurrences requires open dacryocystorhinostomy or via endonasal endoscopy.
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PMID:[Ocular infections of the elderly]. 1240 61

Herpes zoster ophthalmicus occurs when the varicella-zoster virus is reactivated in the ophthalmic division of the trigeminal nerve. Herpes zoster ophthalmicus represents up to one fourth of all cases of herpes zoster. Most patients with herpes zoster ophthalmicus present with a periorbital vesicular rash distributed according to the affected dermatome. A minority of patients may also develop conjunctivitis, keratitis, uveitis, and ocular cranial-nerve palsies. Permanent sequelae of ophthalmic zoster infection may include chronic ocular inflammation, loss of vision, and debilitating pain. Antiviral medications such as acyclovir, valacyclovir, and famcidovir remain the mainstay of therapy and are most effective in preventing ocular involvement when begun within 72 hours after the onset of the rash. Timely diagnosis and management of herpes zoster ophthalmicus. with referral to an ophthalmologist when ophthalmic involvement is present, are critical in limiting visual morbidity.
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PMID:Evaluation and management of herpes zoster ophthalmicus. 1244 71

The role of immunologic factors in the development of ophthalmic pathologies in persons infected by hepatitis B virus (HBV) affecting the liver or in asymptomatic virus carriers (a total of 285 persons, 328 eyes) was studied. The deficit of CD3 and CD4 cells, gammopathy, increased levels of circulating immune complexes and of TNF-alpha in the serum; the deficit of IgA and an enhanced secretion of IgG in the lachrymal fluid; as well as a weakened ability of the local and systematic production of IFN-alpha were typical for a majority of patients. The most profound changes were detected in cases of uveitis; apart from the above mentioned, an increase of the CD4/CD8 index as well as of organ-specific and inter-organ immunization was found. The cases of keratitis (92% of the stromal type) were distinguished through a hypersecretion of TNF-alpha both in the serum and in the lachrymal fluid. Complicated cataracts were observed mainly in convalescents or in asymptomatic virus carriers; immune disorders were less seldom encountered in this category, as compared to the cases of eye inflammations, and basically they were local. The obtained data were considered in treatment. Imunofan, when added to the traditional therapy (symptomatic and corticosteroid one), activated the local and systematic antiviral immunity, suppressed the production of pro-viral cytokines and reduced the autoimmune reactions. As a result of this, the treatment time, the frequency rate of relapses as well as the number of anti-inflammatory and postoperative (in cataracts) complications decreased. The study results are indicative of that the immunopathological reactions, which are typical of HBV patients, can be detected at the ocular level and they can provoke ophthalmic pathologies. The nature, severity and relation between the local and systematic immune disorders predetermine, to a considerable extent, the development of an eye disease and its severity. The treatment (and prophylaxis) of HBV-associated ophthalmic pathologies require an obligatory usage of immunity-correcting means and clinical-and-immunological monitoring.
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PMID:[The role of immunopathological reactions in the development of eye diseases in persons infected by hepatitis B virus and the efficiency of immuno-correcting therapy]. 1280 Apr 83

A total of 439 patients (adults--184, children--255) with herpetic keratitis as well as with uveitis and choriorenitis of different geneses and localizations were examined. An aggravation of HSV-infection was determined by detecting, in the blood), anti-bodies to the unstructured early viral antigens by using the immune enzyme analysis (IEA). The efficiency of the test was demonstrated during the examination of patients with different ophthalmic pathologies. An active infection was detected in 16-39% of patients with various ocular diseases of non-herpetic etiology. The pathogenetic value of reactivated HSV infection is diverse: it can function as an etiological or trigger factor and it can aggravate the main disease through causing, postoperatively, complications.
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PMID:[Diagnosis and importance of the opportunistic herpes-virus infection in etiology and pathogenesis of different eye diseases]. 1280 Apr 84

Because of the wide variety of x-rays now available, selectivity is possible and important in treatment of diseases of the eye. By the use of short-range radiation, newly developed eye shields and the insulation of the eyelid itself, and by careful angulation of the beam, the desired irradiation can be given where it is needed without injury to surrounding tissues. The authors have found the 50 kv x-ray unit to be the most reliable and adaptable for most circumstances. The skin of the eyelid reacts to irradiation more sensitively than other tissues. The cornea reacts with keratitis and sometimes intractable ulceration. The iris, uveal tract and retina are less seriously affected. At the University of California Hospital irradiation has been found satisfactory for treatment of corneal ulcer, keratitis, pterygium, certain types of conjunctivitis, episcleritis, corneal vascularization, iritis, uveitis, and hemangioma. Irradiation may be of great benefit in absolute glaucoma with pain and blindness. Of 42 patients with carcinoma of the eyelid treated between 1935 and 1946, 27 had no recurrence in five years, 5 had recurrence, 7 died of other causes and follow-up was incomplete on 3. Good cosmetic result was usually achieved. No recurrence has been observed in 22 patients treated since 1946. Irradiation has been used with success in other kinds of cancer of the eye structures.
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PMID:Radiation therapy in diseases of the eye. 1312 10

Film-type scleral implants of indomethacin using sodium alginate and PEG 400 and 600 (3, 5, 8, and 10% w/w w.r.t. sodium alginate) as plasticizers were fabricated by solvent casting. The prepared implants were cross-linked by treatment with calcium chloride 10, 20, and 30% w/v solution, for periods between 1 to 24 hr. Uniformity of thickness, weight, and drug content and surface pH of the implants were evaluated. The influence of plasticizer type/concentration and crosslinking time/concentration of calcium chloride on indomethacin release was studied on a static dissolution setup developed by us. Selected batches of the implants were subjected to pharmacodynamic studies, after scleral placement, in uveitis-induced (intravitreal injection of bovine serum albumin 50 microg/ml) rabbit eyes. The release of indomethacin from the implants was influenced by the concentration and nature of plasticizers used. Chemical cross-linking with calcium chloride was successful in retarding the drug release. The pharmacodynamic studies showed a marked improvement in the various clinical parameters (congestion, keratitis, flare, clot, aqueous cells, and synechias) in the implanted eye when compared with the control eye in the rabbits. The implants survived for 2 weeks in vivo.
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PMID:In vitro and in vivo characterization of scleral implant of indomethacin: role of plasticizer and cross-linking time. 1461 43

The term 'vasculitis' includes a wide range of disorders characterised by inflammation of the wall of blood vessels, sometimes with necrosis, leading to ischaemia of the affected organ. The exact pathogenesis of most of these vasculitides is not fully understood and although the presence of circulating auto-antibodies seems to be a common feature among them, each vasculitis has its unique pathogenesis and a predilection for vessels of a defined size. Systemic vasculitis may be associated with ocular complications which include scleritis, keratitis, uveitis and optic neuropathy. These can precede the symptoms/signs of the systemic disease and therefore their recognition may lead to detection of the underlying disorder. The eye may also be affected by the treatment required to control the systemic disease.
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PMID:The eye in systemic vasculitis. 1524 60

This article discusses the diagnosis and medical treatment of stromal keratomalacia or "melting ulcers," stromal abscesses, eosinophilic keratitis (EK), and calcific band keratopathy. These are common and important inflammatory keratopathies of the equine corneal stroma. Keratomalacia and stromal abscesses are associated with infection, leukocytic invasion of the stroma, and loss of tissue and tear film proteinase homeostasis. Eosinophils infiltrate the stroma in response to unknown stimuli in EK. Calcium is deposited in the stroma and epithelium secondary to chronic equine recurrent uveitis in calcific band keratopathy. They are all associated with varying degrees of iridocyclitis.
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PMID:Inflammatory stromal keratopathies: medical management of stromal keratomalacia, stromal abscesses, eosinophilic keratitis, and band keratopathy in the horse. 1527 27

Ocular inflammation in children is of substantial epidemiologic importance, particularly since uveitis in children produces more vision loss than it does in adults. This is partially because there is a higher rate of posterior uveitis in childhood uveitis than in the adult population. Treatment of ocular inflammation in children, ranging from conjunctivitis to keratitis to scleritis to uveitis, depends, of course, on whether or not the problem is microbial, traumatic, malignant, or autoimmune. Most of the cases that are vision threatening are autoimmune, and corticosteroids represent the mainstay of short-term therapy. However, abundant evidence exists which shows that all too often imprudent, prolonged use of corticosteroids is employed with resultant iatrogenic damage, including cataract, glaucoma, and secondary infection.A new paradigm for treating ocular inflammation (uveitis in particular) is espoused in this article. It is based on a limited tolerance to corticosteroid use and a more proactive approach to corticosteroid-sparing immunomodulatory therapy in an effort to induce a durable remission off all corticosteroids.
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PMID:Treatment of ocular inflammation in children. 1544 68

A retrospective study was conducted to determine case histories, microbiological characteristics, and molecular subtypes associated with Listeria monocytogenes infections of the eye in large animals. For selected cases, environmental L. monocytogenes contamination patterns on case farms were also evaluated to probe for potential sources and spread of listerial eye infections. Records of 170 L. monocytogenes isolates from animal infections were reviewed to determine the fraction of isolates associated with eye infections (conjunctivitis, keratitis, and uveitis) of animals and to gather information on the clinical history of these cases. Overall, 4 of 170 Listeria monocytogenes isolates were associated with eye infections; 3 of these had occurred in cows and 1 in a horse. Molecular subtyping (by EcoRI ribotying) showed that 4 different L. monocytogenes subtypes were isolated from these 4 cases; the same ribotypes had previously been found among invasive animal listeriosis infections. Although a variety of L. monocytogenes subtypes were isolated from environmental sources, on 1 farm, the same ribotype associated with the eye infection was also isolated from a fecal sample of a healthy animal and from a soil sample. The data reported in this study further suggest that L. monocytogenes can be a cause of eye infections in several animal species. Listerial eye infections do not seem to require specific pathogen-related virulence characteristics but rather seem to be a function of environmental or host factors, such as direct exposure of the eyes of susceptible animals to high numbers of the pathogen. Although listerial eye infections are rarely diagnosed because of its ubiquitous nature, L. monocytogenes may have to be considered more commonly as a causative agent of eye infections in ruminants and horses.
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PMID:Eye infections due to Listeria monocytogenes in three cows and one horse. 1546 Mar 35


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