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)

We studied intraocular penetration of topically applied trifluridine in five patients with herpetic keratitis undergoing penetrating keratoplasty. We compared the concentration of trifluridine and its metabolite 5-carboxy 2'-deoxyuridine in the aqueous humor to those of normal control patients undergoing routine cataract extraction without preoperative antiviral therapy. Significant concentrations of intact trifluridine were achieved in the acqueous humor after topical application of 1% trifluridine ophthalmic drops. The metabolite, 5-carboxy 2'-deoxyuridine, was not found in the aqueous humor. Unlike idoxuridine and vidarabine, it is possible to achieve therapeutic levels of trifluridine at intraocular sites that would be advantageous in the treatment of deep herpetic disease involving the stroma and iris.
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PMID:Intraocular penetration of trifluridine. 11 Jan 52

Only a few isolated cases of endophthalmitis have Corynebacterium been implicated as etiology. This diphtheroid, which has been considered for a long time as a nonpathogenic contaminant from the conjunctival flora, may produce systemic diseases usually in immuno-deficient patients. Keratitis and endophthalmitis cases have been reported in the literature. We report three cases of chronic endophthalmitis after extracapsular extraction with intraocular chamber posterior lens which are characterized by many subacute iridocyclitis and vitritis attacks treated by topical steroids. These endophthalmitis are characterized by decrease of visual acuity, hypopion, white plaque on posterior capsule and vitritis. In the first case, Corynebacterium has been isolated from the culture of vitreous and in the second and third cases from the culture of aqueous humor. These bacteria are often very slow growing, 8 to 14 days in the 3 cases. Colonies may not become visible on culture plates before one week or more. Corynebacterium grow well on ordinary media (blood and chocolate agar). The major difficulty is not to discard organism frequently considered contaminants. The treatment associated systemic antibiotherapy with steroids or not, central capsulotomy and vitrectomy with intraocular injection of antibiotic with or without steroids. Antibiotics sensitivities among diphteroids vary greatly. Quinolones, penicillins, vancomycin, cyclines and aminosides are often a good choice. However, individual sensitivities determined by the antibiogram must be used for an appropriate treatment.
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PMID:[Chronic Corynebacterium endophthalmitis. Apropos of 3 cases]. 129 92

Pseudomonas keratitis is difficult to treat and aminoglycosides, the drugs now used for this purpose, are not always effective. New drugs are thus needed to cure gentamicin resistant pseudomonas ocular infections. Enoxacin, a new quinolone, active in vitro against Pseudomonas aeruginosa, was evaluated in experimental ulcerative keratitis produced by a gentamicin resistant isolate of Pseudomonas aeruginosa in rabbits. Our study shows that enoxacin eye drops eliminated pseudomonas infection of the cornea and achieved therapeutic levels in the aqueous humor. Supplementation with parenterally given enoxacin augmented this effect. Enoxacin did not penetrate the vitreous. Enoxacin eye drops may be evaluated for their clinical usefulness in case of keratitis caused by Gram-negative bacilli.
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PMID:Enoxacin therapy for experimental pseudomonas keratitis. 191 52

Using a reproducible model of Candida albicans keratitis in rabbits we studied the effect of topical clotrimazole and bifonazole. Candida albicans DSM 70010 (2.5 X 10(5) cells) was injected into the corneal stroma of both eyes of 28 rabbits. All eyes developed a corneal ulcer. Fourty-eight hours after inoculation the animals were divided into four groups: I (14 eyes) receiving 10 X clotrimazole 1% drops and subsequently removing the epithelium; II (14 eyes) receiving only clotrimazole drops; III (8 eyes) receiving 6 x bifonazole 1% drops and IV (19 eyes) serving as control (0.9% NaCl castor oil, untreated), 6 eyes of this group were also debrided. A further 6 rabbits were used respectively to judge if the drugs penetrated into the cornea and aqueous humor. There was a significant difference between the clotrimazole group with debridement (I) and the bifonazole group (IV) concerning hypopyon and complications (descemetocele, corneal perforation). Clotrimazole penetrated into the cornea and after debridement into the aqueous humor. Bifonazole could not be identified in the cornea or aqueous humor.
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PMID:Clotrimazole and bifonazole in the topical treatment of Candida keratitis in rabbits. 210 95

In the late 1980s, HIV seroprevalence in Rwanda stood at 17.8% in urban areas and 1.3% in rural areas. Adult symptoms of AIDS are generally different than those of children. For example, worldwide, the most prevalent symptom (about 50% of patients) of HIV infection among adults is cotton wool spots, fluffy white superficial retinal lesions. In a sample of 110 seropositive children in Rwanda, however, cotton wool spots' prevalence was very low (.9%). Further, 20-40% of all AIDs patients worldwide experience small retinal hemorrhages (.8% for 110 seropositive children in Rwanda), an advanced stage of microvasculopathy, 8% of the children had other microvascular conditions. Researchers have isolated HIV in the aqueous humor of 3 patients in Rwanda with retinal perivasculitis indicating that it may contribute to this disease's etiology. Moreover, 46% of the Rwandan children with AIDs experienced perivasculitis and/or sheathing. HIV has also been found in tears, the conjunctiva, the cornea, the retinal vascular endothelium, and from multiple ocular tissues. Even though cytomegalovirus retinitis is the leading opportunistic infection (26%- 40%) of the eye and the major cause of blindness among AIDS patients in Europe and the US, it only appeared in 5% of AIDS patients in a Rwandan study. Physicians have found herpes simplex keratitis to be more resistant to treatment and recurred more often in AIDS patients than in immunocompetent patients. They have also learned that other infectious diseases of the eyes manifest themselves differently between the 2 groups. Kaposi's sarcoma, B-cell lymphoma, and squamous cell carcinoma are often present in patients with AIDS.
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PMID:Ocular problems in AIDS. 218 17

Studies using ciprofloxacin for the therapy of experimental aminoglycoside-resistant keratitis caused by Pseudomonas aeruginosa were conducted using transcorneal iontophoresis as the drug-delivery system. Corneas infected with P. aeruginosa ATCC 27853/pMG6 were treated 22 hours postinfection with ciprofloxacin delivered by iontophoresis (0.8 mA X 10 min), mock iontophoresis (eyecup with no current), or frequently applied topical drops. Iontophoresis of 10 mg/ml or 25 mg/ml of ciprofloxacin significantly reduced the number of viable bacteria per cornea by more than 5 log units compared with untreated controls (P less than 0.0001). Five hours after the initiation of treatment, mock iontophoresis (10 mg/ml or 25 mg/ml) or 11 applications of topical ciproflaxicin drops (7.5 mg/ml) decreased the viable bacteria relative to the untreated controls by 5 log units (P less than 0.0001). One treatment with an eyecup was as effective as 11 treatments with topical drops (P greater than 0.75). One hour after treatment with iontophoresis or mock iontophoresis of 10 mg/ml of ciprofloxacin, aqueous humor concentrations were 83.75 +/- 8.85 micrograms/ml and 24.87 +/- 4.0 micrograms/ml (mean +/- standard error of the mean), respectively. One hour after the last of five applications of 7.5 mg/ml of ciprofloxacin (every 15 min for 1 hr) the aqueous humor concentration was 4.2 +/- 1.14 micrograms/ml. These results show the value of ciprofloxacin in treating aminoglycoside-resistant infections caused by P. aeruginosa and suggest that ciprofloxacin can be efficiently delivered by iontophoresis.
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PMID:Ciprofloxacin iontophoresis for aminoglycoside-resistant pseudomonal keratitis. 221 Sep 88

Problems associated with the use of 5-iodo-2'-deoxyuridine (IDU) in the treatment of herpes simplex keratitis can be attributed largely to the polar nature of IDU resulting in its poor permeability across the lipoidal epithelial layer of the corneal membrane. Five aliphatic 5'-esters of IDU were synthesized and evaluated as prodrugs for potential use in the treatment of deep ocular infections such as stromal keratitis, iritis, and even retinitis. A parabolic relationship between in vitro corneal membrane permeability and carbon chain length of prodrugs is evident. For a given prodrug, enzymatic hydrolysis proceeded most readily in iris-ciliary body, followed by cornea and aqueous humor. An increase in carbon chain length made the prodrugs more enzymatically labile but more resistant to chemical hydrolysis at pH 7.4 and 34 degrees C. The 5'-butyryl ester of IDU exhibited an approximately fourfold increase in aqueous humor IDU concentration relative to IDU at 25 min following instillation of 25-microliters 5 mM solutions.
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PMID:Prodrugs of 5-iodo-2'-deoxyuridine for enhanced ocular transport. 260 31

Collagen shields made of porcine collagen were placed in a solution containing tobramycin sulfate (40 or 200 mg/ml) for five minutes, then applied to rabbit eyes. One, four, or eight hours after application, the corneas, aqueous humor samples, and shields were assayed for antibiotic. At all intervals, the concentration of antibiotic in the corneas and aqueous humor samples exceeded the mean inhibitory concentration for tobramycin, as determined for most strains of Pseudomonas. Shields immersed in 200 mg/ml tobramycin produced significantly higher concentrations of antibiotic in the cornea at one hour than subconjunctival injections of tobramycin (20 mg) (P = .0001). Shields immersed in 40 mg/ml tobramycin produced higher, although not significantly higher, concentrations of antibiotic in the cornea at one hour than subconjunctival injections of tobramycin (20 mg) (P = .318). Shields immersed in commercially available tobramycin drops or injectable tobramycin solution (40 mg/ml) caused no epithelial damage visible by slitlamp examination. Collagen shields containing antibiotics can serve as a vehicle for drug delivery and may prove superior to current methods for preoperative and postoperative antibiotic prophylaxis and the initial treatment of bacterial keratitis.
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PMID:Collagen shield drug delivery: therapeutic concentrations of tobramycin in the rabbit cornea and aqueous humor. 318 30

A 78-year-old female patient developed mycotic keratitis in her right eye three months after penetrating keratoplasty. Multiple myeloma is presumed to have been the predisposing factor. Candida albicans was isolated from the aqueous humor at the time of surgery. Treatment consisted of systemic ketoconazole (p.o.) and miconazole (i.v.); miconazole eye drops were applied topically and amphotericin B was instilled into the anterior chamber. Resolution of the corneal infection was ultimately achieved with this therapy.
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PMID:[Keratomycosis caused by Candida albicans]. 326 35

Enoxacin is a broad-spectrum quinolone-derivative antibiotic. In a rabbit model of keratitis caused by a Pseudomonas species, enoxacin (3 mg/mL) was as effective as gentamicin sulfate (3 mg/mL) and enoxacin (10 mg/mL) in reducing viable bacterial counts in corneas after 24 hours of hourly therapy with eye drops. Bacterial counts were reduced by about 5000-fold by enoxacin treatment when compared with placebo-treated controls. Penetration studies of topical enoxacin (3 mg/mL) showed that concentrations in cornea and aqueous humor reached levels above reported minimal inhibitory concentrations when an epithelial defect was present. Further investigation of enoxacin for treatment of ocular disease is warranted.
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PMID:Treatment of experimental Pseudomonas corneal ulcers with enoxacin, a quinolone antibiotic. 346 52


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