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 previously unrecognized autosomal dominant syndrome affecting oral, nasal, vaginal, urethral, anal, bladder, and conjunctival mucosa with cataracts, follicular keratosis, nonscarring alopecia, and terminal lung disease is described in a four-generation kindred of German extraction. Severe photophobia, tearing, and nystagmus in infancy heralds the development of keratitis, corneal vascularization, and lens cataracts. Repeated corneal transplants have failed. Red, periorificial mucosal lesions involving the above structures are noted by 1 year of age and may persist throughout life. Chronic rhinorrhea and repeated upper respiratory infections frequently progress to bilateral pneumonia accompanied by loss of hair, diarrhea, occasional melena, enuresis, pyuria, and hematuria. Spontaneous pneumothorax is frequent, terminating in fibrocystic-type lung disease and cor pulmonale. Women have had repeated abnormal vaginal PAP smears. Histologically the mucosal epithelium shows dyshesion, thinning of the epithelial layer, and dyskeratosis. Mucosal PAP smears show lack of epithelial maturation, cytoplasmic vacuoles and inclusions, and individual cell dyskeratosis. Histochemically there is a lack of cornification and keratinization. Ultrastructural studies show lack of keratohyalin granules, a paucity of desmosomes, intercellular accumulations, cytoplasmic vacuolization, and formation of bands and aggregates of filamentous fibers and structures in the cytoplasm resembling desmosomes and gap junctions. The condition is probably a panepithelial cell defect of desmosomal and gap junction structure most prominently affecting mucosal epithelia associated with an increased susceptibility to a variety of adventitious organisms.
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PMID:Hereditary mucoepithelial dysplasia: a disease apparently of desmosome and gap junction formation. 48 50

We studied three cases of Fuchs' superficial marginal keratitis, an uncommon condition that is characterized by intermittent, recurrent episodes of ocular irritation accompanied by marginal infiltrates and that is followed by progressive marginal superficial stromal thinning. Usually, it has an indolent course with spontaneous remission, and good visual acuity is preserved. In advanced cases, a pseudopterygium develops in the area of marginal thinning. The pseudopterygium encroaches onto the cornea over a period of years, but spares the central cornea. In two of our three cases, the degree of thinning beneath the pseudopterygium became marked. This led to corneal perforation during pseudopterygium excision in one case, and after blunt trauma in the other. These complications indicate the need for special precautions when caring for these patients.
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PMID:Fuchs' superficial marginal keratitis. 157 29

A 40-year-old patient frequently self-administered topical oxybuprocaine drops for approximately 7 days after bilateral ultraviolet-light keratitis. Initially, he developed bilateral chronic epithelial defects with diffuse stromal infiltration and edema. After a protracted initial healing period, the patient underwent a penetrating keratoplasty in one eye because of significant corneal scarring. Pathologically, the corneal button revealed scarring and thinning of the central stroma. Results of scanning electron microscopy showed endothelial polymorphism, focal endothelial necrosis, and numerous filamentous processes emanating from abnormally enlarged intercellular gaps. Results of transmission electron microscopy showed markedly attenuated to absent apical cell attachments at the endothelial intercellular junction. Abuse of oxybuprocaine appears to produce irreversible damage to the apical cell attachments at the level of the corneal endothelial cells.
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PMID:Ultrastructural alterations in the endothelium in a patient with topical anesthetic abuse keratopathy. 158 82

The corneas of 50 normal subjects were examined before and after electroretinography performed with gold foil electrodes. Examination included slit-lamp biomicroscopy and staining with sodium fluorescein. All corneas were normal on examination prior to electroretinography. Three types of transient corneal changes were observed--punctate epithelial keratitis, corneal erosions, and stromal thinning. Each cornea was assigned a numerical damage score based on a simple scoring system. Thirty one subjects (62%) had some degree of corneal change, and in three cases (6%) follow-up was required. Multiple regression analysis was performed to discover any risk factors. Both age of the subject and the use of local anaesthetic were strongly associated with corneal changes.
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PMID:Transient corneal changes associated with the use of gold foil electrodes. 261 Nov 95

A recalcitrant corneal ulcer resulted in an extensive corneal opacity requiring penetrating keratoplasty. Histopathologic studies and subsequent cultures established the diagnosis of Acanthamoeba keratitis. A second transplant was performed due to a culture-proven recurrence of the keratitis in both the recipient and the graft, with progressive thinning. This has remained clear for six months on systemic ketoconazole and topical miconazole drops. This case demonstrates the difficulty in initial diagnosis of Acanthamoeba keratitis and the apparent successful medical control of the infection despite transplantation into an infected recipient bed.
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PMID:Management of Acanthamoeba keratitis. A case report and review of the literature. 609 21

Of 32 patients (19 females and 13 males, ranging in age from 2 to 44 years), nine had ocular problems related to neutrophil dysfunction. Four patients had blepharokeratoconjunctivitis and pannus formation. In one of these, severe visual loss secondary to corneal thinning and scarring occurred. Five patients had inactive chorioretinal scars without visual loss. Although some of the other 23 patients had minor ocular abnormalities, we could not demonstrate that they were related to the neutrophil dysfunction. However, none of the control subjects (20 patients with systemic lupus erythematosus and 20 randomly selected eye clinic patients) had lesions resembling those of the patients with neutrophil dysfunction. Fisher's exact test (one-tailed) gave the following values: P less than .03 for keratitis; P less than .01 for chorioretinal scars; and P less than .001 for keratitis and chorioretinal scars. Abnormal neutrophil function probably interferes with the control of normal eyelid flora and predisposes the eye to the development of marginal keratitis. Eyelid hygiene and topical administration of antibiotics and corticosteroids during inflammatory episodes may prevent the progression of corneal vascularization. The chorioretinal scars do not appear to be progressive.
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PMID:Ocular findings in patients with neutrophil dysfunction. 684 53

In the case reported, herpes virus I after having caused relapsing keratitis in an eye promoted the formation of a severe corneal ulcer caused by Scopulariopsis brevicaulis, a saprophytic mycete found in soil, which only once has been described as the cause of keratitis in man. Scopulariopsis was identified microscopically after culturing the conjunctival secretion on Sabouraud dextrose agar medium, while DNA probe tests confirmed the absence of herpes virus I. Topical and oral administration of miconazole and scraping of the corneal infiltrate dispersed the infection. Subsequently local steroids were given to reduce the neovascularization, and a therapeutic contact lens was applied because of intercurrent corneal thinning. Three months after beginning antifungal therapy, the visual acuity had increased from 1/120 to 1/10. The case described confirms that S. brevicaulis can cause opportunist infections in a cornea previously damaged by a different agent.
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PMID:Fungal keratitis due to Scopulariopsis brevicaulis in an eye previously suffering from herpetic keratitis. 784 51

We observed 6 cases of secondary keratoconus with Fleischer's ring pattern corneal epithelial iron ring. These 6 cases were 2 males and 4 females. The causes of secondary keratoconus were 2 cases of trachoma, 2 cases of trauma, 1 case of keratitis, and 1 case of unknown origin. All showed thinning of the cornea and Fleischer's ring pattern corneal epithelial iron ring. After penetrating keratoplasty of 1 case, the button of the recipient showed the deposition of hemosiderin in the corneal epithelium stained blue by Prussian blue. At the same time we confirmed the existence of iron in the corneal epithelium by the X-ray ultimate analysis. Fleischer's ring is considered to be characteristic of keratoconus, but we have found that Fleischer's ring is also seen in secondary keratoconus in which the cornea becomes thinner secondarily for some reason.
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PMID:[Six cases of secondary keratoconus with Fleischer's ring pattern corneal epithelial iron ring]. 864 46

Multifocal stromal infiltrates or "satellite lesions" have been considered a characteristic feature of fungal keratitis. We examined two patients with nontuberculous mycobacterial keratitis who clinically presented with satellite lesions. The keratitis consisted of multifocal stromal infiltrates with indistinct white and fluffy margins. Both patients received topical fortified amikacin therapy with poor response. Lamellar keratectomy or penetrating keratoplasty was performed, respectively, in the two patients because of progressive stromal thinning and enlarging satellite lesions. Histopathologically, the main lesions consisted of dense infiltration of inflammatory cells with numerous acid-fast bacilli, while the satellite lesions were composed chiefly of inflammatory cells with fewer mycobacteria. Besides fungal keratitis, nontuberculous mycobacterial keratitis should also be considered when satellite lesions are present.
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PMID:Clinicopathologic study of satellite lesions in nontuberculous mycobacterial keratitis. 958 43

Blepharokeratitis is a chronic external ocular and adnexal inflammatory condition marked by erythematous and edematous lid margins, lid margin crusting and scaling, meibomian gland inflammation and inspissation, and conjunctival hyperemia. The associated keratitis usually involves the inferior cornea and is characterized by punctate epithelial keratopathy and marginal stromal infiltrates. The inflammation sometimes leads to corneal thinning, scarring, and vascularization. The standard therapy for adult blepharokeratitis includes lid hygiene, topical cortico-steroid preparations, and topical antibiotics. Oral tetracycline and its analogues, doxycycline and minocycline, are used in adults to treat associated meibomian gland dysfunction. Whereas blepharitis is common in children, blepharokeratitis is rare and is often associated with severe ocular and psychosocial morbidity. Treatment of youths may be problematic because of poor compliance with lid hygiene and therapy that includes drops and ointment.(1) Furthermore, the use of tetracycline and its analogues is contraindicated in children aged less than 8 years because it may cause dental enamel abnormalities. Isolated case reports have suggested that erythromycin may be a reasonable alternative to tetracycline in childhood blepharokeratitis.(2,3) We report on the successful treatment of this condition with oral erythromycin in 5 children.
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PMID:Oral erythromycin treatment for childhood blepharokeratitis. 1112 76


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