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 determined the therapeutic efficacy of iontophoretic application of acyclovir and vidarabine monophosphate (ara-AMP) for the treatment of herpes simplex virus (HSV) type 1-induced stromal keratitis in rabbits. The therapeutic efficacy of intravenous administration of acyclovir was assessed in the same model. Stromal keratitis was produced by intrastromal injection of 10 microliters purified HSV-1, McKrae strain. Treatment began the first day after intrastromal injection. Iontophoresis (0.5 mAmp for four minutes) of 3.4 percent (0.1 M) ara-AMP and 5.0 percent (0.22 M) acyclovir was performed once daily for five consecutive days in two treatment groups. Intravenous administration of 50 mg acyclovir/kg was performed twice daily for eight consecutive days. Intravenous administration of NaCl (0.14 M) and ocular iontophoresis of NaCl (0.14 M) were performed as controls in the two treatment groups. At least two scorers performed a single masked evaluation of the disease severity (lesion scoring) of the conjunctiva, corneal epithelium, stroma, and iris by still lamp examination. The eyes were scored daily for 12 consecutive days, and then every other day up to day 22. Iontophoresis of acyclovir or ara-AMP significantly reduced the course of the disease compared with iontophoresis of NaCl. Intravenous administration of acyclovir significantly reduced the disease compared with intravenous NaCl. This suggests that iontophoresis of acyclovir or ara-AMP either alone or in combination with intravenous administration of acyclovir may be of value in the treatment of HSV-1 stromal keratitis.
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PMID:Acyclovir and vidarabine monophosphate: comparison of iontophoretic and intravenous administration for the treatment of HSV-1 stromal keratitis. 617 15

In a detailed study of ocular infection by herpes simplex virus (HSV) type 1 in mice, the course and signs of eye disease were investigated and compared in primary and secondary infection using slit-lamp examination, culture of the tear film, and monitoring of the blink reflex. Response to primary inoculation ranged from subclinical infection to severe keratitis. Compared with conjunctival scarification, corneal scarification resulted in more frequent and severe eye disease and signs of CNS infection. Previous infection in the skin of the contralateral ear considerably modified subsequent infection of the eye so that signs of disease occurred earlier, were limited to dendritic keratitis with some stromal involvement, and were largely reversible. The mouse seems to be a suitable animal for studying ocular infection with HSV.
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PMID:Ocular infection with herpes simplex virus in nonimmune and immune mice. 686 Feb 14

For treatment of herpetic keratitis, 5-iodo-2'-deoxyuridine (IUdR) has been the only drug available in Japan. However, IUdR is not completely satisfactory, and alternative antivirals are required. The Association for Research in Infectious Diseases of the Eye, Japan, carried out a clinical trial in 92 cases of ulcerative herpetic keratitis using 3 percent acyclovir ophthalmic ointment to determine its efficacy and safety. In 63 eyes, it had an excellent effect and ulcers healed within seven days. In 26 eyes, it had a good effect and ulcers healed within 14 days or became half-size within seven days. Therefore, the response to acyclovir in 96.8 percent of cases was excellent or good. The average healing time in 81 eyes in which ulcers disappeared within 14 days was 5.8 +/- 3.4 days. Including the five eyes in which ulcers took more than 14 days to heal, the average healing time of ulcers was 6.6 +/- 4.8 days. Of the 92 patients treated with acyclovir ointment, one had contact blepharoconjunctivitis and another complained of mild irritation. Mild punctate keratitis, as another side effect of acyclovir ointment, was observed in 22 eyes (23.9 percent) by photo-slit lamp examination, but in these patients it was possible to continue treatment without complaint.
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PMID:Clinical evaluation of acyclovir in the treatment of ulcerative herpetic keratitis. 704 17

We report an outbreak of keratoconjunctivitis and skin erythema caused by ultraviolet radiation from a damaged high-intensity mercury vapor lamp. Twenty-six persons became ill after using a basketball court; symptoms included conjunctivitis (100%), skin erythema (54%), and punctate keratitis (19%). This outbreak is one of 37 similar episodes involving at least 629 persons reported to the Food and Drug Administration since 1969. Physicians should be aware that damaged high-intensity mercury vapor lamps are a continuing public health problem with substantial morbidity. Measures to prevent such occurrences are suggested.
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PMID:Ocular complications of malfunctioning mercury vapor lamps. 718 32

Twenty-seven young adult patients with rubeola were evaluated during the acute contagious phase of their disease. Koplik's spots were present in all patients. Conjunctivitis was present in 15 of the 27 (56%), and photophobia was present in 14 of the 27 (52%). Bilateral epithelial keratitis was present in all 27 patients. This keratitis, in otherwise healthy young adults, as in healthy children, was a benign process and required no medical therapy. The epithelial lesions were very slow to resolve completely and continued to be seen at the slit lamp after the patients had become asymptomatic. Ophthalmologists may be more involved in the future in diagnosing the ocular lesions of measles (and in making the initial diagnosis of rubeola) because of the changing nature of the susceptible population group in the United States.
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PMID:Rubeola keratitis. 732 99

Ciprofloxacin and prednisolone, but not an aminoglycoside and dexamethasone, were previously found to be effective in killing bacteria and reducing inflammation for the treatment of Pseudomonas keratitis. We investigated the therapeutic effectiveness of tobramycin/prednisolone and ciprofloxacin/dexamethasone in a rabbit model of experimental keratitis to increase our understanding of the effectiveness of antibiotic/steroid combinations. To our knowledge, this is the first analysis of the effectiveness of a combination of ciprofloxacin and dexamethasone for experimental keratitis. Two experiments were conducted. In the first experiment, 36 rabbits were divided into six groups: 1) untreated; 2) prednisolone acetate, 1.0%; 3) prednisolone phosphate, 1.0%; 4) tobramycin, 1.36%; 5) tobramycin plus prednisolone acetate; 6) tobramycin plus prednisolone phosphate. In the second experiment, 23 rabbits were divided into four groups: 1) untreated; 2) ciprofloxacin, 0.3%, plus dexamethasone alcohol, 0.1%; 3) ciprofloxacin; 4) dexamethasone alcohol. Topical antibiotic and/or steroid was given for 10 h, from 16 to 26 h postinfection, one drop every 15 min for the first hour and then every 30 min for the remaining 9 h. At 27 h postinfection, eyes were evaluated by slit lamp examination (SLE) and assayed for the presence of bacteria in terms of colony forming units (CFU) per cornea. Both prednisolone acetate and prednisolone phosphate reduced ocular inflammation (as determined by SLE), compared with no treatment (P < or = 0.036); the phosphate was more effective (P = 0.005). Tobramycin alone and in combination with prednisolone also significantly reduced SLE, compared with no treatment (P < or = 0.006). The bactericidal activity of tobramycin was not affected by either steroid formulation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effectiveness of specific antibiotic/steroid combinations for therapy of experimental Pseudomonas aeruginosa keratitis. 779 6

The direct immunoperoxidase technique was tested for diagnosis of herpetic keratitis. The technique was performed on corneal epithelial specimens from 28 herpetic keratitis cases and 12 controls. Ulcers were stained with rose bengal or fluorescein and examined at the slit-lamp biomicroscope to differentiate between herpetic and nonherpetic etiology. Scrapings obtained from the corneal epithelial ulcers were stained with direct immunoperoxidase technique. The whole procedure, including staining and examination of the slides, took a total of 70 min. The test proved to be accurate, easy to perform and to interpret, rapid and relatively inexpensive with a sensitivity of 93%, and a specificity of 100%.
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PMID:Rapid diagnosis of herpetic keratitis using direct immunoperoxidase technique. 801 96

Staphylococcus aureus produces a variety of proteins, including alpha-toxin and protein A, that could contribute to corneal tissue damage during keratitis. We examined corneal infections produced by intrastromal injection of four S. aureus strains--three isogenic mutants, one lacking alpha-toxin (Hly- Spa+), one lacking protein A (Hly+ Spa-), and one lacking both alpha-toxin and protein A (Hly- Spa-), and the wild type (Hly+ Spa+)--in a rabbit model of experimental keratitis. Rabbit corneas were injected intrastromally with 100 CFU of one of the four strains, and the eyes were examined by slit lamp biomicroscopy over a 25-h period. Corneal homogenates were used for determination of CFU and neutrophil myeloperoxidase activity at 5-h intervals. All strains had the same logarithmic growth curve from 0 to 10 h postinfection, after which CFU remained constant at 10(7) CFU per cornea. By 15 h postinfection, slit lamp examination scores were significantly higher for eyes infected with Hly+ strains than for Hly(-)-infected eyes. At this time, distinct epithelial erosions were seen in Hly(+)-infected eyes but not in Hly(-)-infected eyes. Myeloperoxidase activity was significantly greater for Hly(+)-infected corneas than for Hly(-)-infected corneas at both 20 and 25 h postinfection. Spa(+)- and Spa(-)-infected eyes showed no differences in slit lamp examination scores or myeloperoxidase activities. These results suggest that alpha-toxin, but not protein A, is a major virulence factor in staphylococcal keratitis, mediating the destruction of corneal tissue in eyes infected with this bacterial pathogen.
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PMID:Corneal virulence of Staphylococcus aureus: roles of alpha-toxin and protein A in pathogenesis. 818 73

This study was conducted to determine whether the age of the host influences the pathogenesis and therapeutic outcome of drug-treated Pseudomonas aeruginosa keratitis. Young (3- to 5-month-old) and old (1.5- to 3-year-old) rabbits were intrastromally infected with P. aeruginosa ATCC 27853. Sixteen hours later, rabbits in both age subpopulations were divided into three groups and treated topically as follows: group 1, phosphate-buffered saline; group 2, 0.3% ciprofloxacin; and group 3, 0.3% ciprofloxacin, 1.0% prednisolone, and 0.03% flurbiprofen. Drops were given every 15 min for 1 h and then every 30 min for 9 h. At 27 h postinfection, ocular pathology was graded with a slit lamp examination (SLE) scoring system. Aqueous humor was collected for ciprofloxacin quantitation, and corneas were harvested for bacterial enumeration and estimation of polymorphonuclear leukocytes. Young rabbits had more severe inflammation and pathology than old rabbits. At 27 h postinfection, SLE scores and polymorphonuclear leukocyte numbers were significantly higher for young rabbits than old rabbits (P < 0.02), regardless of treatment. Prednisolone and flurbiprofen significantly reduced SLE scores in both age groups (P < 0.03) without affecting the antimicrobial efficacy of ciprofloxacin.
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PMID:Age and therapeutic outcome of experimental Pseudomonas aeruginosa keratitis treated with ciprofloxacin, prednisolone, and flurbiprofen. 823 96

A 52-year-old man was first examined because of bilateral superficial punctate keratitis. Slit-lamp examination disclosed numerous intraepithelial minute opacities in both corneas. A corneal biopsy revealed intraepithelial rhomboidal or rectangular crystals that immunohistochemically stained only for IgG-kappa. Serum immunoelectrophoresis demonstrated an IgG-kappa monoclonal gammopathy. Over the ensuing 6 years, the clinical appearance of the crystals changed from small dot-like opacities to polychromatic crystals. At this time, bone marrow examination established the diagnosis of multiple myeloma. Ophthalmologists should be aware of this entity and carefully monitor these patients; the corneal lesions may be the initial manifestation of an asymptomatic monoclonal gammopathy preceding the development of multiple myeloma.
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PMID:Intraepithelial corneal immunoglobulin crystals in IgG-kappa multiple myeloma. 830 67


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