Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022575 (keratoconjunctivitis sicca)
 772 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We followed 210 cases of JRA closely for 14 years. Thirty-six patients (17.2%) developed iridocyclitis; it most frequently occurred in young females (0-4 years) with monarticular or pauciarticular form of the disease. In 30% of the patients iridocyclitis was first detected after 16 years of age. Forty-two percent had active iridocyclitis on entry. By combining quantitative antinuclear antibody titers with age, sex, and time on onset of arthritis, it has been possible to define the risk of developing iridocyclitis in individual patients. Our approach was effective in detecting iridocyclitis in new cases and exacerbations of the disease in established cases. Forty-four percent of patients with iridocyclitis had one or more identifiable early signs or symptoms. Iridocyclitis in 36% of patients did not respond to more than 6 months of intensive topical treatment with corticosteroids and mydriatics. Despite this statistic, patients had a better outcome than those experiencing the 50% incidence of blinding complications cited in earlier studies. Cataract and band keratopathy occurred in only 19% and 11% of our group, respectively. Only one case of chorioretinopathy was found in 173 patients who had received antimalarials; a significant number of posterior subcapsular cataracts were found in 75 patients who had received systemic corticosteroids. Keratoconjunctivitis sicca developed in 3 patients with iridocyclitis. Surgical treatment of cataracts, band keratopathy, and glaucoma achieved uniformly discouraging results.
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PMID:The ocular manifestations of juvenile rheumatoid arthritis. 26 99

Research has been performed, both experimentally and clinically, to establish the value of the association of soft contact lenses and some types of eye drops. The use of soft contact lenses with eye drops may be useful in some special cases: a) more prolonged and more sustained effect compared with the usual way of administration of eye drops (especially antiglaucomatous substances, antimetabolites, mydriatics); b) possibility of reducing the concentration to avoid local discomfort or systemic side-effects, without loss of their effectiveness on the eye conditions to be treated. The combined use of soft lenses (12.5-15 mm in diameter) with eye drops may be obtained either by presoaking the lens in the liquid or by regular instillation of eye drops after insertion of the lens; the two techniques may of course be associated. In the present research the advantages of utilizing hydrophylic lenses with osmotically active substances, to obtain a better and more protracted dehydration of the cornea, were first examined, in vitro and in vivo. The following substances were tested: 10% propylenglycol, 10% glycerol, 10% glucose and 5% natrium chloride. The clearing effect of the different types of treatment was evaluated in 45 patients with edematous bullous keratopathy with an instrument which measured the infrared light emitted by an optic fiber and reflected by the cornea. The effects were more marked for the epithelial than for the stromal oedema. Another group of investigations was performed with two polypeptides with high molecular weight: Eledoisin, extracted from a mediterranean octopus, Eledone moschata, and Physalaemin, extracted from the skin of a south american batrachian, Physalaemus fuscomaculatus, both of these stimulate the lacrimal secretion and were previously successfully employed topically by the authors against keratoconjunctivitis sicca. The increase of the amount of fluid was however short-lived. Eledoisin at a concentration of 200 mug/ml, was examined in its effects both in vitro and in vivo, whereas physalaemin, at a concentration of 20 mug/ml, only in vitro, owing to the present shortage of the product. The clinical tests in 23 eyes of 14 patients with keratoconjunctivitis sicca proved satisfactory, since the lacrymal stimulating effect is not only greater, but lasts three times longer by combining the instillation of eledoisin with a presoaked soft lens. Some antiglaucomatous products (propranolol, clonidine, prostigmine) were, finally, used in association with a soft lens to reduce the concentration of the eye drops for a better tolerance locally (propranolol: a beta-adrenergic blocking agent) or generally (clonidine: alpha-adrenergic agent), also with the advantage of protracted release. With propranolol the concentration could be reduced to 0.01-0,10% (instead of 0.125 to 0.25%) and to 1.5% (instead of 3%) with prostigmine, when lenses were presoaked or instillations took place at regular time intervals, after insertion of the lenses.
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PMID:[Special indications for the use of soft contact lenses as a drug-release-system (author's transl)]. 97 31

We followed 210 cases of juvenile rheumatoid arthritis closely for eleven years. Thirty-six of the 210 patients (17.2%) developed iridocyclitis. Iridocyclitis was seen most frequently in young female patients (0 to 4 years) with the monoarticular or pauciatricular form of the arthritis. However, 30% of the patients developed uveitis after 16 years of age. Although 61% of patients had a noncontributory ocular history on entry, 42% had active uveitis on entry. Our approach was effective in detecting uveitis in new cases and exacerbations of uveitis in established cases. Forty-four percent of patients with uveitis had one or more identifiable signs or symptoms, such as red eye, ocular pain, decreased visual acuity, or photophobia, in order of decreasing frequency. Even after early detection and prompt treatment, 41% of cases of uveitis did not respond to more than six months of intensive topical treatment with corticosteroids and mydriatics. Despite this, there was a dramatic decrease in the 50% incidence of blinding complications of uveitis cited in earlier studies. Cataract and band keratopathy occurred in only 22 and 13% of our group, respectively. We used chloroquine or hydroxychloroquine in 173 of 210 cases and found only one case of chorioretinopathy attributable to these drugs. Systemically administered corticosteroids were used in 75 of 210 cases; a significant number of posterior subcapsular cataracts was found. Typical keratoconjunctivitis sicca developed in three of the uveitis cases. This association with uveitis and JRA was not noted previously. Surgical treatment of cataracts, band keratopathy, and glaucoma achieved uniformly discouraging results.
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PMID:Ocular manifestations of juvenile rheumatoid arthritis. 107 93

Peripheral ulcerative keratopathy and necrotizing scleritis have been reported in rheumatoid arthritis patients after cataract surgery, but the incidence of these complications during the immediate postoperative period is unknown. We retrospectively studied 70 patients with rheumatoid arthritis who underwent a total of 86 cataract extractions between 1973 and 1988. Only 15 of the patients had a preoperative history of keratoconjunctivitis sicca. The best corrected postoperative visual acuity was greater than or equal to 20/30 in 81% of eyes. No episodes of scleritis or peripheral ulcerative keratopathy occurred during the 8-week postoperative period. Three patients (all from the sicca group) developed diffuse superficial punctate keratopathy and/or filamentary keratitis. Results suggest that serious corneal complications after cataract surgery are uncommon in rheumatoid arthritis patients similar to the population found in our study (95% Poisson confidence interval 0-6.6%).
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PMID:Corneal complications after cataract surgery in patients with rheumatoid arthritis. 158 18

The systemic administration of an anesthetic dosage of a combination of xylazine and ketamine hydrochloride produced an acute exposure keratopathy which progressed into a syndrome resembling keratoconjunctivitis sicca. Within a few minutes corneal changes occurred that were characterized by viscous mucus, loss of corneal luster and dryness. Other acute but transient changes included development of cataracts, mydriasis and proptosis. Progressive changes were observed in the cornea within 4 days which lasted at least 8 weeks in some cases, and included punctate epithelial keratopathy progressing to devitalized or keratinized epithelial plaques. Polymorphonuclear cell infiltration of the corneal stroma associated with plaques occurred. Epithelial denudation and neovascularization of the cornea, dilation and engorgement of iridial blood vessels, as well as flare in the anterior chamber were also seen. The ocular lesions induced by xylazine/ketamine should be considered carefully when designing or interpreting research on the anterior segment. Ketamine hydrochloride with sodium pentobarbital produced excellent anesthesia without any significant ocular side-effects and may be preferred in many instances.
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PMID:Keratoconjunctivitis sicca with associated secondary uveitis elicited in rats after systemic xylazine/ketamine anesthesia. 259 1

Evidence is presented which supports the centripetal movement of epithelial cells in the normal corneal epithelium. This movement is not, however, uniform and is influenced by various factors including corneal topography, surface disease states and lid shearing forces. We have studied epithelial morphology with corneal specular microscopy and have demonstrated altered morphology in keratoconjunctivitis sicca, neurotrophic keratitis, and contact lens wearing. Following penetrating keratoplasty, we found a vortex keratopathy in 70 per cent of patients up to two years after surgery. We also found pallisading of epithelial cells around sutures which indicated centripetal movement of epithelial cells around islands of stability created by obstructions. The eyelid also alters epithelial migration and turnover by increasing exfoliation from shearing forces. We advance a new hypothesis that the driving force in the central epithelial cell movement is the preferential loss of surface cells by exfoliation from the central apex secondary to the shearing forces of the upper lid.
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PMID:Corneal epithelial cell movement in humans. 260 18

Subendothelial blebs were seen in cases of superficial keratopathy of varied etiology: superficial punctate keratopathy (42 patients); keratoconjunctivitis sicca (11 patients); epithelial basement membrane dystrophy (9 patients); mild superficial keratopathy due to exposure (9 patients), trichiasis (6 patients), or chemical contact (4 patients); and in contact-lens wearers (29 patients). The blebs were probably due to intercellular edema, separating endothelial cells from Descemet's membrane, and were reversible after resolution of the keratopathy. If the condition is chronic, changes in endothelial morphology may occur, with pleomorphism and polymegathism of the endothelial cells. These cases show that conditions which cause fine disruption of the corneal epithelium affect the integrity of the corneal endothelium. Recognition of resulting long-term changes may be important before intraocular surgery or if the cornea is to be used for grafting.
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PMID:The influence of superficial epithelial keratopathy on the corneal endothelium. 274 24

The authors describe 19 patients with toxic ulcerative keratopathy. These patients were referred with other diagnoses and were victims of overtreatment. Fourteen of these patients had iatrogenic toxic keratopathy, and the other five had self-induced keratoconjunctivitis. The corneal defects tended to be inferior or inferonasal and associated with an intense, coarse superficial keratitis in "comet's impact" fashion. Conjunctival hyperemia, chemosis, and conjunctival staining were considerably more prominent inferiorly and inferonasally. Diagnosis was the key element in management. Treatment consisted of discontinuation of the offending medication or preservative. Other important measures included preservative-free medications, patching, therapeutic contact lenses, goggles, and viscoelastic agents. Many of the patients with iatrogenically induced toxic keratopathy had significant ocular surface disease such as keratoconjunctivitis sicca (6 patients), previous intraocular surgery (6 patients), herpes simplex infection (1 patient), or herpes zoster infection (1 patient).
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PMID:Toxic ulcerative keratopathy. An unrecognized problem. 223 36

We have demonstrated the reversibility of corneal endothelial changes which accompany superficial keratopathy (superficial punctate keratitis, exposure keratopathy, chemical keratopathy and keratoconjunctivitis sicca), stromal keratitis and anterior uveitis (predominantly iridocyclitis). These changes include small subendothelial dark areas equal to or less than one cell in diameter and larger subendothelial dark areas up to two to four cells in diameter. These dark areas are similar but form two groups. The smaller ones may be due to oedema, some developing into larger dark areas, but it is also possible that smaller dark areas represent inflammatory cells or even local destruction of endothelial cells. The larger dark areas elevate the overlying endothelium. Either may be very numerous. They may be present together or separately. They become much less numerous and disappear with resolution or suppression of the acute keratitis or uveitis. The relief mode of corneal specular microscopy was used to distinguish these dark areas from other inflammatory and degenerative changes (such as fine inflammatory deposits, larger keratic precipitates, pigment deposits and guttatae at the level of the corneal endothelium).
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PMID:Reversible corneal endothelial cell changes in diseases of the anterior segment. 343 71

Recent work has shown changes in the corneal endothelium accompanying corneal epithelial disease and anterior uveitis. It is important to differentiate these acute changes from other changes such as guttatae or corneal pigment deposition and to assess the magnitude of their effect upon the corneal endothelium. We have used specular microscopy to study changes in the corneal endothelium and Descemet's membrane and to study deposits on the back of the corneal endothelium and correlate them with changes in the endothelium by the use of conventional specular microscopy and by relief images which give a three dimensional view of the area concerned. This has particularly been applied to the conditions of superficial punctate keratopathy, keratoconjunctivitis sicca, corneal abrasions and exposure keratopathy, iritis and cyclitis, pseudoexfoliation of the lens capsule, anterior segment pigment dispersal syndrome, bullous keratopathy as well as corneal guttatae and pigment granules on the posterior cornea. Preendothelial lesions have been distinguished from endothelial and retrocorneal lesions by this technique aiding elucidation of the state of the endothelium. The changes which we noted occurred either at the level of Descemet's membrane (including formation of small rounded dark blebs less than one cell in diameter, larger blebs one to three cells in diameter, and guttatae, usually larger than the foregoing and sometimes very numerous), or at the level of the posterior endothelial surface (including small shiny nodular deposits, often numerous, due to pigment granules, and keratitic precipitates and inflammatory debris, the former usually large and the latter smaller, more irregular and sometimes very numerous). The differentiation and assessment of these various changes are discussed.
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PMID:Differentiation and assessment of corneal endothelial changes associated with diseases of the anterior segment of the eye. 359 65


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