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Musa M, Enaholo E, Aluyi-Osa G, Atuanya GN, Spadea L, Salati C, Zeppieri M. Herpes simplex keratitis: A brief clinical overview. World J Virol 2024; 13:89934. [PMID: 38616855 PMCID: PMC11008405 DOI: 10.5501/wjv.v13.i1.89934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/28/2023] [Accepted: 01/22/2024] [Indexed: 03/11/2024] Open
Abstract
The aim of our minireview is to provide a brief overview of the diagnosis, clinical aspects, treatment options, management, and current literature available regarding herpes simplex keratitis (HSK). This type of corneal viral infection is caused by the herpes simplex virus (HSV), which can affect several tissues, including the cornea. One significant aspect of HSK is its potential to cause recurrent episodes of inflammation and damage to the cornea. After the initial infection, the HSV can establish a latent infection in the trigeminal ganglion, a nerve cluster near the eye. The virus may remain dormant for extended periods. Periodic reactivation of the virus can occur, leading to recurrent episodes of HSK. Factors triggering reactivation include stress, illness, immunosuppression, or trauma. Recurrent episodes can manifest in different clinical patterns, ranging from mild epithelial involvement to more severe stromal or endothelial disease. The severity and frequency of recurrences vary among individuals. Severe cases of HSK, especially those involving the stroma and leading to scarring, can result in vision impairment or even blindness in extreme cases. The cornea's clarity is crucial for good vision, and scarring can compromise this, potentially leading to visual impairment. The management of HSK involves not only treating acute episodes but also implementing long-term strategies to prevent recurrences and attempt repairs of corneal nerve endings via neurotization. Antiviral medications, such as oral Acyclovir or topical Ganciclovir, may be prescribed for prophylaxis. The immune response to the virus can contribute to corneal damage. Inflammation, caused by the body's attempt to control the infection, may inadvertently harm the corneal tissues. Clinicians should be informed about triggers and advised on measures to minimize the risk of reactivation. In summary, the recurrent nature of HSK underscores the importance of both acute and long-term management strategies to preserve corneal health and maintain optimal visual function.
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Affiliation(s)
- Mutali Musa
- Department of Optometry, University of Benin, Benin 300283, Nigeria
- Department of Ophthalmology, Africa Eye Laser Centre, Km 7, Benin 300105, Nigeria
| | - Ehimare Enaholo
- Department of Ophthalmology, Africa Eye Laser Centre, Km 7, Benin 300105, Nigeria
- Department of Ophthalmology, Centre for Sight Africa, Nkpor 434101, Nigeria
| | - Gladness Aluyi-Osa
- Department of Ophthalmology, Africa Eye Laser Centre, Km 7, Benin 300105, Nigeria
| | | | - Leopoldo Spadea
- Eye Clinic, Policlinico Umberto I, "Sapienza" University of Rome, Rome 00142, Italy
| | - Carlo Salati
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
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Lyle K, Zimmer JL, Gillette WM, Recko MS. Interstitial keratitis presenting as the ocular manifestation of undiagnosed hidradenitis suppurativa. Proc AMIA Symp 2024; 37:479-481. [PMID: 38628332 PMCID: PMC11018041 DOI: 10.1080/08998280.2024.2315540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/27/2023] [Indexed: 04/19/2024] Open
Abstract
Interstitial keratitis is defined as nonulcerative inflammation of the corneal stroma resulting from a bacterial or viral infection, parasitic antigen, or autoimmune response. Hidradenitis suppurativa is an inflammatory skin condition that presents with painful and inflamed boils in apocrine gland-bearing regions of the body, typically with onset around puberty, and ocular comorbidities exist in only a small percentage of these patients. Herein, we describe a unique ocular presentation of hidradenitis suppurativa including pronounced bilateral interstitial keratitis and association with high titer c-ANCA (antineutrophil cytoplasmic antibodies).
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Affiliation(s)
- Kendahl Lyle
- Texas A&M School of Medicine, Baylor Scott & White Health System, Temple, Texas, USA
| | - Joseph L. Zimmer
- Department of Ophthalmology, Baylor Scott & White Health System, Temple, Texas, USA
| | - Wesley M. Gillette
- Department of Ophthalmology, Baylor Scott & White Health System, Temple, Texas, USA
| | - Matthew S. Recko
- Department of Ophthalmology, Baylor Scott & White Health System, Temple, Texas, USA
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Pisitpayat P, Mentreddy A, Pekmezci M, Hwang D, Shantha J, Benador-Shen C, Terry M, Pothikamjorn T, Gonzales J. Stromal Keratitis Associated With CMV Anterior Uveitis. Cornea 2024:00003226-990000000-00471. [PMID: 38294900 DOI: 10.1097/ico.0000000000003487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/21/2023] [Indexed: 02/02/2024]
Abstract
PURPOSE Human cytomegalovirus (CMV) has commonly been reported as a cause of anterior uveitis and corneal endotheliitis. Unlike its other herpetic family members, herpes simplex virus and varicella zoster virus, involvement of the corneal stroma in CMV is uncommon. In this case series, we describe patients with CMV stromal keratitis. METHODS This was a retrospective chart review of patients seen at a tertiary referral center from 1999 to 2023 with stromal keratitis who tested positive for CMV by directed polymerase chain reaction of aqueous fluid or corneal tissue. RESULTS This series describes 5 patients, 4 of whom presented with anterior uveitis and stromal keratitis and were confirmed to be positive for CMV through the polymerase chain reaction of aqueous fluid. The fifth patient experienced recurrent corneal graft failures, with the most recent failed graft being positive for CMV based on immunohistochemical stains of the corneal stroma. The average age of patients was 62 years (range 36-80 years). Only 1 patient (20%) exhibited elevated intraocular pressure with stellate keratic precipitates at the initial presentation, whereas 3 other patients (60%) had a known history of glaucoma. CONCLUSIONS Uveitis specialists are well aware of CMV as a cause of recurrent, hypertensive anterior uveitis but should also consider CMV in cases featuring stromal keratitis. The corneal endothelium may serve as a reservoir for both anterior uveitis and development of corneal stromal inflammation as demonstrated by the immunohistopathology exhibited in 1 case.
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Affiliation(s)
- Punyanuch Pisitpayat
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, CA
- Department of Ophthalmology, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
| | - Akshay Mentreddy
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, CA
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA
| | - Melike Pekmezci
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA
- Department of Pathology, University of California, San Francisco, San Francisco, CA
| | - David Hwang
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA
| | - Jessica Shantha
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, CA
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA
| | | | - Merryl Terry
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA
- Department of Pathology, University of California, San Francisco, San Francisco, CA
| | | | - John Gonzales
- Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, CA
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA
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Daher ND, Syed ZA. Bilateral interstitial keratitis following COVID-19: a case report. BMC Ophthalmol 2023; 23:414. [PMID: 37833623 PMCID: PMC10571384 DOI: 10.1186/s12886-023-03160-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Although the primary target of severe acute respiratory syndrome coronavirus 2 is the respiratory tract, the expression of the angiotensin-converting enzyme 2 receptor in other tissues facilitates viral entry in others parts of the body, including ocular structures. Ocular manifestations may occur before, during, or after systemic infection. CASE PRESENTATION We report the case of a 60-year-old male who presented with bilateral interstitial keratitis after the onset of COVID-19, with ocular symptoms starting within 7 days after systemic symptoms. Laboratory investigation did not identify any alternative etiology for his disease, although the possibility of Epstein-Barr virus or herpes simpex virus could not be definitively ruled out. The patient had already developed significant corneal scarring and visual debilitation by the time topical steroids were initiated, and his final corrected visual acuity with rigid gas permeable contact lenses was 20/50 and 20/80 in the right and left eye, respectively. CONCLUSIONS The involvement of ocular tissue by the virus can lead to permanent sequelae such as severe visual loss, and clinicians should be aware of and recognize ophthalmic manifestations of this disease to prompt early intervention.
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Affiliation(s)
- Nathalie Dalloul Daher
- Cornea Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, 840 Walnut Street, Suite 920, Philadelphia, PA, 19107, USA
| | - Zeba A Syed
- Cornea Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, 840 Walnut Street, Suite 920, Philadelphia, PA, 19107, USA.
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Gu SF, Gao S, Wang HK, He LH, Peng RM, Xiao GG, Hong J. Three-dimensional in vivo evaluation of the cornea in patients with unilateral posterior interstitial keratitis. Front Med (Lausanne) 2023; 10:1180208. [PMID: 37671398 PMCID: PMC10475563 DOI: 10.3389/fmed.2023.1180208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/17/2023] [Indexed: 09/07/2023] Open
Abstract
Purpose The purpose of this study was to investigate the in vivo morphologic features of the cornea in patients with unilateral posterior interstitial keratitis. Methods Seven eyes of 7 patients with unilateral posterior interstitial keratitis were examined by slit-lamp biomicroscopy, anterior segment optical coherence tomography (AS-OCT), and in vivo confocal microscopy (IVCM). The imaging features of the cornea were evaluated and analyzed. Results By slit-lamp examination, the posterior corneal stromal opacities were observed in all 7 eyes, and deep neovascularization in 4 eyes. The posterior stromal opacities showed higher reflectivity with an intact overlying epithelium by AS-OCT and did not invade the Bowman's layer in all cases. IVCM revealed highly reflective dispersed microdots, needle-shaped bodies, and increased reflectivity of keratocytes in the lesion site in all patients. Active Langerhans cells and an attenuated subbasal nerve plexus were observed in 5 eyes. After treatment, the active Langerhans cells disappeared; however, highly reflective microdots and needle-shaped bodies remained. Conclusion The three-dimensional evaluation of slit-lamp biomicroscopy, AS-OCT, and IVCM may help in the early diagnosis of patients with posterior interstitial keratitis.
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Affiliation(s)
- Shao-Feng Gu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Peking University Third Hospital, Beijing, China
| | - Shuang Gao
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Peking University Third Hospital, Beijing, China
| | - Hai-Kun Wang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Peking University Third Hospital, Beijing, China
| | - Lin-Hui He
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Peking University Third Hospital, Beijing, China
| | - Rong-Mei Peng
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Peking University Third Hospital, Beijing, China
| | - Ge-Ge Xiao
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Peking University Third Hospital, Beijing, China
| | - Jing Hong
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerves, Peking University Third Hospital, Beijing, China
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Abd Rashid N, Mohammed SNF, Syed Abd Halim SA, Ghafar NA, Abdul Jalil NA. Therapeutic Potential of Honey and Propolis on Ocular Disease. Pharmaceuticals (Basel) 2022; 15:1419. [PMID: 36422549 PMCID: PMC9696375 DOI: 10.3390/ph15111419] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 09/01/2023] Open
Abstract
Honey and propolis have recently become the key target of attention for treating certain diseases and promoting overall health and well-being. A high content of flavonoids and phenolic acids found in both honey and propolis contributes to the antioxidant properties to scavenge free radicals. Honey and propolis also exhibited antibacterial effects where they act in two ways, namely the production of hydrogen peroxide (H2O2) and gluconic acids following the enzymatic activities of glucose oxidase, which exerts oxidative damage on the bacteria. Additionally, the anti-inflammatory effects of honey and propolis are mainly by reducing proinflammatory factors such as interleukins and tumor necrosis factor alpha (TNF-α). Their effects on pain were discovered through modulation at a peripheral nociceptive neuron or binding to an opioid receptor in the higher center. The aforementioned properties of honey have been reported to possess potential therapeutic topical application on the exterior parts of the eyes, particularly in treating conjunctivitis, keratitis, blepharitis, and corneal injury. In contrast, most of the medicinal values of propolis are beneficial in the internal ocular area, such as the retina, optic nerve, and uvea. This review aims to update the current discoveries of honey and propolis in treating various ocular diseases, including their antioxidant, anti-inflammatory, antibacterial, and anti-nociceptive properties. In conclusion, research has shown that propolis and honey have considerable therapeutic promise for treating various eye illnesses, although the present study designs are primarily animal and in vitro studies. Therefore, there is an urgent need to translate this finding into a clinical setting.
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Affiliation(s)
- Norhashima Abd Rashid
- Department of Biomedical Science, Faculty of Applied Science, Lincoln University College, Petaling Jaya 47301, Malaysia
| | - Siti Nur Farhana Mohammed
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | | | - Norzana Abd Ghafar
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Nahdia Afiifah Abdul Jalil
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
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Dong N, Jiang N, Zhao J, Zhao G, Wang T. Sensitive and Enzyme-Free Pathogenic Bacteria Detection Through Self-Circulation of Molecular Beacon. Appl Biochem Biotechnol 2022; 194:3668-3676. [PMID: 35486346 DOI: 10.1007/s12010-022-03948-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2022] [Indexed: 11/02/2022]
Abstract
This research exhibits the design of a feasible, enzyme-free and sensitive fluorescent sensing assay for the detection of Staphylococcus aureus (S. aureus), using self-circulation of molecular beacons. With protein A on S. aureus as identifying target, the capture probe binds on the surface of S. aureus based on interaction between its aptamer section and protein A. Recognition of protein A by aptamer section in capture probe leads to allosterism of capture probe, exposing initiator section to activate the following self-circulation. After multiple circulation-based signal amplification, the method exhibits a favorable detection sensitivity and shows a promising prospect for the keratitis-related pathogenic bacteria detection. The highlights of the sensing assay are as follows: (i) capture probe is designed with aptamer section which endows the method a high selectivity; (ii) signal of bacteria is converted to nucleic acid signal after recognition of target bacteria by capture probe; and (iii) high sensitivity of method is derived from the self-circulation process. Therefore, we believe that the strategy can provide a useful platform for target bacteria detection and thus contribute to the diagnosis of infectious diseases.
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Affiliation(s)
- Nannan Dong
- Department of Ophthalmology, Zhuji Affiliated Hospital of Shaoxing University, No .9 Jianmin Road Taozhu Street, Zhuji City, 311800, Zhejiang Province, China.
| | - Ning Jiang
- Department of Ophthalmology, Shengjing Hospital of China Medical University, Shenyang City, 110004, Liaoning Province, China
| | - Jiawei Zhao
- Department of Ophthalmology, Zhuji Affiliated Hospital of Shaoxing University, No .9 Jianmin Road Taozhu Street, Zhuji City, 311800, Zhejiang Province, China
| | - Guangming Zhao
- Department of Ophthalmology, Zhuji Affiliated Hospital of Shaoxing University, No .9 Jianmin Road Taozhu Street, Zhuji City, 311800, Zhejiang Province, China
| | - Tiewei Wang
- Department of Ophthalmology, Zhuji Affiliated Hospital of Shaoxing University, No .9 Jianmin Road Taozhu Street, Zhuji City, 311800, Zhejiang Province, China
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Mohanty A, Behera HS, Barik MR, Kaur A, Sharma S, Das S, Fernandes M, Panda S, Sahu SK. Microsporidia-induced stromal keratitis: a new cause of presumed immune stromal (interstitial) keratitis. Br J Ophthalmol 2021; 107:607-613. [PMID: 34937694 DOI: 10.1136/bjophthalmol-2021-319784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/14/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND OBJECTIVE To describe the clinical features, diagnosis and management of immune stromal keratitis/interstitial keratitis (IK) associated with microsporidial epithelial keratitis. METHODS Between October 2020 and January 2021, medical records of IK patients microbiologically proven as microsporidia from samples collected from corneal epithelium on smear examination, and/ or molecular analysis were reviewed. Demography, clinical profile and treatment were analysed. Real-time PCR (RT-PCR) for adenovirus (ADV), Epstein-Barr virus (EBV), herpes simplex virus (HSV) and varicella-zoster virus (VZV) was done. RESULTS Twenty of 152 (13%) microbiologically proven cases of microsporidial keratitis were diagnosed as IK during the study period, the mean age and duration of symptoms were 35.7±11.4 years and 46.3±27.7 days, respectively. Half had predisposing risk factors, like trauma; and 30% had prior recurrences. One-fourth of patients were using antivirals on presentation. Characteristic presentations included disciform keratitis(n=12), incomplete/complete ring(n=5), and combination(n=3), along with variable subepithelial infiltrates (n=14). All cases had stromal oedema, with an intact epithelium and fine pigment dusting on endothelium. Corneal epithelial scrapings had scanty microsporidia spores in smears of 17/20 (85%), and pan-microsporidial DNA was identified in 14/20 (70%), with Vittaforma corneae by sequencing in 11/20 (55%). Other viruses detected were ADV (14,70%), VZV (2,10%), EBV (1,5%) and HSV (1,5%). Rapid resolution of inflammation and oedema within 2 weeks of starting steroids was seen in all cases. CONCLUSION Microsporidia epithelial keratitis induced stromal inflammatory keratitis; is distinguished from microsporidial keratoconjunctivitis and stromal keratitis, by characteristic clinical features, and response to topical steroids.
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Affiliation(s)
- Amrita Mohanty
- Cornea and Anterior Segment, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | | | - Manas Ranjan Barik
- Ocular Microbiology Services, LV Prasad Eye Institute, Bhubaneswar, Orissa, India
| | - Amanjot Kaur
- Cornea and Anterior Segment, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Savitri Sharma
- Jhaveri Microbiology Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Sujata Das
- Cornea and Anterior Segment, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Merle Fernandes
- Cornea and Anterior Segment, L V Prasad Eye Institute, Vishakapatnam, Andhra Pradesh, India
| | | | - Srikant K Sahu
- Cornea and Anterior Segment, LV Prasad Eye Institute, Bhubaneswar, Odisha, India
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October consultation #5. J Cataract Refract Surg 2021; 47:1379-1380. [PMID: 34544092 DOI: 10.1097/01.j.jcrs.0000795216.91028.6e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Morinaka S, Takano Y, Tsuboi H, Goto D, Sumida T. Familial HLA-B*52 Vasculitis: Maternal, Atypical Cogan's Syndrome with Takayasu Arteritis-mimicking Aortitis and Filial Takayasu Arteritis. Intern Med 2020; 59:1899-1904. [PMID: 32321889 PMCID: PMC7474986 DOI: 10.2169/internalmedicine.4067-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Cogan's syndrome (CS), a rare vasculitis characterized by non-syphilitic, interstitial keratitis and Ménière-like attacks, is classified into "typical" and "atypical" forms, while Takayasu arteritis (TAK) is a rare large-vessel vasculitis associated with human leukocyte antigen (HLA)-B*52. Very few cases meet both the CS and TAK classification criteria. We herein report a 53-year-old woman diagnosed with atypical CS and aortitis similar to TAK. Her 25-year-old daughter manifested TAK without symptoms of CS, and both are HLA-B*52 positive. Our case highlights the difficulties of distinguishing aortitis with atypical CS from aortitis with TAK.
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Affiliation(s)
- Satoshi Morinaka
- Division of Rheumatology, Ibaraki Prefectural Central Hospital, Japan
| | - Yohei Takano
- Division of Rheumatology, Ibaraki Prefectural Central Hospital, Japan
| | - Hiroto Tsuboi
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
| | - Daisuke Goto
- Division of Rheumatology, Ibaraki Prefectural Central Hospital, Japan
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
- Division of Rheumatology, Ibaraki Clinical Education and Training Center, Tsukuba University Hospital, Japan
| | - Takayuki Sumida
- Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Japan
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Abstract
PURPOSE OF REVIEW The orbit is subject to a variety of vascular insults that manifest with both specific and nonspecific patterns of vision compromise. The aim of the following review is to highlight the ophthalmic clinical features of systemic vasculitides that most frequently involve the orbit and differentiate them from the most common non-vasculitic orbital disorders. RECENT FINDINGS New studies continue to explore the autoimmune nature of vasculitic disease and seek to determine optimal use of newer therapies such as biologic agents. The pattern of ocular involvement in the context of clinical history allows the knowledgeable physician to distill a differential diagnosis into a specific or likely cause. Establishing a diagnosis in a timely fashion allows for a custom-tailored approach to therapy.
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