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White E, Fazio N, Tourmouzis K, Ryu S, Finger PT, Sassoon J, Keresztes R, Chou T, Kaplowitz K, Honkanen R. Unilateral conjunctival Classic Kaposi Sarcoma following a COVID 19 booster. Am J Ophthalmol Case Rep 2024; 34:101986. [PMID: 38601193 PMCID: PMC11004082 DOI: 10.1016/j.ajoc.2023.101986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 11/13/2023] [Accepted: 12/20/2023] [Indexed: 04/12/2024] Open
Abstract
Purpose We describe a case of Classic Kaposi's sarcoma in a functionally monocular patient following a COVID19 vaccine booster and provide compelling evidence that suggests the booster was a relevant co-factor in the initiation of the disease process. Observations The patient presented with red, irritated conjunctival area described as "bubbling" in her right eye. While her past medical history includes hypercholesterolemia and hypertension, she had no history of a compromised immune system. Her ophthalmologic history is more complex including treatment for glaucoma. The patient has 20/20 uncorrected vision OD and LP OS. Due to her ocular co-morbidities, the patient initially received interferon alpha 2-B qid for 6 weeks. However, topical therapy failed to decrease the size of the conjunctival lesions. After referral to Radiation Oncology, the right eye/orbit was treated with electron beam therapy for 1 month which caused a marked decrease in the size and vascularity of the conjunctival lesions. A slow improvement continued during followup. Conclusion and importance In that the vaccine booster preceded the cancer, it appears etiologic to the appearance of Kaposi's sarcoma. The patient's monocular vision and glaucoma complicated her treatment. This case expands on current concepts of cofactors needed for the development of Kaposi's sarcoma in that vaccine booster administration was relevant to tumor progression and both clinical and mechanistic evidence is presented to support this hypothesis.
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Affiliation(s)
- Emily White
- Renaissance School of Medicine at Stony Brook University, USA
| | - Nicholas Fazio
- Renaissance School of Medicine at Stony Brook University, USA
| | - Konstantinos Tourmouzis
- Barts and the London School of Medicine and Dentistry, UK
- Department of Ophthalmology, Stony Brook University Hospital, USA
| | - Samuel Ryu
- Department of Radiation Oncology, Stony Brook University Hospital, USA
| | - Paul T. Finger
- The Department of Ocular Tumor, Orbital Disease, And Ophthalmic Radiation Therapy, The New York Eye Cancer Center, USA
| | - Jodi Sassoon
- Department of Anatomic & Clinical Pathology, New York Eye, Ear Infirmary of Mount Sinai, USA
| | - Roger Keresztes
- Department of Medicine, Stony Brook University Hospital, USA
| | - Timothy Chou
- Department of Ophthalmology, Stony Brook University Hospital, USA
| | - Kevin Kaplowitz
- Department of Ophthalmology, Loma Linda Veterans Affairs Medical Center, USA
| | - Robert Honkanen
- Department of Ophthalmology, Stony Brook University Hospital, USA
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Wolek M, Tourmouzis K, Garcia A, Byrd J, Weissbart S, Boyle N, Honkanen R. A case of facultative ophthalmomyiasis externa due to Calliphoridae and review of the literature. Am J Ophthalmol Case Rep 2023; 30:101822. [PMID: 36915894 PMCID: PMC10006714 DOI: 10.1016/j.ajoc.2023.101822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 01/23/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Purpose To describe a case of bilateral facultative ophthalmomyiasis externa due to Calliphoridae in a 30-year-old male assault victim at a suburban hospital in New York and review the relevant literature. Observations An adult male was found to have maggot infestation of both eyes and severe secondary injury to the left cornea and ocular surface. He was treated with manual larvae removal, oral ivermectin, broad spectrum IV antibiotics, and topical antibiotics. Anterior segment reconstruction was required. Conclusions and importance We report the first case of ophthalmomyiasis due to Calliphoridae in the United States and document the vision threatening potential of this rare condition. Timely examination by an ophthalmologist with early debridement may help prevent vision-threatening sequelae.
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Affiliation(s)
- Michael Wolek
- Stony Brook University Renaissance School of Medicine, 100 Nicolls Road, Stony Brook, NY, 11794-8430, USA
| | | | - Armando Garcia
- Department of Ophthalmology, Stony Brook University Hospital, 100 Nicolls Road, Stony Brook, NY, 11794-8430, USA
| | - Jason Byrd
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, 32610, USA
| | - Sarah Weissbart
- Department of Ophthalmology, Stony Brook University Hospital, 100 Nicolls Road, Stony Brook, NY, 11794-8430, USA
| | - Nariman Boyle
- Department of Ophthalmology, Stony Brook University Hospital, 100 Nicolls Road, Stony Brook, NY, 11794-8430, USA
| | - Robert Honkanen
- Department of Ophthalmology, Stony Brook University Hospital, 100 Nicolls Road, Stony Brook, NY, 11794-8430, USA
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Huang W, Huang L, Li W, Saglam MS, Tourmouzis K, Goldstein SM, Master A, Honkanen R, Rigas B. Once-Daily Topical Phosphosulindac Is Efficacious in the Treatment of Dry Eye Disease: Studies in Rabbit Models of Its Main Clinical Subtypes. J Ocul Pharmacol Ther 2021; 38:102-113. [PMID: 34964663 PMCID: PMC8817715 DOI: 10.1089/jop.2021.0050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose: Dry eye disease (DED) is classified as aqueous deficient, evaporative, or mixed. We investigated the therapeutic effect of the novel anti-inflammatory drug phosphosulindac (PS) in rabbit models of DED encompassing its pathogenesis, and its transition to chronicity. Methods: We treated three rabbit models of DED with PS (hydrogel formulation) or vehicle topically applied 1 × /day. We induced aqueous-deficient DED (acute and chronic) by injecting Concanavalin A into lacrimal glands; evaporative DED by injecting into the upper eyelid inactivated Mycobacterium tuberculosis in complete Freund's adjuvant; and mixed DED through desiccative stress, induced by holding open the eye for 3 h. We determined corneal sensitivity, tear break-up time (TBUT), Schirmer's tear test (STT), tear osmolality, and fluorescein staining of the ocular surface. Results: PS reversed all abnormal DED parameters. In acute DED, PS dose dependently normalized corneal sensitivity and tear osmolality; and improved TBUT, STT, and fluorescein staining. PS normalized corneal sensitivity and improved all other parameters in chronic aqueous-deficient DED. In evaporative DED, PS normalized corneal sensitivity and improved TBUT and fluorescein staining (osmolality and STT were not significantly changed in this model). In the desiccative stress model, PS improved TBUT and fluorescein staining but had no effect on STT or tear osmolality. Conclusions: PS rapidly reversed almost all DED parameters in its three subtypes. The normalization of the suppressed corneal sensitivity suggests the possibility of marked symptomatic relief by PS. The hydrogel formulation allows once-daily dosing. PS merits further development as a potential treatment for DED.
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Affiliation(s)
- Wei Huang
- Department of Ophthalmology and Population, Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA.,Department of Ophthalmology, 2nd Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Liqun Huang
- Department of Family, Population, Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Wenyi Li
- Department of Family, Population, Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - M Sait Saglam
- Department of Family, Population, Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | | | | | - Adam Master
- Department of Family, Population, Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Robert Honkanen
- Department of Ophthalmology and Population, Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
| | - Basil Rigas
- Department of Family, Population, Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York, USA
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Huang W, Tourmouzis K, Perry H, Honkanen RA, Rigas B. Animal models of dry eye disease: Useful, varied and evolving (Review). Exp Ther Med 2021; 22:1394. [PMID: 34650642 PMCID: PMC8506913 DOI: 10.3892/etm.2021.10830] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/10/2021] [Indexed: 02/07/2023] Open
Abstract
Dry eye disease (DED), which is a prevalent disease that still lacks successful treatment options, remains a major challenge in ophthalmology. Multiple animal models of DED have been used to decipher its pathophysiology and to develop novel treatments. These models use mice, rats, rabbits, cats, dogs and non-human primates. Each model assesses aspects of DED by focusing on elements of the lacrimal functional unit, which controls the homeostasis of the tear film. The present review outlines representative DED animal models and assesses their contribution to the study of DED. Murine models are the most extensively used, followed by rabbit models; the latter offer the advantage of larger eyes, a favorable biochemical profile for drug studies, experimental ease and relatively low cost, contrasting with non-human primates, which, although closer to humans, are not as accessible and are expensive. No comprehensive ‘ideal’ animal model encompassing all aspects of human DED exists nor is it feasible. Investigators often choose an animal model based on their experimental needs and the following four features of a given model: The size of the eye, its biochemical composition, the available research reagents and cost. As research efforts in DED expand, more refined animal models are needed to supplement the enormous contribution made to date by existing models.
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Affiliation(s)
- Wei Huang
- Department of Ophthalmology, Stony Brook University, Stony Brook, NY 11794, USA.,Department of Ophthalmology, Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, P.R. China
| | | | - Henry Perry
- Ophthalomology Consultants of Long Island, Westbury, NY 11590, USA
| | - Robert A Honkanen
- Department of Ophthalmology, Stony Brook University, Stony Brook, NY 11794, USA
| | - Basil Rigas
- Department of Preventive Medicine, Stony Brook University, Stony Brook, NY 11794, USA
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