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Dart JKG, Papa V, Rama P, Knutsson KA, Ahmad S, Hau S, Sanchez S, Franch A, Birattari F, Leon P, Fasolo A, Kominek EM, Jadczyk-Sorek K, Carley F, Hossain P, Minassian DC. The Orphan Drug for Acanthamoeba Keratitis (ODAK) Trial: PHMB 0.08% (Polihexanide) and Placebo versus PHMB 0.02% and Propamidine 0.1. Ophthalmology 2024; 131:277-287. [PMID: 37802392 DOI: 10.1016/j.ophtha.2023.09.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/22/2023] [Accepted: 09/27/2023] [Indexed: 10/10/2023] Open
Abstract
PURPOSE To compare topical PHMB (polihexanide) 0.02% (0.2 mg/ml)+ propamidine 0.1% (1 mg/ml) with PHMB 0.08% (0.8 mg/ml)+ placebo (PHMB 0.08%) for Acanthamoeba keratitis (AK) treatment. DESIGN Prospective, randomized, double-masked, active-controlled, multicenter phase 3 study (ClinicalTrials.gov identifier, NCT03274895). PARTICIPANTS One hundred thirty-five patients treated at 6 European centers. METHODS Principal inclusion criteria were 12 years of age or older and in vivo confocal microscopy with clinical findings consistent with AK. Also included were participants with concurrent bacterial keratitis who were using topical steroids and antiviral and antifungal drugs before randomization. Principal exclusion criteria were concurrent herpes or fungal keratitis and use of antiamebic therapy (AAT). Patients were randomized 1:1 using a computer-generated block size of 4. This was a superiority trial having a predefined noninferiority margin. The sample size of 130 participants gave approximately 80% power to detect 20-percentage point superiority for PHMB 0.08% for the primary outcome of the medical cure rate (MCR; without surgery or change of AAT) within 12 months, cure defined by clinical criteria 90 days after discontinuing anti-inflammatory agents and AAT. A prespecified multivariable analysis adjusted for baseline imbalances in risk factors affecting outcomes. MAIN OUTCOME MEASURES The main outcome measure was MCR within 12 months, with secondary outcomes including best-corrected visual acuity and treatment failure rates. Safety outcomes included adverse event rates. RESULTS One hundred thirty-five participants were randomized, providing 127 in the full-analysis subset (61 receiving PHMB 0.02%+ propamidine and 66 receiving PHMB 0.08%) and 134 in the safety analysis subset. The adjusted MCR within 12 months was 86.6% (unadjusted, 88.5%) for PHMB 0.02%+ propamidine and 86.7% (unadjusted, 84.9%) for PHMB 0.08%; the noninferiority requirement for PHMB 0.08% was met (adjusted difference, 0.1 percentage points; lower one-sided 95% confidence limit, -8.3 percentage points). Secondary outcomes were similar for both treatments and were not analyzed statistically: median best-corrected visual acuity of 20/20 and an overall treatment failure rate of 17 of 127 patients (13.4%), of whom 8 of 127 patients (6.3%) required therapeutic keratoplasty. No serious drug-related adverse events occurred. CONCLUSIONS PHMB 0.08% monotherapy may be as effective (or at worse only 8 percentage points less effective) as dual therapy with PHMB 0.02%+ propamidine (a widely used therapy) with medical cure rates of more than 86%, when used with the trial treatment delivery protocol in populations with AK with similar disease severity. FINANCIAL DISCLOSURE(S) Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- John K G Dart
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; National Institute of Health Research, Moorfields Biomedical Research Centre, London, United Kingdom
| | | | - Paolo Rama
- Cornea and Ocular Surface Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | - Saj Ahmad
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; National Institute of Health Research, Moorfields Biomedical Research Centre, London, United Kingdom
| | - Scott Hau
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; National Institute of Health Research, Moorfields Biomedical Research Centre, London, United Kingdom
| | - Sara Sanchez
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
| | | | | | - Pia Leon
- Ophthalmic Unit, Ospedale SS Giovanni e Paolo, Venice, Italy
| | - Adriano Fasolo
- Research Unit, The Veneto Eye Bank Foundation, Venice, Italy
| | - Ewa Mrukwa Kominek
- Professor K. Gibiński University Clinical Center of Medical University of Silesia in Katowice, Katowice, Poland; Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Katarzyna Jadczyk-Sorek
- Professor K. Gibiński University Clinical Center of Medical University of Silesia in Katowice, Katowice, Poland; Department of Ophthalmology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Fiona Carley
- Manchester Royal Eye Hospital, Manchester, United Kingdom
| | - Parwez Hossain
- Clinical Experimental Sciences, Faculty of Medicine, University of Southampton & University Hospitals Southampton NHS Trust, Southampton, United Kingdom; National Institute of Health Research (NIHR), Southampton Clinical Research Facility, Southampton, United Kingdom
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Hossain P. Reducing the stress of corneal neuropathic pain: 'Pain without Stain'. Eye (Lond) 2024; 38:411. [PMID: 37726335 PMCID: PMC10858179 DOI: 10.1038/s41433-023-02750-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 09/12/2023] [Indexed: 09/21/2023] Open
Affiliation(s)
- Parwez Hossain
- Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
- Eye Unit, Southampton General Hospital, Tremona Road, Southampton, UK.
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Tsatsos M, Athanasiadis I, MacGregor C, Sharma SK, Anderson D, Hossain P. Contact Lens Use Advice-Risks and Outcomes: Are Patients Drowning in Information but Starved for Knowledge? Turk J Ophthalmol 2023; 53:136-141. [PMID: 37345286 DOI: 10.4274/tjo.galenos.2023.73184] [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] [Indexed: 06/23/2023] Open
Abstract
Objectives Microbial keratitis can cause significant visual morbidity and is a common reason for presentation to eye casualty clinics. Contact lens wear and poor contact lens hygiene significantly increase the risk of corneal infection. This study aimed to determine the level of contact lens hygiene awareness amongst contact lens wearers attending our service and determining whether contact lens type and hygiene attitude are related to severity of disease. Materials and Methods This prospective questionnaire-based study included 50 consecutive patients attending the eye casualty clinic of a tertiary referral center. Visual acuity was assessed at presentation and 2 weeks after diagnosis. Patients were divided into subgroups according to contact lens type (monthly, bi-weekly, daily, and extended day and night wear) and risk group (low, medium, and high) depending on their contact lens hygiene practices. Results Thirty-four women and 16 men were included in this study. Twenty-four patients used monthly disposable contact lenses, 16 used daily disposable contact lenses, 6 were using bi-weekly replacement lenses, and 4 patients were using extended wear (day and night) contact lenses. Twenty-five patients were diagnosed with corneal ulcer, 23 of which had some degree of poor contact lens hygiene. Best corrected visual acuity (BCVA) significantly improved after treatment. Mean BCVA was 0.24 LogMAR before treatment and 0.09 LogMAR after treatment (p<0.05). Conclusion Our study highlights the need to improve contact lens hygiene awareness and influence hygiene practices. Patients with the poorest contact lens hygiene had slower visual recovery and a higher prevalence of corneal ulcer. Contact lens hygiene advice needs to be clear and reinforced over time.
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Affiliation(s)
- Michael Tsatsos
- Thessaloniki Aristoteles University, Department of Ophthalmology, Thessaloniki, Greece
| | - Ioannis Athanasiadis
- Thessaloniki Aristoteles University, Department of Ophthalmology, Thessaloniki, Greece
| | | | | | - David Anderson
- Southampton University Hospital, Southampton, United Kingdom
| | - Parwez Hossain
- Southampton University Hospital, Southampton, United Kingdom
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Syed SF, Marshall A, Hossain P, Sadiq SA. Blink Reflex in Neurotrophic Keratopathy: An Electrophysiological Evaluation. Ophthalmic Plast Reconstr Surg 2022; 38:433-437. [PMID: 35170564 DOI: 10.1097/iop.0000000000002141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Neurotrophic keratitis (NK) is a rare condition which may result in visual loss. This case review investigates if there may be an association between NK and the blink reflex in the absence of facial nerve palsy and lagophthalmos. METHODS This is a retrospective case review of 5 patients with trigeminal nerve damage referred to the oculoplastic department with suspected anesthetic corneae. Information on etiology, symptoms, duration, associated medical conditions, medications, examination findings including Mackie stage of keratopathy, management of keratopathy, and blink electrophysiology results was obtained. RESULTS All 5 patients demonstrated absence of corneal sensation. All patients had preserved facial nerve function with no evidence of lagophthalmos. Keratopathy ranged from Mackie stage 0-2. Management ranged from ocular lubricants to Botulinum-toxin-induced ptosis. Blink studies demonstrated reduction in amplitude as well as increased latency in 2 patients, conferring reduced blink strength. Two patients demonstrated an absent blink reflex on the affected side. One patient had blink latency within the normative range; this patient recovered corneal sensation and was discharged. CONCLUSIONS Our finding of reduced amplitude in blink studies offers both a factor in pathogenesis of NK and a potential therapeutic target. Additionally, blink studies may provide prognostic information for recovery and therefore guide management. We suggest performing blink electrophysiology in patients with trigeminal nerve damage to assess nerve function.
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Affiliation(s)
| | - Andrew Marshall
- Faculty of Science, Liverpool John Moores Liverpool, University, United Kingdom
| | - Parwez Hossain
- Eye Unit, Clinical & Experimental Sciences, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Saghir Ahmed Sadiq
- Faculty of Science, Liverpool John Moores Liverpool, University, United Kingdom
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Popiela M, Ardern-Jones M, Hossain P. Response to: 'Comment on: 'Dupilumab-associated ocular surface disease: presentation, management and long-term sequelae''. Eye (Lond) 2021; 36:1516. [PMID: 34594008 DOI: 10.1038/s41433-021-01782-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 08/23/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022] Open
Affiliation(s)
- Magdalena Popiela
- Eye Unit, Southampton General Hospital, Southampton, UK.,Eye Unit, St Bernard's Hospital, Gibraltar, Gibraltar
| | | | - Parwez Hossain
- Eye Unit, Southampton General Hospital, Southampton, UK. .,Clinical Experimental Sciences, University of Southampton, Southampton, UK.
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Hossain P. Reducing the burden of ocular surface disease with serum eye drops. Eye (Lond) 2021; 35:3179-3180. [PMID: 34211139 DOI: 10.1038/s41433-021-01526-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 03/30/2021] [Accepted: 03/30/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Parwez Hossain
- Eye Unit, University Hospitals Southampton NHS Foundation Trust, Southampton, UK. .,Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
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Affiliation(s)
- Parwez Hossain
- Eye Unit, University Hospitals Southampton NHS Foundation Trust, Tremona Road, Southampton, UK.
- Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
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Venkatesh A, Patel R, Goyal S, Rajaratnam T, Sharma A, Hossain P. Ocular manifestations of emerging viral diseases. Eye (Lond) 2021; 35:1117-1139. [PMID: 33514902 PMCID: PMC7844788 DOI: 10.1038/s41433-020-01376-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 06/28/2020] [Revised: 12/02/2020] [Accepted: 12/14/2020] [Indexed: 02/07/2023] Open
Abstract
Emerging infectious diseases (EIDs) are an increasing threat to public health on a global scale. In recent times, the most prominent outbreaks have constituted RNA viruses, spreading via droplets (COVID-19 and Influenza A H1N1), directly between humans (Ebola and Marburg), via arthropod vectors (Dengue, Zika, West Nile, Chikungunya, Crimean Congo) and zoonotically (Lassa fever, Nipah, Rift Valley fever, Hantaviruses). However, specific approved antiviral therapies and vaccine availability are scarce, and public health measures remain critical. Patients can present with a spectrum of ocular manifestations. Emerging infectious diseases should therefore be considered in the differential diagnosis of ocular inflammatory conditions in patients inhabiting or returning from endemic territories, and more general vigilance is advisable in the context of a global pandemic. Eye specialists are in a position to facilitate swift diagnosis, improve clinical outcomes, and contribute to wider public health efforts during outbreaks. This article reviews those emerging viral diseases associated with reports of ocular manifestations and summarizes details pertinent to practicing eye specialists.
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Affiliation(s)
- Ashwin Venkatesh
- grid.5335.00000000121885934School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Ravi Patel
- grid.439257.e0000 0000 8726 5837Moorfields Eye Hospital, London, UK
| | - Simran Goyal
- grid.5335.00000000121885934School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Timothy Rajaratnam
- grid.5335.00000000121885934School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Anant Sharma
- grid.439257.e0000 0000 8726 5837Moorfields Eye Hospital, London, UK
| | - Parwez Hossain
- grid.430506.4Eye Unit, University Hospitals Southampton NHS Foundation Trust, Southampton, UK ,grid.5491.90000 0004 1936 9297Clinical Experimental Sciences, Faculty of Medicine, Univeristy of Southampton, Southampton, UK
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Abstract
OBJECTIVES To compare sociodemographics and vision-related quality of life (QoL) of individuals with or without dry eye disease (DED); and to explore the impact of DED symptom severity on visual function, activity limitations and work productivity. DESIGN Cross-sectional web-based survey. SETTING General UK population. PARTICIPANTS Adults ≥18 years with (N=1002) or without (N=1003) self-reported DED recruited through email and screened. MAIN OUTCOME MEASURES All participants completed the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25), with six additional questions (items A3-A8), and the EuroQol 5 dimensions 5 levels. DED participants also completed Impact of Dry Eye on Everyday Life questionnaire, 5-item Dry Eye Questionnaire and the Standardised Patient Evaluation of Eye Dryness questionnaire along with the Ocular Comfort Index, Work Productivity and Activity Impairment and the Eye Dryness Score (EDS), a Visual Analogue Scale. RESULTS Baseline demographic and clinical characteristics were similar in participants with versus without DED (mean age, 55.2 vs 55.0 years; 61.8% vs 61.0% women, respectively) based on recruitment targets. Scores were derived from NEI VFQ-25 using the new 28-item revised VFQ (VFQ-28R) scoring. Mean (SD) VFQ-28R scores were lower in participants with versus without DED, indicating worse functioning (activity limitations, 73.3 (12.3) vs 84.4 (12.3); socioemotional functioning, 75.3 (21.5) vs 90.3 (16.2); total score, 71.6 (12.8) vs 83.6 (12.6)). Higher percentages of problems/inability to do activities were observed among those with versus without DED. The impact of DED on visual function was worse for participants with more severe DED symptoms, as assessed by EDS. In addition, a higher EDS was associated with worse symptoms on common DED scales and a worse impact on work productivity. CONCLUSIONS DED symptoms were associated with negative effects on visual function, activities and work productivity, whereas worse DED symptoms had a greater impact on vision-related QoL and work productivity.
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Affiliation(s)
- Parwez Hossain
- Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
- Eye Unit, Southampton General Hospital, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - Csaba Siffel
- Global Evidence and Outcomes, Takeda, Lexington, Massachusetts, USA
- Department of Interdisciplinary Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, Georgia, USA
| | - Corey Joseph
- Global Evidence and Outcomes, Takeda, Lexington, Massachusetts, USA
| | - Juliette Meunier
- Patient Centered Outcomes, Modus Outcomes, Lyon, France
- Patient Centered Outcomes, Modus Outcomes, Cambridge, Massachusetts, USA
| | - Jessica T Markowitz
- Patient Centered Outcomes, Modus Outcomes, Lyon, France
- Patient Centered Outcomes, Modus Outcomes, Cambridge, Massachusetts, USA
| | - Reza Dana
- Cornea and Refractive Surgery Service, Massachusetts Eye and Ear, Boston, Massachusetts, USA
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
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Konstantopoulos A, Del Mar Cendra M, Tsatsos M, Elabiary M, Christodoulides M, Hossain P. Author Correction: Morphological and cytokine profiles as key parameters to distinguish between Gram-negative and Gram-positive bacterial keratitis. Sci Rep 2021; 11:5168. [PMID: 33637814 PMCID: PMC7910445 DOI: 10.1038/s41598-021-85007-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Aris Konstantopoulos
- Southampton Eye Unit, MP104, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK.,Clinical and Experimental Sciences, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Maria Del Mar Cendra
- Clinical and Experimental Sciences, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Michael Tsatsos
- Aristotle University of Thessaloniki, Thessaloniki, Greece.,Eye Department, Dorset County Hospital NHS Foundation Trust, Dorchester, UK
| | - Mariam Elabiary
- Southampton Eye Unit, MP104, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK
| | - Myron Christodoulides
- Clinical and Experimental Sciences, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Parwez Hossain
- Southampton Eye Unit, MP104, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, SO16 6YD, UK. .,Clinical and Experimental Sciences, Southampton General Hospital, University of Southampton, Southampton, UK.
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Hossain P. Microbial keratitis-the true costs of a silent pandemic? Eye (Lond) 2021; 35:2071-2072. [PMID: 33594242 DOI: 10.1038/s41433-020-01360-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 11/30/2020] [Accepted: 11/30/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Parwez Hossain
- Eye Unit, University Hospitals Southampton NHS Foundation Trust, Southampton, UK. .,Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
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12
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Stellwagen A, MacGregor C, Kung R, Konstantopoulos A, Hossain P. Personal hygiene risk factors for contact lens-related microbial keratitis. BMJ Open Ophthalmol 2020; 5:e000476. [PMID: 32953996 PMCID: PMC7481083 DOI: 10.1136/bmjophth-2020-000476] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 04/02/2020] [Revised: 08/04/2020] [Accepted: 08/15/2020] [Indexed: 11/28/2022] Open
Abstract
Objective Microbial keratitis is a sight-threatening complication of contact lens wear, which affects thousands of patients and causes a significant burden on healthcare services. This study aims to identify compliance with contact lens care recommendations and identify personal hygiene risk factors in patients who develop contact lens-related microbial keratitis. Methods and analysis A case–control study was conducted at the University Hospital Southampton Eye Casualty from October to December 2015. Two participant groups were recruited: cases were contact lens wearers presenting with microbial keratitis and controls were contact lens wearers without infection. Participants underwent face-to-face interviews to identify lens wear practices, including lens type, hours of wear, personal hygiene and sleeping and showering in lenses. Univariate and multivariate regression models were used to compare groups. Results 37 cases and 41 controls were identified. Showering in contact lenses was identified as the greatest risk factor (OR, 3.1; 95% CI, 1.2 to 8.5; p=0.03), with showering daily in lenses compared with never, increasing the risk of microbial keratitis by over seven times (OR, 7.1; 95% CI, 2.1 to 24.6; p=0.002). Other risks included sleeping in lenses (OR, 3.1; 95% CI, 1.1 to 8.6; p=0.026), and being aged 25–39 (OR, 6.38; 95% CI, 1.56 to 26.10; p=0.010) and 40–54 (OR, 4.00; 95% CI 0.96 to 16.61; p=0.056). Conclusion The greatest personal hygiene risk factor for contact lens-related microbial keratitis was showering while wearing lenses, with an OR of 3.1, which increased to 7.1 if patients showered daily in lenses. The OR for sleeping in lenses was 3.1, and the most at-risk age group was 25–54.
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Affiliation(s)
- Anna Stellwagen
- Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Eye Unit, Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | - Cheryl MacGregor
- Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Roger Kung
- Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Eye Unit, Clinical and Experimental Sciences, University of Southampton, Southampton, UK
| | | | - Parwez Hossain
- Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.,Eye Unit, Clinical and Experimental Sciences, University of Southampton, Southampton, UK
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Hossain P, Barbara R. The future of refractive surgery: presbyopia treatment, can we dispense with our glasses? Eye (Lond) 2020; 35:359-361. [PMID: 32895499 DOI: 10.1038/s41433-020-01172-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/07/2020] [Accepted: 08/25/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Parwez Hossain
- Southampton Eye Unit, University Hospitals Southampton, Southampton, UK. .,Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.
| | - Ramez Barbara
- Southampton Eye Unit, University Hospitals Southampton, Southampton, UK.,Birmingham Midlands Eye Centre, Birmingham, UK
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Seccombe EL, Ardern‐Jones M, Walker W, Austin S, Taibjee S, Williams S, Hossain P, Shenoy D, Fityan A. Bronchiolitis obliterans as a long‐term sequela of Stevens–Johnson syndrome and toxic epidermal necrolysis in children. Clin Exp Dermatol 2019; 44:897-902. [DOI: 10.1111/ced.13969] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2019] [Indexed: 01/10/2023]
Affiliation(s)
- E. L. Seccombe
- Department of Dermatology University Hospital Southampton NHS Foundation Trust Southampton Hampshire UK
| | - M. Ardern‐Jones
- Department of Dermatology University Hospital Southampton NHS Foundation Trust Southampton Hampshire UK
| | - W. Walker
- Paediatric Respiratory Department University Hospital Southampton NHS Foundation Trust Southampton Hampshire UK
| | - S. Austin
- Department of Dermatology Dorset County Hospital NHS Foundation Trust Dorchester Dorset UK
| | - S. Taibjee
- Department of Dermatology Dorset County Hospital NHS Foundation Trust Dorchester Dorset UK
| | - S. Williams
- Department of Paediatrics University Hospital Southampton NHS Foundation Trust Southampton Hampshire UK
| | - P. Hossain
- Department of Ophthalmology University Hospital Southampton NHS Foundation Trust Southampton Hampshire UK
| | - D. Shenoy
- Department of Paediatrics University Hospital Southampton NHS Foundation Trust Southampton Hampshire UK
| | - A. Fityan
- Department of Dermatology University Hospital Southampton NHS Foundation Trust Southampton Hampshire UK
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Tsatsos M, Athanasiadis I, Kopsachilis N, Krishnan R, Hossain P, Anderson D. Comparison of the Endosaver with noninjector techniques in Descemet's stripping endothelial keratoplasty. Indian J Ophthalmol 2017; 65:1133-1137. [PMID: 29133638 PMCID: PMC5700580 DOI: 10.4103/ijo.ijo_360_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Purpose: Minimal loss of corneal endothelial cells during corneal transplantation is a major target but remains a point of controversy among specialists. Hence, the available method to best achieve this continues to stir progress in the field. The aim of this study is to evaluate the use of the Endosaver injector device for graft insertion in Descemet's stripping endothelial keratoplasty (DSEK) and compare the visual outcomes and endothelial cell survival between the Endosaver injector and Goosey grasping forceps insertion techniques. Methods: This was a retrospective, interventional, consecutive case series undertaken at the University of Southampton Eye Department to assess outcomes of DSEK using the Endosaver injector device compared to noninjector DSEK insertion. Postoperative specular microscopy alongside manifest refraction at 6 and 12 months was evaluated and compared. Mann–Whitney U-test was employed for the statistical analysis of data. Results: Both the Endosaver and Goosey forceps groups showed an improvement in best corrected visual acuity. No significant statistical difference was found in preoperative and postoperative best-corrected visual acuity between the Endosaver and non-Endosaver insertion groups. Mean preoperative endothelial cell count was 2660 (±130) for the Endosaver group and 2608 (±66) for the non-Endosaver group. Postoperative endothelial counts at 6 and 12 months showed a significant difference between the Endosaver: 2104 (±199)–1896 (±226) and the non-Endosaver: 1492 (±207)–1314 (±224) (P < 0.005) groups, respectively. Conclusion: The Endosaver injection device is associated with less trauma to endothelium during graft insertion due to the minimal touch technique employed. A smaller insertion wound of 4.0 mm compared to noninjector cases enabled a more stable system during surgery with no or minimal anterior chamber shallowing. The combination of a stable host with minimal endothelial graft handling and subsequent trauma potentially leads to higher endothelial cell counts when the Endosaver injection device is used compared to forceps insertion.
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Affiliation(s)
- Michael Tsatsos
- Moorfields Eye Hospital, London; Eye Clinic, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | | | - Radhika Krishnan
- Eye Clinic, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Parwez Hossain
- Eye Clinic, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - David Anderson
- Eye Clinic, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Del Mar Cendra M, Christodoulides M, Hossain P. Effect of Different Antibiotic Chemotherapies on Pseudomonas aeruginosa Infection In Vitro of Primary Human Corneal Fibroblast Cells. Front Microbiol 2017; 8:1614. [PMID: 28878761 PMCID: PMC5572282 DOI: 10.3389/fmicb.2017.01614] [Citation(s) in RCA: 2] [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] [Received: 05/17/2017] [Accepted: 08/08/2017] [Indexed: 12/11/2022] Open
Abstract
Pseudomonas aeruginosa is a major cause of bacterial keratitis (BK) worldwide. Inappropriate or non-optimal antibiotic chemotherapy can lead to corneal perforation and rapid sight loss. In this study, we tested the hypothesis that P. aeruginosa strain PAO1 invades primary human corneal fibroblasts (hCFs) in vitro and persists intracellularly, despite chemotherapy with antibiotics used commonly to treat BK. In rank order, ciprofloxacin, levofloxacin and polymyxin B showed the highest activity against planktonic PAO1 growth (100% inhibitory concentration ≤10 μg/mL; 50% inhibitory concentration ≤1 μg/mL), followed by gentamicin and ofloxacin (100% inhibitory concentration ≤50 μg/mL; 50% inhibitory concentration ≤10 μg/mL). These bactericidal antibiotics (50–200 μg/mL concentrations) all killed PAO1 in the extracellular environment of infected hCF monolayers. By contrast, the bactericidal antibiotic cefuroxime and the bacteriostatic antibiotic chloramphenicol failed to sterilize both PAO1 broth cultures, even at a concentration of ≥200 μg/mL) and infected hCF monolayers. Statistically, all antibiotics were able to prevent LDH release from PAO1-infected hCF monolayers at both concentrations tested. Intracellular Pseudomonas were significantly reduced (>99%, P < 0.05) following treatment with ciprofloxacin, levofloxacin and ofloxacin, whereas gentamicin, polymyxin B and cefuroxime failed to clear intracellular bacteria over 24 h. Intracellular Pseudomonas infection was resistant to chloramphenicol, with hCF death observed by 9 h. Eventual growth of remaining intracellular Pseudomonas was observed in hCF after removal of all antibiotics, resulting in re-infection cycles and cell death by 48 h. All of the antibiotics reduced significantly (P < 0.05) IL-1β secretion by hCF infected with a Multiplicity Of Infection (MOI) = 1 of PAO1. With higher MOI, no pro-inflammatory effects were observed with antibiotic treatment, expect with polymyxin B and ofloxacin, which induced significant increased IL-1β secretion (P < 0.001). The findings from our study demonstrated that bactericidal and bacteriostatic antibiotics, routinely used to treat BK, failed to eradicate Pseudomonas infection of hCFs in vitro and that their bactericidal efficacies were influenced by the cellular location of the organism.
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Affiliation(s)
- Maria Del Mar Cendra
- Molecular Microbiology, Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine, University of SouthamptonSouthampton, United Kingdom
| | - Myron Christodoulides
- Molecular Microbiology, Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine, University of SouthamptonSouthampton, United Kingdom
| | - Parwez Hossain
- Eye Unit, Academic Unit of Clinical and Experimental Sciences, University Hospital Southampton NHS Foundation Trust, Southampton General HospitalSouthampton, United Kingdom
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Tsatsos M, MacGregor C, Athanasiadis I, Moschos MM, Jameel S, Hossain P, Anderson D. Herpes simplex virus keratitis: an update of the pathogenesis and current treatment with oral and topical antiviral agents - comment. Clin Exp Ophthalmol 2017; 45:932. [PMID: 28544103 DOI: 10.1111/ceo.12991] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 05/13/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Michael Tsatsos
- Royal Eye Infirmary, Dorset County Hospital NHS Foundation Trust, Dorchester, UK.,Southampton University Hospitals NHS Foundation Trust, Southampton, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK.,University of Athens, Athens, Greece
| | - Cheryl MacGregor
- Southampton University Hospitals NHS Foundation Trust, Southampton, UK
| | | | | | | | - Parwez Hossain
- Southampton University Hospitals NHS Foundation Trust, Southampton, UK
| | - David Anderson
- Southampton University Hospitals NHS Foundation Trust, Southampton, UK
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18
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Hossain P, Tourkmani AK, Kazakos D, Jones M, Anderson D. Emergency corneal grafting in the UK: a 6-year analysis of the UK Transplant Registry. Br J Ophthalmol 2017; 102:26-30. [PMID: 28495906 DOI: 10.1136/bjophthalmol-2016-309870] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 11/15/2016] [Revised: 04/19/2017] [Accepted: 04/23/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Corneal graft (CG) surgery is the most common and successful tissue transplant worldwide. A small and important group of patients are operated in emergency situations, typically to save a perforated eye. Our knowledge of the indications and outcomes of emergency corneal graft (eCG) is limited. METHODS Retrospective, multifactorial analysis of all CGs registered by the UK Transplant Service from April 1999 to March 2005. RESULTS A total of 12 976 CGs were performed. 1330 (11.4%) were eCGs including 433 regrafts. Actual perforation occurred in 876 (65.9%) patients. 420 (31.5%) grafts were for tectonic purposes alone and 217 (16.3%) were also grafted for visual rehabilitation. The main diagnostic categories were infection (39.4%), non-infectious ulcerative keratitis (32.2%) and other causes (ectasias, previous ocular surgery, injury, dystrophies and opacification). Graft survival of first eCG at 1, 2 and 5 years was 78%, 66% and 47%, respectively. Best-corrected visual acuity of surviving grafts at 1 year was: 6/12 or better in 29.9%, 6/18 to 6/60 in 38.4%, counting finger to LP in 30.6% and NPL in 1%, with worsening of vision in only 8.7% of the patients. CONCLUSION This study which is the largest of its kind shows that despite the seriousness of the critical corneal pathology and the surgical challenges that it poses, the outcomes of eCG are favourable with most patients keeping their eyesight and avoiding immediate rejection. These clinical outcomes show the value of eye banking facilities that are developed to support corneal tissue supply for eCG.
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Affiliation(s)
- Parwez Hossain
- Academic Unit of Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK.,Southampton Eye Unit, Southampton General Hospital, Southampton, UK
| | | | - Dimitri Kazakos
- Academic Unit of Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Mark Jones
- Statistics and Audit Directorate, NHS Blood and Transplant, Bristol, UK
| | - David Anderson
- Southampton Eye Unit, Southampton General Hospital, Southampton, UK
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19
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Cendra MDM, Christodoulides M, Hossain P. Signaling Mediated by Toll- Like Receptor 5 Sensing of Pseudomonas aeruginosa Flagellin Influences IL-1β and IL-18 Production by Primary Fibroblasts Derived from the Human Cornea. Front Cell Infect Microbiol 2017; 7:130. [PMID: 28469996 PMCID: PMC5395653 DOI: 10.3389/fcimb.2017.00130] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 11/10/2016] [Accepted: 03/29/2017] [Indexed: 12/24/2022] Open
Abstract
Pseudomonas aeruginosa is the principal cause of bacterial keratitis worldwide and overstimulation of the innate immune system by this organism is believed to contribute significantly to sight loss. In the current study, we have used primary human corneal fibroblast (hCF) cells as an ex vivo model of corneal infection to examine the role of P. aeruginosa flagellum and type three secretion system (TTSS) in inducing inflammasome-associated molecules that trigger IL-1β and IL-18 production during the early stages of the infection. Our results show that P. aeruginosa infection stimulated the non-canonical pathway for IL-1β and IL-18 expression and pathway stimulation was influenced predominantly by the flagellum. Both IL-1β and IL-18 cytokines were expressed intracellularly during bacterial infection, but only the former was released and detected in the extracellular environment. We also investigated the signaling pathways in hCFs mediated by Toll-Like Receptor (TLR)4 and TLR5 sensing of P. aeruginosa, and our data show that the signal triggered by TLR5-flagellin sensing significantly contributed to IL-1β and IL-18 cytokine production in our model. Our study suggests that IL-18 expression is wholly dependent on extracellular flagellin sensing by TLR5, whereas IL-1β expression is also influenced by P. aeruginosa lipopolysacharide. Additionally, we demonstrate that IL-1β and IL-18 production by hCFs can be triggered by both MyD88-dependent and -independent pathways. Overall, our study provides a rationale for the development of targeted therapies, by proposing an inhibition of flagellin-PRR-signaling interactions, in order to ameliorate the inflammatory response characteristic of P. aeruginosa keratitis.
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Affiliation(s)
- Maria Del Mar Cendra
- Division of Clinical and Experimental Sciences, Department of Molecular Microbiology, Faculty of Medicine, University of SouthamptonSouthampton, UK
| | - Myron Christodoulides
- Division of Clinical and Experimental Sciences, Department of Molecular Microbiology, Faculty of Medicine, University of SouthamptonSouthampton, UK
| | - Parwez Hossain
- Eye Unit, Division of Clinical and Experimental Sciences, Faculty of Medicine, University of SouthamptonSouthampton, UK
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20
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Affiliation(s)
- P Hossain
- Division of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,University Hospital Southampton NHS Foundation Trust, Southampton, UK
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21
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22
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Tsatsos M, MacGregor C, Athanasiadis I, Moschos MM, Hossain P, Anderson D. Herpes simplex virus keratitis: an update of the pathogenesis and current treatment with oral and topical antiviral agents - response. Clin Exp Ophthalmol 2016; 45:317. [DOI: 10.1111/ceo.12835] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 09/07/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Michael Tsatsos
- Royal Eye Infirmary; Dorset County Hospital NHS Foundation Trust; Dorchester UK
- Southampton University Hospitals NHS Foundation Trust; Southampton UK
- Moorfields Eye Hospital NHS Foundation Trust; London UK
- University of Athens; Athens Greece
| | - Cheryl MacGregor
- Southampton University Hospitals NHS Foundation Trust; Southampton UK
| | | | | | - Parwez Hossain
- Southampton University Hospitals NHS Foundation Trust; Southampton UK
| | - David Anderson
- Southampton University Hospitals NHS Foundation Trust; Southampton UK
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23
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Tsatsos M, MacGregor C, Athanasiadis I, Moschos MM, Hossain P, Anderson D. Herpes simplex virus keratitis: an update of the pathogenesis and current treatment with oral and topical antiviral agents. Clin Exp Ophthalmol 2016; 44:824-837. [PMID: 27273328 DOI: 10.1111/ceo.12785] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [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: 11/29/2015] [Revised: 04/02/2016] [Accepted: 05/25/2016] [Indexed: 01/02/2023]
Abstract
Ophthalmic herpes simplex viral keratitis is responsible for a range of ocular manifestations from superficial epithelial disease to stromal keratitis and endotheliitis. The Herpetic Eye Disease Study has guided the management of herpetic eye disease for almost twenty years, but newer medications such as valacyclovir are now available and are considered to have better bioavailability than acyclovir. In this review, we examine the existing evidence on the pathogenesis of different ophthalmic herpes simplex viral keratitis disease modalities and the role of oral and topically administered antiviral drugs in the treatment of herpes simplex viral keratitis.
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Affiliation(s)
- Michael Tsatsos
- Royal Eye Infirmary, Dorset County Hospital NHS Foundation Trust, Dorchester, UK.,Southampton University Hospitals NHS Foundation Trust, Southampton, UK.,Moorfields Eye Hospital NHS Foundation Trust, London, UK.,University of Athens, Athens, Greece
| | - Cheryl MacGregor
- Southampton University Hospitals NHS Foundation Trust, Southampton, UK
| | | | | | - Parwez Hossain
- Southampton University Hospitals NHS Foundation Trust, Southampton, UK
| | - David Anderson
- Southampton University Hospitals NHS Foundation Trust, Southampton, UK
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24
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Hossain P. Shaikh Ali Hossain. Assoc Med J 2016. [DOI: 10.1136/bmj.i3904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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25
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Affiliation(s)
- P Hossain
- Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Eye Unit, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - A Konstantopoulos
- Clinical Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,Eye Unit, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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26
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Taube MA, del Mar Cendra M, Elsahn A, Christodoulides M, Hossain P. Pattern recognition receptors in microbial keratitis. Eye (Lond) 2015; 29:1399-415. [PMID: 26160532 DOI: 10.1038/eye.2015.118] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 05/31/2015] [Indexed: 12/12/2022] Open
Abstract
Microbial keratitis is a significant cause of global visual impairment and blindness. Corneal infection can be caused by a wide variety of pathogens, each of which exhibits a range of mechanisms by which the immune system is activated. The complexity of the immune response to corneal infection is only now beginning to be elucidated. Crucial to the cornea's defences are the pattern-recognition receptors: Toll-like and Nod-like receptors and the subsequent activation of inflammatory pathways. These inflammatory pathways include the inflammasome and can lead to significant tissue destruction and corneal damage, with the potential for resultant blindness. Understanding the immune mechanisms behind this tissue destruction may enable improved identification of therapeutic targets to aid development of more specific therapies for reducing corneal damage in infectious keratitis. This review summarises current knowledge of pattern-recognition receptors and their downstream pathways in response to the major keratitis-causing organisms and alludes to potential therapeutic approaches that could alleviate corneal blindness.
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Affiliation(s)
- M-A Taube
- Division of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - M del Mar Cendra
- Division of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - A Elsahn
- Division of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - M Christodoulides
- Division of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - P Hossain
- Division of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK.,University Hospital Southampton NHS Foundation Trust, Southampton, UK
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27
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Glaser DA, Hossain P, Perkins W, Griffiths T, Ahluwalia G, Weng E, Beddingfield FC. Long-term safety and efficacy of bimatoprost solution 0·03% application to the eyelid margin for the treatment of idiopathic and chemotherapy-induced eyelash hypotrichosis: a randomized controlled trial. Br J Dermatol 2015; 172:1384-94. [PMID: 25296533 PMCID: PMC4832276 DOI: 10.1111/bjd.13443] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2014] [Indexed: 11/29/2022]
Abstract
Background Bimatoprost ophthalmic solution 0·03% is approved in several countries for the treatment of eyelash hypotrichosis. Previous trials were limited to 4 months of treatment and primarily idiopathic hypotrichosis. Objectives To evaluate the long‐term safety and efficacy of bimatoprost in patients with idiopathic or chemotherapy‐induced hypotrichosis. Methods This multicentre, double‐masked, randomized, parallel‐group study included two 6‐month treatment periods [treatment period 1 (TP1) and treatment period 2 (TP2)]. Patients with idiopathic hypotrichosis were randomized to three treatment groups: (i) bimatoprost (TP1 and TP2); (ii) bimatoprost (TP1) and vehicle (TP2); and (iii) vehicle (TP1) and bimatoprost (TP2). Patients with chemotherapy‐induced hypotrichosis were randomized to two treatment groups: (i) bimatoprost or vehicle (TP1) and (ii) bimatoprost (TP2). Primary end point was a composite of at least a one‐grade improvement in investigator‐assessed Global Eyelash Assessment and at least a three‐point improvement in patient‐reported Eyelash Satisfaction Questionnaire Domain 2 at month 4. Secondary measures included digitally assessed eyelash characteristics. Results The primary efficacy end point was met in both populations (idiopathic responder rate was 40·2% for bimatoprost vs. 6·8% for vehicle; postchemotherapy responder rate was 37·5% for bimatoprost vs. 18·2% for vehicle). Efficacy by month 6 was maintained (idiopathic) or enhanced (postchemotherapy) at 12 months. Treatment effects were maintained for approximately 2 months but markedly diminished 4–6 months following treatment cessation in patients with idiopathic hypotrichosis. No drug‐related serious adverse events were reported. Conclusions Daily treatment with bimatoprost ophthalmic solution 0·03% for 1 year was effective and well tolerated in patients with idiopathic and chemotherapy‐induced hypotrichosis. What's already known about this topic? The safety and efficacy of bimatoprost ophthalmic solution 0·03% have been previously established for idiopathic hypotrichosis in studies lasting up to 4 months.
What does this study add? Very little has been reported on eyelash loss and regrowth after chemotherapy, and there is currently no standard prevention or treatment for chemotherapy‐induced hypotrichosis of the eyelashes. We provide long‐term (up to 12 months) safety and efficacy data for treatment with bimatoprost ophthalmic solution 0·03% in chemotherapy‐induced and idiopathic hypotrichosis.
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Affiliation(s)
- D A Glaser
- Department of Dermatology, Saint Louis University, St Louis, MO, U.S.A
| | - P Hossain
- NIHR Wellcome Trust Clinical Research Facility, Southampton General Hospital, University of Southampton, Southampton, U.K
| | - W Perkins
- Department of Dermatology, Nottingham University Hospitals, Nottingham, U.K
| | - T Griffiths
- The Dermatology Centre, Salford Royal NHS Foundation Trust, Salford, U.K.,University of Manchester, Manchester, U.K
| | | | - E Weng
- Allergan, Inc., Irvine, CA, U.S.A
| | - F C Beddingfield
- Department of Medicine, Division of Dermatology, David Geffen School of Medicine, University of California, Los Angeles, CA, U.S.A.,Kythera Biopharmaceuticals, Inc., Westlake Village, CA, U.S.A
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28
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Chen X, Thomson H, Cooke J, Scott J, Hossain P, Lotery A. Adult limbal neurosphere cells: a potential autologous cell resource for retinal cell generation. PLoS One 2014; 9:e108418. [PMID: 25271851 PMCID: PMC4182722 DOI: 10.1371/journal.pone.0108418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 08/27/2014] [Indexed: 01/15/2023] Open
Abstract
The Corneal limbus is a readily accessible region at the front of the eye, separating the cornea and sclera. Neural colonies (neurospheres) can be generated from adult corneal limbus invitro. We have previously shown that these neurospheres originate from neural crest stem/progenitor cells and that they can differentiate into functional neurons invitro. The aim of this study was to investigate whether mouse and human limbal neurosphere cells (LNS) could differentiate towards a retinal lineage both invivo and invitro following exposure to a developing retinal microenvironment. In this article we show that LNS can be generated from adult mice and aged humans (up to 97 years) using a serum free culture assay. Following culture with developing mouse retinal cells, we detected retinal progenitor cell markers, mature retinal/neuronal markers and sensory cilia in the majority of mouse LNS experiments. After transplantation into the sub-retinal space of neonatal mice, mouse LNS cells expressed photoreceptor specific markers, but no incorporation into host retinal tissue was seen. Human LNS cells also expressed retinal progenitor markers at the transcription level but mature retinal markers were not observed invitro or invivo. This data highlights that mouse corneal limbal stromal progenitor cells can transdifferentiate towards a retinal lineage. Complete differentiation is likely to require more comprehensive regulation; however, the accessibility and plasticity of LNS makes them an attractive cell resource for future study and ultimately therapeutic application.
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Affiliation(s)
- Xiaoli Chen
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Heather Thomson
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Jessica Cooke
- School of Clinical Sciences, University of Bristol, Bristol Eye Hospital, Bristol, United Kingdom
| | - Jennifer Scott
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Parwez Hossain
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
| | - Andrew Lotery
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
- Eye Unit, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
- * E-mail:
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29
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Affiliation(s)
- C MacGregor
- Southampton Eye Unit, Southampton University Hospitals NHS Trust, Southampton, UK
| | - M Tsatsos
- 1] Southampton Eye Unit, Southampton University Hospitals NHS Trust, Southampton, UK [2] Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - P Hossain
- Southampton Eye Unit, Southampton University Hospitals NHS Trust, Southampton, UK
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30
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Athanasiadis Y, Tsatsos M, Sharma A, Hossain P. Subconjunctival Triamcinolone Acetonide in the Management of Ocular Inflammatory Disease. J Ocul Pharmacol Ther 2013; 29:516-22. [DOI: 10.1089/jop.2012.0208] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Michael Tsatsos
- NHS Foundation Trust Eye Unit, University Hospital Southampton, Southampton, United Kingdom
| | - Anant Sharma
- Moorfields Eye Hospital NHS Foundation Trust, Bedford, United Kingdom
| | - Parwez Hossain
- NHS Foundation Trust Eye Unit, University Hospital Southampton, Southampton, United Kingdom
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31
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32
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Konstantopoulos A, Yadegarfar ME, Yadegarfar G, Stinghe A, Macleod A, Jacob A, Hossain P. Deep sclerectomy versus trabeculectomy: a morphological study with anterior segment optical coherence tomography. Br J Ophthalmol 2013; 97:708-14. [DOI: 10.1136/bjophthalmol-2012-301926] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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33
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Trikha S, Turnbull AMJ, Morris RJ, Anderson DF, Hossain P. The journey to femtosecond laser-assisted cataract surgery: new beginnings or a false dawn? Eye (Lond) 2013; 27:461-73. [PMID: 23370418 PMCID: PMC3625999 DOI: 10.1038/eye.2012.293] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 12/15/2012] [Indexed: 02/03/2023] Open
Abstract
Femtosecond laser-assisted cataract surgery (FLACS) represents a potential paradigm shift in cataract surgery, but it is not without controversy. Advocates of the technology herald FLACS as a revolution that promises superior outcomes and an improved safety profile for patients. Conversely, detractors point to the large financial costs involved and claim that similar results are achievable with conventional small-incision phacoemulsification. This review provides a balanced and comprehensive account of the development of FLACS since its inception. It explains the physiology and mechanics underlying the technology, and critically reviews the outcomes and implications of initial studies. The benefits and limitations of using femtosecond laser accuracy to create corneal incisions, anterior capsulotomy, and lens fragmentation are explored, with reference to the main platforms, which currently offer FLACS. Economic considerations are discussed, in addition to the practicalities associated with the implementation of FLACS in a healthcare setting. The influence on surgical training and skills is considered and possible future applications of the technology introduced. While in its infancy, FLACS sets out the exciting possibility of a new level of precision in cataract surgery. However, further work in the form of large scale, phase 3 randomised controlled trials are required to demonstrate whether its theoretical benefits are significant in practice and worthy of the necessary huge financial investment and system overhaul. Whether it gains widespread acceptance is likely to be influenced by a complex interplay of scientific and socio-economic factors in years to come.
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Affiliation(s)
- S Trikha
- Eye Unit, University Hospital Southampton Foundation Trust, Southampton, UK
| | - A M J Turnbull
- Department of Ophthalmology, Salisbury District Hospital, Salisbury, UK
| | - R J Morris
- Eye Unit, University Hospital Southampton Foundation Trust, Southampton, UK
| | - D F Anderson
- Eye Unit, University Hospital Southampton Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - P Hossain
- Eye Unit, University Hospital Southampton Foundation Trust, Southampton, UK
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
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34
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Chen X, Thomson H, Hossain P, Lotery A. Characterisation of mouse limbal neurosphere cells: a potential cell source of functional neurons. Br J Ophthalmol 2012; 96:1431-7. [DOI: 10.1136/bjophthalmol-2012-301546] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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35
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Shinton AJ, Tsatsos M, Konstantopoulos A, Goverdhan S, Elsahn AF, Anderson DF, Hossain P. Impact of graft thickness on visual acuity after Descemet's stripping endothelial keratoplasty. Br J Ophthalmol 2011; 96:246-9. [DOI: 10.1136/bjophthalmol-2011-300462] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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36
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Yeoh S, Church M, Lackie P, McGill J, Mota M, Hossain P. Increased conjunctival expression of protease activated receptor 2 (PAR-2) in seasonal allergic conjunctivitis: a role for abnormal conjunctival epithelial permeability in disease pathogenesis? Br J Ophthalmol 2011; 95:1304-8. [PMID: 21558289 DOI: 10.1136/bjo.2010.191221] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS Aeroallergen exposure to the conjunctival epithelium in seasonal allergic conjunctivitis (SAC) may induce a cellular stress response that disrupts the barrier properties of the conjunctival epithelium, resulting in allergic disease. Whether such changes occur in SAC is unknown. Epithelial permeability is known to be increased when protease activated receptor 2 (PAR-2) is activated. We evaluated the expression of PAR-2 in patients with SAC-in-season (SACS) and compared it with control non-atopic subjects or those with out-of-season allergic conjunctivitis (OSAC). METHODS Six SACS, eight normal and four OSAC specimens were examined immunohistochemically for PAR-2 and quantified in a masked fashion for the percentage of epithelia stained for each marker using Image-J software. Conjunctival epithelial heights were measured in all groups to confirm the presence of allergic eye disease. RESULTS Mean percentage staining of PAR-2 was significantly greater in SACS that in normal specimens (73.4 ± 15.4% vs 32.8 ± 30.0%, p=0.038) or in OSAC (73.4 ± 15.4% vs 1.4 ± 2.2%, p=0.01). Mean conjunctival epithelial height was significantly raised in SACS (63.8 ± 9.0 μm) versus controls (44.7 ± 11.2 μm) (p=0.003, unpaired t test). CONCLUSIONS Conjunctival epithelial PAR-2 is significantly upregulated in SAC. This supports the view that disruption of the barrier properties of the conjunctival epithelium is an important event in SAC pathogenesis.
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Affiliation(s)
- S Yeoh
- Division of Infection, Inflammation & Immunity, Faculty of Medicine, University of Southampton, Southampton General Hospital, Southampton, UK
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Wong Y, Sethu C, Louafi F, Hossain P. Lipopolysaccharide Regulation of Toll-Like Receptor-4 and Matrix Metalloprotease-9 in Human Primary Corneal Fibroblasts. ACTA ACUST UNITED AC 2011; 52:2796-803. [DOI: 10.1167/iovs.10-5459] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Yuk Wong
- From the Division of Infection, Inflammation and Immunity, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; and
| | - Claire Sethu
- From the Division of Infection, Inflammation and Immunity, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; and
| | - Fethi Louafi
- From the Division of Infection, Inflammation and Immunity, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; and
| | - Parwez Hossain
- From the Division of Infection, Inflammation and Immunity, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; and the 2Eye Unit, Southampton General Hospital, Southampton, United Kingdom
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Abstract
The epidemiology of microbial keratitis has been investigated in several studies by analysis of organisms cultured from corneal scrapes. However, a comparison of the frequency of different organisms causing keratitis in different parts of the world is lacking. The authors present a review incorporating an analysis of data from studies worldwide. The data provide a comparison of the frequency of culture-positive organisms found in different parts of the world. Associations between a country's gross national income and types of causative organism are explored. The highest proportion of bacterial corneal ulcers was reported in studies from North America, Australia, The Netherlands and Singapore. The highest proportion of staphylococcal ulcers was found in a study from Paraguay, while the highest proportion of pseudomonas ulcers was reported in a study from Bangkok. The highest proportions of fungal infections were found in studies from India and Nepal. The Spearman correlation coefficient demonstrated statistically significant correlations between gross national income and percentages of bacterial (0.85 (95% CI 0.68 to 0.91, p<0.0001)), fungal (-0.81 (95% CI -0.90 to -0.66, p<0.0001)) and streptococcal (-0.43 (95% CI -0.66 to -0.12, p=0.009)) isolates.
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Konstantopoulos A, Yadegarfar G, Fievez M, Anderson DF, Hossain P. In Vivo Quantification of Bacterial Keratitis with Optical Coherence Tomography. ACTA ACUST UNITED AC 2011; 52:1093-7. [DOI: 10.1167/iovs.10-6067] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Aristides Konstantopoulos
- From the Southampton Eye Unit, Southampton University Hospitals NHS Trust, Southampton, United Kingdom
| | - Ghasem Yadegarfar
- the Biostat & Epidemiology Department, School of Public Health Sciences, Isfahan University of Medical Sciences, Isfahan, Iran; and
| | - Marina Fievez
- From the Southampton Eye Unit, Southampton University Hospitals NHS Trust, Southampton, United Kingdom
| | - David F. Anderson
- From the Southampton Eye Unit, Southampton University Hospitals NHS Trust, Southampton, United Kingdom
| | - Parwez Hossain
- From the Southampton Eye Unit, Southampton University Hospitals NHS Trust, Southampton, United Kingdom; the 3Division of Infection, Inflammation & Immunity, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
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Konstantopoulos A, Hossain P. Limitations of Fourier-domain OCT. J Cataract Refract Surg 2010; 36:534; author reply 534-5. [PMID: 20202572 DOI: 10.1016/j.jcrs.2009.08.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2009] [Accepted: 08/26/2009] [Indexed: 11/28/2022]
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Konstantopoulos A, Yadegarfar G, Madhusudhana K, Canning C, Luff A, Anderson D, Hossain P. Prognostic factors that determine visual outcome following cataract surgery complicated by vitreous loss. Eur J Ophthalmol 2009; 19:247-53. [PMID: 19253242 DOI: 10.1177/112067210901900212] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To identify prognostic factors that determine visual outcome following phacoemulsification cataract surgery complicated by vitreous loss. METHODS A retrospective cohort study. All cases of vitreous loss during phacoemulsification surgery at a university hospital, between June 2000 and December 2005, were identified from the hospital computer database. By reviewing the medical notes, preoperative, intraoperative, and postoperative data were collected. Outcome of interest was presence of poor visual outcome (best-corrected visual acuity [BCVA] <6/12). Chi-square and Mann-Whitney U tests were used to compare groups of poor and good visual outcome. RESULTS A total of 230 consecutive cases (eyes) were identified; medical notes were available for 228. Mean patient age was 78.4 years (SD 11); median follow-up 13.4 weeks (range 1-203). In multivariable logistic regression analysis poor visual outcome was independently associated with poor preoperative vision (BCVA <6/12) (OR 3.78, 95% CI 1.76-8.11), age-related macular degeneration (OR 3.04, 95% CI 1.16-8.00), cystoid macular edema (OR 3.85, 95% CI 1.29-11.51), and secondary pars plana vitrectomy (PPV) for nuclear fragment loss (OR 4.42, 95% CI 1.03-19.02). Primary PPV for nuclear fragment loss, age >70, ocular comorbidity, axial length, vitreous loss during irrigation/aspiration, or lens implantation, anterior chamber lens, and secondary lens implantation were not significant associations (p>or= 0.05). In 33 (14.5%) eyes BCVA was reduced by at least one Snellen line compared to before surgery. CONCLUSIONS Poor visual outcome was associated with poor preoperative vision, age-related macular degeneration, cystoid macular edema, and secondary PPV following nuclear fragment loss. Primary PPV for nuclear fragment loss was not a significant association.
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Konstantopoulos A, Kuo J, Anderson D, Hossain P. Assessment of the use of anterior segment optical coherence tomography in microbial keratitis. Am J Ophthalmol 2008; 146:534-542. [PMID: 18602080 DOI: 10.1016/j.ajo.2008.05.030] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Revised: 05/19/2008] [Accepted: 05/20/2008] [Indexed: 11/17/2022]
Abstract
PURPOSE To investigate the imaging capabilities of anterior segment optical coherence tomography (AS OCT) in microbial keratitis and to assess whether measurements of the quantitative parameters, infiltrate thickness and corneal thickness, were possible. DESIGN Prospective, noncomparative, observational case series. METHODS The study was conducted at a university hospital clinical setting. Seven patients (eyes) with suspected microbial keratitis underwent standard clinical examination and treatment based on slit-lamp clinical findings. AS OCT scanning was performed on presentation and at two follow-up appointments. All scans were carried out with the scanning beam passing through the center of the infiltration and at a specific meridian. Examination was carried out by the same operator. RESULTS Corneal infiltration was imaged as a hyperreflective area in the corneal stroma on high-resolution AS OCT scans. Retrocorneal pathologic features and anterior chamber inflammatory cells could be imaged. Corneal and infiltrate thickness could be measured with calipers in six cases. In one case, corneal and infiltrate thickness could not be measured because of a thick inflammatory plaque attached to the endothelium. In this case, the width of the plaque was measured on serial scans. CONCLUSIONS AS OCT imaging provides a range of parameters that can be used to assess microbial keratitis and the treatment response objectively.
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Abstract
Corneal confocal microscopy is a novel clinical technique for the study of corneal cellular structure. It provides images which are comparable to in-vitro histochemical techniques delineating corneal epithelium, Bowman's layer, stroma, Descemet's membrane and the corneal endothelium. Because, corneal confocal microscopy is a non invasive technique for in vivo imaging of the living cornea it has huge clinical potential to investigate numerous corneal diseases. Thus far it has been used in the detection and management of pathologic and infectious conditions, corneal dystrophies and ecstasies, monitoring contact lens induced corneal changes and for pre and post surgical evaluation (PRK, LASIK and LASEK, flap evaluations and Radial Keratotomy), and penetrating keratoplasty. Most recently it has been used as a surrogate for peripheral nerve damage in a variety of peripheral neuropathies and may have potential in acting as a surrogate marker for endothelial abnormalities.
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Affiliation(s)
- Mitra Tavakoli
- Division of Cardiovascular Medicine, University of Manchester and Manchester Royal Infirmary, Manchester, UK
| | - Parwez Hossain
- University of Southampton, Southampton Eye Unit, Southampton General Hospital, Southampton, UK
| | - Rayaz A Malik
- Division of Cardiovascular Medicine, University of Manchester and Manchester Royal Infirmary, Manchester, UK
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Madhusudhana KC, Hossain P, Thiagarajan M, Newsom RSB. Use of anterior segment optical coherence tomography in a penetrating eye injury. Br J Ophthalmol 2007; 91:982-3. [PMID: 17576718 PMCID: PMC1955674 DOI: 10.1136/bjo.2006.097923] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Anterior segment imaging is a rapidly advancing field of ophthalmology. New imaging modalities, such as rotating Scheimpflug imaging (Pentacam-Scheimpflug) and anterior segment optical coherence tomography (Visante OCT and Slit-Lamp OCT), have recently become commercially available. These new modalities supplement the more established imaging devices of Orbscan scanning slit topography and ultrasound biomicroscopy (UBM). All devices promise quantitative information and qualitative imaging of the cornea and anterior chamber. They provide a quantitative angle estimation by calculating the angle between the iris surface and the posterior corneal surface. Direct angle visualisation is possible with the OCT devices and UBM; they provide images of the scleral spur, ciliary body, ciliary sulcus and even canal of Schlemm in some eyes. Pentacam-Scheimpflug can measure net corneal power, a feature particularly useful for cataract patients having undergone previous corneal surgery. Anterior segment OCT can measure corneal flap depth following LASIK and anterior chamber width prior to phakic intraocular lens implantation. The arrival of the new imaging devices may herald the dawn of a new era for ophthalmic diagnosis, particularly in view of the ease and non-contact nature of examination.
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Perrella G, Brusini P, Spelat R, Hossain P, Hopkinson A, Dua HS. Expression of haematopoietic stem cell markers, CD133 and CD34 on human corneal keratocytes. Br J Ophthalmol 2006; 91:94-9. [PMID: 16956910 PMCID: PMC1857557 DOI: 10.1136/bjo.2006.097352] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To study the expression of CD133 and CD34 antigens on cultured human keratocytes over time. METHODS Primary cultures of human corneal stromal cells were established from explants derived from cadaver eye donors. The cultures were sorted for CD133+ and CD34+ cells using magnetic beads. Both the primary cultures and secondary passages of sorted cells were further analysed by flow cytometry and western blot analysis for expression of the same antigens over time. RESULTS Four different cell populations-namely, CD133+, CD133-, CD34+ and CD34-, were identified in the culture samples. Two further specific subgroups were identified by flow cytometry: CD133+/CD34- cells and CD133+/CD34+ cells. Expression of CD133 declines more than CD34 with time in cell cultures. Although most cells lost expression of these markers, small populations retained staining up to 5 weeks in culture. CONCLUSION Human keratocytes express the haematopoietic stem cell markers CD133 and CD34. This expression decreases with time in culture, with most but not all cells losing expression. On the basis of these markers, the corneal stroma shows a heterogeneous population of cells. Expression or down regulation of expression of these molecules could represent different stages of activation of these cells.
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Affiliation(s)
- G Perrella
- Department of Experimental and Clinical Pathology and Medicine, University of Udine. Ple SM Misericordia, Udine 33100, Italy.
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Abstract
Retinal vein occlusions (RVO) are the second commonest sight threatening vascular disorder. Despite its frequency treatments for RVO are unsatisfactory and include several that have not been tested by large, well designed, prospective, randomised controlled trials. There is also the lack of long term follow up in many of the available small uncontrolled studies, and the timings of interventions are haphazard. This review aims to evaluate the current knowledge relating to the pathogenesis, suggested treatments for the different types of RVO, and their complications. Isovolaemic haemodilution is of limited benefit and should be avoided in patients with concurrent cardiovascular, renal, or pulmonary morbidity. Evidence to date does not support any therapeutic benefit from radial optic neurotomy, optic nerve decompression, or arteriovenous crossing sheathotomy on its own. Vitrectomy combined with intravenous thrombolysis may offer promise for central RVO. Similarly, vitrectomy combined with arteriovenous sheathotomy intravenous tissue plasminogen activator may offer benefits for branch RVO. RVOs occur at significantly high frequency to allow future prospective randomised controlled studies to be conducted to evaluate the role of different therapeutic modalities singly or in combination.
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Affiliation(s)
- H Shahid
- Prince Charles Eye Unit, King Edward VII Hospital, Windsor, UK
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Affiliation(s)
- Parwez Hossain
- University of Southampton, Southampton Eye Unit, Southampton General Hospital, Southampton SO16 6YD, UK.
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Affiliation(s)
- Parwez Hossain
- Academic Department of Ophthalmology, University of Nottingham, Eye, Ear, Nose, and Throat Centre, Queen's Medical Centre, Nottingham NG7 2UH
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Joseph A, Hossain P, Jham S, Jones RE, Tighe P, McIntosh RS, Dua HS. Expression of CD34 and L-selectin on human corneal keratocytes. Invest Ophthalmol Vis Sci 2003; 44:4689-92. [PMID: 14578387 DOI: 10.1167/iovs.02-0999] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To investigate the expression of CD34, a hematopoietic stem cell marker and an adhesion molecule, and its ligand L-selectin in the human cornea. METHODS Seventeen normal adult human corneal specimens were studied by immunohistochemistry using a panel of monoclonal antibodies against all three classes of the hematopoietic stem cell marker CD34 and its ligand L-selectin. An additional six corneal specimens were used for protein extraction and analysis by Western blotting, using the CD34 and L-selectin antibodies. PCR was used to determine expression of mRNA for CD34 and L-selectin in the corneal specimens. RESULTS Only corneal keratocytes showed positive immunostaining for all three classes of CD34. Western blotting confirmed the expression of CD34 by these cells and mRNA expression for CD34 in the corneal stroma was demonstrated by PCR. For L-selectin, positive staining around keratocytes was noted on immunohistochemistry but L-selectin could not be detected either by Western blotting or PCR. CONCLUSIONS Normal human corneal keratocytes express all three classes of CD34. The expression of this adhesion molecule on corneal keratocytes suggests that it may have a role in keeping the keratocytes anchored in their microniche, between the collagen lamellae. The positive staining for L-selectin found by immunohistochemistry but not by Western blotting or PCR would indicate the presence of either another ligand from the selectin family or a cross-reactive epitope on corneal keratocytes.
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Affiliation(s)
- Annie Joseph
- Larry A. Donoso Laboratory for Eye Research, Division of Ophthalmology and Visual Sciences, Eye, Ear, Nose, and Throat Centre, University of Nottingham, Queen's Medical Centre, Nottingham, United Kingdom
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