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Kornhauser T, Pemberton JD. Temozolomide-associated blepharo conjunctivitis: a case report. BMC Ophthalmol 2024; 24:162. [PMID: 38609860 PMCID: PMC11010290 DOI: 10.1186/s12886-024-03417-6] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Temozolomide (TMZ) is an effective oral alkylating agent used in treating glioblastoma multiforme (GBM) and high-grade gliomas. It works by introducing methyl groups into DNA, inhibiting cell division. A case of blepharoconjunctivitis linked to the administration of TMZ is detailed in this report. CASE PRESENTATION We present a case of a 58-year-old African-American man diagnosed with GBM. Following adjuvant TMZ treatment, he developed blepharoconjunctivitis, characterized by eyelid and conjunctival inflammation. Symptoms included eyelid swelling, crusting, and conjunctival discharge, which were promptly resolved with topical steroid cream and eye drops. CONCLUSIONS Reports specifically linking TMZ to blepharoconjunctivitis are limited. The exact mechanism remains unclear but may involve inflammation extending from blepharitis to the conjunctiva. Healthcare providers must recognize and manage ophthalmic complications promptly. This case report highlights blepharoconjunctivitis associated with TMZ use in a GBM patient. While TMZ is an effective treatment, ophthalmic side effects can occur.
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Affiliation(s)
- Tom Kornhauser
- Jones Eye Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, 72207, Little Rock, AR, USA.
| | - John D Pemberton
- Jones Eye Institute, University of Arkansas for Medical Sciences, 4301 W. Markham Street, 72207, Little Rock, AR, USA
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Jeong S, Han SY, Moon S, Lee D, Kim SY, Kim M, Park J, Kim MM, Jae Kim W. Parental perspectives and concerns regarding exotropia surgery and comparison with clinicians' predictions. J AAPOS 2024; 28:103862. [PMID: 38458599 DOI: 10.1016/j.jaapos.2024.103862] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/20/2024] [Accepted: 01/28/2024] [Indexed: 03/10/2024]
Abstract
PURPOSE To evaluate parental perspectives and concerns regarding exotropia surgery and compare them with clinicians' predictions of parental responses in Korean pediatric patients with intermittent exotropia. METHODS This survey study included the parents of pediatric patients with intermittent exotropia who underwent surgery and clinicians at five hospitals from June 2022 to February 2023, who participated in the Survey of Parental Attitude and Concerns of Exotropia surgery (SPACE) study 1. Parental attitudes and concern about exotropia surgery were assessed using a questionnaire. Clinicians' estimation of each item corresponding to the parental questionnaire was also assessed and compared with parental responses. RESULTS A total of 266 parents and 41 clinicians were included. More parents responded that information about surgery was most helpful or most commonly received from clinicians than clinicians estimated (P = 0.001). More parents reported actively communicating with the child about surgery than clinicians estimated (P < 0.001). Parents showed a higher level of concern for general anesthesia and the hospital environment than clinicians thought they would (P = 0.002 and P < 0.001, resp.). In the postoperative follow-up items, parents showed high levels of concern regarding postoperative infection (P < 0.001), conjunctival redness (P = 0.040), persistent overcorrection (P < 0.001), and glasses wearing (P = 0.019). CONCLUSIONS Parental perspectives and concerns regarding pediatric intermittent exotropia surgery differed from clinicians' estimations thereof. More parents obtain information on exotropia surgery from clinicians and actively talk about surgery with their child than estimated by clinicians. Parents had a higher level of concern regarding general anesthesia, hospital environment, postoperative infection, conjunctival redness, persistent overcorrection, and glasses wearing compared with clinician estimations.
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Affiliation(s)
- Seongyong Jeong
- Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea
| | - So Young Han
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sunghyuk Moon
- Department of Ophthalmology, Inje University Busan Paik Hospital, Busan, Korea
| | - Donghun Lee
- Department of Ophthalmology, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Sook Young Kim
- Department of Ophthalmology, Daegu Catholic University School of Medicine, Daegu, Korea
| | | | | | | | - Won Jae Kim
- Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, Korea.
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Das GK, Kashyap B, Bahal A, Yadav P, Singh B, Singh N. Conjunctivitis outbreak in Delhi: Lessons learnt to combat breach in antimicrobial stewardship. Trop Doct 2024; 54:202-203. [PMID: 38247295 DOI: 10.1177/00494755241227464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Affiliation(s)
- G K Das
- Director Professor, Department of Opthalmology, University College of Medical Sciences (UCMS) & Guru Teg Bahadur (GTB) Hospital, Delhi, India
| | - Bineeta Kashyap
- Director Professor, Department of Microbiology, University College of Medical Sciences (UCMS) & Guru Teg Bahadur (GTB) Hospital, Delhi, India
| | - Ashish Bahal
- Professor, Department of Microbiology, Army Hospital R & R, Delhi Cantt, India
| | - Pooja Yadav
- Scientist B, Viral Research and Diagnostic Laboratory, Army Hospital R & R, Delhi Cantt, India
| | - Babli Singh
- Post Graduate Student, Department of Opthalmology, University College of Medical Sciences (UCMS) & Guru Teg Bahadur (GTB) Hospital, Delhi, India
| | - Neha Singh
- Post Graduate Student, Department of Opthalmology, University College of Medical Sciences (UCMS) & Guru Teg Bahadur (GTB) Hospital, Delhi, India
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Ligero-López J, Escosa-García L, Schüffelmann-Gutiérrez C, Laplaza-González M, Quiles-Melero MI, Moreno-Ramos F, Baquero-Artigao F, Cacho-Calvo J, Cendejas-Bueno E. Is it in their eyes? Correlation between microorganisms isolated from bronchial aspirates and conjunctival swabs in a Pediatric Intensive Care Unit. Rev Esp Quimioter 2024; 37:176-179. [PMID: 38258553 PMCID: PMC10945105 DOI: 10.37201/req/116.2023] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024]
Abstract
OBJECTIVE Our observational, retrospective study aimed to determine the correlation between bacteria isolated from bronchial aspirates of pediatric ICU patients (PICU) with respiratory infections and those obtained from conjunctival swabs of the same patients exhibiting clinical conjunctivitis. METHODS Throughout the period from 2015 to 2022, we reviewed all clinically significant bronchial aspirates (≥105 CFU/mL) and positive conjunctival swabs obtained from PICU patients. These records were retrieved from the microbiology database, cross-referencing the data to identify patients who tested positive for both during the same clinical episode. RESULTS The median age of the patients was 5 months (interquartile range: 1-7). Among the cohort, twenty-one patients exhibited positivity in both bronchial aspirate and conjunctival swab samples, showcasing a microbial match in 85.71% of cases (18 out of 21). The most frequently isolated microorganisms were Haemophilus influenzae (55.6%), followed by Pseudomonas aeruginosa (14.3%), Klebsiella aerogenes (9.5%), and Escherichia coli, Stenotrophomonas maltophilia, and Enterobacter cloacae, each accounting for 4.8% of the isolates. CONCLUSIONS Our study demonstrates a strong concordance between the isolated microorganisms from both samples in patients presenting clear symptoms of clinical conjunctivitis. These findings provide a basis for future prospective studies that may leverage conjunctival swabs as a predictive tool for identifying microorganisms involved in respiratory infections.
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Affiliation(s)
| | | | | | | | | | | | | | | | - E Cendejas-Bueno
- Emilio Cendejas-Bueno, Clinical Microbiology Department, Hospital Universitario La Paz, Madrid, Spain, Paseo de La Castellana 261, 28046 Madrid, Spain.
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Deiner MS, Deiner NA, Hristidis V, McLeod SD, Doan T, Lietman TM, Porco TC. Use of Large Language Models to Assess the Likelihood of Epidemics From the Content of Tweets: Infodemiology Study. J Med Internet Res 2024; 26:e49139. [PMID: 38427404 PMCID: PMC10943433 DOI: 10.2196/49139] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 12/20/2023] [Accepted: 01/19/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Previous work suggests that Google searches could be useful in identifying conjunctivitis epidemics. Content-based assessment of social media content may provide additional value in serving as early indicators of conjunctivitis and other systemic infectious diseases. OBJECTIVE We investigated whether large language models, specifically GPT-3.5 and GPT-4 (OpenAI), can provide probabilistic assessments of whether social media posts about conjunctivitis could indicate a regional outbreak. METHODS A total of 12,194 conjunctivitis-related tweets were obtained using a targeted Boolean search in multiple languages from India, Guam (United States), Martinique (France), the Philippines, American Samoa (United States), Fiji, Costa Rica, Haiti, and the Bahamas, covering the time frame from January 1, 2012, to March 13, 2023. By providing these tweets via prompts to GPT-3.5 and GPT-4, we obtained probabilistic assessments that were validated by 2 human raters. We then calculated Pearson correlations of these time series with tweet volume and the occurrence of known outbreaks in these 9 locations, with time series bootstrap used to compute CIs. RESULTS Probabilistic assessments derived from GPT-3.5 showed correlations of 0.60 (95% CI 0.47-0.70) and 0.53 (95% CI 0.40-0.65) with the 2 human raters, with higher results for GPT-4. The weekly averages of GPT-3.5 probabilities showed substantial correlations with weekly tweet volume for 44% (4/9) of the countries, with correlations ranging from 0.10 (95% CI 0.0-0.29) to 0.53 (95% CI 0.39-0.89), with larger correlations for GPT-4. More modest correlations were found for correlation with known epidemics, with substantial correlation only in American Samoa (0.40, 95% CI 0.16-0.81). CONCLUSIONS These findings suggest that GPT prompting can efficiently assess the content of social media posts and indicate possible disease outbreaks to a degree of accuracy comparable to that of humans. Furthermore, we found that automated content analysis of tweets is related to tweet volume for conjunctivitis-related posts in some locations and to the occurrence of actual epidemics. Future work may improve the sensitivity and specificity of these methods for disease outbreak detection.
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Affiliation(s)
- Michael S Deiner
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
| | - Natalie A Deiner
- College of Letters and Science, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Vagelis Hristidis
- Department of Computer Science and Engineering, University of California, Riverside, Riverside, CA, United States
| | - Stephen D McLeod
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- American Academy of Ophthalmology, San Francisco, CA, United States
| | - Thuy Doan
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Thomas M Lietman
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Travis C Porco
- Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Francis I. Proctor Foundation for Research in Ophthalmology, University of California, San Francisco, San Francisco, CA, United States
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
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Sana M, Ali MH, Irfan H, Talha M. From Bangladesh to Pakistan: Tracking the Regional Surge in Conjunctivitis Cases. Asia Pac J Public Health 2024; 36:270-271. [PMID: 38247045 DOI: 10.1177/10105395231226152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Affiliation(s)
- Mawiya Sana
- Department of Ophthalmology, Shaikh Khalifa Bin Zayed Al Nahyan Medical and Dental College, Lahore, Pakistan
| | - Mohammad Haris Ali
- Department of Ophthalmology, Shaikh Khalifa Bin Zayed Al Nahyan Medical and Dental College, Lahore, Pakistan
| | - Hamza Irfan
- Department of Ophthalmology, Shaikh Khalifa Bin Zayed Al Nahyan Medical and Dental College, Lahore, Pakistan
| | - Muhammad Talha
- Department of Ophthalmology, Shaikh Khalifa Bin Zayed Al Nahyan Medical and Dental College, Lahore, Pakistan
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Sanders FWB, Huang J, Alió Del Barrio JL, Hamada S, McAlinden C. Amniotic membrane transplantation: structural and biological properties, tissue preparation, application and clinical indications. Eye (Lond) 2024; 38:668-679. [PMID: 37875701 PMCID: PMC10920809 DOI: 10.1038/s41433-023-02777-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 07/20/2023] [Accepted: 09/25/2023] [Indexed: 10/26/2023] Open
Abstract
The amniotic membrane is a single epithelial layer of the placenta. It has anti-inflammatory, anti-scarring, anti-angiogenic and possibly bactericidal properties. The basement membrane of the amniotic membrane acts as a substrate to encourage healing and re-epithelialisation. It has been used in many ocular surface diseases including persistent epithelial defects (corneal or conjunctival), chemical or thermal burns, limbal stem cell deficiency, cicatrising conjunctivitis, ocular graft versus host disease, microbial keratitis, corneal perforation, bullous keratopathy, dry eye disease, corneal haze following refractive surgery and cross-linking, band keratopathy, ocular surface neoplasia, pterygium surgery, and ligneous conjunctivitis. This review provides an up-to-date overview of amniotic membrane transplantation including the structural and biological properties, preparation and application, clinical indications, and commercially available products.
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Affiliation(s)
- Francis W B Sanders
- Department of Ophthalmology, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
| | - Jinhai Huang
- Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Jorge L Alió Del Barrio
- Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain; and Cornea, Cataract and Refractive Surgery Department, VISSUM Corporation, Alicante, Spain
| | - Samer Hamada
- Corneo Plastic Unit and Eye Bank, Queen Victoria Hospital, East Grinstead, UK
| | - Colm McAlinden
- Eye and ENT Hospital, Fudan University, Shanghai, China.
- Corneo Plastic Unit and Eye Bank, Queen Victoria Hospital, East Grinstead, UK.
- School of Optometry and Vision Sciences, Cardiff University, Maindy Road, Cardiff, UK.
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Groot J, Keller A, Sigsgaard T, Loft S, Nybo Andersen AM. Residential exposure to mold, dampness, and indoor air pollution and risk of respiratory tract infections: a study among children ages 11 and 12 in the Danish National Birth Cohort. Eur J Epidemiol 2024; 39:299-311. [PMID: 38393605 PMCID: PMC10994992 DOI: 10.1007/s10654-024-01101-z] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/10/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND The burden of respiratory tract infections (RTIs) is high in childhood. Several residential exposures may affect relative rates. OBJECTIVES To determine risk of RTIs in children ages 11 and 12 by residential exposures. METHODS We included children in the Danish National Birth Cohort (DNBC) at ages 11 and 12. We estimated incidence risk ratios (IRR) and 95% confidence intervals (CI) for counts of RTIs within the last year by exposure to mold/dampness, gas stove usage, summer and winter candle-burning, fireplace usage, cats and dogs indoors, and farmhouse living. We also estimated IRR and 95% CI for RTIs for predicted scores of four extracted factors ('owned house', 'mold and dampness', 'candles', and 'density') from exploratory factor analyses (EFA). RESULTS We included 42 720 children with complete data. Mold/dampness was associated with all RTIs (common cold: IRRadj 1.09[1.07, 1.12]; influenza: IRRadj 1.10 [1.05, 1.15]; tonsillitis: IRRadj 1.19 [1.10, 1.28]; conjunctivitis: IRRadj 1.16 [1.02, 1.32]; and doctor-diagnosed pneumonia: IRRadj 1.05 [0.90, 1.21]), as was the EFA factor 'mold/dampness' for several outcomes. Gas stove usage was associated with conjunctivitis (IRRadj 1.25 [1.05, 1.49]) and with doctor-diagnosed pneumonia (IRRadj 1.14 [0.93, 1.39]). Candle-burning during summer, but not winter, was associated with several RTIs, for tonsillitis in a dose-dependent fashion (increasing weekly frequencies vs. none: [IRRadj 1.06 [0.98, 1.14], IRRadj 1.16 [1.04, 1.30], IRRadj 1.23 [1.06, 1.43], IRRadj 1.29 [1.00, 1.67], and IRRadj 1.41 [1.12, 1.78]). CONCLUSION Residential exposures, in particular to mold and dampness and to a lesser degree to indoor combustion sources, are related to the occurrence of RTIs in children.
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Affiliation(s)
- Jonathan Groot
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Amélie Keller
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Torben Sigsgaard
- Environment, Work and Health, Department of Public Health, University of Aarhus, Aarhus, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Takayama T, Inoda S, Takahashi H, Tsukii R, Yoshida H, Kasuya Y, Nagaoka K, Takahashi R, Arai Y, Kawashima H. Scleritis following intravitreal brolucizumab injection: a case series. J Med Case Rep 2024; 18:80. [PMID: 38419100 PMCID: PMC10902930 DOI: 10.1186/s13256-024-04402-9] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 01/22/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND This study reports the first cases of scleritis following intravitreal brolucizumab (IVBr) injection for nAMD, emphasizing the need to be aware of the possibility of scleritis following IVBr injections. CASE PRESENTATION Case 1. A 74-year-old Japanese man with nAMD complained of conjunctivitis and decreased vision in the right eye 8 days after his eighth IVBr injection. Examination revealed scleritis without anterior inflammation. Topical 0.1% betamethasone and 0.3% gatifloxacin eye drops were started. The scleritis worsened in the following 2 weeks and became painful. He underwent sub-Tenon's capsule triamcinolone acetonide (STTA) injection. Two days later, he returned with a complaint of severe vision loss. Fundus examination revealed retinal artery occlusion, vasculitis, and vitreous opacity in the right eye. Vitreous surgery was performed. CASE 2 An 85-year-old Japanese woman with nAMD in the right eye complained of reddening of the eye 27 days after her fifth IVBr injection. Examination showed conjunctivitis and scleritis without anterior inflammation in the right eye. She was started on 0.1% fluorometholone and 0.5% levofloxacin hydrate eye drops. The scleritis worsened in the following 3 weeks. Her treatment was switched to 0.1% betamethasone eye drops. One month later, the scleritis had improved and a sixth IVBr injection was administered. There was no worsening of the scleritis at that time. However, 1 month after a seventh IVBr injection, she complained of severe hyperemia and decreased vision. Fundus examination revealed vitreous opacification. She underwent STTA, and the vitreous opacity improved in 24 days. Case 3. A 57-year-old Japanese man with nAMD complained of pain and decreased vision in the right eye 21 days after a fourth IVBr injection. Examination revealed scleritis with high intraocular pressure but no anterior chamber or fundus inflammation. STTA and topical eye drops were performed. One month later, scleritis improved but visual acuity didn't due to progression of nAMD. CONCLUSIONS Intraocular inflammation following IVBr injection may progress to the posterior segment. Scleritis can occur after IVBr injection, and topical eye drops alone may not be sufficient for initial treatment. Clinicians should consider the possibility of scleritis in patients with worsening inflammation after IVBr injection.
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Affiliation(s)
- Takuya Takayama
- Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi, 329-0431, Japan
| | - Satoru Inoda
- Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi, 329-0431, Japan.
| | - Hidenori Takahashi
- Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi, 329-0431, Japan
| | - Rika Tsukii
- Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi, 329-0431, Japan
| | - Hana Yoshida
- Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi, 329-0431, Japan
| | - Yuka Kasuya
- Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi, 329-0431, Japan
| | - Kosuke Nagaoka
- Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi, 329-0431, Japan
| | - Ryota Takahashi
- Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi, 329-0431, Japan
| | - Yusuke Arai
- Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi, 329-0431, Japan
| | - Hidetoshi Kawashima
- Department of Ophthalmology, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-Shi, Tochigi, 329-0431, Japan
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Korkmaz I, Barut Selver O, Egrilmez S, Yagci A, Keser G, Aksu K, Palamar M. Ocular manifestations of granulomatosis with polyangiitis: report from a tertiary eye care center. Int Ophthalmol 2024; 44:16. [PMID: 38321188 DOI: 10.1007/s10792-024-02989-y] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 10/19/2023] [Indexed: 02/08/2024]
Abstract
PURPOSE To report demographic characteristics and ophthalmological manifestations of patients with granulomatosis with polyangiitis (GPA) in a tertiary eye care center in Turkey. METHODS Medical records of patients with GPA-related ocular manifestations evaluated between 2013 and 2023 were included. Demographic and clinical characteristics of the patients including nature of systemic involvement, ophthalmologic symptoms and signs, laboratory investigations and treatment modality were reviewed. RESULTS Twelve eyes of 10 patients (5 female/5 male) were included. The mean age was 57.2 ± 12.2 (35-71) years. Five (50%) patients were already diagnosed with GPA. Ocular involvement was the first manifestation of GPA in 3 patients. The remaining 2 patients had simultaneous systemic and ocular symptoms at presentation. Conjunctival hyperemia (9 eyes) and pain (7 eyes) were the most frequent presenting symptoms followed by blurred vision (3 eyes). The frequencies of ocular manifestations were as follows:episcleritis (3 eyes), isolated peripheral ulcerative keratitis (PUK) (3 eyes), scleritis (3 eyes), simultaneous PUK and scleritis (2 eyes) and periorbital mass (1 eye). CONCLUSION Ophthalmological manifestations can be the initial findings in GPA. Since GPA can affect different structures of the eye, it sometimes might be challenging for ophthalmologists. Therefore, it is crucial for ophthalmologists to be well-informed about GPA-related ocular findings and to have a high index of suspicion for GPA. Although PUK associated with scleritis is highly suggestive for GPA, isolated cases of PUK or scleritis can be seen in GPA. Therefore, it is important to adopt a multidisciplinary approach, consider GPA in differential diagnosis, and benefit from accurate diagnostic tests.
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Affiliation(s)
- Ilayda Korkmaz
- Department of Ophthalmology, Ege University Medical Faculty Hospital, 35100, Bornova, Izmir, Turkey
| | - Ozlem Barut Selver
- Department of Ophthalmology, Ege University Medical Faculty Hospital, 35100, Bornova, Izmir, Turkey
| | - Sait Egrilmez
- Department of Ophthalmology, Ege University Medical Faculty Hospital, 35100, Bornova, Izmir, Turkey
| | - Ayse Yagci
- Department of Ophthalmology, Ege University Medical Faculty Hospital, 35100, Bornova, Izmir, Turkey
| | - Gokhan Keser
- Department of Internal Medicine, Division of Rheumatology, Ege University, Izmir, Turkey
| | - Kenan Aksu
- Department of Internal Medicine, Division of Rheumatology, Ege University, Izmir, Turkey
| | - Melis Palamar
- Department of Ophthalmology, Ege University Medical Faculty Hospital, 35100, Bornova, Izmir, Turkey.
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Alamillo-Velazquez J, Ortiz-Morales G, Gonzalez-Gonzalez SE, Lopez-Altamirano DF, Rodríguez-Garcia A. Actinic conjunctivitis and its relationship with prurigo in an indigenous population from the Highlands of Chiapas, Mexico. Int Ophthalmol 2024; 44:4. [PMID: 38315255 DOI: 10.1007/s10792-024-02925-0] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/17/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE Actinic conjunctivitis (AC), along with cheilitis (AChe), is part of the clinical spectrum of actinic prurigo (AP), a rare photo dermatosis that affects high-risk populations. We analyzed the clinical manifestations and onset of actinic conjunctivitis (AC), and its relationship with prurigo (AP) in a susceptible population. METHODS This prospective observational cohort study was performed on Indigenous populations from the highlands of Chiapas, Mexico. Thorough dermatological and ophthalmological examinations were performed in patients attending a primary health care center. The clinical features, labor and environmental factors, onset timing, and clinical staging of AC and AP were analyzed. RESULTS Of the 2913 patients studied, 54 patients (108 eyes) (1.8%) had AC, and 14 patients (25.9%) had AP. The mean age at diagnosis was 36.18 ± 18.52 years (6-70 years). The mean residential altitude was 1884 ± 434.2 m above sea level. Mean self-reported sun exposure was 5.14 ± 3.1 h a day (0.5-12 h). A total of 90.7% reported exposure to biomass fuels during cooking, and 50% to farm animals. AC was the sole manifestation in 70% of the cases. All patients had nasal and temporal photo-exposed conjunctiva. Among the eyes, 12.9% were classified as stage-1, 64.8% as stage-2, and 22.2% stage-3. A total of 83.3% of the patients had hyperpigmented lesions, and 35.1% had evaporative dry eye disease. CONCLUSIONS AC may be the initial or sole manifestation of AP. Most AC cases (87%) were initially observed at the advanced stages of the disease. Although solar exposure was not associated with late AC stages, a positive association was found with farm animal exposure. Evaporative dry eye associated with meibomian gland dysfunction has not been previously reported in patients with AC.
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Affiliation(s)
- Jimena Alamillo-Velazquez
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico
- Institute of Ophthalmology and Visual Sciences, Monterrey, Mexico
| | - Gustavo Ortiz-Morales
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico
- Institute of Ophthalmology and Visual Sciences, Monterrey, Mexico
| | | | - Daniel F Lopez-Altamirano
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico
- Clinical Pathology Department, Hospital San Jose Tec Salud, Monterrey, Mexico
| | - Alejandro Rodríguez-Garcia
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico.
- Institute of Ophthalmology and Visual Sciences, Hospital Zambrano-Hellion TecSalud. Av, Batallon de San Patricio No. 112, Col. Real de San Agustin, CP. 66270, San Pedro Grarza Garcia, Nuevo León, Mexico.
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Kalogeropoulos D, Asproudis C, Priavali E, Pappa C, Kalogeropoulos C, Asproudis I. A novel case of Raoultella planticola - associated acute dacryocystitis. Orbit 2024; 43:157-159. [PMID: 35730243 DOI: 10.1080/01676830.2022.2089168] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/05/2022] [Indexed: 10/17/2022]
Abstract
This study aims to report an acute dacryocystitis associated with Raoultella planticola infection. The patient's medical records and laboratory were thoroughly assessed. A thorough literature search was performed in PubMed database. An additional search was made in Google Scholar to complete the collected items. This is the first recorded case of acute dacryocystitis attributed to Raoultella planticola infection. A limited number of studies has related this pathogen with conjunctivitis. Acute dacryocystitis on rare occasions can also be caused by atypical organisms. Swabs must be obtained and patients must be started on empirical treatment while waiting for the laboratory results.
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Affiliation(s)
- Dimitrios Kalogeropoulos
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Christopher Asproudis
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Efthalia Priavali
- Department of Microbiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Chrysavgi Pappa
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Chris Kalogeropoulos
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Ioannis Asproudis
- Department of Ophthalmology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece
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Solomon L, Cunningham SJ. Bedside Leukocyte Esterase Testing to aid in Diagnosing Bacterial Conjunctivitis in Children. J Emerg Med 2024; 66:91-96. [PMID: 38309981 DOI: 10.1016/j.jemermed.2023.11.003] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 11/03/2023] [Accepted: 11/05/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND Conjunctivitis is a frequent symptom in pediatric emergency departments; however, the etiology of conjunctivitis is difficult to clinically differentiate. OBJECTIVE Our study objective was to evaluate the test performance characteristics of leukocyte esterase (LE) test strips in diagnosing bacterial conjunctivitis. METHODS Patients aged from 3 months through 21 years presenting to an emergency department with symptoms of conjunctivitis were prospectively enrolled from September 2018 to March 2020. A swab of the affected eye was applied to the LE test strip and another swab was sent for culture processing. The primary outcome was the association between LE test results and eye culture results. RESULTS We enrolled 189 patients. Overall, 117 eye cultures (62%) were positive. The sensitivity and specificity of LE testing was 96% (95% CI 90-98%) and 14% (95% CI 7-25%), respectively. Positive predictive value was 64% (95% CI 57-71%) and negative predictive value was 67% (95% CI 39-87%). CONCLUSIONS The LE test strip had limited ability to differentiate bacterial conjunctivitis from other etiologies.
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Affiliation(s)
- Linda Solomon
- Department of Pediatrics, Division of Pediatric Emergency Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, New York
| | - Sandra J Cunningham
- Department of Pediatrics, Division of Pediatric Emergency Medicine, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, New York
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Warad C, Mohapatra S, Mehta A. Bedside assessment of ophthalmic manifestations in neurocritical care: A study in Southern India. Indian J Ophthalmol 2024; 72:201-205. [PMID: 38099377 PMCID: PMC10941915 DOI: 10.4103/ijo.ijo_2878_22] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 09/21/2023] [Accepted: 09/23/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE This study aimed to investigate the incidence of Ocular Surface Disorders (OSDs), including Dry Eye Disease, Chemosis, and Exposure Keratitis, among patients admitted to the Neurocritical Care Unit (NCC). Additionally, we sought to assess the correlation between these OSDs, the length of hospitalization at NCC, and the Glasgow Coma Score (GCS). The heightened risk of OSD development in the NCC environment, coupled with pre-existing neurological impairments, can lead to conditions like dry eye disease, chemosis, corneal abrasions, and infectious keratitis, ultimately resulting in corneal opacities and perforations that significantly impact visual acuity and overall quality of life. METHODS In this observational cross-sectional study, we examined the ocular health of all patients admitted to an NCC unit from February to May 2022. We assessed the presence of Conjunctivitis, chemosis, Keratitis, and Dry Eyes in relation to the duration of stay at NCC, GCS, lagophthalmos, adherence to the prescribed eye care protocol in NCC, and the use of mechanical ventilation. Our study comprised one hundred subjects over a four-month period, with a mean age of 51.92 ± 18.73 years (ranging from 17 to 89), including 70% males and 30% females (gender ratio of 2.33). RESULTS Our findings revealed that 26 eyes (13%) exhibited Conjunctival Hyperemia, 23 eyes (11.5%) displayed Chemosis, and severe dry eye was prevalent in 41 (20.5%) eyes. A statistically significant association was observed between GCS (p-value <0.001) and Keratitis (p-value 0.0035) with dry eyes (Chi-Square Test). Notably, the incidence of dry eyes was significantly higher among patients with a prolonged stay of ≥10 days (p-value 0.003). CONCLUSIONS Patients admitted to Neurocritical Care Units necessitate meticulous eye care and structured protocols to mitigate the risk of long-term ocular complications such as exposure keratitis. Given their heightened susceptibility to these conditions, proactive measures are imperative to ensure optimal ocular health among NCC patients.
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Affiliation(s)
- Chethana Warad
- Department of Ophthalmology, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research (KAHER), Belagavi, Karnataka, India
| | - Shrusty Mohapatra
- Department of Neurosurgery and Neurology, Jawaharlal Nehru Medical College, Belagavi, Karnataka, India
| | - Abhyudaya Mehta
- Department of Neurosurgery and Neurology, Jawaharlal Nehru Medical College, Belagavi, Karnataka, India
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Kadam AR, Prabu VR, Reddy JK, Muralidhar V, Thulasidas M. Conjunctiva in strabismus surgery - to stitch or to stick? - A randomized clinical trial. Indian J Ophthalmol 2024; 72:223-227. [PMID: 38099382 PMCID: PMC10941947 DOI: 10.4103/ijo.ijo_543_23] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 07/22/2023] [Accepted: 08/11/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE To evaluate the clinical outcomes with fibrin glue in comparison with vicryl sutures for limbal conjunctival wound closure in strabismus surgery. METHODS In this prospective interventional study, patients undergoing horizontal muscle strabismus surgery were randomized into two groups: the vicryl suture group and the fibrin glue group. The limbal conjunctival incisions were closed with 8-0 vicryl in the suture group and with fibrin glue in the other group. The outcomes measured were post-operative conjunctival inflammation and wound apposition, patient comfort with the help of a questionnaire, and conjunctival thickness using anterior segment optical coherence tomography (AS-OCT) for both groups at 6 weeks. RESULTS The study included 64 eyes of 64 patients (32 eyes in each group). The fibrin glue group performed better than the vicryl suture group for most of the symptoms like redness, irritation, watering, and foreign body sensation till 2 weeks post-operatively ( P < 0.001), after which both the groups performed similarly. As for clinical signs, no significant difference was noted between the two groups, except for conjunctival hyperemia, which was significantly lesser in the fibrin glue group at 2 weeks post-operatively ( P < 0.001). The conjunctival thickness measured at 6 weeks using AS-OCT revealed that the thickness increased significantly in the suture group compared to that in the glue group ( P < 0.001 medial site, P = 0.004 lateral site). CONCLUSION Because of greater patient comfort and reduced inflammation associated with fibrin glue, it may be considered as a procedure of choice for conjunctival wound closure in strabismus surgery in the absence of the cost constraints.
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Affiliation(s)
- Aishwarya R Kadam
- Department of Ophthalmology, Sankara Eye Hopital, Coimbatore, Tamil Nadu, India
| | - V Rajesh Prabu
- Department of Pediatric Ophthalmology and Strabismology, Sankara Eye Hopital, Coimbatore, Tamil Nadu, India
| | - Jagadeesh K Reddy
- Department of Cornea and Refractive Sevices, Sankara Eye Hopital, Coimbatore, Tamil Nadu, India
| | - Venu Muralidhar
- Consultant Pediatric Ophthalmology Strabismus and Cataract, Gomabai Netralaya, Neemuch, Madhya Pradesh, India
| | - Mithun Thulasidas
- Department of Cataract and Glaucoma Services, Sankara Eye Hopital, Coimbatore, Tamil Nadu, India
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Siegel H, Lang S, Maier P, Reinhard T. [Bacterial Conjunctivitis: Current Aspects of Diagnosis and Therapy]. Klin Monbl Augenheilkd 2024; 241:231-246. [PMID: 37977204 DOI: 10.1055/a-2193-2658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Bacterial conjunctivitis is a leading cause of infectious conjunctivitis in children and second most common cause in adults. Although often self-limiting, it can lead to complications like corneal scarring and systemic infections in high-risk groups including newborns and immunocompromised patients. Thus, prompt diagnosis and treatment are essential for these vulnerable populations. Common bacterial causes are Staphylococcus aureus and Streptococcus pneumoniae in adults and Haemophilus influenzae and Moraxella catarrhalis in children. Clinical features alone do not reliably identify the causative pathogen. Microbiological testing is necessary for persistent or severe cases. Topical antibiotics like azithromycin or fluorochinolones are usually prescribed. However, gonococcal and chlamydial conjunctivitis warrant systemic antibiotics due to their potential for severe complications. Increasing antibiotic resistance might even necessitate tailored therapy based on antibiotic susceptibility profiles. Screening and treating pregnant women is an effective prevention strategy by reducing perinatal transmission (especially of gonococcal and chlamydial infections). In summary, while often self-limiting, potential complications and rising antibiotic resistance underscore the importance of timely diagnosis and treatment of bacterial conjunctivitis. Preventive measures including maternal screening are crucial public health initiatives to curb the risks associated with this common eye infection.
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Liu R, Fang Y, Yang F, Liu D. NLRP3 inflammasome-a likely target for the treatment of immunologic conjunctivitis: A protocol for systematic review and meta-analysis. PLoS One 2024; 19:e0296994. [PMID: 38277371 PMCID: PMC10817214 DOI: 10.1371/journal.pone.0296994] [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] [Received: 07/30/2023] [Accepted: 12/21/2023] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Immune-mediated conjunctivitis is a prevalent ocular ailment characterized by inflammation and immune reactions in the conjunctiva. However, the precise causes and therapeutic approaches for this condition remain the main focus for numerous ophthalmological specialists. Recently, accumulating evidence from human and mouse experiments has demonstrated the critical involvement of the NLRP3 inflammasome, IL-1β, and IL-18 in the development of allergic diseases. Targeting specific NLRP3 inflammasome and its related inhibitors may hold potential as therapeutic agents for immunologic conjunctivitis. Despite this, there has been no systematic review specifically addressing the treatment of immunologic conjunctivitis related to NLRP3. Therefore, this study aims to conduct a systematic review and meta-analysis of currently published randomized controlled trials (RCTs) on NLRP3-related treatments for immunologic conjunctivitis patients, with the goal of evaluating their efficacy and safety. METHODS We will conduct a comprehensive search for relevant studies on NLRP3 inflammasome inhibitors or NLRP3-related treatments for immunologic conjunctivitis in various databases including PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), VIP, and Wanfang. The search will encompass studies from their respective inception dates to July 2023. A meta-analysis will be performed using data extracted from eligible randomized controlled trials (RCTs), focusing on the clinical manifestations of immunologic conjunctivitis, levels of NLRP3-related factors in serum or tear samples, quality of life outcomes, and adverse events. Review Manager 5.4.1 software will be employed for the meta-analysis, and the results will be analyzed using either random-effects or fixed-effects models, depending on the presence of heterogeneity. The reliability and quality of evidence will be evaluated using the Grading of Recommendations, Development, and Evaluation (GRADE) system. RESULTS The findings of this study will yield robust and high-quality evidence regarding the efficacy and safety of NLRP3-related treatments for immunologic conjunctivitis. This evidence will contribute significantly to our understanding of the potential benefits and risks associated with such treatments and will assist healthcare professionals in making informed decisions regarding the management of immunologic conjunctivitis. CONCLUSION This study represents the first comprehensive meta-analysis aiming to evaluate the efficacy and safety of NLRP3-related treatments for immunologic conjunctivitis. The findings from this study will provide valuable evidence to guide clinical management strategies for this disease. The results are anticipated to significantly contribute to the understanding of the therapeutic potential and safety profile of NLRP3-related treatments, offering valuable insights for healthcare professionals involved in the care of patients with immunologic conjunctivitis. TRIAL REGISTRATION Systematic review registration: PROSPERO with registration number CRD42023437076.
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Affiliation(s)
- Ruoxi Liu
- Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, China
| | - Yi Fang
- Heilongjiang Mingshui Kangying Hospital, Suihua, Heilongjiang, China
| | - Fang Yang
- The EYE Hospital of Daqing, Daqing, Heilongjiang, China
| | - Donghui Liu
- Senhai Hospital, Harbin, Heilongjiang, China
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Lo KA, Goh LG, Ramachandran R. Multisystem inflammatory syndrome in children (MIS-C) of a toddler initially presenting with fever and pyuria. BMJ Case Rep 2024; 17:e253756. [PMID: 38171640 PMCID: PMC10773415 DOI: 10.1136/bcr-2022-253756] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2023] [Indexed: 01/05/2024] Open
Abstract
We report a case of multisystem inflammatory syndrome in children (MIS-C) in an East Asian toddler. He presented with a 2-day history of fever and pyuria, 5 weeks before that he had recovered from COVID-19. He was initially treated as urinary tract infection. On day 5 of fever, he was noted to have bilateral non-suppurative limbus-sparing conjunctivitis, red and cracked lips and erythematous extremities. Investigations showed raised inflammatory markers (C-reactive protein and erythrocyte sedimentation rate), thrombocytopenia and a markedly elevated NT-proBNP. He received prompt and appropriate treatment inpatient; however, he still had mild coronary abnormalities at 9 months postdischarge. The aim of this paper is to describe the initial presentation and progress of a case of MIS-C. The unique features of this case are his initial presentation of pyuria and notably, his demography (young age, East Asian) which is more typical of Kawasaki disease than MIS-C.
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Affiliation(s)
- Kinyui Alice Lo
- Department of Family Medicine, National University Health System, Singapore
| | - Lee Gan Goh
- Department of Family Medicine, National University Health System, Singapore
- Department of Medicine, National University Health System, Singapore
| | - Rajeev Ramachandran
- Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore
- Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Beuran DI, Macovei ML, Boca IR. Multiple ocular manifestations in a patient diagnosed with herpes zoster ophthalmicus: case report. Rom J Ophthalmol 2024; 68:81-86. [PMID: 38617727 PMCID: PMC11007559 DOI: 10.22336/rjo.2024.16] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/16/2024] Open
Abstract
Objective: Our purpose was to present a case of a patient diagnosed with herpes zoster ophthalmicus with multiple ocular manifestations. Case presentation: A 70-year-old Caucasian male presented to the hospital for headache and skin hyperesthesia on the scalp and forehead on the left side. The diagnoses of herpes zoster ophthalmicus and acute conjunctivitis were made for the left eye. The patient was followed up for 6 months and during that period the following diagnoses were made for the same eye: peripheral sterile corneal infiltrates, episcleritis, and hypertensive anterior uveitis. Discussions: Herpes zoster ophthalmicus occurs when the reactivation of the dormant virus involves the ophthalmic division of the trigeminal nerve. The most frequent ocular presentations are conjunctivitis, keratitis, uveitis, episcleritis, and scleritis. The standard therapy consists of antivirals, such as acyclovir, valacyclovir, and famciclovir to limit the replication of the virus. The patient's risk factors, the course of treatment, and the severity of the disease, all affect the prognosis, which is highly variable. Prevention of the disease consists of vaccination with one of the following two vaccines, Zostavax and Shingrix. Conclusions: Final visual acuity for the left eye remained 1 despite numerous manifestations of the disease. Abbreviations: VZV = Varicella-zoster virus, BCVA = best-corrected visual acuity, OU = both eyes, OD = right eye, OS = left eye, IOP = intraocular pressure, NCT = non-contact tonometer, ZVX = Zostavax vaccine.
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Affiliation(s)
- David-Ionuț Beuran
- Department of Ophthalmology, „Dr. Carol Davila” Central Military University Emergency Hospital, Bucharest, Romania
| | - Mioara-Laura Macovei
- Department of Ophthalmology, „Dr. Carol Davila” Central Military University Emergency Hospital, Bucharest, Romania
- „Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
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Mas-Castells M, Verity DH, Timlin H, Rose GE. Progressive Necrotizing Ocular Surface Disease, Despite Immunosuppression. Ophthalmic Plast Reconstr Surg 2024; 40:e24-e25. [PMID: 37791832 DOI: 10.1097/iop.0000000000002526] [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: 10/05/2023]
Abstract
A 60-year-old man was referred with 2 years of left conjunctivitis that persisted despite antibiotic and systemic corticosteroid therapy. The severity and extent of surface disease had increased slowly after prior dacryocystorhinostomy. Subsequent conjunctival biopsies demonstrated granulomas with patchy necrosis but no evidence of malignancy or organisms; systemic screening for sarcoidosis and tuberculosis was negative. A markedly thickened and inflamed left ocular surface was present on referral, with areas of conjunctival ischemia and patchy white slough on the tarsi. Further ocular surface biopsy did not reveal malignancy, and therefore mycobacterial infection was considered a possible cause. Mycobacterium tuberculosis was cultured, albeit only after repeated conjunctival swabs and biopsies. Appropriate treatment led to a very rapid resolution of ocular surface disease. Localized periocular tuberculosis is extremely rare outside developing nations, and its rarity may cause this differential diagnosis for persistent severe ocular surface disease to be overlooked in industrialized nations.
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Nelson HS, Bernstein DI, Biedermann T, Nolte H. Sublingual immunotherapy tablets in monosensitized and polysensitized adults with allergic rhino conjunctivitis. Allergy Asthma Proc 2024; 45:33-36. [PMID: 38151733 DOI: 10.2500/aap.2024.45.230068] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Background: Most patients with allergic rhinitis/conjunctivitis (AR/C) are sensitized to more than one allergen. An ongoing question is the efficacy of single-allergen immunotherapy in patients who are polysensitized. Objective: To evaluate the efficacy and safety of grass, ragweed, tree, and house-dust mite (HDM) sublingual immunotherapy (SLIT) tablets in adults with AR/C who are mono- or polysensitized. Methods: Data from adults (ages ≥ 18 years) with AR/C who participated in phase III double-blind, placebo controlled field trials (four grass, two ragweed, two HDM, one tree) were included in the post hoc analyses. Efficacy was assessed by the total combined score (TCS) (sum of AR/C daily symptom and medication scores) during the entire pollen season for grass and tree trials, and peak pollen season for ragweed trials versus placebo. Efficacy for the HDM SLIT-tablet was assessed by the total combined rhinitis score (TCRS) (sum of rhinitis daily symptom and medication scores) during the last 8 weeks of treatment versus placebo. Results: For the grass SLIT-tablet, TCS improved by 20% (mean difference 1.33 [95% confidence interval {CI}, 0.44-2.22]) in the subjects who were monosensitized (n = 442) and 20% (mean difference 1.28 [95% CI, 0.90-1.67]) in the subjects who were polysensitized (n = 1857). For the ragweed SLIT-tablet, TCS improved by 19% (mean difference 1.72 [95% CI, -0.20 to 3.63]) in the subjects who were monosensitized (n = 115) and 27% (mean difference 2.27 [95% CI, 1.28-3.27]) in the subjects who were polysensitized (n = 528). For the tree SLIT-tablet, TCS improved by 54% (mean difference 4.65 [95% CI, 2.48-6.82]) in the subjects who were monosensitized (n = 138) and 34% (mean difference 2.51 [95% CI, 1.34-3.69]) in the subjects who were polysensitized (n = 437). For the HDM SLIT-tablet, TCRS improved by 20% (mean difference 1.24 [95% CI, 0.48-1.99]) in the subjects who were monosensitized (n = 468) and 17% (mean difference 0.85 [95% CI, 0.43-1.28]) in the subjects who were polysensitized (n = 1294). The overall safety profile was not qualitatively different between the subjects who were monosensitized and the subjects who were polysensitized. Conclusion: Grass, ragweed, tree, or HDM SLIT-tablet treatment is effective for the specific allergen in question in adults with AR/C and who are monosensitized or polysensitized. Targeting one relevant allergen with SLIT-tablets induces a clinical effect for that allergen in patients who were polysensitized.
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Affiliation(s)
- Harold S Nelson
- From the Department of Medicine, National Jewish Health, Denver, Colorado
| | - David I Bernstein
- Division of Immunology and Allergy, University of Cincinnati College of Medicine and Bernstein Clinical Research Center, Cincinnati, Ohio
| | - Tilo Biedermann
- Department of Dermatology and Allergology, Technical University of Munich, Munich, Germany, and
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Schmid-Grendelmeier P, Gooderham MJ, Hartmann K, Konstantinou GN, Fellmann M, Koulias C, Clibborn C, Biswas P, Brunner PM. Efficacy and safety of abrocitinib in patients with moderate-to-severe atopic dermatitis and comorbid allergies. Allergy 2024; 79:174-183. [PMID: 37988255 DOI: 10.1111/all.15952] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 10/17/2023] [Accepted: 11/05/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Abrocitinib efficacy by comorbidity status in patients with moderate-to-severe atopic dermatitis (AD) has not been previously assessed. This post hoc analysis evaluated the efficacy and safety of abrocitinib in patients with AD and allergic comorbidities. METHODS Data were pooled from patients who received abrocitinib 200 mg, 100 mg, or placebo in phase 2b (NCT02780167) and phase 3 (NCT03349060, NCT03575871) monotherapy trials. Patients with and without allergic comorbidities (allergic asthma, rhinitis, conjunctivitis, or food allergy) were evaluated for Investigator's Global Assessment (IGA) response (clear [0] or almost clear [1]), ≥75% improvement in the Eczema Area and Severity Index (EASI-75), ≥4-point improvement in Peak Pruritus Numerical Rating Scale (PP-NRS4), and Dermatology Life Quality Index (DLQI) response (<2 with baseline score ≥2). Other outcomes were Patient-Oriented Eczema Measure (POEM), SCORing Atopic Dermatitis (SCORAD), Pruritus and Symptoms Assessment for Atopic Dermatitis (PSAAD), and treatment-emergent adverse events (TEAEs). RESULTS Of 942 patients, 498 (53%) reported at least one allergic comorbidity (asthma only, 33%; conjunctivitis only or rhinitis only or both, 17%; food allergies only, 15%; >1 allergic comorbidity, 34%). Regardless of comorbidity status, from Week 2 to Week 12, higher percentages of patients treated with either abrocitinib dose achieved IGA 0/1, EASI-75, PP-NRS4, or DLQI 0/1 versus placebo-treated patients. Changes from baseline in POEM, SCORAD, and PSAAD were greater with abrocitinib than with placebo in patients with and without allergic comorbidities. Most TEAEs were mild or moderate. CONCLUSIONS Efficacy and safety data support abrocitinib use to manage AD in patients with or without allergic comorbidities.
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Affiliation(s)
| | - Melinda J Gooderham
- SKiN Centre for Dermatology, Queen's University, and Probity Medical Research, Peterborough, Ontario, Canada
| | - Karin Hartmann
- Division of Allergy, Department of Dermatology, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - George N Konstantinou
- Department of Allergy and Clinical Immunology, 424 General Military Training Hospital, Thessaloniki, Greece
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23
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Amza A, Nassirou B, Kadri B, Ali S, Mariama B, Ibrahim CM, Roufaye LA, Lebas E, Colby E, Zhong L, Chen C, Ruder K, Yu D, Liu Y, Abraham T, Chang A, Mai L, Hinterwirth A, Seitzman GD, Lietman TM, Doan T. Comprehensive Profile of Pathogens and Antimicrobial Resistance in Conjunctivitis Cases from Niger. Am J Trop Med Hyg 2023; 109:1333-1338. [PMID: 37931292 DOI: 10.4269/ajtmh.23-0498] [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] [Received: 07/28/2023] [Accepted: 08/26/2023] [Indexed: 11/08/2023] Open
Abstract
Infectious conjunctivitis outbreaks remain a public health burden. This study focuses on the pathogen and antimicrobial resistance (AMR) profiles identified in Niger. Sixty-two patients with acute infectious conjunctivitis who presented to health posts were enrolled from December 2021 to May 2022. Nasal and conjunctival swabs were obtained from each patient. Unbiased RNA deep sequencing (RNA-seq) was used to identify associated pathogens. A pathogen was identified in 39 patients (63%; 95% CI, 50-74). Of those, an RNA virus was detected in 23 patients (59%; 95% CI, 43-73). RNA viruses were diverse and included human coronaviruses (HCoVs): SARS-CoV-2, HCoV-229E, HCoV-HKU1, and HCoV-OC43. A DNA virus was identified in 11 patients (28%; 95% CI, 17-44). Of those, four patients had a coinfection with an RNA virus and two patients had a coinfection with both an RNA virus and a bacterium. DNA viruses were predominantly human herpesvirus (cytomegalovirus, Epstein-Barr virus, human herpesvirus 8) and human adenovirus species B, C, and F. Eighteen patients (46%; 95% CI, 32-61) had a bacteria-associated infection that included Haemophilus influenza, Haemophilus aegyptius, Staphylococcus aureus, Streptococcus pneumoniae, and Moraxella spp. Antimicrobial resistance determinants were detected in either the conjunctiva or nasal samples of 20 patients (32%; 95% CI, 22-45) and were found to be more diverse in the nose (Shannon alpha diversity, 1.12 [95% CI, 1.05-1.26] versus 1.02 [95% CI, 1.00-1.05], P = 0.01). These results suggest the potential utility of leveraging RNA-seq to surveil pathogens and AMR for ocular infections.
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Affiliation(s)
- Abdou Amza
- Programme Nationale de Santé Oculaire, Niamey, Niger
| | | | | | - Saley Ali
- Programme Nationale de Santé Oculaire, Niamey, Niger
| | | | | | | | - Elodie Lebas
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Emily Colby
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Lina Zhong
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Cindi Chen
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Kevin Ruder
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Danny Yu
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - YuHeng Liu
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Thomas Abraham
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Aaron Chang
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Lina Mai
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Armin Hinterwirth
- Francis I. Proctor Foundation, University of California, San Francisco, California
| | - Gerami D Seitzman
- Francis I. Proctor Foundation, University of California, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, California
| | - Thomas M Lietman
- Francis I. Proctor Foundation, University of California, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California
- Institute for Global Health Sciences, University of California, San Francisco, California
| | - Thuy Doan
- Francis I. Proctor Foundation, University of California, San Francisco, California
- Department of Ophthalmology, University of California, San Francisco, California
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24
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Özkaya E, Kuzugüdenli S, Impram Ntousounous O, Öztürk Sarı Ş. Recurrent large perianal plaque, conjunctivitis, erosive stomatitis, penile erosions and generalized bullous skin lesions. J Dtsch Dermatol Ges 2023; 21:1574-1577. [PMID: 37857559 DOI: 10.1111/ddg.15237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 08/01/2023] [Indexed: 10/21/2023]
Affiliation(s)
- Esen Özkaya
- Department of Dermatology and Venereology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Sevgi Kuzugüdenli
- Department of Dermatology and Venereology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Ozgke Impram Ntousounous
- Department of Dermatology and Venereology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Şule Öztürk Sarı
- Department of Pathology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey
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25
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Prinz J, Hartmann K, Migliorini F, Hamesch K, Walter P, Fuest M, Kuerten D. Efficacy of allogenous fascia lata grafts in the management of lower eyelid retraction. Int Ophthalmol 2023; 43:4729-4737. [PMID: 37721702 PMCID: PMC10724318 DOI: 10.1007/s10792-023-02873-1] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/26/2023] [Indexed: 09/19/2023]
Abstract
PURPOSE To report on the use of allogenous fascia lata (FL) grafts in patients with lower eyelid retraction (LER). METHODS In this retrospective study, a consecutive series of 27 patients (39 eyes) with LER who underwent lower eyelid elevation with FL was included. Examinations including measurement of the palpebral fissure vertical height (PFVH), the inferior scleral show distance, the margin reflex distance 2 (MRD 2), and the evaluation of conjunctival hyperemia were conducted at baseline and after a mean postoperative time of 25.9 ± 25.5 (5.0-81.0, median 13.0, last follow-up) months in all patients. RESULTS At the last follow-up, a significant reduction of the PFVH (11.3 ± 1.7 versus 12.8 ± 2.1 at baseline, p < 0.001), the inferior scleral show distance (0.7 ± 1.0 mm versus 2.1 ± 1.1 at baseline, p < 0.001), and the MRD 2 (6.4 ± 0.9 versus 7.8 ± 1.3 at baseline, p < 0.001) occurred. The conjunctival hyperemia grading score (McMonnies) was significantly reduced (1.8 ± 0.7) at the last follow-up compared to baseline (2.6 ± 0.6, p < 0.001). No case of ectropion or entropion was observed at the last follow-up visit. CONCLUSION In this case series, lower eyelid elevation with FL grafts as a spacer led to a significant reduction of the PFVH, MRD 2, inferior scleral show distance, and conjunctival hyperemia. No severe surgery-related complications occurred.
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Affiliation(s)
- Julia Prinz
- Department of Ophthalmology, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Kathi Hartmann
- Department of Ophthalmology, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
| | | | - Karim Hamesch
- Department of Gastroenterology and Hepatology, RWTH Aachen University, Aachen, Germany
| | - Peter Walter
- Department of Ophthalmology, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Matthias Fuest
- Department of Ophthalmology, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
| | - David Kuerten
- Department of Ophthalmology, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
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26
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Zhang Y, Zhang XJ, Yuan N, Wang YM, Ip P, Chen LJ, Tham CC, Pang CP, Yam JC. Secondhand smoke exposure and ocular health: A systematic review. Surv Ophthalmol 2023; 68:1166-1207. [PMID: 37479063 DOI: 10.1016/j.survophthal.2023.07.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/04/2023] [Accepted: 07/10/2023] [Indexed: 07/23/2023]
Abstract
The toxicology of secondhand smoke (SHS), along with the harm of its exposure to human health, has been generally acknowledged; however, specific evidence is lacking on the association between SHS exposure and ocular health. In this systematic review (PROSPERO registration number: CRD42022247992), we included 55 original articles published by 12 May 2023, which dealt with SHS exposure and ocular disorders, such as eye irritation, conjunctivitis, dry eye diseases, uveitis, myopia, astigmatism, contact lens discomfort, age-related macular degeneration, glaucoma, and thyroid eye disease that addressed the ocular neurovascular structures of the macular, retinal nerve fiber layer, choroid, and corneal biomechanical parameters. We found compelling correlational evidence for eye irritation, conjunctivitis, and dry eye symptoms-supporting that SHS exposure was positively associated with inflammatory and allergic changes in the eyes. Yet, evidence about the associations between SHS exposure and other ocular disorders, structures, and parameters is still limited or controversial. Given the limitations of existing literature, more investigations with high quality and rigorous design are warranted to elucidate the potentially harmful effects of SHS exposure on ocular health.
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Affiliation(s)
- Youjuan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiu Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China
| | - Nan Yuan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Kunming Bright Eye Hospital, Kunming, China
| | - Yu Meng Wang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Department of Neurobiology, Interdisciplinary Center for Neurosciences (IZN), Heidelberg University, Heidelberg, Germany
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Clement C Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China; Hong Kong Eye Hospital, Hong Kong SAR, China; Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China; Joint Shantou International Eye Center, Shantou University, Shantou, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China; Hong Kong Eye Hospital, Hong Kong SAR, China; Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong SAR, China; Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China.
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27
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Ferrer Torres Á. Clinical evaluation of subcutaneous immunotherapy with a polymerized molecular allergoid of Alt a 1 in patients with allergic rhino conjunctivitis and/or allergic asthma caused by the mould Alternaria alternata. Eur Ann Allergy Clin Immunol 2023; 55:303-309. [PMID: 36047760 DOI: 10.23822/eurannaci.1764-1489.267] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary This is a retrospective analysis of the clinical evolution of 14 patients diagnosed with allergic rhinoconjunctivitis (AR) and/or allergic asthma (AA) caused by Alternaria alternata, who were attended by the allergology service of Vega Baja Hospital of Orihuela (Alicante, Spain). The purpose was to assess the clinical impact and safety of 1-year of subcutaneous immunotherapy with a polymerized molecular allergoid of Alt a 1. Impact of the treatment on allergic diseases (mean number AR/AA episodes and ARIA/GINA classifications), changes in symptoms and prescribed medication, change in the global subjective clinical status of patients and satisfaction with the treatment were also evaluated. Adverse reactions were also recorded and analyzed. After 1-year of treatment, fewer AR and AA episodes (p less than 0.05) and improvements in ARIA/GINA classifications were observed. Significant improvements of symptoms (p less than 0.05) and a resulting general reduction of the medication prescribed was also detected. Improvements in the global subjective clinical status and good satisfaction rates were observed. Only 1 patient presented a local and not clinically relevant adverse reaction. The treatment showed promising effects with a significant improvement in the clinical status of all patients with a good safety profile.
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Affiliation(s)
- Á Ferrer Torres
- Service of Allergology, Hospital Vega Baja, San Bartolomé, Orihuela, Alicante, Spain
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Singh S, Basu S, Jakati S. Cicatricial Entropion in Chronic Cicatrizing Conjunctivitis: Potential Pathophysiologic Mechanisms and Long-Term Outcomes of a Modified Technique. Ophthalmic Plast Reconstr Surg 2023; 39:563-569. [PMID: 37145030 DOI: 10.1097/iop.0000000000002400] [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: 05/06/2023]
Abstract
PURPOSE The purpose of this study was to assess the long-term outcomes of severe cicatricial entropion repair with mucous membrane grafting in patients with chronic cicatrizing conjunctivitis and report histopathological changes in the eyelid margin area. METHODS Prospective interventional study included 19 patients with severe cicatricial entropion with trichiasis (N = 20 eyelids; 19 upper and 1 lower eyelid) who underwent anterior lamellar recession (with back cuts) and mucous membrane grafting cover for bare anterior tarsus, lid margin, and 2 mm of marginal tarsus, and had a minimum 6 months of follow-up. The anterior lamella and metaplastic eyelid margins were sent for routine Haematoxylin and Eosin and special staining with Masson trichrome stain. RESULTS The etiologies were chronic Stevens-Johnson syndrome (N = 6), chemical injury (N = 11), and drug-induced pseudopemphigoid (N = 2). Five eyes had undergone entropion correction in the past, and 9 had electroepilation for trichiasis. Entropion was well corrected (without residual trichiasis) in 85% of eyelids with primary surgery. The etiology-wise success rates were 100% for Stevens-Johnson syndrome, 72.7% for chemical injury, and 100% for drug-induced pseudopemphigoid. Three eyelids with failure belonged to chemical injury, and trichiasis in these eyes could be managed with subsequent interventions except in 1 case. All eyelids had no entropion at a mean follow-up of 10.8 months (range, 6-18). Histopathological evaluation of anterior lamella (N = 10) and eyelid margins revealed significant fibrosis in subepithelial, perimysium (muscle of Riolan), and perifollicular areas. CONCLUSION Anterior lamellar recession combined with mucous membrane grafting achieves good cicatricial entropion correction except in eyes with chemical injury. The eyelid margins in these eyes have persistent inflammation, and fibrosis involving lash follicles.
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Affiliation(s)
- Swati Singh
- Ophthalmic Plastic Surgery Services, LV Prasad Eye Institute, Hyderabad, India
| | - Sayan Basu
- The Cornea Institute, LV Prasad Eye Institute, Hyderabad, India
| | - Saumya Jakati
- Ophthalmic Pathology Laboratory, LV Prasad Eye Institute, Hyderabad, India
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29
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Villatoro GA, Topilow NJ, Korn BS, Liu CY. Millet-Seed Tarsal Conjunctivitis in Eyelid Sarcoid. Ophthalmic Plast Reconstr Surg 2023; 39:e214. [PMID: 37351855 DOI: 10.1097/iop.0000000000002411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Affiliation(s)
- George A Villatoro
- Division of Oculofacial Plastic and Reconstructive Surgery, UC San Diego Department of Ophthalmology, Shiley Eye Institute, La Jolla, California, U.S.A
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30
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Kowanz DH, Rokohl AC, Heindl LM. [Viral Conjunctivitis: Findings, Therapy, and Prophylaxis]. Klin Monbl Augenheilkd 2023; 240:1317-1331. [PMID: 37586401 DOI: 10.1055/a-2129-1255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Viral conjunctivitis is one of the most common acute eye diseases. The fall and winter months are known to be the main season for viral infections which is also reflected in the ophthalmological outpatient clinics. Viral conjunctivitis is often accompanied by symptoms of the upper and lower respiratory tract, fever, chills, arthralgia or skin lesions. The spectrum of pathogens comprises DNA viruses such as Adeno-, Herpes simplex and Molluscum contagiosum as well as RNA viruses. Symptoms caused by pandemic pathogens such as SARS-CoV-2 and mpox viruses can also cause ocular manifestation. Viral conjunctivitis is often self-limiting leaving no residual symptoms, however an ophthalmologist should be consulted if there are inflammatory symptoms of the anterior eye accompanied by visual disturbance. It is particularly important to recognize the affection of corneal or even intraocular structures early to initiate an adequate and effective therapy. Affection of the cornea, vitreus or retina can result in temporary or permanent impairment of the field of vision and visual acuity. The diagnosis is usually made without further tests on the basis of the typical clinical presentation. Rapid tests or PCR diagnostics are also available for confirmation. In most patients the treatment is symptomatically with artificial tears and antibiotic eye drops in cases accompanied by secondary bacterial infections, not prophylactically. If the cornea or other ocular structures are affected by certain viruses, local as well as systemic virostatic therapy is initiated. The most important prophylactic measure is meticulous and consistent hygiene.
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Módis L, Süveges I. [Allergic and immunopathological diseases of the ocular surface]. Orv Hetil 2023; 164:1686-1692. [PMID: 37898906 DOI: 10.1556/650.2023.32910] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 08/29/2023] [Indexed: 10/31/2023]
Abstract
Allergic and immunopathological diseases of the ocular surface are inflammations that can occur with mild to severe symptoms that cause visual impairment. Allergic inflammations mainly affect the conjunctiva, causing acute and/or chronic conjunctivitis. Several forms are distinguished: seasonal allergic conjunctivitis, vernal conjunctivitis, atopic keratoconjunctivitis, contact allergy, giant papillary conjunctivitis. The most common is the seasonal form, which is linked to seasons. Allergic ocular surface processes require local treatment with artificial tears, anti-allergic eye drops. If complications occur, topical corticosteroid and cyclosporin treatment may be used. Immunopathological inflammations of the ocular surface are associated with systemic diseases. Keratoconjunctivitis sicca, although occurring in the absence of systemic disease, is a common companion of Sjögren's syndrome and collagen diseases. Ocular pemphigoid belongs to the group of mucous membrane pemphigoids. After the initial conjunctivitis symptoms, subconjunctival fibrosis begins, leading to the development of sym- and ankyloblepharon. In the final stage, the ocular surface is covered by scar tissue (ocular cicatricial pemphigoid) which practically results in loss of vision. Peripheral ulcerative keratitis is usually associated with collagen vascular disease, rheumatoid arthritis. A 3-4 mm long, curved infiltration starting near the limbus becomes ulcerated and then perforates, on which the iris may prolapse. First, systemic treatment is required, which is an interdisciplinary task. Topical corticosteroid and cyclosporine eye drops may be administered. In the case of corneal perforation, amniotic membrane transplantation and/or keratoplasty may be performed. Orv Hetil. 2023; 164(43): 1686-1692.
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Affiliation(s)
- László Módis
- 1 Debreceni Egyetem, Általános Orvostudományi Kar, Szemészeti Tanszék Debrecen, Nagyerdei krt. 98., 4032 Magyarország
| | - Ildikó Süveges
- 2 Semmelweis Egyetem, Általános Orvostudományi Kar, Szemészeti Klinika Budapest Magyarország
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González Martín-Moro J, Zarallo-Gallardo J, Guzmán-Almagro E, Antón Rodríguez C. A systematic review and meta-analysis on the efficacy of topical povidone iodine in adenoviral conjunctivitis. Cont Lens Anterior Eye 2023; 46:101873. [PMID: 37380515 DOI: 10.1016/j.clae.2023.101873] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 06/06/2023] [Accepted: 06/15/2023] [Indexed: 06/30/2023]
Abstract
PURPOSE To evaluate if topical povidone iodine (alone (PI) or combined with dexamethasone (PI-DXM)) is superior to placebo for treating adenoviral conjunctivitis (AC). METHODS A systematic review was performed according to Preferred Reporting Items for the Systematic Review and Meta-Analyses (PRISMA) Statement. An electronic search was made on PubMed, Embase and Cochrane Library. Randomized control studies that compared PI or PI-DXM with placebo were included. At least three researchers were involved in all phases. Primary outcomes were AC duration and the number of clinical resolutions during the first week. Secondary outcomes were conjunctival redness and serous discharge one week after starting treatment and the rate of AC complications. RESULTS Only five studies met the inclusion criteria. PI-DXM reduced the duration of the disease by 2.4 days (IC95% 4.09-0.71), however this result was based only in one study. PI and PI-DXM did not modify the probability of clinical resolution during the first week; relative risk (RR) = 1.77 (IC95% 0.63-4.96) and 1.70 (IC95% 0.67-4.36). The impact of PI on the probability of pseudomembranes could not be estimated. PI-DXM did not influence the risk of developing subepithelial infiltrates RR = 0.73 (IC95% 0.02-33.38). CONCLUSIONS At this time there is great uncertainty about the usefulness of PI on the course of adenoviral conjunctivitis. PI-DXM may have a small effect on AC duration. To make future reviews possible, it is important to standardize the way in which these results are reported. Futures studies should include etiological confirmation, unit of study (eyes vs patients) and report on those aspects that are more relevant for patient quality of life (duration of the disease, development of complications: pseudomembranes and subepithelial infiltrates).
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Affiliation(s)
- Julio González Martín-Moro
- Department of Ophthalmology, University Hospital of Henares, Av. de Marie Curie, 0, 28822 Coslada, Madrid, Spain; Faculty of Medicine, Universidad Francisco de Vitoria, Carretera Pozuelo, km 1800, 28223 Majadahonda, Madrid, Spain.
| | - Jesús Zarallo-Gallardo
- Department of Ophthalmology, University Hospital of Henares, Av. de Marie Curie, 0, 28822 Coslada, Madrid, Spain; Faculty of Medicine, Universidad Francisco de Vitoria, Carretera Pozuelo, km 1800, 28223 Majadahonda, Madrid, Spain
| | - Elena Guzmán-Almagro
- Department of Ophthalmology, University Hospital of Henares, Av. de Marie Curie, 0, 28822 Coslada, Madrid, Spain
| | - Cristina Antón Rodríguez
- Faculty of Medicine, Universidad Francisco de Vitoria, Carretera Pozuelo, km 1800, 28223 Majadahonda, Madrid, Spain
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Yang K, Babalola CM, Mussa A, Ryan R, Wynn A, Simon S, Bame B, Morroni C, Klausner JD. Case series and literature review of chlamydial ophthalmia neonatorum in Botswana. Int J STD AIDS 2023; 34:860-868. [PMID: 37338101 DOI: 10.1177/09564624231173028] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
BACKGROUND We describe 12 cases of chlamydial ophthalmia neonatorum and the current scientific evidence on its prevention and treatment. The data presented were obtained from the "Maduo" study, a prospective observational study of the relationship between curable sexually transmitted infections and adverse neonatal outcomes at four antenatal clinics in Gaborone, Botswana. METHODS Infants of mothers with perinatal chlamydia infection were evaluated for chlamydial ophthalmia neonatorum based on clinical presentation of conjunctivitis or positive test via GeneXpert CT/NG assay. Data on 29 infants born to mothers with postnatal C. trachomatis infection were analysed. RESULTS 12 infants were diagnosed with chlamydial ophthalmia neonatorum. Eight of those cases were confirmed with the GeneXpert CT/NG assay while four were identified as probable cases based on clinical history and presentation. Overall, nine infants presented with signs of conjunctivitis, while three who had a positive diagnostic test result had asymptomatic infection. All but one infant had received ocular 1% tetracycline prophylaxis at birth, and four infants had signs suggestive of chlamydial pneumonia at presentation. Two out of five symptomatic cases whose mothers reported completion of their treatment course with erythromycin had lingering symptoms. CONCLUSIONS Our findings affirm that the current prophylaxis and treatment modalities for chlamydial ophthalmia neonatorum are inadequate. To the extent feasible in low- and middle-income countries, we recommend implementation of routine C. trachomatis screening and treatment in pregnant women.
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Affiliation(s)
- Kevin Yang
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chibuzor M Babalola
- Keck School of Medicine, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Aamirah Mussa
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Rebecca Ryan
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Adriane Wynn
- University of California, San Diego, Division of Infectious Diseases and Global Public Health, La Jolla, CA, USA
| | | | - Bame Bame
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
| | - Chelsea Morroni
- Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, United Kingdom
| | - Jeffrey D Klausner
- Keck School of Medicine, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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Malagón-Liceaga A, Recillas-Gispert C, Ruiz-Quintero NC, Ruelas-Villavicencio AL. Treatment of ocular rosacea: A practical review from an interdisciplinary approach. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:577-585. [PMID: 37696488 DOI: 10.1016/j.oftale.2023.09.001] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 07/13/2023] [Indexed: 09/13/2023]
Abstract
Rosacea is a chronic and inflammatory disease that primarily affects the skin, although more than half of cases also present with ocular symptoms ranging from blepharitis to conjunctivitis and keratitis. It represents a frequent reason for consultation with a psychosocial impact, affecting quality of life, and requires management involving ophthalmologists, dermatologists, and primary care physicians. For this paper, a search was conducted in several databases, including Medline, Embase, Cochrane, and Google Scholar, using the MeSH term "rosacea" in conjunction with other relevant keywords such as "ocular rosacea", "management", "treatment", and "guidelines". Available articles were reviewed. International and local guidelines recommend initiating the management of rosacea with lifestyle changes, including ocular hygiene and avoidance of triggers. Topical or oral treatment is recommended as the next step, with topical cyclosporine, topical azithromycin, topical tacrolimus, and oral doxycycline being the treatments most supported by evidence. Combination treatments are also recommended. Current management guidelines mainly focus on cutaneous manifestations, generating few guidelines on ophthalmologic treatment, and most recommendations are issued by experts. This work compares local and international treatment guidelines for rosacea, as well as other available medical literature, and suggests a practical and interdisciplinary treatment scheme for ocular involvement based on the reviewed bibliography.
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Affiliation(s)
- A Malagón-Liceaga
- Departamento de Dermatología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | - C Recillas-Gispert
- Departamento de Oftalmología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | - N C Ruiz-Quintero
- Departamento de Oftalmología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico
| | - A L Ruelas-Villavicencio
- Departamento de Dermatología, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México, Mexico.
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Mahjoub H, Ssekasanvu J, Yonekawa Y, Justin GA, Cavuoto KM, Lorch A, Madan V, Sivakumar I, Zhao X, Quintero M, Simeon OF, Salabati M, Wu CM, Woreta FA. Most Common Ophthalmic Diagnoses in Eye Emergency Departments: A Multicenter Study. Am J Ophthalmol 2023; 254:36-43. [PMID: 36965840 DOI: 10.1016/j.ajo.2023.03.016] [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] [Received: 12/18/2022] [Revised: 02/24/2023] [Accepted: 03/11/2023] [Indexed: 03/27/2023]
Abstract
PURPOSE To characterize the most common ophthalmic conditions seen in the emergency department (ED) DESIGN: Cross-sectional study METHODS: This is a multicenter study of 64,988 patients who visited the Bascom Palmer Eye Institute, Massachusetts Eye and Ear, Wills Eye Hospital, and Johns Hopkins Hospital/Wilmer Eye Institute from January 1, 2019, until December 31, 2019. Demographic and primary diagnosis data were extracted including gender, age, race, ethnicity, insurance type, and ophthalmology consult status. Descriptive statistics were performed on all data using STATA IC 14 (64-bit). RESULTS A total of 64,988 patients with primary ocular diagnoses were seen across all 4 EDs. The majority of patients were White (63.1%), non-Hispanic/Latino (64.8%), and female (52.3%). The most frequently seen age group was 50-64 years (28.6%). The most common diagnoses across all institutions were conjunctivitis (7.91%), corneal abrasions (5.61%), dry eye (4.49%), posterior vitreous detachments (4.15%), chalazions (3.71%), corneal ulcers (3.01%), subconjunctival hemorrhages (2.96%), corneal foreign bodies (2.94%), retinal detachments (2.51%), and glaucoma (2.12%). Specifically, viral conjunctivitis (2283 of 5139, 44.4%) and primary open-angle glaucoma (382 of 1379, 27.7%) were the most frequently seen subtypes of conjunctivitis and glaucoma. CONCLUSIONS The most regularly treated ophthalmic conditions in high-volume EDs tend to be lower acuity diagnoses. To combat ED overcrowding and rising health care costs in the United States, we suggest diverting eye-related ED visits to a specialized eye ED service or same-day eye clinic appointment in addition to expanding education for patients and primary care clinicians.
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Affiliation(s)
- Heba Mahjoub
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Johns Hopkins Hospital (F.A.W.)
| | - Joseph Ssekasanvu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (J.S.)
| | - Yoshihiro Yonekawa
- Wills Eye Hospital Retina Service, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania (Y.Y., M.S.)
| | - Grant A Justin
- Department of Ophthalmology, Duke Eye Center, Durham, North Carolina (G.A.J.)
| | - Kara M Cavuoto
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida (K.M.C.)
| | - Alice Lorch
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts (A.L.)
| | - Vrinda Madan
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland (V.M., I.S., X.Z., M.Q., O.F.S.)
| | - Ishwarya Sivakumar
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland (V.M., I.S., X.Z., M.Q., O.F.S.)
| | - Xiyu Zhao
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland (V.M., I.S., X.Z., M.Q., O.F.S.)
| | - Michael Quintero
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland (V.M., I.S., X.Z., M.Q., O.F.S.)
| | - Olivia Febles Simeon
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland (V.M., I.S., X.Z., M.Q., O.F.S.)
| | - Mirataollah Salabati
- Wills Eye Hospital Retina Service, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania (Y.Y., M.S.)
| | - Connie M Wu
- Wills Eye Hospital Retina Service, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania (Y.Y., M.S.)
| | - Fasika A Woreta
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Johns Hopkins Hospital (F.A.W.).
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Ticknor IL, Lee MP, Kearns D, Ibraheim MK, Kraus C, Elsensohn A. Expanding the Histologic Spectrum of Sudden Conjunctivitis, Lymphopenia, and Rash Combined With Hemodynamic Changes. Am J Dermatopathol 2023; 45:718-720. [PMID: 37522571 DOI: 10.1097/dad.0000000000002500] [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: 08/01/2023]
Abstract
ABSTRACT Sudden conjunctivitis, lymphopenia, and rash combined with hemodynamic changes (SCoRCH) is a recently described hypersensitivity reaction to trimethoprim-sulfamethoxazole. To date, only 1 case of histologic findings in SCoRCH has been reported, revealing a superficial perivascular dermatitis. In this article, we present a 53-year-old woman with a four-day history of a widespread, confluent, erythematous, and dusky rash after exposure to trimethoprim-sulfamethoxazole. Histologic examination revealed a vacuolar interface dermatitis with several apoptotic keratinocytes at multiple levels of the epidermis, similar to an erythema multiforme-like presentation. As described in SCoRCH, our patient's clinical findings rapidly improved within 48 hours of presentation without treatment. This case adds to the current literature by identifying a newly described histopathological presentation of SCoRCH.
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Affiliation(s)
- Iesha L Ticknor
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA
| | - Michael P Lee
- Department of Dermatology, Loma Linda University Health, Loma Linda, CA
| | - Donovan Kearns
- Department of Dermatology, Loma Linda University Health, Loma Linda, CA
| | - Marina K Ibraheim
- Department of Dermatology, Loma Linda University Health, Loma Linda, CA
| | - Christina Kraus
- Department of Dermatology, University of California Irvine, Irvine, CA; and
| | - Ashley Elsensohn
- Department of Dermatology, Loma Linda University Health, Loma Linda, CA
- Department of Pathology and Human Anatomy, Loma Linda University Health, Loma Linda, CA
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Badawi AE, Kasem MA, Moemen D, El Sayed Zaki M. Molecular, Epidemiological and Clinical Assessment of Adenoviral Kerato conjunctivitis in Egypt: Institutional Study. Ocul Immunol Inflamm 2023; 31:1640-1646. [PMID: 35816022 DOI: 10.1080/09273948.2022.2092004] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 06/15/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To evaluate the frequency of Human adenovirus (HAdV) and its serotypes in keratoconjunctivitis patients who attended the outpatient clinics of Mansoura Ophthalmic Center, Egypt. METHODS Conjunctival secretions and corneal scrapings were collected from patients complaining of clinically diagnosed viral keratoconjunctivitis. The molecular method for HAdV detection was performed by polymerase chain reaction (PCR) followed by restriction enzymes (REA) determination of serotypes for hexone gene. RESULTS HAdV infection was detected in 38% of samples. There were 4 serotypes of Human adenovirus species D (HAdV-D) isolated (4, 8, 37, 3), where HAdV-D8 was the most dominant. Contact with infected patient, follicular conjunctivitis and subepithelial corneal infiltrates are useful features for clinical diagnosis of adenoviral conjunctivitis. CONCLUSION HAdV was significant etiological factor of acute follicular conjunctivitis. Accurate diagnosis of adenoviral conjunctivitis is essential for appropriate management, reducing permanent visual impairment and to limit the transmission of the virus within the community.
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Affiliation(s)
- Amani E Badawi
- Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Manal Ali Kasem
- Mansoura Ophthalmic Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Dalia Moemen
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Maysaa El Sayed Zaki
- Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Panthagani J, Suleiman K, Vincent RC, Ong HS, Wallace GR, Rauz S. Conjunctival transcriptomics in ocular mucous membrane pemphigoid. Ocul Surf 2023; 30:142-149. [PMID: 37690517 DOI: 10.1016/j.jtos.2023.09.005] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 09/07/2023] [Accepted: 09/07/2023] [Indexed: 09/12/2023]
Abstract
PURPOSE Ocular Mucous Membrane Pemphigoid (OcMMP) is an orphan disease characterized by chronic autoimmune-driven conjunctival inflammation leading to progressive scarring, debilitating symptoms, and blinding sequelae. This feasibility study aims to demonstrate conjunctival genetic transcriptomic analyses as a putative tool for interrogation of pathogenic signaling pathways in OcMMP. METHODS Conjunctival RNA profiling using the NanoString nCounter Human Fibrosis panel was undertaken on RNA extracted from conjunctival swabs obtained from 6 MMP patients (8 eyes; 4 M/2F; median age 78 [range 64-84] years); and 8 age-matched control participants (15 eyes; 3 M/5F; median age 69.5 [range 69-88] years). Data from 770 genes were analyzed with ROSALIND HyperScale architecture and stratified according to the level of clinically visible bulbar conjunctival inflammation. Normalization, fold-changes (≥+1.5-fold or ≤ -1.5-fold) and p-values adjustment (<0.05) using the Benjamini-Hochberg method were calculated. RESULTS 93 differentially expressed genes (DEGs) were observed between OcMMP versus controls of which 48 were upregulated, and 45 downregulated. The top 4 upregulated DEGs represented fibrosis (COL3A1, COL1A1, FN1 and THBS1) while the key under-expressed genes (SCIN, HMGS2, XCL1/2) were indicative of ocular surface failure (goblet cell loss, keratinization, vulnerability to secondary infections). Forty-four pathways had a global significance score ≥2, the most significant being those related to extracellular matrix (ECM) remodeling, synthesis, and degradation. These pathways were accentuated in eyes with visible inflammation. CONCLUSIONS NanoString methodology acquired via a simple conjunctival swab identifies profibrotic genes in OcMMP group and differentiates inflamed eyes. Longitudinal sampling and following investigative intervention will further mechanistic insight and development of novel biomarkers to monitor disease progression.
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Affiliation(s)
- Jesse Panthagani
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, UK; Birmingham and Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK
| | - Kusy Suleiman
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, UK; Birmingham and Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK
| | - Rachel C Vincent
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, UK
| | - Hon Shing Ong
- Tissue Engineering and Cell Therapy Group, Singapore Eye Research Institute, Singapore; Corneal and External Diseases Department, Singapore National Eye Centre, Singapore, Singapore; Ophthalmology & Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Graham R Wallace
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, UK
| | - Saaeha Rauz
- Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, UK; Birmingham and Midland Eye Centre, Sandwell and West Birmingham NHS Trust, Birmingham, UK.
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Us MC, Coci K, Akkuş E, Okay B, Akkoç G. A Single-Center Evaluation of Pediatric Measles Cases in Istanbul, Türkiye, in 2019. Jpn J Infect Dis 2023; 76:267-274. [PMID: 37121672 DOI: 10.7883/yoken.jjid.2022.701] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Although measles can be prevented and eliminated by vaccination, it is a highly contagious viral disease that can lead to serious complications, disability, and death. The aim of this retrospective study was to evaluate the characteristics of measles cases in a single center. All children with clinically suspected measles who attended the Pediatric Clinic at Esenler Maternity and Child Health Hospital in Istanbul, Türkiye, between January 1 and June 30, 2019 were included in the analysis. None of the children with measles were fully vaccinated. The incidence and duration of conjunctivitis were significantly higher in the unvaccinated group than in the partially vaccinated group (P = 0.027 and P = 0.019, respectively). Unvaccinated patients had a significantly lower median leukocyte count (P = 0.019) and significantly higher median C-reactive protein level (P = 0.021). The vitamin A level and leukocyte count were moderately positively correlated (r = 0.698; P = 0.008). Children should be fully vaccinated in order to prevent measles.
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Affiliation(s)
- Mahmut Caner Us
- Department of Pediatrics, Maternity Ward, Esenler Maternity and Child Health Hospital, Türkiye
- Department of Pediatrics, Haseki Training and Research Hospital, Türkiye
| | - Kübra Coci
- Department of Pediatrics, Maternity Ward, Esenler Maternity and Child Health Hospital, Türkiye
| | - Erkan Akkuş
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Cerrahpasa Medical Faculty, Istanbul University, Türkiye
| | - Berker Okay
- Department of Pediatrics, Maternity Ward, Esenler Maternity and Child Health Hospital, Türkiye
| | - Gülşen Akkoç
- Department of Infectious Diseases, Haseki Training and Research Hospital, Türkiye
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Wang Y, Yi X, Luo M, Wang Z, Qin L, Hu X, Wang K. Prediction of outpatients with conjunctivitis in Xinjiang based on LSTM and GRU models. PLoS One 2023; 18:e0290541. [PMID: 37733673 PMCID: PMC10513229 DOI: 10.1371/journal.pone.0290541] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 08/10/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Reasonable and accurate forecasting of outpatient visits helps hospital managers optimize the allocation of medical resources, facilitates fine hospital management, and is of great significance in improving hospital efficiency and treatment capacity. METHODS Based on conjunctivitis outpatient data from the First Affiliated Hospital of Xinjiang Medical University Ophthalmology from 2017/1/1 to 2019/12/31, this paper built and evaluated Long Short-Term Memory (LSTM) and Gated Recurrent Unit (GRU) models for outpatient visits prediction. RESULTS In predicting the number of conjunctivitis visits over the next 31 days, the LSTM model had a root mean square error (RMSE) of 2.86 and a mean absolute error (MAE) of 2.39, the GRU model has an RMSE of 2.60 and an MAE of 1.99. CONCLUSIONS The GRU method can better predict trends in hospital outpatient flow over time, thus providing decision support for medical staff and outpatient management.
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Affiliation(s)
- Yijia Wang
- College of Mathematics and System Science, Xinjiang University, Urumqi Xinjiang, China
| | - Xianglong Yi
- Department of Ophthalmology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Mei Luo
- Department of Ophthalmology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Zhe Wang
- Department of Medical Information, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Long Qin
- EClinCloud (Shenzhen) Technology Co., Ltd, Shenzhen Bay Science and Technology Ecological Park, Nanshan District, Shenzhen, Guangdong, China
| | - Xijian Hu
- College of Mathematics and System Science, Xinjiang University, Urumqi Xinjiang, China
| | - Kai Wang
- Department of Medical Engineering and Technology, Xinjiang Medical University, Urumqi Xinjiang, China
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Mevissen MRJ, Hoogslag-Bienfait MF, Stoutenbeek R, Olie L, Wijdh RJHJ. [Keratoconus in a young patient with itching eyes and blurred vision]. Ned Tijdschr Geneeskd 2023; 167:D7531. [PMID: 37823889] [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] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Keratoconus is an asymmetric bilateral eye condition that results in an increase in corneal curvature and a decrease of corneal thickness. Increasing myopia and astigmatism result in a decrease of visual acuity. The condition frequently begins in the second decade, gets worse during the next few years, and stabilizes about age 35. Risk factors include eye rubbing, and familial predisposition. Contact lenses or corneal transplants are two possible treatments. Nowadays, the illness can be stopped through corneal cross-linking.
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Affiliation(s)
- Maximiliaan R J Mevissen
- Universitair Medisch Centrum Groningen, afd. Oogheelkunde, Groningen
- Contact: Maximiliaan R.J. Mevissen
| | | | - Remco Stoutenbeek
- Universitair Medisch Centrum Groningen, afd. Oogheelkunde, Groningen
| | - Lisette Olie
- Universitair Medisch Centrum Groningen, afd. Oogheelkunde, Groningen
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Xing X, Wang H. Correlation of serum HMGB1 and HMGB2 levels with clinical symptoms in allergic rhinitis children. Medicine (Baltimore) 2023; 102:e34921. [PMID: 37713866 PMCID: PMC10508371 DOI: 10.1097/md.0000000000034921] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 08/03/2023] [Indexed: 09/17/2023] Open
Abstract
This research aimed to explore the serum high-mobility group box 1 (HMGB1) and high-mobility group box 2 (HMGB2) levels in allergic rhinitis (AR) children and its correlation with clinical results. This present prospective observational study enrolled 179 AR children and 100 healthy children who came to our hospital during October 2020 to August 2022. The serum HMGB1, HMGB2, interleukin (IL)-6, IL-1β, interferon-γ, and C-reactive protein (CRP) levels were measured by enzyme-linked immunosorbent assay. Demographic and clinical statistics including age, body mass index (BMI), sex, diastolic blood pressure, SBP, family history of allergy, Visual Analogue Score (VAS) and Rhinoconjunctivitis Quality of Life Questionnaire were collected. All data used SPSS 18.0 to statistical analyses. The proportion of family history of allergy was obviously higher in the AR group than that in the healthy group. The serum levels of HMGB1, HMGB2 and cytokines were remarkably enhanced in the AR patients. Spearman analysis supported that positive correlation existed among the HMGB1, HMGB2, CRP, IL-6 and IL-1β levels. Serum IL-6, CRP, HMGB2, IL-1β, VAS score and Rhinoconjunctivitis Quality of Life Questionnaire score levels were significantly higher and serum interferon-γ levels were significantly lower in the HMGB1 high expression group. Similar results were found in in the HMGB2 high group compared to the HMGB2 low group. In addition, HMGB1 and HMGB2 could be potential diagnostic biomarkers of AR patients. Finally, we found that HMGB1, HMGB2, IL-6, IL-1β, and family history of allergy were the risk factors for AR. This study showed that the serum HMGB1 and HMGB2 levels was remarkably enhanced in AR patients and closely associated with cytokines. This study may provide new targets and a comprehensive approach for the treatment of AR patients.
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Affiliation(s)
- Xinxin Xing
- Department of Pediatrics II, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Xiangfang District, Harbin, China
| | - Hai Wang
- Department of Pediatrics II, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Xiangfang District, Harbin, China
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Mondì V, Tzialla C, Aversa S, Merazzi D, Martinelli S, Araimo G, Massenzi L, Cavallaro G, Gagliardi L, Piersigilli F, Giuffrè M, Lozzi S, Manzoni P, Mosca F, Cetin I, Trojano V, Valensise H, Colacurci N, Orfeo L, Auriti C. Antibiotic prophylaxis for ophthalmia neonatorum in Italy: results from a national survey and the Italian intersociety new position statements. Ital J Pediatr 2023; 49:117. [PMID: 37697419 PMCID: PMC10494339 DOI: 10.1186/s13052-023-01507-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/08/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Ophthalmia neonatorum is an acute conjunctivitis that occurs in newborns within the first month of life. The most serious infections are due to Chlamydia trachomatis and Neisseria gonorrhoeae, that may cause permanent damages. The use of ophthalmic prophylaxis varies widely around the world, according to the different health and socio-economic contexts. To date in Italy there is no a clear legislation regarding ophthalmia neonatorum prophylaxis at birth. METHODS We invited all birth centers in Italy to carry out a retrospective survey relating the last three years. We collected data regarding demographics of neonates, drugs used for ophthalmic prophylaxis and results of the screening of pregnant women for Chlamydia trachomatis and Neisseria gonorrhoeae vaginal infections. RESULTS Among 419 birth centers, 302 (72,1%) responded to the survey. Overall 1041384 neonates, 82,3% of those born in the three years considered, received ophthalmic prophylaxis. Only 4,585 (0,4%) of them received one of the drugs recommended by the WHO. The Centers that participated to the survey reported 12 episodes of Chlamydial conjunctivitis and no Gonococcal infection in the three years. Only 38% of the Centers performed vaginal swabs to pregnant women: 2,6% screened only for Neisseria, 9,6% only for Chlamydia and 25,8% for both germs. CONCLUSIONS The data obtained from the survey showed a low incidence of neonatal conjunctivitis due to either Neisseria gonorrhoeae or Chlamydia trachomatis in Italy. Due to the lack of legislation regulating the prophylaxis of ophthalmia neonatorum in newborns, the Italian Society of Neonatology, the Italian Society of Obstetrics and Gynecology and the Italian Society of Perinatal Medicine have recently issued new recommendations on this topic.
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Affiliation(s)
- Vito Mondì
- Neonatology and Neonatal Intensive Care Unit, Policlinico Casilino, Via Casilina 1049, Rome, Italy
| | - Chryssoula Tzialla
- Neonatal and Pediatric Unit, ASST Pavia, Via Volturno 14, Voghera, Italy.
| | - Salvatore Aversa
- Neonatal Intensive Care Unit, Children's Hospital, ASST Spedali Civili, Piazzale Spedali Civili 1, Brescia, Italy
| | - Daniele Merazzi
- Division of Neonatology, 'Valduce' Hospital, Via Dante Alighieri 11, Como, Italy
| | - Stefano Martinelli
- Neonatal Intensive Care Unit, ASST Grande Ospedale Metropolitano Niguarda, Piazza Dell'Ospedale Maggiore 3, Milan, Italy
| | - Gabriella Araimo
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 28, Milan, Italy
| | - Luca Massenzi
- Division of Neonatology, Central Teaching Hospital of Bolzano, Via Lorenz Böhler 5, Bolzano, Italy
| | - Giacomo Cavallaro
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 28, Milan, Italy
| | - Luigi Gagliardi
- Division of Neonatology and Pediatrics, Versilia Hospital, Azienda USL Toscana Nord Ovest, SS1 335, ViareggioPisa, Italy
| | - Fiammetta Piersigilli
- Section of Neonatology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Avenue Hippocrate 10, Brussels, Belgium
| | - Mario Giuffrè
- Neonatal Intensive Care Unit, A.U.O.P. 'P. Giaccone,' Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties 'G. D'Alessandro', University of Palermo, Via del Vespro 129, Palermo, Italy
| | - Simona Lozzi
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS,, Piazza Di Sant'Onofrio 4, 00165, Rome, Italy
| | - Paolo Manzoni
- Department of Maternal, Neonatal and Infant Medicine, University Hospital "Degli Infermi", Via Dei Ponderanesi 2, Ponderano, Italy
| | - Fabio Mosca
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 28, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Via Della Commenda 19, Milan, Italy
| | - Irene Cetin
- Department of BioMedical and Clinical Sciences, University of Milan, Via Givan Battista Grassi 74, Milan, Italy
- Department of Obstetrics and Gynecology, Hospital V. Buzzi, ASST Fatebenefratelli Sacco, Via Lodovico Castelvetro 32, Milan, Italy
| | - Vito Trojano
- Department of Obstetrics and Gynaecology, Mater Dei Hospital, Via Samuel F. Hahnemann 10, Bari, Italy
| | - Herbert Valensise
- Department of Surgical Sciences, University of Rome Tor Vergata, Via Montpellier, 1, Rome, Italy
- Obstetrics and Gynecology, Policlinico Casilino, Via Casilina 1049, Rome, Italy
| | - Nicola Colacurci
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Via Luigi De Crecchio 2, Naples, Italy
| | - Luigi Orfeo
- Neonatal Intensive Care Unit, Fatebenefratelli Isola Tiberina - Gemelli Isola, Via Di Ponte Quattro Capi 39, Rome, Italy
| | - Cinzia Auriti
- Neonatal Intensive Care Unit, Medical and Surgical Department of Fetus, Newborn and Infant - "Bambino Gesù" Children's Hospital IRCCS,, Piazza Di Sant'Onofrio 4, 00165, Rome, Italy
- Villa Margherita Private Clinic, Via Di Villa Massimo 48, 00161, Rome, Italy
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Yao B, Hu C, Yue X, Liu G, Wang B. Clinical Characteristics and Prognosis of Pediatric Phthirus pubis Coinfestation of the Eyelashes and Scalp Hairs. Am J Trop Med Hyg 2023; 109:686-689. [PMID: 37524328 PMCID: PMC10484248 DOI: 10.4269/ajtmh.23-0071] [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] [Received: 02/02/2023] [Accepted: 06/26/2023] [Indexed: 08/02/2023] Open
Abstract
Phthirus pubis infestation is a highly infectious parasitic disease, affecting 1.3-4.6% of people globally. However, the coinfestation of P. pubis on the eyelashes and scalp hairs in children is uncommon, and the clinical characteristics and prognosis have not been fully studied. In this retrospective study, we report five pediatric patients diagnosed with eyelash and scalp coinfestation of P. pubis. The samples were obtained after treatment and sent for pathological examination. The demographic and clinical characteristics of the study participants were analyzed in detail. Numerous lice and nits were detectable on the eyelashes and scalp hairs in all enrolled patients. The ages ranged from 2 to 5 years. The duration of onset ranged from 3 to 10 days. The common clinical presentations were itching (100%) and conjunctivitis (60%). Treatment included eyelash and scalp hair trimming to the root (100%) and mechanical removal of the parasites (100%), in addition to topical tobramycin eye ointment (100%) and phenothrin shampoo (80%). Symptoms resolved by a 1-week follow-up. Pediatric P. pubis coinfestation mainly occurs on the eyelashes and temporal scalp in females, and sometimes contact tracing fails to identify the source. Phthirus pubis infestation of eyelashes can be misdiagnosed as blepharoconjunctivitis. Sexually transmitted diseases should be ruled out for patients with P. pubis infestation. Untreated or persistent cases may lead to several serious infections.
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Affiliation(s)
- Bangtao Yao
- Department of Ophthalmology, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China
| | - Chang’an Hu
- Department of Otolaryngology, Head and Neck Surgery, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China
| | - Xiaoli Yue
- Department of Pathology, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China
| | - Gang Liu
- Department of Ophthalmology, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China
| | - Bei Wang
- Department of Ophthalmology, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, China
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Singh S, Basu S, Jakati S. Reply Re: "Cicatricial Entropion in Chronic Cicatrizing Conjunctivitis: Potential Pathophysiologic Mechanisms and Long-Term Outcomes of a Modified Technique". Ophthalmic Plast Reconstr Surg 2023; 39:512-513. [PMID: 37681706 DOI: 10.1097/iop.0000000000002473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Affiliation(s)
| | | | - Saumya Jakati
- Ophthalmic Pathology Laboratory, LV Prasad Eye Institute, Hyderabad, India
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46
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Matono T, Yamate R. Dengue Fever with Conjunctivitis Mimicking Zika Virus Infection. Intern Med 2023; 62:2583. [PMID: 37661417 PMCID: PMC10518553 DOI: 10.2169/internalmedicine.1037-22] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 11/17/2022] [Indexed: 09/05/2023] Open
Affiliation(s)
- Takashi Matono
- Department of Infectious Diseases, Aso Iizuka Hospital, Japan
| | - Ryosuke Yamate
- Department of Infectious Diseases, Aso Iizuka Hospital, Japan
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47
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Smit DP, Mathew DK, Khairallah M, Yeh S, Cunningham ET. A Review of Human Ocular RNA Virus Infections Excluding Coronavirus, Human T-Cell Lymphotropic Virus, and Arboviruses. Ocul Immunol Inflamm 2023; 31:1454-1460. [PMID: 37315305 DOI: 10.1080/09273948.2023.2220027] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/03/2023] [Accepted: 05/26/2023] [Indexed: 06/16/2023]
Abstract
We provide an updated review of pre-selected RNA viruses causing ocular inflammation in humans. RNA viruses such as coronaviruses and arboviruses are reviewed elsewhere. A Google Scholar search was conducted to identify recent publications on ocular inflammation caused by the RNA viruses specified here. Human RNA viruses target a wide range of ocular tissues from the anterior to the posterior. Influenza, measles and mumps cause anterior segment manifestations including conjunctivitis and keratitis, while retinitis and optic neuritis may be seen posteriorly. Newcastle disease and RSV cause conjunctivitis, whereas HIV causes characteristic anterior uveitis. Cataracts, microphthalmos, and iris abnormalities are common in congenital Rubella, while Rubella virus is associated with Fuchs uveitis syndrome. Newer technologies make it possible to detect more than one pathogen if present simultaneously. RNA viruses may produce significant ocular morbidity, and care should be taken to investigate ocular symptoms during disease outbreaks.
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Affiliation(s)
- Derrick P Smit
- Division of Ophthalmology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Dony K Mathew
- Division of Ophthalmology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Moncef Khairallah
- Department of Ophthalmology, Faculty of Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
| | - Steven Yeh
- Truhlsen Eye Institute, Department of Ophthalmology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Emmett T Cunningham
- The Department of Ophthalmology, California Pacific Medical Center, San Francisco, California, USA
- The Department of Ophthalmology, Stanford University School of Medicine, Stanford, California, USA
- The Francis I. Proctor Foundation, UCSF School of Medicine, San Francisco, California, USA
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48
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Ghahvehchian H, Kashkouli MB, Karimi N, Ramadan M, Mahdian Rad A. Re: "Cicatricial Entropion in Chronic Cicatrizing Conjunctivitis: Potential Pathophysiologic Mechanisms and Long-Term Outcomes of a Modified Technique". Ophthalmic Plast Reconstr Surg 2023; 39:512. [PMID: 37681705 DOI: 10.1097/iop.0000000000002472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Affiliation(s)
| | - Mohsen Bahmani Kashkouli
- Skull Base Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Science, Tehran, Iran
| | | | | | - Atefeh Mahdian Rad
- Eye Research Center
- Department of Ophthalmology, Faculty of Medicine, Infectious Ophthalmic Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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49
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Abedifar Z, Fallah F, Asadiamoli F, Bourrie B, Doustdar F. Chlamydia trachomatis Serovar Distribution in Patients with Follicular Conjunctivitis in Iran. Turk J Ophthalmol 2023; 53:218-221. [PMID: 37602552 PMCID: PMC10442745 DOI: 10.4274/tjo.galenos.2022.12080] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/12/2022] [Indexed: 08/22/2023] Open
Abstract
Objectives Chlamydia trachomatis infects the urogenital tract and eyes. Anatomical tropism is correlated with serovars which are characterized according to the variation in the major outer membrane proteins encoded by the ompA gene. The aim of the present study was to determine the distribution of C. trachomatis serovars among patients with follicular conjunctivitis in Iran. Materials and Methods A total of 68 conjunctival specimens from symptomatic adults were studied for the presence of C. trachomatis using polymerase chain reaction (PCR) analysis. Serovars were determined by Omp1 PCR-RFLP analysis. Results C. trachomatis was detected in 38 (55.9%) of patients with follicular conjunctivitis, with higher C. trachomatis prevalence in the younger age groups. Twenty-six (38.2%) of these patients had a history of urinary tract infection. Four distinct serovars were identified in the conjunctiva samples using molecular genotyping. The most prevalent was serovar E, followed by G, I, and F. Conclusion Our serovar distribution indicated that chlamydial follicular conjunctivitis usually has a genital source. Genital serovars may cause eye diseases, especially in sexually active adults. On the other hand, conjunctivitis might be the only sign of sexually transmitted infection. Therefore, genotyping C. trachomatis in ocular and genital specimens could be beneficial for acquiring more detailed epidemiological information about the etiology of the disease and monitoring treatment success.
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Affiliation(s)
- Zohreh Abedifar
- Shahid Beheshti University of Medical Sciences Faculty of Medicine, Department of Microbiology, Tehran, Iran
| | - Fatemeh Fallah
- Shahid Beheshti University of Medical Sciences Faculty of Medicine, Department of Microbiology, Tehran, Iran
| | - Fahimeh Asadiamoli
- Tehran University of Medical Sciences Faculty of Medicine, Department of Pathology, Tehran, Iran
| | - Ben Bourrie
- University of Alberta Food, and Nutritional Science, Department of Agricultural, Edmonton, Canada
| | - Farahnoosh Doustdar
- Shahid Beheshti University of Medical Sciences Faculty of Medicine, Department of Microbiology, Tehran, Iran
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50
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Wang J, Ning X, Xu Y, Wang R, Guo X, Xu J, Guo J, Ma Q, Li H, Niu D, Liu Y, Mao N, Zhu Z. Etiological Study of Acute Conjunctivitis Caused by Human Adenovirus in Shanxi Province, China, between 2016 and 2019. Microbiol Spectr 2023; 11:e0015923. [PMID: 37486235 PMCID: PMC10434163 DOI: 10.1128/spectrum.00159-23] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023] Open
Abstract
Human adenovirus (HAdV) is the primary cause of acute conjunctivitis. To improve our understanding of the etiology of adenoviral conjunctivitis, ocular samples were collected from 160 conjunctivitis cases in the Shanxi province of northern China between 2016 and 2019. Through preliminary identification, virus isolation, and type identification, a total of 63 HAdV isolates were obtained from the samples. Three species and seven types (HAdV-3, HAdV-4, HAdV-8, HAdV-37, HAdV-53, HAdV-64, and HAdV-85) were detected, with HAdV-64, HAdV-3, and HAdV-8 being the predominant types in 2016, 2018, and 2019, respectively. Further phylogenetic analysis indicated the relative genomic stability of seven HAdV-type strains, except for 4 HAdV-3 strains in 2018 with a novel amino acid insertion site (Pro) between P19 and S20 in the penton base gene. It is worth noting that the genomes of two Shanxi HAdV-85 strains from 2016 were almost identical to those of previously reported HAdV-85 strains that circulated in Japan in 2014 to 2018. China was the second country to sample and isolate HAdV-85, suggesting that HAdV-85 might be underreported as an ocular pathogen. Data obtained in this study provide valuable information on the prevalence of acute conjunctivitis caused by HAdV. IMPORTANCE HAdV types in cases of conjunctivitis in Shanxi province, China, in 2016 to 2019 showed evident diversity, with seven types (HAdV-3, HAdV-4, HAdV-8, HAdV-37, HAdV-53, HAdV-64, and HAdV-85) being identified, and relative genome stability of these viruses was observed. In addition, China was the second country to sample and isolate HAdV-85, which suggests that HAdV-85 might be underreported as an important pathogen associated with ocular infections. These results enhance the understanding of the etiology of adenoviral conjunctivitis and may aid in the development of prevention and control strategies for HAdV-related ocular infections in China.
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Affiliation(s)
- Jitao Wang
- Department of Microbiology Test, Taiyuan Center for Disease Control and Prevention, Taiyuan, People’s Republic of China
| | - Xiaoling Ning
- Comprehensive Inspection Section, Shanxi Eye Hospital, Taiyuan, People’s Republic of China
| | - Yang Xu
- Department of Microbiology Test, Taiyuan Center for Disease Control and Prevention, Taiyuan, People’s Republic of China
| | - Rui Wang
- Department of Microbiology Test, Taiyuan Center for Disease Control and Prevention, Taiyuan, People’s Republic of China
| | - Xiaofang Guo
- Department of Microbiology Test, Taiyuan Center for Disease Control and Prevention, Taiyuan, People’s Republic of China
| | - Jihong Xu
- Department of Microbiology Test, Taiyuan Center for Disease Control and Prevention, Taiyuan, People’s Republic of China
| | - Jiane Guo
- Department of Microbiology Test, Taiyuan Center for Disease Control and Prevention, Taiyuan, People’s Republic of China
| | - Qin Ma
- Comprehensive Inspection Section, Shanxi Eye Hospital, Taiyuan, People’s Republic of China
| | - Hong Li
- Clinical Research Institute, The Affiliated Hospital of Southwest Medical University, Luzhou, People’s Republic of China
| | - Dandan Niu
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Ying Liu
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Naiying Mao
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
| | - Zhen Zhu
- NHC Key Laboratory of Medical Virology and Viral Diseases, National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
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