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De novo mutation in the gene encoding connexin-26 (GJB2) in a sporadic case of keratitis-ichthyosis-deafness (KID) syndrome

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AMERICAN JOURNAL OF MEDICAL GENETICS PART A 2003年第1期117A卷 89-91页

作者： Alvarez, A del Castillo, I Pera, A Villamar, M Moreno-Pelayo, MA Moreno, F Moreno, R Tapia, MC Hosp Ramon & Cajal Unidad Genet Mol Madrid 28034 Spain Hosp Ramon & Cajal Dermatol Serv E-28034 Madrid Spain Hosp Clin San Carlos Pabellon Serv ORL E-28034 Madrid Spain

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A description of human T-lymphotropic virus type I-related chronic interstitial keratitis in 20 patients

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2001年第3期131卷 305-308页

作者： Merle, H Cabre, P Merle, S Gerard, M Smadja, D CHU Ft de France Hop Pierre Zobda Quitman Serv Ophtalmol BP 632 Fort De France 97261 Martinique France CHU Ft de France Serv Ophtalmol Fort De France 97261 Martinique France CHU Ft de France Serv Neurol Fort De France 97261 Martinique France Entree Hop Clarac Observ Reg Sante Martinique Fort De France Martinique France

OBJECTIVE: This study aimed to describe a syndrome that the authors call human T-lymphotropic virus type I-related chronic interstitial keratitis. METHODS: A consecutive series of 194 human T-lymphotropic virus type I-infected patients (divided into 119 patients with human T-lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis and 75 asymptomatic human T-lymphotropic virus type I carriers) was systematically examined. RESULTS: Twenty patients (10.3%) had bilateral anterior stromal lesions made up of approximately 10 elevated, rounded or cloudy whitish opacities that were more or less confluent. The opacities were characteristically situated at the periphery of the anterior stroma, and the visual axis remained unaffected, The interstitial keratitis was chronic and unresponsive to topical administration of corticosteroids. It was mainly observed in patients affected by human T-lymphotropic virus type I-associated myelopathy/tropical spastic paraparesis among whom there were 18 cases (15.1%), as opposed to two cases (2.7%) in asymptomatic carriers. CONCLUSION: A new cause of interstitial keratitis is reported. Human T-lymphotropic virus type I infection may have a much broader spectrum of ocular manifestations than previously described. As with the other manifestations of human T-lymphotropic virus type I infection, corneal lesions could be linked to a lymphoplasmocytic infiltration of the stroma leading to corneal opacities. (Am J Ophthalmol 2001;131:305-308. (C) 2001 by Elsevier Science Inc, All rights reserved.).

关键词：慢性病角膜混浊/流行病学角膜混浊/病理学角膜混浊/病毒学角膜基质/病理学角膜基质/病毒学眼感染病毒性/流行病学眼感染病毒性/病理学眼感染病毒性/病毒学 HTLV-Ⅰ抗体/分析人类嗜T淋巴细胞病毒1型/分离和提纯角膜炎/流行病学角膜炎/病理学角膜炎/病毒学马提尼克/流行病学轻截瘫热带痉挛性/流行病学轻截瘫热带痉挛性/病理学轻截瘫热带痉挛性/病毒学前瞻性研究综合征视敏度成年人老年人老年人 80以上女(雌)性人类男(雄)性中年人

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Diffuse lamellar keratitis associated with epithelial defects after laser in situ keratomileusis

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JOURNAL OF CATARACT AND REFRACTIVE SURGERY 2000年第9期26卷 1312-1318页

作者： Shah, MN Misra, M Wihelmus, KR Koch, DD Baylor Coll Med Dept Ophthalmol Cullen Eye Inst Houston TX 77030 USA

Purpose: To describe the association between the presence of epithelial defects and the development of diffuse lamellar keratitis (DLK), "Sands of the Sahara" syndrome, following laser in situ keratomileusis (LASIK). Setting: Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA. Methods: in this retrospective study, the postoperative clinical course and surgical outcomes in 735 eyes of 358 consecutive patients who had myopic LASIK between December 1998 and August 1999 were reviewed. Of the 735 procedures, 680 were primary LASIK procedures and 55 were retreatments performed by lifting the existing Raps. The incidence and severity of DLK and the relationship of DLK to epithelial defects were tabulated. Results: Diffuse lamellar keratitis developed in 9 of the 16 eyes that had postoperative epithelial defects. Seventeen eyes without epithelial defects also developed DLK. The presence of an epithelial defect increased an individual's risk of developing DLK 24 times (95% confidence interval, 13 to 45). In 8 eyes, the inflammation resolved following treatment with intense topical corticosteroids. One eye had irrigation under the flap because of dense central inflammation;the final outcome was mild inferior corneal steepening. All eyes recovered preoperative best spectacle-corrected visual acuities. Conclusion: Patients who have epithelial defects of any size following LASIK are at significantly increased risk of developing DLK. (C) 2000 ASCRS and ESCRS.

关键词：角膜地形图上皮角膜/病理学角膜炎/药物疗法角膜炎/病因学角膜炎/病理学角膜磨镶术激光原位/副作用近视/外科学眼药水泼尼松龙/投药和剂量泼尼松龙/类似物和衍生物药物前体/投药和剂量回顾性研究视敏度成年人女(雌)性人类男(雄)性中年人

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Penetrating keratoplasty for keratoconus: A long-term review of results and complications

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JOURNAL OF CATARACT AND REFRACTIVE SURGERY 2000年第7期26卷 987-991页

作者： Olson, RJ Pingree, M Ridges, R Lundergan, ML Alldredge, C Clinch, TE Univ Utah Hlth Sci Ctr Dept Ophthalmol Salt Lake City UT 84132 USA

Purpose: To study the long-term complications of penetrating keratoplasty (PKP) to evaluate current recommendations to patients with keratoconus. Setting: John Moran Eye Center, University of Utah, Salt Lake City, Utah. USA. Methods: Retrospective study of all PKP procedures for keratoconus performed by 4 surgeons during a 3 1/2 year period. Follow-Lip was 1 day and 1, 3, 6, 12, and 24 months post-PKP. Data from 93 eyes were reviewed for allograft reaction, astigmatism, visual acuity, reasons for decreased visual acuity, and other complications. Results: Allograft reaction was seen in 31% of cases but no graft failure due to allograft reaction. Mean astigmatism was 2.76 diopters (D) +/- 1.99 (SD) at 24 months, with only 15% > 5.00 D. Last best corrected visual acuity was 20/25 or better in 77% of cases (87% had 20/25 or better at some time during follow-up). Complications that did not cause decreased visual acuity were noted. Punctate keratitis was noted in 20% of patients 180 days or more after surgery. Conclusion: Penetrating keratoplasty is a good treatment option for patients with keratoconus but should be reserved for those who do not tolerate contact lenses or do not get needed visual acuity with contact lenses because of complications. This procedure has become a second-line treatment for keratoconus patients and has generally good results. J Cataract Refract Surg 2000;26:987-991 (C) 2000 ASCRS and ESCRS.

关键词：散光/病因学随访研究发病率角膜炎/病因学角膜炎/病理学圆锥角膜/外科学角膜移植术穿透性/副作用角膜移植术穿透性/病理学屈光眼回顾性研究移植同种/病理学视敏度人类

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Topical treatment with nerve growth factor for neurotrophic keratitis

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OPHTHALMOLOGY 2000年第7期107卷 1347-1351页

作者： Bonini, S Lambiase, A Rama, P Caprioglio, G Aloe, L Univ Roma Tor Vergata Dept Ophthalmol I-00100 Rome Italy GB Bietti Eye Fdn Rome Italy CNR Inst Neurobiol Rome Italy Hosp Venice SS Giovanni & Paolo Div Ophthalmol Venice Italy

Objective: To evaluate the efficacy of nerve growth factor (NGF) in patients with neurotrophic keratitis. Design: Prospective, noncomparative, interventional case series. Participants: Forty-five eyes of 43 consecutive patients with moderate (stage 2, n = 17) to severe (stage 3, n = 28) neurotrophic keratitis unresponsive to other nonsurgical therapies. Methods: After a 10-day washout with preservative-free artificial tears, 45 eyes with neurotrophic keratitis received murine NGF (200 mu g/ml) every 2 hours for 2 days followed by one drop six times daily until the ulcer healed. A maintenance dose of one drop NGF (100 mu g/ml) was administered four times daily for the 2 weeks subsequent to ulcer healing. Main Outcome Measures: Size and depth of the ulcer or the epithelial defect, corneal sensitivity, best corrected visual acuity, side effects, and relapse of the disease in the follow-up period. Results: All patients had a complete resolution of the persistent epithelial defect (with or without an ulcer) after 12 days to 6 weeks of treatment with NGF. Patients affected by both stages of the disease demonstrated both improved corneal sensitivity and visual acuity (P < 0.001). No significant differences were observed in the time to complete corneal healing between stage 2 and stage 3 patients. Hyperemia and ocular and periocular pain were side effects reported during the first days of treatment. No relapse of the disease was observed during the follow-up period, with the exception of three patients with trigeminal nerve resection, who required a single retreatment. Conclusions: Nerve growth factor eye drops improved corneal sensitivity and promoted corneal epithelial healing in both moderate and severe neurotrophic keratitis. Although performed in an uncontrolled and nonrandomized series of patients, this therapy shows promise for the restoration of ocular surface integrity and visual function in neurotrophic corneal disease. (C) 2000 by the American Academy of Ophthalm

关键词：投药局部角膜/神经支配角膜/病理学颅神经疾病/药物疗法颅神经疾病/病理学药物评价角膜炎/药物疗法角膜炎/病理学神经生长因子/投药和剂量神经生长因子/治疗应用眼神经/药物作用眼神经/病理学眼药水/投药和剂量眼药水/治疗应用前瞻性研究感觉治疗结果青少年成年人老年人儿童女(雌)性人类男(雄)性中年人

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Diffuse interface keratitis after laser in situ keratomileusis (LASIK): A nonspecific syndrome

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2000年第3期129卷 380-381页

作者： Steinert, RF McColgin, AZ White, A Horsburgh, GM Ophthalm Consultants Boston Boston MA 02114 USA Harvard Univ Sch Med Dept Ophthalmol Boston MA USA Ctr Eye Res & Educ Boston MA USA

PURPOSE: To characterize the presentation of diffuse interface keratitis after laser in-situ keratomileusis (LASIK), METHODS: Case report. RESULTS: Diffuse interface keratitis occurred in the left eye of a postoperative LASIK patient after central epithelial debridement without exposure of the flap margin or elevation of the flap. CONCLUSION: Diffuse interface keratitis is a nonspecific presentation of corneal inflammation after LASIK, with accumulation of inflammatory cells in the potential space bf the interface. Diffuse interface keratitis after LASIK may have multiple causes. (C) 2000 by Elsevier Science Inc. Al;rights reserved.

关键词：散光/外科学角膜/病理学角膜/外科学角膜炎/病因学角膜炎/病理学近视/外科学视敏度成年人人类男(雄)性

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Marginal keratitis: An uncommon form of topical dorzolamide allergy

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2000年第1期130卷 120-122页

作者： Taguri, AH Khan, MA Sanders, R Univ Edinburgh Dept Ophthalmol Edinburgh EH3 9HA Midlothian Scotland

PURPOSE: To report a case of marginal keratitis resulting from topical dorzolamide hypersensitivity. METHOD: Case report. RESULTS: A 68 year old woman presented with bilateral marginal keratitis 2 weeks after commencing bilateral topical dorzolamide. One week after discontinuation of topical dorzolamide, the patient was asymptomatic with complete resolution of corneal infiltrates. CONCLUSIONS: Topical dorzolamide may cause a hypersensitivity reaction in the form of marginal keratitis. Discontinuation of the offending medication should result in complete resolution. (C) 2000 by Elsevier Science Inc. All rights reserved.

关键词：投药局部碳酸酐酶抑制剂/治疗应用药物过敏/病因学药物过敏/病理学青光眼开角型/药物疗法角膜炎/化学诱导角膜炎/病理学眼药水/治疗应用磺胺类/治疗应用噻吩类/治疗应用老年人女(雌)性人类

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Fungal keratitis after laser in situ keratomileusis

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JOURNAL OF CATARACT AND REFRACTIVE SURGERY 2000年第4期26卷 613-615页

作者： Sridhar, MS Garg, P Bansal, AK Sharma, S LV Prasad Eye Inst Hyderabad 500034 Andhra Pradesh India Cornea & Anterior Segment Serv Hyderabad Andhra Pradesh India Jhaveri Microbiol Ctr Hyderabad Andhra Pradesh India

A 22-year-old woman presented with pain, redness, watering, and decrease in vision in her left eye 15 days after laser in situ keratomileusis for myopia. Slitlamp examination showed a central full-thickness infiltrate with hyphate edges. Microscopic examination of corneal scrapings from the edge and underneath the flap showed fungal filaments, and the growth on culture media was identified as Scedosporium apiospermum. J Cataract Refract Surg 2000;26:613-615 (C) 2000 ASCRS and ESCRS.

关键词：抗真菌药/投药和剂量抗真菌药/治疗应用角膜/微生物学角膜/病理学角膜/外科学角膜移植眼感染真菌性/病因学眼感染真菌性/病理学眼感染真菌性/治疗角膜炎/微生物学角膜炎/病理学角膜炎/治疗角膜磨镶术激光原位/副作用足菌肿/病因学足菌肿/病理学足菌肿/治疗近视/外科学眼药水假霉样真菌属/分离和提纯再手术外科伤口感染/微生物学外科伤口感染/病理学外科伤口感染/治疗视敏度成年人女(雌)性人类

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Corneal microsporidiosis - Report of case, including electron microscopic observations

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OPHTHALMOLOGY 2000年第9期107卷 1769-1775页

作者： Font, RL Samaha, AN Keener, MJ Chevez-Barrios, P Goosey, JD Baylor Coll Med Cullen Eye Inst Ophthalm Pathol Lab Houston TX 77030 USA Univ Texas Hlth Sci Ctr Dept Ophthalmol & Visual Sci Houston TX USA

Objective: To report a case of corneal stromal infection caused by a protozoon of the genus Microsporidia, including clinical, histopathologic, and electron microscopic observations. Design: Case report. Methods: Light and electron microscopy studies were performed on keratectomy specimens from a 67-year-old immunocompetent man who had a unilateral chronic stromal keratitis that was refractory to medical treatment, Initial corneal biopsy followed by lamellar and penetrating keratoplasty were performed on the patient. All the specimens were studied histopathologically. Results: Light microscopy of the corneal biopsy and the subsequent keratectomy specimens demonstrated myriad small, round to oval microsporidial organisms measuring 3.5 to 5.0 mu m in length that stained positively with the periodic acid-Schiff, Grocott-methenamine silver, and acid-fast methods and were gram positive. Electron microscopic observations demonstrated viable blastospores that had a thin osmiophilic outer cell wall and contained 11 to 13 coils of the filament. The light and electron microscopic features, the tinctorial characteristics, and the selective corneal stromal involvement ave consistent with microsporidial keratitis. Conclusions: Microsporidiosis should be considered in the differential diagnosis of a culture-negative stromal keratitis refractory to medical treatment. The diagnosis can be easily established based on the morphologic features of the protozoa in the keratectomy specimens. No effective medical treatment for the stromal disease is available. Full-thickness keratoplasty is suggested because, in our patient, lamellar keratoplasty did not preclude recurrence of the disease. Ophthalmology 2000;107:1769-1775 (C) 2000 by the American Academy of Ophthalmology.

关键词：活组织检查角膜基质/寄生虫学角膜基质/超微结构诊断鉴别眼感染寄生虫性/寄生虫学眼感染寄生虫性/病理学角膜炎/寄生虫学角膜炎/病理学角膜移植术穿透性显微镜检查电子微孢子虫目/分离和提纯微孢子虫目/超微结构微孢子虫病/寄生虫学微孢子虫病/病理学老年人动物人类男(雄)性

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Sterile interface keratitis associated with micropannus hemorrhage after laser in situ keratomileusis

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JOURNAL OF CATARACT AND REFRACTIVE SURGERY 1999年第12期25卷 1679-1681页

作者： MacRae, S Macaluso, DC Rich, LF Oregon Hlth Sci Univ Casey Eye Inst Portland OR 97201 USA

Numerous etiologies have been suspected to lead to sterile interface keratitis after laser in situ keratomileusis. This tan interface haze wit a a rippled appearance has been called Sands of the Sahara. We present 2 cases in which red blood cells entered the interface after a small hemorrhage from peripheral corneal vascularization during the microkeratome pass. Although this bleeding was controlled and all visible blood cells were removed at surgery, both patients developed the appearance of a focal interface keratitis on the first postoperative day. J Cataract Refract Surg 1999;25:1679-1681 (C) 1999 ASCRS and ESCRS.

关键词：散光/外科学角膜/血液供给角膜/病理学角膜/外科学角膜新生血管化/病因学角膜新生血管化/病理学眼出血/病因学眼出血/病理学角膜炎/病因学角膜炎/病理学近视/外科学视敏度女(雌)性人类中年人

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