Ocular Surface (ocular + surface)

Distribution by Scientific Domains

Terms modified by Ocular Surface

  • ocular surface disease

  • Selected Abstracts

    Cell-penetrating peptide TAT-mediated delivery of acidic FGF to retina and protection against ischemia,reperfusion injury in rats

    Yi Wang
    Abstract The development of non-invasive ocular drug delivery systems is of practical importance in the treatment of retinal disease. In this study, we evaluated the efficacy of transactivator of transcription protein transduction domain (TAT-PTD, TAT49,57) as a vehicle to deliver acidic FGF (aFGF) to retina in rats. TAT-conjugated aFGF-His (TAT-aFGF-His) exhibited efficient penetration into the retina following topical administration to the ocular surface. Immunochemical staining with anti-His revealed that TAT-aFGF-His proteins were readily found in the retina (mainly in the ganglion cell layer) at 30 min. and remained detectable for at least 8 hrs after administration. In contrast, His+ proteins were undetectable in the retina after topical administration of aFGF-His, indicating that aFGF-His cannot penetrate the ocular barrier. Furthermore, TAT-aFGF-His, but not aFGF-His, mediated significant protection against retinal ischemia,reperfusion (IR) injury. After IR injury, retina from TAT-aFGF-His-treated rats showed better-maintained inner retinal layer structure, reduced apoptosis of retinal ganglion cells and improved retinal function compared to those treated with aFGF-His or PBS. These results indicate that conjugation of TAT to aFGF-His can markedly improve the ability of aFGF-His to penetrate the ocular barrier without impairing its biological function. Thus, TAT49,57 provides a potential vehicle for efficient drug delivery in the treatment of retinal disease. [source]

    Intact corneal stroma visualization of GFP mouse revealed by multiphoton imaging

    Wen Lo
    Abstract The aim of this work is to demonstrate that multiphoton microscopy is a preferred technique to investigate intact cornea structure without slicing and staining. At the micron resolution, multiphoton imaging can provide both large morphological features and detailed structure of epithelium, corneal collagen fibril bundles and keratocytes. A large area multiphoton cross-section across an intact eye excised from a GFP mouse was obtained by a homebuilt multiphoton microscope. The broadband multiphoton fluorescence (435,700 nm) and second harmonic generation (SHG, 360,400 nm) signals were generated by the 760 nm output of a femtosecond titanium-sapphire laser. A water immersion objective (Fluor Ō, 40X, NA 0.8; Nikon) was used to facilitate imaging the curve ocular surface. The multiphoton image over entire cornea provides morphological information of epithelial cells, keratocytes, and global collagen orientation. Specifically, our planar, large area multiphoton image reveals a concentric pattern of the stroma collagen, indicative of the laminar collagen organization throughout the stroma. In addition, the green fluorescence protein (GFP) labeling contributed to fluorescence contrast of cellular area and facilitated visualizing of inactive keratocytes. Our results show that multiphoton imaging of GFP labeled mouse cornea manifests both morphological significance and structural details. The second harmonic generation imaging reveals the collagen orientation, while the multiphoton fluorescence imaging indicates morphology and distribution of cells in cornea. Our results support that multiphoton microscopy is an appropriate technology for further in vivo investigation and diagnosis of cornea. Microsc. Res. Tech., 2006. © 2006 Wiley-Liss, Inc. [source]

    The contribution of accommodation and the ocular surface to the microfluctuations of wavefront aberrations of the eye

    Mingxia Zhu
    Abstract We have used videokeratoscopy and wavefront sensing to investigate the contribution of the ocular surface and the effect of stimulus vergence on the microfluctuations of the wavefront aberrations of the eye. The fluctuations of the wavefront aberrations were quantified by their variations around the mean and by using power spectrum analysis. Integrated power was determined in two regions: 0.1,0.7 Hz (low frequencies) and 0.8,1.8 Hz (high frequencies). Changes in the ocular surface topography were measured using high-speed videokeratoscopy and variations in the ocular wavefront aberrations were measured with a wavefront sensor. The microfluctuations of wavefront aberrations of the ocular surface were found to be considerably smaller than the microfluctuations of the wavefront aberrations of the total eye. The fluctuations in defocus while viewing a closer target at 2 or 4 D were found to be significantly greater than fluctuations in defocus when viewing a far target. This increase in defocus fluctuations (p , 0.001) occurred in both the low- and high-frequency regions of the power spectra. [source]

    Spectral optical coherence tomography: a new imaging technique in contact lens practice

    omiej J. Ka
    Abstract Purpose:, Spectral optical coherence tomography (SOCT) is a new non-invasive, non-contact, high-resolution technique, which provides cross-sectional images of objects that weakly absorb and scatter light. The aim of this article is to demonstrate the application of SOCT to imaging of eyes fitted with contact lenses. Methods:, Nine eyes of six different subjects fitted with various contact lenses have been examined with a slit-lamp and a prototype SOCT instrument. Results:, Our SOCT system provides high-resolution (4,6 ,m longitudinal, 10 ,m transversal) tomograms composed of 3000,5000 A-scans with acquisition time of 100,250 ms. The quality of the images is adequate for detailed evaluation of contact lens fit. Design, shape and lens edge position were assessed, and complications of contact lens wear could be visualized. Thickness of the lens, corneal epithelium and stroma as well as the space between the lens and the eye surface have been measured. Conclusions:, SOCT allows high-resolution, cross-sectional visualization of the eye fitted with a contact lens. The ability to carry out a detailed evaluation of the fitting relationship between the lens and the ocular surface might be useful in research and optometric practice. SOCT can also be helpful in diagnosis, evaluation and documentation of contact lens complications. [source]

    Detection, aetiology and management of conjunctival intraepithelial neoplasia

    Andrew Jaworski
    Summary Conjunctival intraepithelial neoplasia (CIN) are considered to be the third most common ocular tumour and the most common tumour of the ocular surface. Due to their malignant potential, they must be carefully differentially and promptly treated. A recurrence rate of approximately 30% leads to the need for monitoring of patients even after successful treatment. This article presents several cases of CIN and reviews their histopathology, aetiology, appearance, differential diagnosis and management. Typical patient presentations and prognoses are also discussed. [source]

    Utility of studying the ocular surface in patients with acne vulgaris treated with oral isotretinoin: a randomized controlled trial

    P. Aragona
    No abstract is available for this article. [source]

    3222: New developments in dry eye treatment

    Purpose This study summarizes the management and therapeutic options for treating dry eye disease. Goals of this review is to identify appropriate therapeutic methods for the management of dry eye disease and recommend a sequence or strategy for their application, based on evidence-based review of the literature. Methods To achieve this a comprehensive review of clinical textbooks and scientific literature was performed and the quality of published evidence graded according to an agreed standard, using objective criteria for clinical and basic research studies. Results There have been tremendous advances in the treatment of dry eye and ocular surface disease in the last decades related to the increase in knowledge regarding the pathophysiology of dry eye. This has led to a paradigm shift in dry eye management from simply lubricating and hydrating the ocular surface with arti,cial tears to strategies that stimulate natural production of tear constituents, maintain ocular surface epithelial barrier function, and inhibit the in,ammatory factors that adversely impact the ability of ocular surface and glandular epithelia to produce tears. Conclusion The authors will present current and future treatment options for dry eye disease. [source]

    3223: Dry eye syndrome and omega-3 fatty acids

    Purpose Dry eye disease is characterized by an inflammatory component of the ocular surface. Pathways to modulate inflammation include corticoids and cyclosporine. Omega-3 fatty acids like eicosapentaenoic acid and docosahexaenoic acid represent an alternate pharmacologic way to influence the inflammatory cascade. Methods Clinical studies. Results An epidemiologic study in 32.470 healthy women showed that those with a higher intake of omega-3 fatty acids had a 68% decreased prevalence of dry eye syndrome. Hyposecretory dry eye was tested after intake of omega-3 fatty acids for 45 days. Symptoms, signs and inflammatory markers like HLA-DR improved. Hyperevaporative dry eye improved after a long-term supplementation with omega-3 fatty acids with respect to symptoms, break-up time and meibom score. Patients with refractive surgery (PRK) improved after omega-3 fatty acids intake; this was derived from the OSDI-score, Schirmer I test and tear clearance. In 102 contact-lens wearers the symptoms and signs of dry eye improved after 12 weeks therapy with omega-3 fatty acids. Conclusion Nutricionals with omega-3 fatty acids show evidence-based effects on the inflammatory component of ocular surface disease and tear film disorder. Their beneficial effect was tested for hypovolemic and hyperevaporative dry eye. Patients after refractive surgery and contact lens wearers improved after supplementation, too. In contrast to the available anti-inflammatory therapy the supplementation is apt for a long-term application. [source]

    3224: Chitosan in the treatment of dry eye

    Purpose To demonstrate the safety and efficacy of a new eye drop formulation containing a novel thiolated biopolymer, namely chitosan-N-acetylcysteine, in a number of pre-clinical tests. It is postulated that interaction between thiol groups of the topically applied chitosan-N-acetylcysteine and cysteine-rich mucin (MUC5AC) increases polymer residence time on the ocular surface and tear film stability. Methods The efficacy of isotonic and buffered chitosan-N-acetylcysteine eye drops was evaluated in two different dry eye mouse models. The dosage dependent ocular residence time and biodistribution were investigated in a rabbit model using microPET technology. Long-term irritation and delayed-type hypersensitivity tests with chitosan-N-acteylcysteine eye drop formulation were conducted in rabbits. Results In both dry eye studies mice treated with chitosan-N-acetylcysteine showed decreased expression of ocular surface mRNA of IL-,, IL-10, IL-12,, and TNF, indicating that the formulation may have protective ocular surface properties. The residence time of chitosan-N-acetylcysteine eye drops on the ocular surface of rabbits was increased (detection up to 22h). Results of a long-term ocular irritation study in rabbits demonstrate that the novel formulation is well tolerated and non-irritant to the eye. Conclusion Based on the promising pre-clinical study results both in terms of efficacy and safety a clinical phase 1 trial is scheduled in the near future. Commercial interest [source]

    2434: Alterations of the lid wiper zone in ocular surface disease

    J NEPP
    Purpose The marginal part of the tarsal conjunctiva forms a lid wiper structure that wipes the ocular surface and distributes the tear film during the blink. It was attempted to investigate whether this region of the upper and lower lid shows specific changes in several kinds of ocular surface diseases. Methods 44 eyes of patients from the outdoor department of the university eye clinic Vienna were observed by slit lamp investigation of the ocular surface, vital staining with fluorescein and lissamin green. It was focused on evaluation of the tarsal conjunctiva including the lid margin and the wiper. Vessel dilatation, teleangiectatic changes and vital staining were each designed in three stages. The patients suffered from inflammation or affections of the lid, the conjunctiva and the cornea including chemical burns, graft versus host disease and injuries Results Compared to normal eyes dilatation of vessels and staining was observed more in patents with inflammations but although in serious affections like chemical burn or injuries. Even in corneal affections changes of vessels were observed. Conclusion Changes of the wiper can be observed in several diseases of the ocular surface and may be a sign of strain in this region. [source]

    2435: Control of the Meibomian gland in health and disease

    Purpose The meibomian gland is extremely important in maintaining the health and integrity of the ocular surface. This gland, through its lipid synthesis and secretion, promotes the stability and prevents the evaporation of the tear film. Conversely, meibomian gland dysfunction (MGD) leads to a decreased stability and increased evaporation of the tear film. Indeed, meibomian gland dysfunction is thought to be the major cause of dry eye syndromes throughout the world. Our goal is to advance understanding of the regulation of meibomian gland function and the mechanisms underlying MGD. Methods Procedures included the immortalization of human meibomian gland epithelial cells with human telomerase reverse transcriptase, the evaluation of cellular responsiveness, and the identification of glandular gene expression changes in MGD. Gene analyses were conducted with Illumina HumanHT-12 v3 Expression BeadChips and Geospiza bioinformatics software. Results To date we have [a] immortalized human meibomian gland epithelial cells that respond to secretagogue, growth factor, neurotransmitter and hormone exposure with alterations in proliferation, differentiation, signaling, gene expression and/or lipogenesis; [b] discovered human meibomian gland genes that may facilitate the development and/or progression of MGD. These genes encode proteins that promote keratinization and amplify inflammation. Conclusion Our findings advance our understanding of the control of the meibomian gland in both health and disease. [Acknowledgments: S.M. Richards, M. Hatton, A.M. Fay and K. Lo; Supported by grants from NIH (R01EY05612) and Alcon] Commercial interest [source]

    Recent developments of dry eye in children

    Purpose Dry eye syndrome in children is a rare disease sometimes difficult to diagnose. The research of the etiology can contribute to adjust the treatment. Methods Two features of dry eye syndrome in children can be distinguished. Dry eye integrated in general disease with evidence of diagnosis and etiology and asymptomatic dry eye which needs a careful check up to recognize the primary etiology. Keratitis sicca usually does not lead to children complaint and simple signs as rubbing or blinking are often observed. Clinical and practical cases are described. Results Review of literature confirms common conditions with adult dry eye but also the specificity of the pediatric dry eye. Dry eye in children is also commonly an inflammatory condition of the ocular surface. New treatment with their indications are listed including tear-like topical therapies and anti-inflammatory or immunosuppressive drugs for ocular surface with specificities in children. Conclusion Dry eye syndrome in children must be recognized and diagnosed. In addition to classical tear-like treatment, specific therapy should be adapted to the etiology. [source]

    In vivo confocal microscopic evaluation of inflammatory changes in the ocular surface

    Purpose The ocular surface constitutes a complex physiopathological and anatomical entity assuring the barrier between the outside world and the fragile ocular structures. Ophthalmic instruments such as the slit lamp, which magnifies approximately 40 times, cannot provide details of the corneal structures at the cellular level. Methods In vivo confocal microscopy using the HRT Rostock Cornea module® (HRT / RCM) provides better resolution and therefore outlines distinctively in vivo inflammatory changes occurring in the ocular surface. Results In vivo confocal microscopy is capable of providing corneal, conjunctival and limbal cellular details in different ocular surface diseases such as dry eye, infectious keratitis, toxic keratitis, corneal intraepithelial neoplasia or vernal keratoconjunctivitis. Conclusion In correlation with ex vivo impression cytology analysis, in vivo confocal microscopy constitutes an interesting aid in the diagnosis and management of complex ocular surface conditions. [source]

    History of and necessity for KPros

    C LIU
    The history of keratoprostheses goes back over 200 years. There was a resurgence in interest in the second half of the twentieth century as it was recognised that keratoplasty could not solve all types of corneal blindness. Many devices have been described but few have survived. Corneal transplantation is complicated by graft rejection and astigmatism. There is also a problem with adequate supply, and there is a risk of transmission of infection. There is a desire for an artificial cornea which surpasses cadaveric transplantation. There is much ongoing work, but the majority of clinical work on keratoprostheses are for corneal blindness not amenable to cadaveric grafts. These can be separated into two main groups. The wet blinking eye which have had multiple graft failures, and the dry eye with a keratinised ocular surface which may also have a deficiency in lid cover. The approaches to these are quite different. [source]

    How do we get started with offering MOOKP clinical service?

    Modified osteo-odonto keratoprosthesis (MOOKP) is complicated two step surgery. Firstly, we must understand why it is effective for visual recovery of end-stage ocular surface diseases like Stevens- Johnson syndrome. MOOKP have a lot of advantages compared to other K-pros, for example the using auto tissue of canine tooth root and buccal mucous membrane, the tight adhesions between optical cylinder and canine tooth root, the adhesion between MOOKP lamina and sclera or cornea, the strong ocular surface by auto buccal mucous membrane, no inflammation on the back of optical cylinder and so on. However, the precise surgical techniques and proper instructions are necessary to succeed the very first case in newly set surgical center. In Japan, we successfully set up the MOOKP center and did perform 4 cases of MOOKP since 2003. We share our experience about it and point out our modification adjustable for Japanese patients. [source]

    Keratinisation status and cytokeratins of the human Meibomian gland epithelium

    E KNOP
    Purpose The Meibomian gland (MG) is an indispensable component of the functional anatomy of the ocular surface. Increasing evidence points to a high impact of hyper-keratinisation as a major cause of obstructive MG dysfunction (MGD) and evaporative dry eye. Information of normal keratinisation status and cytokeratin composition of the human MG is limited. Methods Conjunctival whole-mount specimens including the lid margin from ten body donors of older age were embedded in paraffin. Serial sections were stained by H&E and Masson-Goldner stain and by immunohistochemistry with an antibody panel to cytokeratins. Results In conventional stains, the MG shows distinct similarities with the pilo-sebaceous unit of the cilia. The keratinised skin epithelium extended into the terminal part of the MG excretory duct similar to the hair follicle. Preliminary IHC results showed that the epithelium was positive there for the skin keratin CK10. Along the central duct the keratinisation CK10 expression was gradually lost similar to keratinisation marker involucrin. However, filaggrin, a marker for incipient stages of keratinisation and located in keratohyalin granules continued in the superficial layer of the duct epithelium all along the Meibomian central ductal system. CK14 a marker for basal undifferentiated cells showed a homogenous expression all along the basal cell layer of the MG ducts and the acini. Conclusion The MG shares similarities with the cilia in embryology, in structure and in the cytokeratin composition. It can hence be regarded as a "hair without a hair shaft". All parts of the MG ducts have signs of incipient keratinisation and preserve a commitment to keratinisation. Upregulation in MGD explain hyper-keratinisation as a typical event in obstructive MGD. [source]

    Detection of osmoprotective effect of topical compatible solutes on ocular surface epithelia

    Purpose Inflamation and hyperosmolarity play an important role in generating dry-eye related damage on the ocular surface. A new approach is the use of topical compatible solutes (CS) to induce osmoprotective effect on ocular surface epithelia. Aim of this study was to evaluate the osmoprotective action of topical CS on ocular surface in dry-eye patients. Methods We evaluated 48 eyes of 24 dry-eye patients, current users of artificial tears. At baseline they underwent impression cytology (IC) and immunoflurescence staining to detect expression of inflammatory cytokines linked with hyperosmolarity in ocular surface epithelia. In vivo confocal microscopy (IVCM) of corneal and conjunctival surface was performed and epithelial morphology and inflammatory cells infiltration were evaluated. Patients started topical treatment with methilcellulose and CS in one randomly selected eye, while the fellow eye continued previous eye drops.IC and IVCM were performed after 30,60 and 90 days. Results At baseline IVCM and IC results were comparable in both eyes . At 90 days IVCM showed a significant improvement in epithelial regularity in treated eyes while in control group no significant changes were observed.IC evidenced a significant reduction of inflammatory cytokines between baseline time and day 60, stable till the end of follow-up, while in control group no significant changes were observed. Conclusion The use of topical CS can improve epithelial regularity and reduce ocular surface inflammation in dry-eye syndrome. [source]

    Ophthalmic microsporidiosis: the Manchester experience

    Purpose We report cases of ocular and adnexal microsporidiosis diagnosed in Manchester, UK, and review the literature. Methods The archives of the National Specialist Ophthalmic Pathology (NSOPS) Manchester Laboratory and Health Protection Agency Laboratory (HPA)at Manchester Royal Infirmary were reviewed for cases of microsporidiosis between 1990 and 2009. Results 8 cases of ocular and adnexal microsporidiosis were identified. Organisms were Encephalitozoon hellem, Encephalitozoon sp., Vittaforma corneae, Trachipleistophora hominis, Nosema sp. with infection of ocular surface, cornea, nasolacrimal apparatus and nasal sinuses, and eyelid; a historical case of Microsporidium ceylonensis keratitis, first reported by Norman Ashton in 1973 was also reviewed. Ages ranged from 11 years (Ashton's case) to 50 years. One case was from an HIV +ve patient, the others were immunocompetent. At least 4 infections were contracted whilst the patient was outside the UK. Conclusion Microsporidia, minute obligate intracellular parasites related to fungi, infect via a polar tube housed within a highly resistant spore. Microsporidial infection in HIV/AIDS, usually entereic, is the most reported. Antiretroviral treatment has lowered the incidence of enteric microsporidiosis and ocular infection is increasingly prevalent and often not HIV-related. In our cases the majority were immunocompetent individuals. LM can be diagnostic if characteristic refractile ZN-positive spores are seen, but LM does not permit speciation, which usually requires EM. Diligent searching for organisms may be necessary as distribution may be focal. Insufficient data exist for PCR-based diagnosis of most microsporidial species.Sources and mechanisms of microsporidial infection remain speculative. [source]

    Activity of corneal nociceptive nerve fibers during allergic challenge of the ocular surface

    Purpose The aim of this work was to study in vitro the spontaneous and stimulus-evoked electrical activity of corneal nociceptive nerve fibers during acute allergic inflammation of the ocular surface induced in the guinea-pig. Methods Animals received i.p. 10% ovalbumin (OVA). 14 days later, a 10µl drop of OVA was applied topically to each eye. Blinking and scratching movements directed to the eye were measured during 10 min, and ocular symptoms (edema and hyperemia) and tear rate were measured. Animals were killed afterwards and both eyes were immediately excised and mounted in a superfused (32°C) recording chamber. Electrical activity of corneal sensory receptors was recorded from nerve filaments dissected from the ciliary nerves. Mechanical (calibrated von Frey hairs), thermal (bath solution temperature down to 20°C or up to 52°C), and chemical stimulation (30s-pulses of 98%CO2) were performed. Spontaneous (SA) and stimulus-evoked activity were analyzed. Results After the allergic challenge, eye-scratching behavior was present in 4 out of 15 animals and blinking movements increased from 1±0.05 to 26±5. Tearing also increased compared to control (33±3 vs. 5±1 mm). Compared to naive eyes, proportion of nociceptors with SA (17% vs. 5%) and spontaneous discharge rate (0.13±0.07 vs. 0.01±0.01 imp/s) were increased. Mechanical threshold of mechano-nociceptive units decreased significantly (0.37±0.05 vs. 0.89±0.13 mN). Chemosensitivity of polymodal nociceptors was slightly increased (1.87±0.42 vs. 1.34±0.23 imp/s). Conclusion Changes in corneal sensory nerve activity observed acutely after allergic challenge of the eye surface may constitute the basis of itching and discomfort sensations, and hypersensitivity observed in allergic patients. [source]

    Vernal keratoconjunctivitis: a major review

    Sunil Kumar
    Abstract. Vernal keratoconjunctivitis (VKC) is a chronic, bilateral, at times asymmetrical, seasonally exacerbated, allergic inflammation of the ocular surface, involving tarsal and/or bulbar conjunctiva. Though the allergic nature of this entity has been accepted for a long time, the accumulation of a large amount of immunological data has proved that the pathogenesis of VKC is much more complex than a mere type 1 hypersensitivity reaction. In the past several years, many clinical and experimental studies about the cells and mediators involved in initiating and perpetuating the ocular allergic inflammation have shown that T helper type 2 cells and their cytokines, corneal fibroblasts and epithelium along with various growth factors play an important role in the pathogenesis of VKC. Based on this information about the pathogenesis of VKC newer, more selective drugs like anti-chemokine receptor antibodies and leukotriene receptor antagonists are under evaluation. Cyclosporine has been shown to be effective in the treatment of VKC but further randomized control trials are required to establish the minimum effective concentration. [source]

    Conjunctival impression cytology and tear-film changes in patients with familial Mediterranean fever

    Aylin Karalezli
    Abstract. Purpose:, To evaluate the ocular surface changes and tear-film functions in patients with familial Mediterranean fever (FMF). Methods:, This prospective case,control clinical study examined 35 patients with FMF (group 1) and 35 controls (group 2). All patients underwent a full ophthalmological examination. Ocular surface changes were evaluated by determining cell content of surface conjunctival epithelium using conjunctival impression cytology and tear-film functions using Schirmer-I, break-up time (BUT), corneal fluorescein and Rose Bengal tests. Subjective ocular complaints were scored with a four-point scale. Between-group results were compared. Results:, In group 1, impression cytology revealed grade 0 changes in 15 eyes, grade 1 changes in 11 eyes and grade 2 changes in nine eyes in group 1; in group 2, it revealed grade 0 changes in 27 eyes, grade 1 changes in five eyes and grade 2 changes in three eyes (p = 0.013). Mean goblet cell density was 765 ± 45 cells/mm2 in group 1 and 1730 ± 100 cells/mm2 in group 2 (P < 0.001). Mean results on the Schirmer-I test results were 17.36 ± 3.18 mm in group 1 and 19.60 ± 4.17 mm in group 2 (p = 0.364). Mean BUT was 8.20 ± 1.60 seconds in group 1 and 9.93 ± 2.33 seconds in group 2 (p = 0.001). Mean corneal fluorescein and Rose Bengal staining scores were 3.26 ± 1.67 and 0.96 ± 0.71 in group 1 and 1.37 ± 0.34 and 0.40 ± 0.49 in group 2 (p = 0.037, p = 0.005). The presence of subjective ocular complaints was more frequent in group 1 than in group 2. Conclusion:, Despite normal tear production, the ocular surface and tear-film functions of FMF patients differ from those of healthy individuals. These changes may be related to the chronic inflammatory nature of FMF. [source]

    Compartmental factors influencing tear film osmolarity

    Purpose To illustrate how compartmental factors could influence the distribution of tear osmolarity at the ocular surface in normals and dry eye. Methods Mathematical modelling using parameters in the literature. Results Tear film hyperosmolarity is a final common pathway causing ocular surface damage in dry eye. Modelling predicts that tear osmolarity is higher in the tear film than the meniscus, which may influence the distribution of ocular surface damage and the initiation of symptoms caused by hyperosmolarity. Once tear film break up occurs within the blink interval it is likely that this differential is amplified locally. The model allows the effect of compartmental factors on tear osmolarity to be addressed, including: regional differences in air flow and surface temperature, variations in ambient temperature and humidity, imperfect tear mixing, differential corneal and conjunctival exposure and individual differences in reflex tear flow, evaporation rate and blink interval. We hypothesise that interactions between these factors determine the dry eye phenotype in an individual. Additional considerations suggest that events at the ocular surface differ in aqueous-deficient and evaporative dry eye. Conclusion Hyperosmolarity at the ocular surface is affected by multiple factors, each of which may make different contributions to distribution and severity of surface damage in a given individual. This may determine the phenotype, frequency and severity of dry eye in a population. [source]

    Proteomic analysis of conjucntival swab by mass spectrometry

    Purpose: The purpose of this study was to identify proteins present in the tears and mucosal epithelium of the ocular surface. Methods: A cotton swab was rubbed across the anaesthetized inferior conjunctiva of a dry eye patient. Protein was extracted and subjected to 1D gel electrophoresis. After excision and trypsinisation, protein profiles from swab samples were identified using mass spectrometry carried out on a 3200 Q-TRAP Hybrid ESI Quadropole linear ion trap. Protein identification was performed using MASCOT software against a human database extracted from NCBI. Curation of the protein list was achieved using the bioinformatics tool PROVALT, which also calculated false-discovery rates. Results: In total 75 validated proteins were identified including the tear proteins, lactotransferrin, lysozyme, and proline rich proteins as well as a number of proteins not previously associated with the tear proteome. Proteins identified had a wide range of physio-chemical properties and included structural and functional proteins. Conclusions: Use of a simple swab combined with a GeLC-MS proteomic protocol led to unequivocal identification of a large range of proteins associated with the ocular surface proteome. This may allow a better characterisation of the ocular surface environment and discrimination between various eye conditions. Tear collection using capillaries can be tedious and may discourage clinicians from performing such a test. Use of a swab that can be frozen for analysis may encourage the use of this methodology. Analysis of this proteome offers huge clinical potential for investigation of ocular surface biomarkers for the development of novel diagnostic tools and monitoring of ocular disease. [source]

    Tear functions in patients with pinguecula

    Halit Oguz
    ABSTRACT. Purpose: To investigate the tear flow, tear film stability and condition of mucus in patients with pinguecula. Methods: The Schirmer I and ferning tests were performed and break-up time (BUT) was determined in 57 patients with pinguecula [random eyes; 34 males and 23 females, 18 to 70 years of age (mean±SD: 39.1±13.5 years)] and in 57 age-matched subjects (control) [random eyes; 35 males and 22 females, 11 to 70 years of age (mean±SD: 37.8±15.2 years)], and the test results were statistically analysed. Results: The mean Schirmer test value was 22.72±12 mm in the eyes with pinguecula and 22.7±8.5 mm in the control eyes. There was no statistically significant difference (t=0.01, p=0.99) between the groups. The mean BUTs were 11.42±6.89 s in the eyes with pinguecula and 15.46±5.85 s in the control eyes. Comparison of BUTs between the groups revealed a statistically significant difference (t=3.37, p=0.0010). Also, ferning types were found to be significantly abnormal in the eyes with pinguecula (p<0.01). Conclusion: The alteration in the mucin layer is a possible change inducing pinguecula formation, or it may reflect an already existing pathology in the cells on the ocular surface. [source]

    Alterations of the ocular surface epithelial mucins 1, 2, 4 and the tear functions in patients with atopic keratoconjunctivitis

    M. Dogru
    Summary Background An increased understanding of the ocular surface alterations at the cellular level in the conjunctiva and the cornea, may help explain the pathogenesis and the subsequent clinical appearance of atopic ocular allergies, which may be potentially blinding. Purpose To investigate MUC 1, 2 and 4 alterations, tear function and the ocular surface disorder in patients with atopic keratoconjunctivitis. Methods Twenty-eight eyes of 14 atopic keratoconjunctivitis patients as well as 22 eyes of 11 age-and sex-matched normal subjects were studied. The subjects underwent corneal sensitivity measurements, Schirmer's test, tear film break-up time (BUT), fluorescein and Rose Bengal staining of the ocular surface, conjunctival impression cytology and brush cytology. Impression cytology samples underwent periodic acid-Schiff and immunohistochemical staining with MUC 1, 2 and 4 antibodies. Brush cytology specimens underwent evaluation for inflammatory cell numbers and quantitative real-time-PCR for MUC 1, 2 and 4 mRNA expression. Patient eyes with fluorescein and Rose Bengal scores greater than four points were regarded to have significant epithelial disease in this study. Results The mean corneal sensitivity and BUT values were significantly lower in atopic patients with significant epithelial disease, compared with patients with insignificant epithelial disease and controls (P<0.01). Brush cytology specimens from patients with significant epithelial disease revealed significantly higher numbers of inflammatory cells (P<0.01). Specimens from patient eyes showed positive staining for MUC 1, 2 and 4. MUC 1, 2 and 4 mRNA expressions were significantly higher in eyes with significant epithelial disease compared with eyes with insignificant epithelial disease and eyes of control subjects. Conclusion Ocular surface inflammation, decline in corneal sensitivity, tear film instability, changes in conjunctival epithelial MUC 1, 2 and 4 mRNA expressions were thought to be important in the pathogenesis of atopic ocular surface disease. [source]

    Delayed ocular complications of mustard gas poisoning and the relationship with respiratory and cutaneous complications

    Mohammad Etezad-Razavi MD
    Abstract Background:, This study was aimed to determine the correlation between ocular complications and respiratory or cutaneous complications in a group of 40 Iranian veterans with late complications of sulphur mustard (SM) poisoning. Methods:, Thorough ophthalmologic examination was performed on all severely SM-poisoned veterans in the province of Khorasan, Iran. Spirometric evaluation of pulmonary function, as well as estimation of the burned skin area, was performed for all the patients. The severities of ocular, respiratory and cutaneous complications were classified into four grades in each patient and were compared with each other, using Spearman's rank correlation test. Results:, Forty male patients (aged 43.8 ± 9.8 years) with confirmed SM poisoning were studied 16,20 years after their initial exposure. Common symptoms were recorded as itching (42.5%), burning sensation (37.5%), photophobia (30%) and tearing (27.5%). Abnormal conjunctival and limbal findings were chronic conjunctivitis (17.5%), perilimbal hyperpigmentation (17.5%), vascular tortuosity (15%) and limbal ischaemia (12.5%). Abnormal corneal findings were subepithelial opacity (15%), corneal thinning (15%), diffuse corneal opacity (10%), neovascularization (7.5%) and epithelial defects (5%). A significant positive correlation was found between the severity of ocular and respiratory complications (r = 0.322, P = 0.043). Cutaneous complications revealed no significant correlation with either ocular or respiratory complications. Conclusions:, SM causes delayed destructive lesions in the ocular surface and cornea, leading to progressive visual deterioration and ocular irritation. Late complications of SM poisoning in the eyes, respiratory system and skin are mainly due to SM's local irritant effects. [source]

    Modulation of tear film protein secretion with phosphodiesterase inhibitors

    Victoria Evans BOptom
    ABSTRACT A double-blind randomized clinical study was conducted to determine whether nicardipine hydrochloride was a useful treatment for dry eye. We examined its effect on the tear film, ocular surface and ocular comfort. Nicardipine hydrochloride, 3-isobutyl-1-methylxanthine and pilocarpine hydrochloride were dissolved in an artificial tear vehicle and applied topically to one eye of 12 subjects on separate days. Ocular physiology, ocular comfort and tear volume were assessed. The trial was repeated with nicardipine in an aqueous gel vehicle. Tears were collected and assessed for protein concentration and protein profile, using electrophoresis and mass spectrometry. Nicardipine induced conjunctival redness and symptoms of dryness and irritation. There was no change in total tear protein concentration or volume. An increase in a 68 kDa protein was observed, this was probably due to conjunctival vessel dilation and leakage of albumin. The adverse symptomatology and increased conjunctival redness experienced with nicardipine make it an undesirable treatment for dry eye. [source]

    Which is more important to the initiation of contact lens related microbial keratitis, trauma to the ocular surface or bacterial pathogenic factors?

    Mark DP Willcox BSc (Hons) PhD
    No abstract is available for this article. [source]