Sarcoma de Kaposi en conjuntiva bulbar / Kaposi´s sarcoma in bulbar conjunctiva

Paciente masculino de 29 años de edad, raza blanca, soltero, profesor universitario, con antecedentes de padecer crisis de epilepsia tratado con fenitoína y actualmente controlado, menciona que desde hace aproximadamente 4 semanas comenzó con ojo rojo y molestias oculares del ojo derecho, por lo cual acudió a su área de salud donde fue tratado como cuadro de conjuntivitis. No mostró mejoría alguna, sino empeoramiento del cuadro clínico, y observó un enrojecimiento ocular intenso en el ángulo interno de dicho ojo que se fue extendiendo, acompañado de ligera fotofobia. Por la tórpida evolución del cuadro decidió acudir a nuestra institución por lo cual fue remitido a la Consulta de Oculoplastia. También refirió que desde hacía dos meses había presentado anorexia, dificultad al comer, así como pérdida de peso, por lo cual se decidió comenzar estudio y tratamiento. Se decidió realizar la resección de la masa tumoral en conjuntiva bulbar y se envió para estudio anatomopatológico. El resultado fue compatible con un sarcoma de Kaposi(AU)

A twenty-nine years-old male Caucasian patient, single and university professor, with a history of epilepsy treated with fenitoin and managed at present. He stated that 4 weeks ago approximately, he began feeling ocular discomfort in addition to reddened eye, so he went to his health area where he was treated as a conjunctivitis case. No improvement occurred, the clinical picture worsened and there was intensive ocular reddening in the internal angle of the eye that extended and mild photofobia. Because of the rapid profession of the clinical picture, he decided to go to our institution where he was referred to the Oculoplasty Service. He also said that he had been suffering anorexia, difficulties to eating and weight loss two months ago. It was then decided to start the study and treatment of this case. First, the tumor mass from the bulbar conjunctiva was resected and then sent to anatomical pathological study service. The result was compatible with Kaposi´s sarcoma diagnosis(AU)

Comparative evaluation of conventional medical treatment alone versus conventional medical treatment with amniotic membrane transplantation in infective corneal ulcer

To compare the effect of amniotic membrane transplantation along with conventional therapy and the conventional therapy alone for the treatment of infective corneal ulcer. This study was conducted at Ophthalmology Department, Hayatabad Medical Complex Peshawar. The duration of study was 6 months, i.e., from April 2010 to October 2010, in which a total of 68 patients were included using WHO software for sample size determination. They were divided into two equal groups of 34 each. Non probability purposive sampling technique was used. In this study, mean age was 50 +/- 0.24 years. Forty six [67.6%] patients were male while 32.4% [n=22] patients were female. Conventional Medical Treatment alone was effective in 87% [n=30] cases while Conventional Medical Treatment with Amniotic Membrane was effective in 96% [n=33] cases with a p-value of 0.03. This study showed encouraging results of amniotic membrane trans plantation along with conventional treatment in corneal ulcer in improving both symptoms and signs

Melanose primária adquirida associada a erosões epiteliais recorrentes da córnea / Primary acquired melanosis associated with recurrent corneal erosions

Relato de caso de melanose primária adquirida unilateral em paciente do sexo feminino, de 59 anos, com cerca de quatro anos de evolução, associada a episódios de erosões recorrentes do epitélio corneano. A paciente foi submetida à exerese cirúrgica da conjuntiva alterada, ceratectomia superficial e uso de mitomicina-C tópica no pós-operatório. O exame anatomopatológico confirmou o diagnóstico de melanose primária adquirida, com atipias nucleares discretas a moderadas. Um ano após a cirurgia, a paciente não apresentou novos episódios de erosões recorrentes do epitélio corneano, sendo mantida apenas com o uso noturno de pomada lubrificante.

A case report of a 59 years old woman who has had ocular primary melanosis for four years, associated with episodes of corneal epithelial recurrent erosions. The patient underwent resection of the affected conjunctiva, superficial keratectomy and topical mitomicin C after the surgery. The pathologic examination confirmed the diagnosis of primary acquired melanosis, with mild to moderate nuclear atypia. One year after the treatment, she had only a small area of pigmented epithelium located in the lower corneal surface, showing no tendency to progression. She used lubricant ointment at night and did not have other epithelial erosions during the follow-up period.

[Study of topical human umbilical cord blood serum in the treatment of alkaline corneal epithelial wounds in rabbit model]

One of the important functions of the cornea is to maintain normal vision by refracting light onto the lens and retina. This property is dependent in part on the ability of the corneal epithelium to undergo continuous renewal. Ocular surface failure which follows a variety of endogenous and exogenous precipitating factors, the most common being: chemical trauma, infection, alkaline burn, inflammation and hereditary conditions, lid or lash abnormalities tear deficiency or reduced sensation. The core principal underpinning management strategy for ocular surface failure is establishing or promoting new growth of healthy conjunctiva and corneal epithelium. This process is mediated by many proteins that are inducers of corneal cell migration, proliferation, and differentiation. The current study was performed to investigate the efficacy of umbilical cord serum on alkaline corneal epithelial wound healing in the rabbit model. In this study conducted at Yasuj University of Medical Sciences in 2010, thirty two rabbits were randomly assigned into two equal groups. Central corneal alkali wound was formed in one eye of the rabbits by applying a 6-mm round filter paper, soaked in 1 N NaOH, for 60 seconds. Group one of animals received umbilical cord blood serum; and group two received Sno Tear in the eyes. The treatment was dosed 4 times a day with the eye drops, and epithelial wound closure was recorded using slit lamp. The data were analyzed to determine the rate of wound closure. The mean wound radius closure rate was 0.77 mm/day [SD=0.013] for umbilical cord blood serum-treated eyes, 0.73 mm/day [SD=0.018] for artificial tear-treated eyes. This study shows that alkali-injured corneal epithelial wound heal faster when treated with umbilical cord blood serum than with artificial tear in rabbit model

Effects of mitomycin C on infiltration of polymorphonuclear leukocytes after epithelial scrape injury in the mouse cornea / Efeito da mitomicina C na infiltração de leucócitos polimorfonucleares após lesão epitelial em córnea de camundongo

PURPOSE: To determine whether mitomycin C (MMC) alters appearance and disappearance of polymorphonuclear leucocytes (PMN) in the cornea stroma, using an epithelial scrape injury in eye mouse model. METHODS: Twenty-mice underwent mechanical epithelium debridement in the central cornea using 20 percent ethanol. After the scrape, the right eye received 0.02 percent MMC for one minute, while the left eye received physiological saline. The animals were sacrificed on days 1, 2, 5, and 14 after surgery, and corneal whole mounts were prepared for histology. PMN distribution was analyzed in digitized microscope images. Cell division in the cornea was determined by immunohistochemical detection of bromodeoxyuridine (BrdU), which was injected intraperitoneally before the mice were sacrificed. RESULTS: Epithelial scrape injury triggered infiltration of PMNs into the corneal stroma. An analysis of PMN distribution revealed that there was no difference between eyes treated with and without MMC at all time points. BrdU labeling showed that 0.02 percent MMC for one minute blocked keratocyte proliferation completely. CONCLUSION: MMC treatment regimen, which is common in clinical practice, inhibits keratocyte proliferation during wound healing, but when used at 0.02 percent for one minute, it does not affect PMN infiltration into the corneal stroma, and subsequent movement toward the injury site, or the disappearance of PMNs from the stroma, in the mouse epithelial injury model.

OBJETIVO: O objetivo do estudo foi determinar se a mitomicina C (MMC) altera o aparecimento dos leucócitos polimorfonucleares (PMN) no estroma corneano após abrasão epitelial central, utilizando olhos de camundongo como modelo. MÉTODOS: Vinte camundongos foram submetidos à abrasão epitelial em córnea central utilizando etanol a 20 por cento. Após a lesão, o olho direito recebeu MMC a 0,02 por cento por 1 minuto, enquanto o olho esquerdo recebeu solução salina. Os animais foram sacrificados em 1, 2, 5 e 14 dias após a cirurgia e a córnea foi preparada para histologia. A distribuição dos PMN foi analisada e digitalizada em imagens microscópicas. A divisão celular na córnea foi detectada pela imuno-histoquímica da bromodeoxirudina (BrdU), injetada intraperitonialmente duas horas antes dos animais serem secrificados. RESULTADOS: A lesão epitelial gerou infiltração de PMN no estroma da córnea. A análise da distribuição dos PMNs revelou que não houve diferença estatisticamente significante entre os olhos tratados e não tratados com MMC, em todos os tempos estudados. O estudo com BrdU mostrou que a MMC quando utilizada a 0,02 por cento por um minuto bloqueou completamente a proliferação de ceratócitos. CONCLUSÃO: O tratamento com MMC, que é utilizada comumente na prática clínica, inibe a proliferação dos ceratócitos durante a cicatrização corneana, porém quando utilizada a 0,02 por cento por um minuto, não altera a infiltração dos PMNs dentro do estroma corneano após lesão epitelial em córneas de camundongos.

Efeito do mel e do soro autólogo na cicatrização do epitélio corneano em coelhos / Effect of honey and autologous serum on corneal epithelial healing in rabbits

OBJETIVO: Avaliar a eficácia de substâncias consideradas estimulantes da cicatrização, como o mel puro e o soro autólogo a 20 por cento na cicatrização do epitélio corneal de coelhos. MÉTODOS: Foi realizada a remoção do epitélio corneal de dois grupos de coelhos que receberam a instilação de solução de mel puro (G1) ou soro autólogo (G2) a cada 4 horas. O olho contralateral foi usado como controle e submetido ao mesmo procedimento de remoção do epitélio, recebendo a instilação de BSS®. A área de desepitelização corneal foi avaliada 12, 24 e 48 horas após a indução do defeito epitelial. RESULTADOS: Os grupos estudados foram estatisticamente semelhantes: mel (48 horas) e controle (48 horas) p<0,87; soro autólogo (48 horas) e controle (48 horas) p<0,072. CONCLUSAO: Mesmo constatando-se discreta melhora clínica no uso tópico do soro autólogo, a cicatrização do epitélio corneal não foi significativamente diferente durante este estudo em nenhum dos grupos estudados.

Collagen corneal shields

Our clinical experience is that the collagen shield works well in promoting epithelial healing, while providing adequate prophylaxis against infection. It is more effective in the treatment of acute epithelial erosions and holds great promise in drug delivery to the cornea and anterior chamber