ABSTRACT
ABSTRACT Ligneous conjunctivitis is a rare form of chronic and recurrent bilateral conjunctivitis, in which thick membranes develop on the tarsal conjunctiva and on other mucosae. We report the case of a 55-year old female patient with bilateral ligneous conjunctivitis who was successfully treated with 50% heterologous serum. There was no recurrence or side effects after one-year follow-up. We suggest the use of 50% heterologous serum should be further studied to better determine its efficacy as a treatment option for ligneous conjunctivitis.
RESUMO A conjuntivite lenhosa é uma forma rara de conjuntivite bilateral crônica e recorrente, na qual há formação de membranas espessas na conjuntiva tarsal e em outras mucosas. Relatamos o caso de uma paciente de 55 anos com conjuntivite lenhosa bilateral, que obteve sucesso no tratamento com soro heterólogo em concentração de 50%. Não houve recorrência após um ano de seguimento e nem efeitos colaterais ao tratamento. Dessa forma, o uso de soro heterólogo a 50% poderia ser mais estudado para melhor avaliação de sua eficácia como opção de tratamento para a conjuntivite lenhosa.
Subject(s)
Humans , Female , Plasminogen/deficiency , Serum , Plasminogen/therapeutic use , Skin Diseases, Genetic/pathology , Treatment Outcome , Conjunctivitis/pathology , Middle AgedABSTRACT
ABSTRACT Rothmund-Thomson syndrome (RTS) is a rare dermatosis with about 300 cases reported to date. The authors describe two siblings with RTS and inflammatory conjunctival disease featuring fornix shortening and symblepharon as well as palpebral disease with sparse eyelashes. These cases demonstrate RTS ocular surface findings different to those usually described.
RESUMO A síndrome de Rothmund-Thomson (SRT) é uma dermatose rara com cerca de 300 casos reportados. Os autores descrevem dois irmãos com síndrome de Rothmund-Thomson e doença inflamatória conjuntival com encurtamento do fundo de saco e simbléfaro, assim como doença palpebral com escassez de cilíos. Ambos os casos demonstram achados da superfície ocular diferentes dos habitualmente descritos.
Subject(s)
Humans , Male , Female , Adult , Rothmund-Thomson Syndrome/pathology , Conjunctivitis/pathology , Eyelid Diseases/pathology , Tissue Adhesions , Conjunctiva/pathology , Eyelashes/pathologyABSTRACT
ABSTRACTA 6-month-old female infant presented to our clinic with bilateral eyelid swelling, yellowish-white membranes under both lids, and mucoid ocular discharge. Her aunt had similar ocular problems that were undiagnosed. The conjunctival membranes were excised and histopathological investigation of these membranes showed ligneous conjunctivitis. Further, laboratory examination revealed plasminogen deficiency. A good response was observed to topical fresh frozen plasma (FFP) treatment without systemic therapy, and the membranes did not recur during the treatment. Topical FFP treatment may facilitate rapid rehabilitation and prevent recurrence in patients with ligneous conjunctivitis.
RESUMOUma criança feminina com seis meses de idade se apresentou à nossa clínica com edema palpebral bilateral, membranas brancas amareladas sob as pálpebras de ambos os olhos e descarga mucosa. Sua tia já havia apresentado problemas oculares semelhantes que não foram diagnosticados. As membranas conjuntivais foram excisadas e a investigação histopatológica das membranas demonstraram conjuntivite lenhosa. O diagnóstico de deficiência de plasminogênio foi obtido a partir de um exame laboratorial. Tratamento tópico com plasma fresco congelado (FFP) sem qualquer terapia sistêmica mostrou boa resposta. Não foram observadas recorrências das membranas. O tratamento tópico com FFP pode ajudar a reabilitação rápida e prevenir a recorrência em pacientes com conjuntivite lenhosa.
Subject(s)
Female , Humans , Infant , Administration, Ophthalmic , Conjunctivitis/therapy , Ophthalmic Solutions/administration & dosage , Plasma , Plasminogen/deficiency , Skin Diseases, Genetic/therapy , Conjunctivitis/pathology , Skin Diseases, Genetic/pathology , Treatment OutcomeABSTRACT
11 years old girl, from south region of Chile, without history of travels outside Chile nor the province, complaints of red eye with blepharitis and blood-tingued epiphora. Eye exam revealed a pseudomembrane. Clinical diagnosis was folicular conjunctivitis. A surgical removal was performed and the lesion sent to biopsy analysis. On microscopic examination numerous 50-150 μm cysts with keratinous wall and numerous endospores were found. Rinosporidiosis is an infection caused by Rhinosporidium seeberi that frecuently affects nasal cavity but could infect eye, urogenital tract and airways. This infections is considered endemic in Asia and Africa, but it is very important to have the suspicious among polyps in these areas because travel to endemic areas is become more frecuently.
Escolar de 11 años, de sexo femenino, proveniente de la Región del Bío-Bío, sin antecedentes de viajes, consultó por ojo rojo, blefaritis y epífora sanguinolenta; al examen oftalmológico reveló una pseudomembrana. La sospecha clínica fue de una conjuntivitis folicular. Se realizó la remoción quirúrgica de la lesión y en el estudio histopatológico se observaron lesiones características de rinosporidiosis, correspondiente a quistes de 50-150 μm con pared quitinosa y numerosas endosporas. La rinosporidiosis es una infección causada por Rhinosporidium seeberi, que afecta con mayor frecuencia la cavidad nasal, pero puede también afectar el ojo, aparato urogenital y la vía aérea, entre otros. Es considerado endémico en países de Asia y África, pero dado el aumento de viajes a estas regiones es importante reconocer este agente como causal de pólipos en la zona nasal y ocular.
Subject(s)
Child , Female , Humans , Conjunctivitis/pathology , Eye Infections, Parasitic/pathology , Rhinosporidiosis/pathology , Conjunctivitis/surgery , Eye Infections, Parasitic/surgery , Rhinosporidiosis/surgeryABSTRACT
PURPOSE: Recently, conjunctivochalasis repair surgery using electrocauterization has been gaining popularity. However, patients with electrocauterized conjunctivoplasty tend to complain of more postoperative pain than patients undergoing simple excision with suturing. Therefore, we investigated the effects of electrocauterization on inflammation of the conjunctiva using an experimental animal model and compared these with the effects of simple excision with suturing. METHODS: Ten New Zealand white rabbits underwent cauterization in the right eyes and excision and suturing in the left eyes. For each eye, we excised or electrocauterized the inferior bulbar conjunctiva, 1 mm in width and 6 mm in length, 2 mm from the limbus. A fine-needle electrode was inserted subconjunctivally, and electrocauterization was performed. In the contralateral eye, the corresponding area was excised and re-approximated with 10-0 nylon sutures. Sutures were removed after 14 days. Tissue samples were obtained at 21 days post-procedure, and inflammatory cells were counted in five randomly selected fields (x200) on hematoxylin-eosin stained slides. Tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta concentrations in tears were measured using enzyme linked immunosorbent assays. RESULTS: All cauterized eyes demonstrated smooth surface healing without scarring after 5 days, whereas sutured eyes presented with mild edema with some scarring until the suture was removed. The number of inflammatory cells was significantly greater in sutured eyes compared with cauterized eyes (p = 0.035, Mann-Whitney U-test) at 21 days post-procedure. Tear TNF-alpha and IL-1beta concentrations at 21 days were similar in both groups. CONCLUSIONS: Electrocauterization for conjunctivoplasty seems to be advantageous in terms of inflammation compared with simple suturing and excision.
Subject(s)
Animals , Humans , Male , Rabbits , Conjunctiva/pathology , Conjunctivitis/pathology , Disease Models, Animal , Edema/pathology , Electrocoagulation/methods , Pain, Postoperative/pathology , Suture Techniques , Treatment OutcomeABSTRACT
PURPOSE: To compare the frequency of conjunctival HLA-DR expression (a surrogate marker for inflammation) in eyes treated with topical prostaglandin analogues versus eyes treated with other topical antiglaucomatous drugs. METHODS: Patients diagnosed with primary open-angle glaucoma presenting indication for trabeculectomy were divided in groups according to the use or not of prostaglandin analogues. All subjects were treated with the maximum tolerated dose of antiglaucomatous drugs until the date of the surgery. At the beginning of the surgical procedure, a 5 x 5 mm biopsy of the bulbar conjunctiva was collected, incubated with monoclonal anti-HLA-DR antibody and processed for histological analysis. RESULTS: Of the 31 eyes included (31 patients), 25 were under topical prostaglandin analogues (Group 1) and six under other topical pharmacological agents (Group 2). Fourteen eyes of Group 1 (56%) and three of Group 2 (50 %) were positive for the inflammatory marker HLA-DR (P=1.0). The percentage of stained cells ranged from 15.49 to 48.09% (median: 27.61) in Group 1, and from 18.35 to 28 (median: 20.71) in Group 2, with no differences statistically significant (p=0.33). CONCLUSION: The use of prostaglandin analogues did not increase conjunctival expression of HLA-DR compared to other topical antiglaucomatous agents.
OBJETIVO: Comparar a frequência da expressão conjuntival de HLA-DR (marcador inflamatório) em olhos tratados com análogos de prostaglandinas de uso tópico com a frequência em olhos tratados com outros medicamentos. MÉTODOS: Pacientes com glaucoma primário de ângulo aberto apresentando indicação de trabeculectomia foram agrupados segundo o uso ou não de análogos de prostaglandinas. Todos os participantes foram tratados com medicação máxima tolerada até o momento da cirurgia. Ao início do procedimento cirúrgico, uma biópsia de 5 x 5 mm da conjuntiva bulbar foi coletada, incubada com anticorpo monoclonal anti-HLA-DR e processada para análise histológica RESULTADOS: Dentre os 31 olhos incluídos (31 pacientes), 25 estavam em uso de análogos de prostaglandinas (Grupo 1) e seis em uso de outros agentes antiglaucomatosos (Grupo 2). Quatorze olhos do Grupo 1 (56%) e três do Grupo 2 (50%) apresentaram positividade para o marcador HLA-DR (p=1,0). A porcentagem de células coradas variou de 15,49 a 48,09% (mediana: 27,61%) no Grupo 1 e de 18,35 a 28% (mediana: 20,71%) no Grupo 2, com diferenças não estatisticamente significativas (p=0,33). CONCLUSÃO: O uso de análogos de prostaglandinas não aumenta a expressão conjuntival de HLA-DR comparado com outros medicamentos tópicos para o tratamento de glaucoma.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Conjunctiva/drug effects , Conjunctivitis/chemically induced , Glaucoma/drug therapy , HLA-DR Antigens/analysis , Prostaglandins, Synthetic/adverse effects , Administration, Ophthalmic , Analysis of Variance , Biopsy , Biomarkers/analysis , Conjunctiva/pathology , Conjunctivitis/pathology , Glaucoma/surgery , Prostaglandins, Synthetic/therapeutic useABSTRACT
We report a case of unilateral conjunctival ulcer due to Stenotrophomonas maltophilia infection in an immunocompetent individual. A 44-year-old male presented with complaints of pain and yellowish discharge in the right eye for one week. Patient underwent complete ophthalmic evaluation and relevant laboratory investigations. Anterior segment examination revealed localized conjunctival and episcleral congestion with conjunctival ulceration on the bulbar conjunctiva in the right eye. Gram's stain revealed gram-negative bacilli. Culture and sensitivity revealed S. maltophilia and responded well to topical moxifloxacin with systemic co-trimoxazole therapy.
Subject(s)
Adult , Anti-Infective Agents/therapeutic use , Aza Compounds/therapeutic use , Conjunctivitis/drug therapy , Conjunctivitis/microbiology , Conjunctivitis/pathology , Gram-Negative Bacterial Infections/complications , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/pathology , Humans , Male , Quinolines/therapeutic use , Stenotrophomonas maltophilia/isolation & purification , Ulcer/drug therapy , Ulcer/microbiology , Ulcer/microbiologyABSTRACT
Os autores discutem as várias teorias etiológicas e possibilidades terapêuticas da conjuntivite lenhosa. Apresentam um caso da patologia, e sua evoluçäo favorável com uso de ciclosporina, hialuronidase e cromoglicato dissódico
Subject(s)
Humans , Male , Infant , Conjunctivitis/etiology , Conjunctivitis/drug therapy , Conjunctivitis/pathologyABSTRACT
Num estudo laboratorial realizado em pacientes com conjuntivite crônica o agente encontrado em 40 por cento dos casos foi o estáfilococo. 20 por cento dos casos estavam contaminados com Clamidia e os restantes foram divididos entre micro-organismos. Para o diagnóstico da Clamidia o exame mais confiável é a imunofluorescência direta. Na presença de uma conjuntivite crônica o exame clínico deve ser completamentado pela cultura, citologia, exame anótomo patológico e métodos de imunologia
Subject(s)
Humans , Male , Female , Child , Adult , Conjunctivitis/diagnosis , Conjunctivitis/drug therapy , Conjunctivitis/immunology , Conjunctivitis/pathology , Conjunctivitis/therapy , Eye Infections , Eye Infections, Bacterial/diagnosis , Eye Infections, Bacterial/drug therapy , Eye Infections, Bacterial/therapyABSTRACT
La citología exfoliativa es un procedimento diagnóstico rápido, confiable y simple con un amplio campo en la Oftalmología. No es un método nuevo, pero cada día es mejor reconocida su aplicación y utilidad en la clínica oftalmológica. Este procedimiento está indicado en las úlceras corneales, conjuntivitis, tumores de las túnicas externas del ojo, en ciertos tumores intraoculares y en padecimientos inmunes e inflamatorios de las estructuras oculares. Este método es de gran ayuda en el diagnóstico y tratamiento, ya que está al alcance de cualquier oftalmólogo. Aunque este método no requiere de equipo especializado y costoso, es necesario tener en mente que el patólogo debe tener entrenamiento en citología ocular y patología ocular, puesto que en el globo ocular existen algunos cuadros clinicopatológicos que no tienen representación en otro sitio del organismo
Subject(s)
Humans , Conjunctivitis/pathology , Cytological Techniques , Eye Neoplasms/pathology , Corneal Ulcer/pathologyABSTRACT
Se reporta un paciente afectado simultaneamente de actinoreticulosis (AR) y conjuntivitis exuberante pigmentada (CEP), afecciones que de modo aislado son de observación relativamente frecuentes en las zonas más altas del territorio boliviano. Esta asociación patológica apoyaría el origen actínico de la CEP, en tanto que para la AR tal orígen no ofrece duda. Se describen las características más importantes de ambas afecciones, estableciendose la diferención de la CEP con la denominada conjuntivitis primaveral. A la luz de esta asociación y de casos semejantes de CEP en el curso de otras fotodermatosis, creemos apropiado considerar esta lesión ocular, al menos por el momento, como la única alteración extracutánea y un signo más en el especto clínico de las fotodermatosis "de altura"