ABSTRACT
Objetivo: Caracterizar el diagnóstico de infección ocular por virus herpes simples (HSV) en un grupo de niños chilenos, mediante el estudio clínico y de laboratorio virológico. Métodos: La población estudiada comprendió niños menores de 15 años, con diagnóstico clínico de herpes ocular, que fueron atendidos por los autores y un grupo de oftalmólogos entrenados especialmente para el estudio. Junto con detallar el tipo de infección herpética, a todos los pacientes se les tomaron muestra para estudio virológico que incluyó estudio de cultivos celulares y posteriormente técnica de reacción en cadena de polimerasa (PCR), con el fin de tipificar las cepas y características genómicas del virus infectante. Resultados: El estudio enroló 18 niños, cuyas edades fluctuaron entre los 40 días y 13 años, con una media de 6 años. De las formas clínicas observadas, la más frecuentes fueron la blefaritis y la queratitis dendrítica constituyendo en 27 y 22 por ciento de los casos, respectivamente. El diagnóstico de HSV fue confirmado en 15 de 18 pacientes, constituyendo un 83 por ciento de positividad. 14 de 15 casos correspondieron a HSV tipo 1, y en un niño se diagnóstico infección por HSV tipo 2. Los antecedentes clínicos de este caso confirmaron que se trataba de una infección perinatal, lo que permitió instaurar el tratamiento en forma oportuna. El estudio permitió identificar un caso de excreción ocular viral asintomática, lo que sumando a un cuadro de recurrencias múltiples obligó a indicar terapia profiláctica permanente con aciclovir. Conclusiones: La blefaritis y queratitis herpética constituyeron en conjunto el 70 por ciento de los casos. El rendimiento celular y PCR fue elevado en los casos con alto índice de replicación viral, como la queratitis y blefaritis. En los casos con menor replicación, como queratitis estromal o conjuntivitis, el estudio PCR demostró una mayor sensibilidad que el estudio en cultivo celular. La presencia de un caso de infección perinatal por HSV-2 pudiera ser indicativo de un aumento en la frecuencia de esta forma de presentación.
Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Genome, Viral , Keratitis, Herpetic/classification , Keratitis, Herpetic/diagnosis , Keratitis, Herpetic/epidemiology , Keratitis, Herpetic/virology , Simplexvirus/isolation & purification , Simplexvirus/genetics , Blepharitis/virology , Chile , Polymerase Chain Reaction , Keratitis, Dendritic/virology , Corneal Ulcer/virologyABSTRACT
BACKGROUND: Herpes simplex virus (HSV) infection of the cornea is a leading cause of blindness in occidental countries and a common recurrent manifestation of it is the immune stromal keratitis (ISK). However, it is not known whether active viral replication occurs during the acute phase of the disease, because isolation of the virus by conventional culture techniques has not been accomplished. AIM: To establish the presence of HSV in patients with ISK. MATERIAL AND METHODS: Fourteen corneal swabbing samples, from active diseased eyes of patients with clinical diagnosis of ISK, were submitted to Herpchek and PCR for the identification of HSV antigens and genome. RESULTS: All ISK samples were negative by both techniques. CONCLUSIONS: It was not possible to identify HSV antigens nor their genome by the methodology used. It is likely that, they can't be detected in corneal superficial layers or probably there is no viral replication at this stage of the disease, so antiviral therapy should be reconsidered.
Subject(s)
Keratitis, Herpetic/virology , Simplexvirus/genetics , Simplexvirus/immunology , Acute Disease , Adolescent , Adult , Antigens, Viral/analysis , Child , Child, Preschool , Chronic Disease , Corneal Stroma/virology , Female , Genome, Viral , Humans , Male , Middle Aged , Polymerase Chain Reaction , Severity of Illness IndexABSTRACT
BACKGROUND: Herpetic keratitis is the main infectious cause of corneal opacity. The existence of effective antiviral agents underscores the need of an early diagnosis. AIM: To correlate clinical features of herpetic keratitis with virological studies. PATIENTS AND METHODS: Forty one patients with a clinical diagnosis of herpetic keratitis were studied. Viral isolation, polymerase chain reaction (PCR) and typification were done in a sample taken by swabbing the ocular lesion. RESULTS: Twenty six patients (31% female) had epithelial keratitis, that was mild or moderate in 88% of cases and acute in 77% of them. In 20 patients (77%), viral isolation and PCR were positive (HSV-2 in one case). Fifteen patients (67% female) had stromal keratitis, 93% of cases were moderate or severe and 53% were acute. Viral isolation was negative in all cases and in 20% PCR was positive. CONCLUSIONS: Viral isolation and PCR were equally sensitive in epithelial keratitis, but in stromal keratitis only PCR could detect the virus. Moderate acute dendrite was the predominant clinical manifestation. The higher proportion of women with stromal keratitis supports its possibly autoimmune etiology. HSV-2 is seldomly isolated and possibly associated to vertical transmission.
Subject(s)
Keratitis, Herpetic/virology , Simplexvirus/isolation & purification , Acute Disease , Adolescent , Adult , Aged , Child , Child, Preschool , Chronic Disease , Female , Humans , Infant , Keratitis, Herpetic/diagnosis , Male , Middle Aged , Polymerase Chain Reaction , Predictive Value of Tests , Simplexvirus/geneticsABSTRACT
One hundred and twelve primary posterior chamber intraocular lens implants from a series of 560 eyes operated on at the Eye Service of Hospital Salvador in Santiago, Chile, were analyzed to determine the postoperative visual acuity. The follow up time varied between 3 and 26 months. Lenses were implanted by experienced ophthalmologists and residents in training. Visual acuity was 0.5 or better in 79.5% of cases. The postoperative visual acuity varied with age, being worse in patients over 70 years old.
Subject(s)
Cataract Extraction/methods , Lenses, Intraocular , Adult , Age Factors , Aged , Aged, 80 and over , Cataract Extraction/statistics & numerical data , Chile , Female , Follow-Up Studies , Hospitals, Teaching , Humans , Male , Middle Aged , Prognosis , Sex FactorsABSTRACT
Between June 1983 and September 1987, 2799 disability pensions were given in the East Santiago Area, population 676,269. Of them, 222 (7.9%) were due to ophthalmological causes. Blindness as defined by the WHO was present in 57 cases. It was caused by myopia (33%), glaucoma (21%), diabetic retinopathy (9.8%), retinal detachment, cataract and optic atrophy (5.2%) and ocular trauma (3.5%).
Subject(s)
Blindness/etiology , Pensions , Adult , Age Factors , Aged , Blindness/epidemiology , Chile/epidemiology , Disability Evaluation , Female , Glaucoma/complications , Humans , Male , Middle Aged , Myopia/complications , Retinal Diseases/complications , Retrospective Studies , Sex FactorsABSTRACT
A series of 114 penetrating corneal transplants performed in a public hospital in Santiago de Chile by the first author is reported. The first cause of corneal grafting was herpes simplex keratitis (37%), the second keratoconus (22%). Signs of rejection were observed in 32.5% of the grafts and of these, 32% lost transparency. Graft clarity was good in 74% of the grafts and poor in 17.5%. Poor transparency was due to graft rejection in 65% of the cases. Phakic eyes had good transparency in 81% of cases and aphakic eyes only in 48%. Preoperatively the visual acuity was 0.1 or less in 79% of cases and post-operatively it was better than 0.5 in 50% and better than 0.1 in 82% of the cases. The mean postoperative astigmatism was 4.4 diopters. Results in graft clarity were classified according to preoperative prognosis.
Subject(s)
Corneal Transplantation/methods , Adolescent , Adult , Age Factors , Aged , Child , Child, Preschool , Chile/epidemiology , Corneal Transplantation/classification , Corneal Transplantation/statistics & numerical data , Female , Follow-Up Studies , Humans , Infant , Male , Middle Aged , Postoperative Complications/epidemiology , Sex Factors , Visual AcuityABSTRACT
Twenty-six eyes in 16 patients with aphakic peripheral corneal edema showed most of the signs described in 1969 by Brown and McLean in a syndrome they called "peripheral corneal edema after cataract extraction," consisting mainly of aphakia, marginal corneal edema, and discrete orange punctate pigmentation of the endothelial surface of the edematous areas. The syndrome was observed in 21 eyes after intracapsular cataract extraction, in three eyes after extracapsular surgery, and in two eyes with spontaneous absorption of the lens. In one case the spontaneous absorption of the lens was attributable to trauma, and in the other it was seen in association with congenital rubella syndrome. There was a high incidence of myopia (61%) in the affected eyes in this series.
Subject(s)
Cataract Extraction/adverse effects , Corneal Diseases/etiology , Edema/etiology , Adult , Aged , Cornea/pathology , Corneal Diseases/pathology , Edema/pathology , Female , Humans , Male , Middle Aged , SyndromeABSTRACT
Se presentan los hallazgos clinicos e histologicos de una degeneracion esferoidal bilateral en banda en una paciente de 49 anos portadora de una ictiosis vulgar congenita. No sabemos que la conjuncion de ambas afecciones haya sido descrita en la literatura. Se analizan las posibles causas y las caracteristicas clinicas de la degeneracion esferoidal de la cornea y de la conjuntiva. Se postula que la perdida de cejas y pestanas provocada por la ictiosis haya hecho mas vulnerable las corneas a la radiacion ultravioleta y desencadenado con ello la degeneracion esferoidal
Subject(s)
Middle Aged , Humans , Female , Corneal Diseases , Conjunctival Diseases , IchthyosisSubject(s)
Adrenal Gland Neoplasms/pathology , Neoplasms, Multiple Primary/pathology , Neuroma/pathology , Pheochromocytoma/pathology , Adrenal Gland Neoplasms/diagnosis , Adult , Carcinoma/diagnosis , Carcinoma/pathology , Cornea/pathology , Female , Humans , Neoplasms, Multiple Primary/diagnosis , Pheochromocytoma/diagnosis , Thyroid Neoplasms/diagnosis , Thyroid Neoplasms/pathology , Tomography, X-Ray Computed , Tongue Neoplasms/pathologyABSTRACT
Se analiza el cuadro de la neoplasia endocrina multiple tipo II-B constituido por carcinoma medular del tiroides, feocromocitomas y neuromas mucosos multiples. El hallazgo oftalmologico mas relevante, y que puede conducir al diagnostico, es la hipertrofia de los nervios corneales. En el ojo tambien puede encontrarse neuromas de la conjuntiva bulbar y palpebral, y queratoconjuntivitis sicca. Se presentan 4 casos clinicos de NEM tipo II-B que constituyen los primeros en la literatura medica nacional. Como hallazgos no descritos previamente en la literatura destacan la marcada hipoestesia corneal presente en los 2 pacientes examinados por el autor, y las microcorneas y papila inclinada que presentaba uno de los pacientes y cuya significacion en este sindrome se desconoce
Subject(s)
Corneal Diseases , Pheochromocytoma , Thyroid NeoplasmsABSTRACT
Patients with active dendritic herpetic keratitis that was unresponsive to topical idoxuridine or vidarabine therapy were treated topically with a 1% solution of trifluridine. The dendritic ulcers healed in an average time of 6.1 days. All patients tolerated the drug well except for one patient in whom a reversible crystalline epithelial keratitis developed.
