ABSTRACT
PURPOSE: A 66-year-old woman presented with a 1-month history of prominent mucoid discharge and foreign body sensation in her left eye. METHODS: Ocular evaluation revealed a moderately severe superficial punctate keratitis involving the temporal half of the left cornea. The superior tarsal conjunctiva showed marked papillary reaction with an area of indentation temporally. A mass was present in the superior temporal aspect of the fornix, clinically resembling a pyogenic granuloma. At the posterior aspect of this mass and covered by mucoid material, was a soft contact lens. RESULTS: Upon removal of the lens, without any additional therapy, the patient became asymptomatic and totally resolved her keratitis and mass lesion. Cultural identification of the soft contact lens was positive for Aspergillus fumigatus. CONCLUSIONS: We hypothesize that the mucoid discharge and mass lesion represented a mechanism similar to allergic fungal sinusitis.
Subject(s)
Aspergillosis/etiology , Conjunctival Diseases/microbiology , Contact Lenses, Hydrophilic/adverse effects , Eye Infections, Fungal/microbiology , Keratoconjunctivitis/microbiology , Prosthesis-Related Infections/etiology , Aged , Aspergillus fumigatus/growth & development , Aspergillus fumigatus/isolation & purification , Contact Lenses, Hydrophilic/microbiology , Cornea/microbiology , Cornea/pathology , Equipment Contamination , Female , Follow-Up Studies , Granuloma, Pyogenic/microbiology , Humans , Immunocompromised HostABSTRACT
PURPOSE: To evaluate the effect of substituting topical cyclosporin A 0.5% for topical corticosteroids in patients with postkeratoplasty glaucoma. METHODS: Topical cyclosporin A 0.5% was prospectively substituted for topical corticosteroids to treat 25 patients with postkeratoplasty glaucoma. RESULTS: Twenty-one (84%) of 25 patients showed a reduction in intraocular pressure (IOP) (range, 1-22 mm Hg; mean, 8.7 mm Hg). Follow-up ranged from 3 to 12 months (mean, 5.8). Graft clarity was maintained in all patients, with one allograft rejection episode. Thirteen patients were able to discontinue one or more glaucoma medication(s). CONCLUSION: Topical cyclosporin A 0.5% may be substituted for topical corticosteroids to aid in the management of postkeratoplasty patients with glaucoma. However, the resultant decrease in IOP may be associated with an increased risk for immune rejections.
Subject(s)
Cyclosporine/therapeutic use , Glaucoma/drug therapy , Immunosuppressive Agents/therapeutic use , Keratoplasty, Penetrating/adverse effects , Postoperative Complications/drug therapy , Administration, Topical , Adult , Aged , Aged, 80 and over , Cyclosporine/administration & dosage , Dose-Response Relationship, Drug , Female , Follow-Up Studies , Glaucoma/etiology , Glucocorticoids/administration & dosage , Glucocorticoids/therapeutic use , Humans , Immunosuppressive Agents/administration & dosage , Intraocular Pressure/drug effects , Male , Middle Aged , Ophthalmic Solutions , Postoperative Complications/etiology , Risk Factors , Treatment OutcomeABSTRACT
Chloro-aluminum sulfonated phthalocyanine (CASPc) is a photoactive dye capable of generating photochemical reactions when excited with 675 nm light. We used CASPc to produce photochemical closure of retinal medullary ray vessels and choroidal vessels in normal rabbits. Irradiation prior to CASPc injection produced no photographic, angiographic, or histologic lesions in any eyes. Identical irradiation of medullary ray and choroidal vessels after CASPc injection produced complete vessel closure in all eyes. Histopathologic examination showed marked thrombosis of medullary ray and choroidal vessels, with minimal damage to contiguous tissues including the neurosensory retina. We conclude that CASPc can produce profound closure of normal retinal and choroidal vessels with minimal deleterious effect on surrounding tissues.
