- [Theodor Leber's first description of conjunctivitis petrificans (1895, 1900)]. [JOURNAL ARTICLE]
- Ophthalmologe 2016 Aug 18.
- Demodex musculi Infestation in Genetically Immunomodulated Mice. [Journal Article]
- Comp Med 2016; 66(4):278-85.
Demodex musculi, a prostigmatid mite that has been reported infrequently in laboratory mice, has been identified with increasing frequency in contemporary colonies of immunodeficient mice. Here we describe 2 episodes of D. musculi infestation with associated clinical signs in various genetically engineered mouse strains, as well as treatment strategies and an investigation into transmissibility and host susceptibility. The first case involved D. musculi associated with clinical signs and pathologic lesions in BALB/c-Tg(DO11.10)Il13(tm) mice, which have a defect in type 2 helper T cell (Th2) immunity. Subsequent investigation revealed mite transmission to both parental strains (BALB/c-Tg[DO11.10] and BALB/c-Il13(tm)), BALB/c-Il13/Il4(tm), and wild-type BALB/c. All Tg(DO11.10)Il13(tm) mice remained infested throughout the investigation, and D. musculi were recovered from all strains when they were cohoused with BALB/c-Tg(DO11.10)Il13(tm) index mice. However, only Il13(tm) and Il13/Il4(tm) mice demonstrated persistent infestation after index mice were removed. Only BALB/c-Tg(DO11.10)Il13(tm) showed clinical signs, suggesting that the phenotypic dysfunction of Th2 immunity is sufficient for persistent infestation, whereas clinical disease associated with D. musculi appears to be genotype-specific. This pattern was further exemplified in the second case, which involved NOD.Cg-Prkdc(scid)Il2r(tm1Wjl)/SzJ (NSG) and C;129S4 Rag2(tm1.1Flv) Il2rg(tm1.1Flv)/J mice with varying degrees of blepharitis, conjunctivitis, and facial pruritis. Topical amitraz decreased mite burden but did not eliminate infestation or markedly ameliorate clinical signs. Furthermore, mite burden began to increase by 1 mo posttreatment, suggesting that topical amitraz is an ineffective treatment for D. musculi. These experiences illustrate the need for vigilance regarding opportunistic and uncommon pathogens in rodent colonies, especially among mice with immunologic deficits.
- Ocular Onset of Paraneoplastic Pemphigus Presenting as Hyperemic Conjunctivitis and Massive Bilateral Eyelid Ulceration: A Case Report and Literature Review. [JOURNAL ARTICLE]
- Ocul Immunol Inflamm 2016 Aug 18.:1-4.
Paraneoplastic clinical signs are characterized by a large and heterogeneous variety of manifestations due to several possible underlying neoplasms. Paraneoplastic pemphigus (PNP) is a particular paraneoplastic variety that usually primarily affects the dermic and/or oral mucosa and is characterized by a high rate of mortality (90%). Therefore, it is important to recognize its possible signs early. This report describes a case of ocular paraneoplastic pemphigus (PNP) presenting with recalcitrant eyelid ulceration and hyperemic conjunctivitis caused by an undiagnosed prostate cancer.A 77-year-old man was admitted to our department because of recalcitrant hyperemic conjunctivitis in both eyes, complicated with large ulceration of both upper eyelids in spite of topical therapy. After 3 weeks, oral mucositis and bullous dermatitis on the chest and arms developed.Complete slit lamp ocular study, conjunctival swabs, routine hematologic tests, serum neoplasm markers, indirect immunofluorescence study, immunoblotting, and oral mucose biopsy with direct immunofluorescence were performed under the hypothesis of a paraneoplastic sign. Total body computed tomography scan and ultrasound-guided needle prostate biopsy completed the diagnostic process and confirmed the diagnosis of prostate PNP. Complete remission of ocular clinical signs was achieved by treatment of the prostate malignancy with systemic immunosuppressive therapy and chemotherapy.
- Autochthonous Chikungunya Fever in Traveler Returning to Japan from Cuba. [Letter]
- Emerg Infect Dis 2016 Sep; 22(9):1683-5.
- Phylodynamic Characterization of an Ocular-Tropism Coxsackievirus A24 Variant. [Journal Article]
- PLoS One 2016; 11(8):e0160672.
Recent phylodynamic studies have focused on using tree topology patterns to elucidate interactions among the epidemiological, evolutionary, and demographic characteristics of infectious agents. However, because studies of viral phylodynamics tend to focus on epidemic outbreaks, tree topology signatures of tissue-tropism pathogens might not be clearly identified. Therefore, this study used a novel Bayesian evolutionary approach to analyze the A24 variant of coxsackievirus (CV-A24v), an ocular-tropism agent of acute hemorrhagic conjunctivitis. Analyses of the 915-nucleotide VP1 and 690-nt 3Dpol regions of 21 strains isolated in Taiwan and worldwide during 1985-2010 revealed a clear chronological trend in both the VP1 and 3Dpol phylogenetic trees: the emergence of a single dominant cluster in each outbreak. The VP1 sequences included three genotypes: GI (prototype), GIII (isolated 1985-1999), and GIV (isolated after 2000); no VP1 sequences from GII strains have been deposited in GenBank. Another five genotypes identified in the 3Dpol region had support values >0.9. Geographic and demographic transitions among CV-A24v clusters were clearly identified by Bayes algorithm. The transmission route was mapped from India to China and then to Taiwan, and each prevalent viral population declined before new clusters emerged. Notably, the VP1 and 3Dpol genes had high nucleotide sequence similarities (94.1% and 95.2%, respectively). The lack of co-circulating lineages and narrow tissue tropism affected the CV-A24v gene pool.
- Case report: Providencia stuartii conjunctivitis. [Letter]
- J Ophthalmic Inflamm Infect 2016 Dec; 6(1):29.
The purpose of this study is to report a case of Providencia stuartii conjunctivitis.This study is a retrospective chart review of a patient with persistent conjunctivitis.We report the first case of P. stuartii conjunctivitis. Our patient was an elderly man living in a nursing home who was likely immunocompromised from longstanding diabetes mellitus. A conjunctival swab culture was able to identify the infecting bacteria and its antibiotic susceptibility. The conjunctivitis was successfully treated with vancomycin drops and oral sulfamethoxazole and trimethoprim.P. stuartii is an increasingly common bacterium found in the urine of immunocompromised nursing home residents with indwelling Foley catheters. While it has rarely been found to cause ocular infections, P. stuartii may be suspected in elderly, immunocompromised nursing home residents.
- The effects of povidone iodine (pH 4.2) on patients with adenoviral conjunctivitis. [Journal Article]
- J Pak Med Assoc 2016 Aug; 66(8):968-70.
To compare the efficacy of classical treatment and povidone-iodine treatment for adenoviral conjunctivitis.This retrospective study was conducted at the Centre of Marmara Eye Health, Sakarya, Turkey, between January 2011 and February 2014, and comprised adult patients suffering from adenoviral conjunctivitis. The participants were randomly divided into two groups. Group I was given povidone-iodine solution while Group II was given the classical treatment and was taken as control. Povidone-iodine treatment was administered as three drops three times per day. The classical treatment comprised three drops of trifluorothymidine three times per day. Treatment were continued for two weeks. The patients who had not recovered in this time frame were defined as 'late recovering' patients. SPSS 23 was used for data analysis.Of the 112 participants, there were 56(50%) in each group. In Group I, 54(96.4%) patients recovered in two weeks, while 2(3.6%) took more time. In Group II, 33(58.9%) patients recovered in two weeks while 23(41.1%) took more time (p<0.001). Overall, 92(82.1%) patients had familial transmission-contamination.A new treatment protocol of povidone-iodine was used safely in patients with adenoviral conjunctivitis. Familial transmission was found very important to adenoviral conjunctivitis infection.
- Efficacy of moxidectin 2.5% and imidacloprid 10% in the treatment of ocular thelaziosis by Thelazia callipaeda in naturally infected dogs. [Journal Article]
- Vet Parasitol 2016 Aug 30.:118-21.
Thelazia callipaeda (Spirurida, Thelaziidae) has been documented as agent of ocular infection in domestic animals (dogs and cats), wildlife (e.g., foxes, hares, rabbits), and humans. In the last two decades, this parasitosis has been increasingly reported in several European countries. Both adult and larval stages of the eyeworm are responsible for symptoms ranging from mild (e.g., lacrimation, ocular discharge, epiphora) to severe (e.g., conjunctivitis, keratitis, and corneal opacity or ulcers). The present study evaluated the clinical efficacy and safety of imidacloprid 10% and moxidectin 2.5% spot on (Advocate(®), Bayer Animal Health) in comparison to milbemycin oxime/praziquantel tablets (Milbemax(®), Novartis-Animal Health), as positive control, in the treatment of canine thelaziosis in naturally infected dogs and, a third group was used as an untreated control. Forty-seven dogs (27 females and 20 males) harbouring at least one live adult worm of T. callipaeda in one eye were enrolled from an endemic area of southern Italy. Each dog was then weighed and assigned in accordance with a random treatment allocation plan to one of the treatment groups (G1: imidacloprid 10% and moxidectin 2.5% spot on, G2: Untreated control and G3: milbemycin oxime/praziquantel tablets). On Day (D) 7, 14, 28 and 35 dogs were physically examined and the infection level was assessed by examination of both eyes, including conjunctival pouch and third eyelid for live adult T. callipaeda count and clinical scores. Dogs in G1 were treated on D0 and D28, whereas those in G3 on D0 and D7. Efficacy in G1 was 100% at each day post treatment (p<0.01). For the G3 group efficacy was 57.39% on D7 (p<0.05), 92.79% on D14 and 100% on D28 and D35 (p<0.01). The application of the spot on formulation moxidectin 2.5% and imidacloprid 10% was highly effective in the treatment of canine thelaziosis caused by T. callipaeda. Advocate(®) spot on can be recommended for the control of T. callipaeda infection, considering that this formulation is currently licensed in Europe for the treatment of a wide range of parasites affecting dogs.
- Efficacy of House Dust Mite SLIT-Tablet in North American Adolescents and Adults in a Randomized, Placebo-Controlled Trial. [JOURNAL ARTICLE]
- J Allergy Clin Immunol 2016 Aug 10.
House dust mite (HDM) sublingual immunotherapy tablet (SLIT-tablet; MK-8237; Merck/ALK) has demonstrated beneficial effects on allergic rhinoconjunctivitis and asthma outcomes in European trials.This is the first trial to assess the efficacy/safety of HDM SLIT-tablets in North American subjects with HDM allergic rhinitis with/without conjunctivitis (AR/C).In this double-blinded, multicenter trial (NCT01700192), 1,482 subjects (aged ≥12 years) with HDM AR/C with or without asthma were randomized to daily SQ HDM SLIT-tablet (12 SQ-HDM dose) or placebo for up to ≈52 weeks. A rhinitis daily-symptom score (DSS, 4 nasal symptoms, maximum=12) of ≥6, or ≥5 with 1 symptom being severe, on 5 of 7 consecutive days before randomization was required. The primary endpoint was average total combined rhinitis score (TCRS), defined as rhinitis DSS plus rhinitis daily-medication score (DMS), during the last 8 treatment weeks.12 SQ-HDM treatment improved TCRS 17% vs placebo (95% CI: 10%, 25%). Improvements vs placebo in the secondary endpoints average rhinitis DSS, rhinitis DMS, total combined rhinoconjunctivitis score, and visual analogue scale-assessed ARC symptoms were 16%, 18%, 17%, and 16%, respectively. All nominal P-values were <0.001 vs placebo except rhinitis DMS (P=0.15). No treatment-related AEs meeting the ICH definition of serious were reported; 1 non-serious treatment-related systemic allergic reaction occurred (assessed as moderate intensity) at first administration under medical supervision and was treated with epinephrine.In the first North American trial of a SLIT-tablet for HDM allergy, 12 SQ-HDM was well tolerated and improved HDM rhinitis symptoms in adults and adolescents.
- Allergic manifestations of contact lens wearing. [JOURNAL ARTICLE]
- Curr Opin Allergy Clin Immunol 2016 Aug 11.
Contact lens-induced papillary conjunctivitis (CLPC) is a common ocular allergic disease in contact lens wearers. In its more severe form, it can cause giant papillary conjunctivitis, resulting in contact lens intolerance and the need to discontinue the use of contact lenses. This review presents the pathogenesis, clinical manifestations and management guidelines of this common disorder.Different types of contact lenses are associated with differences in the severity of CLPC. Refitting patients with silicone hydrogel contact lenses or with daily disposable contact lenses may improve the signs and symptoms of CLPC. The recent introduction of the topical immunomodulatory agent tacrolimus in other severe allergic eye diseases may apply in suppressing the allergic inflammation in CLPC as well.CLPC is a common ocular disorder in contact lens wearers, with a significant impact on the quality of vision. It should be promptly recognized by healthcare practitioners and managed by modifications of the types and wearing schedules of contact lenses, as well as novel treatment options with topical immunomodulators.