Ocular signs, symptoms and tear function tests of papulopustular rosacea patients receiving azithromycin.

BACKGROUND: Tetracycline derivatives provide moderate benefit in the treatment of ocular rosacea. Recently, azithromycin has been found to be an effective alternative in the treatment of cutaneous papulopustular rosacea. OBJECTIVE: We planned a study to evaluate the effects of azithromycin on ocular symptoms, signs and tear function tests of papulopustular rosacea patients. METHODS: An open-labelled study was performed in a population of 20 papulopustular rosacea patients. RESULTS: Eighteen subjects completed the trial. Significant improvement was seen in ocular symptoms, eyelid findings and conjunctival hyperaemia scores (P = 0.002, P < 0.0001, and P = 0.005, respectively). Therapeutic benefit was not observed in ocular surface staining scores. Baseline values of Schirmer test results were within normal limits. No significant side-effects were observed. Limitations The study population is limited to dermatology patients who had been referred to the ophthalmology clinic. CONCLUSION: Azithromycin may be a new promising therapeutic alternative in ocular rosacea.

Design and initial performance evaluation of a full field digital mammography upgrade cassette.

This paper discusses the criteria underlying the design of an innovative X-ray active pixel sensor in CMOS technology. This X-ray detector is used in a Full Field-of-view Digital Mammography (FFDM) camera. The CMOS imager is a three-side buttable 29mm x 119mm, 48 mum active pixel CMOS sensor in 0.18 mum technology. The 1(st) silicon FFDM devices were fabricated at the end of June, 2007. The device suffers a common failure mode of high current and currently is in failure analysis at Bioptics foundry. Current target for revision A1 tape out is at the end of August, 2007.

Anti-Ro/SSA and anti-La/SSB autoantibodies in the tear fluid of patients with Sjögren's syndrome.

PURPOSE: To investigate the presence of anti-Ro/SSA and anti-La/SSB antibodies in the tear fluid and serum of patients with Sjögren's syndrome and to evaluate the association of these autoantibodies with the severity of keratoconjunctivitis sicca. METHODS: Tear fluid and serum were obtained from 28 patients with Sjögren's syndrome and 17 age matched normal control subjects. Evaluation of tear fluid and sera anti-Ro/SSA and anti-La/SSB levels was done by using a quantitative enzyme linked immunosorbent assay kit designed for the quantitative measurement of IgG class autoantibodies directed against highly purified SSA and SSB antigens. Tear function and ocular surface were evaluated by Schirmer I test, tear break up time, and rose bengal staining. Dry eye symptom scores were recorded. RESULTS: Increased levels of anti-Ro/SSA and anti-La/SSB antibodies were detected in sera of 57.1% and 50% of SS patients, respectively. Six patients had increased levels of anti-Ro/SSA in the tear fluid, in one case anti-Ro/SSA being detected in tear fluid when it was negative in serum. Ten patients had positive anti-La/SSB titres in tear fluid and in four of these patients, anti-La/SSB titres were not elevated in serum. A positive correlation was observed between serum and tear fluid titres of anti-Ro/SSA (r = 0.43, p = 0.02), but not of anti-La/SSB. Serum anti-Ro/SSA and anti-La/SSB concentrations correlated positively with dry eye symptom scores (r = 0.42, p = 0.02 and r = 0.48, p = 0.01, respectively) and negatively correlated with Schirmer I test scores (r = -0.39, p = 0.04 and r = -0.40, p = 0.03, respectively). Significant correlations were found between tear anti-La/SSB concentrations and dry eye symptom score (r = 0.56, p = 0.02) and also rose bengal staining scores of the ocular surface (r = 0.44, p = 0.02). CONCLUSION: This study shows that autoantibodies against Ro/SSA and La/SSB antigens are present in the tear fluid of some patients with SS and their presence in serum or tear fluid is associated with the severity of keratoconjunctivitis sicca. Additional measurement of tear fluid levels of anti-Ro/SSA and anti-La/SSB may serve as a valuable diagnostic indicator of SS.

Tear and serum eosinophil cationic protein levels in seasonal allergic conjunctivitis.

PURPOSE: Eosinophil cationic protein (ECP) levels in tear fluid and sera of patients with seasonal allergic conjunctivitis (SAC) were measured to assess local and systemic eosinophilic activity in SAC. The correlation between ECP levels and disease activity was evaluated. METHODS: Tears and sera were collected from 21 patients with SAC and 13 healthy control subjects. ECP levels in tears and sera were measured before and 4 weeks after treatment with 0.1% lodoxamide eyedrops. Clinical signs and symptoms of SAC were scored and the correlation of ECP levels with the clinical scores was evaluated. RESULTS: Tear and serum levels of ECP were significantly increased (p = 0.01, p = 0.02, respectively) in patients with SAC compared with the control subjects, but ECP levels were not correlated with the severity of the disease. Following treatment with topical 0.1% lodoxamide eyedrops, the mean level of ECP in tears decreased significantly (p = 0.02), whereas no significant change was observed in serum ECP levels. Furthermore, a significant decrease in clinical signs and symptoms scores was found after treatment (both p < 0.0001). CONCLUSIONS: Increased serum and tear ECP levels in patients with SAC confirms that both local and systemic eosinophil activation occurs in SAC. However, clinical signs and symptoms of SAC were not found to be correlated with the degree of eosinophilic activity. Thus ECP does not seem to have an important role in clinical manifestations of SAC.

Bilateral central anterior stromal opacity of the cornea: dystrophy or degeneration?

PURPOSE: To describe a bilateral, central, oval corneal opacity not resembling any known corneal degeneration or dystrophy. METHODS: Ophthalmic examination, corneal topography, and pachymetry. RESULTS: A 30-year-old woman presented complaining of blurred vision. Biomicroscopic examination revealed bilateral, centrally located, oval, diffuse opacification of the anterior corneal stroma. Corneal topography showed slightly paracentral corneal flattening and irregular astigmatism in both eyes. Pachymetry indicated thinning of the central cornea in the left eye. No evidence of systemic disease was found. Family members had no corneal abnormalities. CONCLUSIONS: This unusual keratopathy closely resembles climatic proteoglycan stromal keratopathy. However, it is not clear whether the condition should be described as a dystrophy or degeneration.

High dose intravenous steroid therapy for severe posterior segment uveitis in Behçet's disease.

AIM: To evaluate the safety and effectiveness of high dose intravenous steroid therapy (HDIST) in Behçet's disease patients with severe posterior segment uveitis attacks. METHODS: Five patients with ocular Behçet's disease were treated with HDIST for severe posterior segment attacks. Two patients had vasculitis, one patient had papillitis, and the other two had retinitis; four patients also had accompanying severe vitritis. The visual acuities and improvement in ocular signs after HDIST were evaluated. RESULTS: During HDIST, patients had no systemic complications caused by treatment. All patients responded to HDIST with evidence of a decrease in intraocular inflammatory activity and improved visual acuities within a mean time of 7 (1-15) days of commencing treatment. During follow up three out of five patients had new posterior segment attacks. CONCLUSION: HDIST is effective in controlling severe, vision threatening acute posterior segment Behçet's uveitis attacks and in improving visual function in a short period of time

Cell adhesion molecules in subretinal fluid: soluble forms of VCAM-1 (vascular cell adhesion molecule-1) and L-selectin.

PURPOSE: In this study we investigated the presence of soluble VCAM-1 and soluble L-selectin-1 in subretinal fluids (SRF) of patients suffering from rhegmatogenous retinal detachment . METHOD: Subretinal fluids were collected from drainage sclerotomies during surgery from 27 patients with rhegmatogenous retinal detachment complicated by proliferative vitreoretinopathy (PVR) or uncomplicated retinal detachment. Levels of sVCAM-1 and sL-selectin-1 were quantified with ELISA. RESULTS: The mean +/- SEM values of sVCAM-1 and sL-selectin-1 were 222.2 +/- 81 ng/ml and 171.7 +/- 42.1 ng/ml, respectively. The concentrations of sVCAM-1 in patients with Grade C PVR (498.2 +/- 1703 ng/ml) were significantly different from those with Grade B PVR (45.6 +/- 16.5 ng/ml) and uncomplicated retinal detachments (19.4 +/- 12.3 ng/ml). SVCAM-1 concentration in detachments which had been present for more than 8 weeks was 738.8 +/- 431 ng/ml, significantly higher than the levels in detachments of shorter duration (132.4 +/- 47.7 ng/ml). sL-selectin-1 level in Grade C PVR (291.6 +/- 92.8 ng/ml) was higher than in uncomplicated retinal detachments (72.8 +/- 13.5 ng/ml). Significantly elevated levels of sL-selectin-1 were observed in detachments lasting more than 8 weeks (605 +/- 151.1 ng/ml) compared to those of shorter duration (96.3 +/- 13.1 ng/ml). CONCLUSION: The present study supports growing evidence that these cell adhesion molecules are involved in the inflammatory process during the development and progression of PVR.