Effect of atopic conditions on development and recurrences of infectious keratitis.

BACKGROUND: Atopic conditions are known to be associated with viral and bacterial infections. The purpose of this study was to determine the relationship between the effects of atopic conditions on the severity and recurrence of ocular infections including herpes simplex virus (HSV). METHODS: This study was performed on 474 consecutive patients with infectious keratitis caused by bacteria, fungus, acanthamoeba, HSV, or varicella-zoster virus. The relationships between the atopic condition and specific infectious pathogens and HSV were determined using real-time PCR. RESULTS: Our findings showed that atopic dermatitis (AD) was significantly associated with the incidence of HSV keratitis (odds ratio (OR), 10.2; P = 0.000). Other associations with AD were observed only with bacteria in an adverse manner. HSV proliferation in the lesions of patients with HSV keratitis whose AD was associated with non-infectious atopic blepharitis were significantly greater by 145-folds (P = 0.000). The presence of asthma or allergic rhinitis also increased the HSV DNA copy numbers. A recurrence of HSV keratitis was observed in 70 patients (43.2 %), and mean time to recurrence was 1647 days. Cox proportional hazard model indicated that the epithelial type of HSV recurrence but not the stromal type was associated with atopic conditions especially with AD. The factors significantly associated with a recurrence was AD associated with non-infectious atopic blepharitis (HR: 6.11, P = 0.000) and asthma (HR: 3.03, P = 0.025). CONCLUSIONS: Atopic conditions, especially AD with atopic blepharitis, are significantly associated with the development, increased proliferation, and shorter time to a recurrence on HSV keratitis.

Intraoperative Measurement of Crystalline Lens Diameter in Living Humans.

BACKGROUND: There are no reports on accurate measurement of lens equatorial diameter of the living human eye. This study aimed to measure lens equatorial diameter with a special measurement device during cataract surgery and examine the relationships with preoperative parameters. METHODS: From April 7 to December 1, 2019, the equatorial diameters of 24 eyes from 24 patients who underwent cataract surgery at Kushimoto Arita Hospital were measured with a loop shaped measurement device during cataract surgery. Correlations between the value of the diameters and various preoperative parameters measured by CASIA2® were evaluated. RESULTS: The average value of the measured equatorial diameter using the device was 10.5 ± 0.4 mm and the value estimated by circular approximation using the CASIA2®ï¸ was 10.1 ± 0.7 mm. A significant difference was observed between these two groups (P = 0.016), and only a weak correlation was observed (γ = 0.31). A positive correlation was observed between equatorial diameter and anterior chamber depth (ACD) or anterior chamber width (ACW) (γ = 0.57 and 0.47, respectively). No significant correlation was found between other parameters and the value measured by the device. CONCLUSION: Our method is a completely new approach to measuring the living human lens equatorial region of the eye. No complications were observed in any of the cases. One new finding was the values of the lens equatorial diameters are actually longer than those reported previously. The results suggest that the values of the equatorial diameter measured by the loop device and those estimated by CASIA2® measurement were closer than those reported previously by other methods, although both were slightly different. We conclude that it is still difficult to estimate the equatorial diameter of the living human lens using preoperative examination parameters. This research will greatly contribute to the development of accommodative intraocular lenses in the future.

Efficacy of compartmentalization in controlling an adenovirus type 54 keratoconjunctivitis outbreak on Oki Island, Japan.

PURPOSE: To analyze the epidemiologic characteristics of an outbreak of human adenovirus type 54 (HAdV-54) on Oki Island, Shimane Prefecture, Japan, in 2017 and to assess the effectiveness of a compartmentalization method in controlling the incidence and spread. STUDY DESIGN: Retrospective cohort study. METHODS: The infection was diagnosed in 136 individuals, and typing was confirmed by PCR and direct sequencing. The epidemiologic characteristics of the disease including the infection rate, incubation period, and basic reproductive number (R0), ie, number of cases directly infected by an infectious patient during the course of the disease, were investigated. The effectiveness of compartmentalization for infection control was determined by simulating the outbreak using the Susceptible-Exposed-Infectious-Recovered (SEIR) model. RESULTS: The majority of the HAdV-54-infected individuals were the children of 3 nursery schools (A, B, and C) and their parents on Oki Island. The infection rates in the 3 schools were 13.2%, 16.9%, and 17.2%, respectively. The one class of school B without the index case was initially compartmentalized, and the infection rate in this compartment was 0%. The incubation period was calculated to be 9.3 ± 3.5 days, and the disease duration, 13.0 ± 5.4 days. The R0 was 1.43. Using these parameters, a SEIR model was constructed. The SEIR model well predicted the daily incidence of infection and indicated that the compartmentalization method provides effective reduction in the incidence of the infection, with much earlier control. CONCLUSIONS: The compartmentalization method is effective to control HAdV-54 outbreaks.