Subject(s)
Eye Diseases/diagnosis , Eye/immunology , Skin Pigmentation/immunology , Stevens-Johnson Syndrome/complications , Adolescent , Adult , Aged , Eye Diseases/immunology , Female , Humans , Male , Middle Aged , Retrospective Studies , Severity of Illness Index , Stevens-Johnson Syndrome/immunology , Young AdultSubject(s)
Eye Diseases/epidemiology , Mental Disorders/epidemiology , Nail Diseases/epidemiology , Stevens-Johnson Syndrome/complications , Adult , Contact Lenses , Disease Progression , Eye Diseases/etiology , Eye Diseases/pathology , Eye Diseases/prevention & control , Female , Follow-Up Studies , Humans , Male , Mental Disorders/etiology , Mental Disorders/psychology , Middle Aged , Nail Diseases/etiology , Quality of Life , Retrospective Studies , Risk Factors , Sclera/pathology , Skin/pathology , Stevens-Johnson Syndrome/psychologyABSTRACT
INTRODUCTION: Meibomian gland dysfunction (MGD) is the most common cause of dry eye syndrome. The goal of this study was to evaluate the efficacy of combined intense pulsed light (IPL) and low-level light therapy (LLLT) in symptomatic MGD. MATERIALS AND METHODS: This retrospective study analyzed data from 30 patients with MGD causing dry eye symptoms not relieved by medical therapy and managed with combined IPL and LLLT. The primary endpoint was the Ocular Score Disease Index (OSDI) score at 1 month and 1 year. Secondary endpoints were visual acuity, intraocular pressure, tear film break-up time, Schirmer's test, Oxford score, and infrared meibographic score at 1 month after the conclusion of treatment. RESULTS: The mean OSDI score decreased from 43±19 to 17±12 (1 month; p<0.0001) and then to 29±11 (12 months; p=0.013); 63% of patients were meibographic grade 2 before versus 7% after treatment (range, 1-4) (p=0.009); 75% of patients were Oxford grade 1 before versus 41% after treatment (p=0.004) (range, 1-3). No significant difference in the other secondary endpoints was noted. CONCLUSION: Over time, IPL therapy in combination with LLLT appears to improve patients with symptomatic MGD resistant to medical therapy.
Subject(s)
Low-Level Light Therapy , Meibomian Gland Dysfunction , Humans , Meibomian Glands , Retrospective Studies , TearsABSTRACT
Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) can lead to severe ophthalmologic sequelae. The main risk factor is the severity of the initial ocular involvement. There are no recommendations for ocular management during acute phase.We conducted a national audit of current practice in the 11 sites of the French reference center for toxic bullous dermatoses and a review of the literature to establish therapeutic consensus guidelines. We sent a questionnaire on ocular management practices in SJS/ TEN during acute phase to ophthalmologists and dermatologists. The survey focused on ophthalmologist opinion, pseudomembrane removal, topical ocular treatment (i.e. corticosteroids, antibiotics, antiseptics, artificial tear eye drops, vitamin A ointment application), amniotic membrane transplantation, symblepharon ring use, and systemic corticosteroid therapy for ophthalmologic indication. Nine of 11 centers responded. All requested prompt ophthalmologist consultation. The majority performed pseudomembrane removal, used artificial tears, and vitamin A ointment (8/9, 90%). Combined antibiotic-corticosteroid or corticosteroid eye drops were used in 6 centers (67%), antibiotics alone and antiseptics in 3 centers (33%). Symblepharon ring was used in 5 centers (55%) if necessary. Amniotic membrane transplantation was never performed systematically and only according to the clinical course. Systemic corticosteroid therapy was occasionally used (3/9, 33%) and discussed on a case-by-case basis.The literature about ocular management practice in SJS/ TEN during acute phase is relatively poor. The role of specific treatments such as local or systemic corticosteroid therapy is not consensual. The use of preservatives, often present in eye drops and deleterious to the ocular surface, is to be restricted. Early amniotic membrane transplantation seems to be promising.
Subject(s)
Eye Diseases , Stevens-Johnson Syndrome , Adrenal Cortex Hormones/therapeutic use , Amnion , Eye Diseases/etiology , Eye Diseases/therapy , Humans , Prospective Studies , Retrospective Studies , Stevens-Johnson Syndrome/complications , Stevens-Johnson Syndrome/drug therapySubject(s)
Eye Infections, Parasitic , Rhinosporidiosis , Rhinosporidium , Humans , Rhinosporidiosis/diagnosis , Rhinosporidiosis/pathology , Eye Infections, Parasitic/diagnosis , Eye Infections, Parasitic/pathology , Eye Infections, Parasitic/parasitology , Male , Rhinosporidium/isolation & purification , Animals , Conjunctival Diseases/diagnosis , Conjunctival Diseases/parasitology , Conjunctival Diseases/pathology , Conjunctiva/pathology , Conjunctiva/parasitologyABSTRACT
Early onset torsion dystonia are rare movement disorders. Molecular defect is known for only a subgroup, consisting of a unique and recurrent mutation in the TOR1A gene. We undertook a nationwide census of French TOR1A-mutation carriers and the assessment of clinical associated signs. Overall, 53 index cases and 104 relatives were studied and haplotypes linked to the mutation constructed. The previously reported Ashkenazi-Jewish haplotype was found in 11 families with the remainder carrying distinct haplotypes suggesting independent mutation events. This study demonstrates the scarcity of this disease in France with estimated disease frequency of 0.13:100,000 and mutation frequency of 0.17:100,000.