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2.
BMJ Case Rep ; 17(5)2024 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-38782433

RESUMO

A man in his late 50s presented with a gradually enlarging, painless, reddish mass on the white portion of his left eye for 2 weeks. His best-corrected visual acuity was 20/20 in both eyes. Slit-lamp examination showed a congested, nodular, elevated lesion on the temporal bulbar conjunctiva with two pustule-like elevations. Anterior segment optical coherence tomography showed a subconjunctival solid mass rather than an abscess or a cyst. Scleral deroofing was performed and a long thread-like object resembling a dead worm was identified. The worm was removed intact, and its histopathology confirmed the diagnosis of Dirofilaria Peripheral blood smear did not show any microfilariae. No recurrences or new lesions were observed during the follow-up examinations at 1 and 5 months post-surgery. This case highlights the importance of considering a parasitic aetiology in cases of nodular or infectious scleritis.


Assuntos
Dirofilariose , Infecções Oculares Parasitárias , Esclerite , Humanos , Masculino , Esclerite/diagnóstico , Dirofilariose/diagnóstico , Dirofilariose/cirurgia , Pessoa de Meia-Idade , Diagnóstico Diferencial , Infecções Oculares Parasitárias/diagnóstico , Infecções Oculares Parasitárias/cirurgia , Animais , Dirofilaria/isolamento & purificação , Tomografia de Coerência Óptica , Doenças da Túnica Conjuntiva/diagnóstico , Doenças da Túnica Conjuntiva/parasitologia , Túnica Conjuntiva/parasitologia , Túnica Conjuntiva/patologia
3.
BMJ Case Rep ; 17(5)2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38749513

RESUMO

We present two cases which underwent complex ocular surface reconstruction to achieve a stable ocular surface. Conjunctival autograft (CAG) procedure was required more than once, in addition to simple limbal epithelial transplantation to address extensive symblepharon in the eyes with total unilateral limbal stem cell deficiency secondary to acid ocular burns. These cases demonstrate that multiple CAGs may be harvested from the contralateral unaffected eye to correct recurrent symblepharon without any donor site complications if the correct surgical technique is adopted.


Assuntos
Autoenxertos , Queimaduras Químicas , Túnica Conjuntiva , Queimaduras Oculares , Humanos , Queimaduras Químicas/cirurgia , Queimaduras Oculares/cirurgia , Queimaduras Oculares/induzido quimicamente , Túnica Conjuntiva/transplante , Masculino , Adulto , Feminino , Transplante Autólogo , Doenças da Túnica Conjuntiva/cirurgia , Limbo da Córnea/cirurgia , Recidiva
5.
Arq Bras Oftalmol ; 87(6): e2021, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38597522

RESUMO

Implantation of glaucoma drainage devices is a valuable therapeutic option, particularly in children with glaucoma refractory to primary surgical treatment. Glaucoma drainage devices are typically used when conjunctival scarring hampers filtration surgery or prior angle procedures are not effective in controlling intraocular pressure. Despite known complications, the use of glaucoma drainage devices in children has increased in recent years, even as the primary surgical option. In this review, we evaluate the results of recent studies involving the implantation of glaucoma drainage devices in children, discussing new advances, and comparing the success rates and complications of different devices.


Assuntos
Doenças da Túnica Conjuntiva , Implantes para Drenagem de Glaucoma , Glaucoma , Criança , Humanos , Implantes para Drenagem de Glaucoma/efeitos adversos , Glaucoma/cirurgia , Pressão Intraocular , Implantação de Prótese/métodos , Estudos Retrospectivos , Resultado do Tratamento
6.
JAMA Ophthalmol ; 142(4): 389-391, 2024 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-38483399

RESUMO

This case report describes a patient with conjunctival ulceration following pembrolizumab therapy for breast cancer.


Assuntos
Doenças da Túnica Conjuntiva , Humanos , Anticorpos Monoclonais Humanizados
7.
Eur J Ophthalmol ; 34(3): NP101-NP104, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38380886

RESUMO

PURPOSE: To report an atypical presentation of an epibulbar simple cartilaginous choristoma with a unique pigmented multicystic component. CASE DESCRIPTION: A 69-year-old African American female presented for evaluation of a right nasal epibulbar lesion that had progressed over the prior year. Slit-lamp evaluation revealed an immobile, mildly pigmented multicystic lesion measuring 6.0 × 4.5 mm that involved the nasal bulbar conjunctiva and the plica semilunaris. The lesion appeared benign, without feeder vessels or features of epithelial dysplasia. Given its recent growth and the patient's cosmetic concerns, the lesion was excised with ocular surface reconstruction. Histopathological evaluation disclosed a well-circumscribed nodule of well-differentiated cartilage in the substantia propria, consistent with a simple cartilaginous choristoma. The overlying conjunctival stroma contained multiple cysts lined by focally pigment epithelium. The patient recovered well from surgery, with satisfactory cosmetic results. CONCLUSIONS: Our case of epibulbar simple cartilaginous choristoma includes a prominent superficial component of pigmented epithelial cysts, which has not been previously reported in the literature. This augments our knowledge on the spectrum of presentations of cartilaginous choristomas and underscores the importance of histopathological evaluation for definitive diagnosis.


Assuntos
Coristoma , Humanos , Coristoma/diagnóstico , Coristoma/patologia , Coristoma/cirurgia , Feminino , Idoso , Doenças da Túnica Conjuntiva/diagnóstico , Doenças da Túnica Conjuntiva/cirurgia , Cartilagem/patologia , Cistos/diagnóstico , Cistos/cirurgia , Túnica Conjuntiva/patologia , Procedimentos Cirúrgicos Oftalmológicos , Epitélio Pigmentado Ocular/patologia
8.
Cornea ; 43(5): 537-544, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38305353

RESUMO

PURPOSE: The aim of this study was to observe the expression of interleukin (IL)-17 and intercellular adhesion molecule (ICAM)-1 in conjunctivochalasis (CCH) and to analyze the correlations between cytokines and the severity of CCH. METHODS: Serum samples were collected from 22 patients with CCH and 18 normal controls (NCs). The Ocular Surface Disease Index, tear film break-up time, Schirmer I test, and corneal fluorescein staining were used to evaluate the ocular surface signs and symptoms. The concentrations of IL-17, IL-23, and ICAM-1 in serum and cellular supernatants were measured by enzyme-linked immunosorbent assays, and the gene expression levels of cytokines were measured by a quantitative real-time polymerase chain reaction. The relationships between serum concentrations of IL-17, IL-23, and ICAM-1 with clinical ocular surface parameters in CCH were analyzed using the Spearman correlation analysis. RESULTS: The concentrations of IL-17 and ICAM-1 in serum and cellular supernatants of CCH were significantly higher than those of NCs (all P < 0.001). The concentrations of IL-23 in serum and cellular supernatants of CCH showed no significant difference from those of NCs ( P > 0.05). The mRNA expression levels of IL-17 and ICAM-1 in conjunctival fibroblasts of CCH were significantly higher than those of NCs (all P < 0.001). The mRNA expression of IL-23 in conjunctival fibroblasts of CCH was higher than that of NCs, without a significant difference ( P > 0.05). Furthermore, the serum concentrations of IL-17 and ICAM-1 were positively correlated with Ocular Surface Disease Index and fluorescein staining (all P < 0.05), and negatively correlated with break-up time and Schirmer I test of CCH (all P < 0.05). CONCLUSIONS: The expression levels of IL-17 and ICAM-1 were significantly increased in CCH serum and associated with the disease severity. We postulate that IL-17 and ICAM-1 may play a role in the pathogenesis of CCH. IL-17 and ICAM-1 antagonists may be a potential treatment option for CCH in the future.


Assuntos
Doenças da Túnica Conjuntiva , Molécula 1 de Adesão Intercelular , Humanos , Molécula 1 de Adesão Intercelular/genética , Interleucina-17 , Doenças da Túnica Conjuntiva/patologia , Citocinas , Fluoresceína , Interleucina-23 , RNA Mensageiro/genética
9.
Int Ophthalmol ; 44(1): 39, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38334808

RESUMO

PURPOSE: To evaluate the correlation between clinical tests, patient symptoms, and conjunctivochalasis in contact lens wearers and non-wearers. METHODS: This study comprised 40 eyes of 40 current soft contact lens users and 40 eyes of 40 control subjects. Cross-sectional areas of conjunctivochalasis at three locations (nasal, central, temporal) during straight and downward gazes were determined using anterior segment optical coherence tomography in all participants. Tear film break up time test and Schirmer test with anesthesia were performed and for evaluation of symptoms, the participants completed ocular surface disease index questionnaire. RESULTS: During straight gaze, the mean cross-sectional areas of conjunctivochalasis were 0.0112 ± 0.009 and 0.006 ± 0.005 mm2 at nasal, 0.0096 ± 0.007 and 0.002 ± 0.004 mm2 at central, 0.0176 ± 0.014 and 0.008 ± 0.009 mm2 at temporal in contact lens and control groups, respectively. Regardless of location and gaze direction, the mean cross-sectional conjunctivachalasis areas of the contact lens group were significantly higher than those of the controls (all, p < 0.05). Significant positive correlations between ocular surface disease index score and measured conjunctivachalasis areas (in all sites) during straight gaze and downward gaze were observed in the contact lens group (all, p < 0.05 and r > 0.450). CONCLUSION: Wearing soft contact lenses is associated with increased conjunctivochalasis areas. Anterior segment optical coherence tomography determined conjunctivochalasis area is an objective clinical measurement value that is positively correlated with patients' symptoms in soft contact lens wearers.


Assuntos
Doenças da Túnica Conjuntiva , Lentes de Contato Hidrofílicas , Humanos , Doenças da Túnica Conjuntiva/diagnóstico , Doenças da Túnica Conjuntiva/epidemiologia , Doenças da Túnica Conjuntiva/etiologia , Lentes de Contato Hidrofílicas/efeitos adversos , Olho , Tomografia de Coerência Óptica , Lágrimas
11.
Ocul Immunol Inflamm ; 32(1): 62-70, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36637982

RESUMO

PURPOSE: To evaluate ocular surface involvement, tear cytokine levels, and histopathological changes in pemphigus and pemphigoid patients. METHODS: A total of 22 patients (15 pemphigus and 7 pemphigoids) and 21 non-diseased controls were enrolled in our study. All participants underwent ocular surface evaluation, which included ocular surface disease index test, slit lamp observation, dry eye-related examination, tear multicytokine analysis, and conjunctival impression cytology. RESULTS: Pemphigus and pemphigoid patients presented much more severe conjunctivochalasis, corneal epithelial defects, corneal opacity, symblepharon   and dry eye. Severe ocular surface squamous metaplasia and a significant increase of tear macrophage inflammatory protein-1beta, tumor necrosis factor-alpha, interleukin (IL)-1ß, IL -6, and IL-8 occurred in pemphigus and pemphigoid patients. CONCLUSIONS: Our results revealed that ocular surface inflammation and dry eye persist in most pemphigus and pemphigoid patients, and do not occur in parallel with the systemic course. Regular ophthalmological examinations and local anti-inflammatory should be provided for pemphigus and pemphigoid patients.


Assuntos
Doenças da Túnica Conjuntiva , Síndromes do Olho Seco , Penfigoide Bolhoso , Pênfigo , Humanos , Penfigoide Bolhoso/complicações , Penfigoide Bolhoso/diagnóstico , Pênfigo/complicações , Pênfigo/diagnóstico , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/etiologia , Síndromes do Olho Seco/patologia , Doenças da Túnica Conjuntiva/diagnóstico , Doenças da Túnica Conjuntiva/etiologia , Túnica Conjuntiva/patologia , Lágrimas , Interleucina-1beta , Inflamação/diagnóstico , Inflamação/patologia
13.
Vet Ophthalmol ; 27(2): 177-183, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37676115

RESUMO

OBJECTIVE: To describe the clinical and histopathological features of ocular abnormalities noted in a litter of black-footed ferrets (Mustela nigripes), including corneal opacification, cataracts, persistent pupillary membranes, microphthalmia, symblepharon and anterior segment malformation. ANIMALS STUDIED: A litter of eight black-footed ferrets examined at 10 weeks old with a history of ophthalmia neonatorum first noted at 7 days old and histopathological examination of three globes from three ferrets of the same litter between 5 and 7 months old following routine subconjunctival enucleation. PROCEDURES: Due to the fractious nature of black-footed ferrets, slit-lamp biomicroscopic examination was performed under general isoflurane anesthesia at 10 weeks of age. Corneal opacification was noted in 9/16 eyes, cataracts in 4/16 eyes, and persistent pupillary membranes in 3/16 eyes, among other findings. Histopathology revealed persistent pupillary membranes and Descemet's membrane abnormalities consistent with congenital anterior segment malformation in all three globes. In one ferret, a posterior cortical cataract with posterior lenticular malformation and lens capsule discontinuity was noted. Purulent discharge was cultured at time of enucleation in one ferret with growth of E. coli. CONCLUSIONS: A novel constellation of ocular malformations with primary congenital and secondary to ophthalmia neonatorum etiologies is described in black-footed ferrets. Due to endangered status of black-footed ferrets, small genetic pool and the requirement for adequate vision for wild-release, congenital ocular abnormalities such as anterior segment malformation and likely the cataracts described are of particular concern. Further investigation and monitoring are warranted to determine the heritability of these ocular abnormalities.


Assuntos
Catarata , Doenças da Túnica Conjuntiva , Oftalmia Neonatal , Animais , Furões , Escherichia coli , Oftalmia Neonatal/veterinária , Catarata/veterinária , Doenças da Túnica Conjuntiva/veterinária
14.
Cornea ; 43(2): 201-206, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36961445

RESUMO

PURPOSE: The aim of this study was to evaluate the efficacy of plasma-based conjunctivoplasty as a new surgical approach for conjunctivochalasis. METHODS: This prospective, noncomparative, interventional study included research on 42 eyes of 33 patients who underwent plasma therapy because of conjunctivochalasis between February 2020 and December 2021. Maintaining a 2-mm distance from the limbus, at least 3 lines (approximately 2 mm deep) of plasma therapy were applied to the conjunctiva from the temporal quadrant to the nasal quadrant. Patient symptoms, the fluorescein clearance test, ocular surface integrity with fluorescein staining, the Ocular Surface Disease Index questionnaire, tear breakup time (TBUT), tear meniscus height, and complications were evaluated. RESULTS: The mean patient age at the time of surgery was 67.3 ± 7.2 (range: 54-81) years. After surgery, the grades of conjunctivochalasis decreased in all patients. Although epiphora was present in 28 eyes (66.6%) preoperatively, none of the cases had epiphora during the follow-up period. The Ocular Surface Disease Index score improved significantly from 34.7 ± 10.3 preoperatively to 5.0 ± 4.2 3 months postoperatively ( P <0.001). Although the preoperative TBUT was 5.1 ± 2.2 seconds, the TBUT increased to 10.0 ± 2.3 seconds 3 months postoperatively ( P <0.001). Chemosis developed in only 1 eye (2.3%) and completely regressed with topical steroid treatment in the first postoperative week. CONCLUSIONS: Plasma-based conjunctivoplasty is a minimally invasive and simple surgery with less intraoperative and postoperative discomfort, a fast recovery, and can be suggested as an alternative approach to other treatment methods.


Assuntos
Doenças da Túnica Conjuntiva , Síndromes do Olho Seco , Doenças do Aparelho Lacrimal , Humanos , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Estudos Prospectivos , Doenças da Túnica Conjuntiva/cirurgia , Doenças da Túnica Conjuntiva/diagnóstico , Túnica Conjuntiva/cirurgia , Lágrimas , Fluoresceínas , Síndromes do Olho Seco/etiologia
15.
Cornea ; 43(2): 245-248, 2024 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-37098106

RESUMO

PURPOSE: The purpose of this study was to report conjunctival granular formation as one of the causative factors of a traumatic corneal conjunctival epithelial disorder after plastic suture blepharoplasty. METHODS: Clinical charts of 7 patients who had visited Ohshima Eye Hospital with a symptomatic corneal epithelial disorder and history of suture blepharoplasty were reviewed. Clinical evidence of conjunctival granular formations was observed in all patients at the tarsal conjunctiva facing to corneal conjunctival traumatic epithelial disorders. The desired outcome was to alleviate the disorder. The assessment included tabulating results after the placement of a soft contact lens bandage and subsequent partial tarsal plate resection of the granular formation. RESULT: Seven women (mean age 45.0 ± 10.9 years) enrolled in this study had previously undergone suture blepharoplasty (mean 18.3 ± 6.9 years before). Soft contact lens bandages relieved all of the patients' complaints immediately. After resecting the granular formation, the traumatic corneal conjunctival epithelial disorder disappeared, and no recurrence was observed after surgery. CONCLUSIONS: The conjunctival granular formation within the tarsal conjunctiva after suture blepharoplasty caused the late-onset traumatic corneal conjunctival epithelial disorder. A complete cure was obtained after resection of the granular formation at the tarsal conjunctiva. To the best of our knowledge, this is the first report to identify the removal of granular formations in 7 patients with late-onset traumatic corneal conjunctival disorders many years after blepharoplasty. The resection of these lesions is a promising procedure to treat late-onset ocular epithelial disorder after suture blepharoplasty.


Assuntos
Blefaroplastia , Doenças da Túnica Conjuntiva , Doenças da Córnea , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Blefaroplastia/efeitos adversos , Blefaroplastia/métodos , Pálpebras/cirurgia , Túnica Conjuntiva/cirurgia , Córnea/cirurgia , Doenças da Córnea/etiologia , Doenças da Córnea/cirurgia , Doenças da Túnica Conjuntiva/etiologia , Doenças da Túnica Conjuntiva/cirurgia , Suturas
20.
Br J Ophthalmol ; 108(3): 380-385, 2024 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-36810151

RESUMO

PURPOSE: To evaluate the long-term visual acuity (VA) outcome of cataract surgery in inflammatory eye disease. SETTING: Tertiary care academic centres. DESIGN: Multicentre retrospective cohort study. METHODS: A total of 1741 patients with non-infectious inflammatory eye disease (2382 eyes) who underwent cataract surgery while under tertiary uveitis management were included. Standardised chart review was used to gather clinical data. Multivariable logistic regression models with adjustment for intereye correlations were performed to evaluate the prognostic factors for VA outcomes. Main outcome measure was VA after cataract surgery. RESULTS: Uveitic eyes independent of anatomical location showed improved VA from baseline (mean 20/200) to within 3 months (mean 20/63) of cataract surgery and maintained through at least 5 years of follow-up (mean 20/63). Eyes that achieved 20/40 or better VA at 1 year were more likely to have scleritis (OR=1.34, p<0.0001) or anterior uveitis (OR=2.2, p<0.0001), VA 20/50 to 20/80 (OR 4.76 as compared with worse than 20/200, p<0.0001) preoperatively, inactive uveitis (OR=1.49, p=0.03), have undergone phacoemulsification (OR=1.45 as compared with extracapsular cataract extraction, p=0.04) or have had intraocular lens placement (OR=2.13, p=0.01). Adults had better VA immediately after surgery, with only 39% (57/146) paediatric eyes at 20/40 or better at 1 year. CONCLUSIONS: Our results suggest that adult and paediatric eyes with uveitis typically have improved VA following cataract surgery and remain stable thereafter for at least 5 years.


Assuntos
Extração de Catarata , Catarata , Doenças da Túnica Conjuntiva , Facoemulsificação , Uveíte , Adulto , Humanos , Criança , Estudos Retrospectivos , Catarata/complicações , Resultado do Tratamento , Extração de Catarata/métodos , Acuidade Visual , Uveíte/complicações , Uveíte/diagnóstico , Uveíte/cirurgia , Transtornos da Visão
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