Bengal Staining Research Articles

Characterization of T-Cell Large Granular Lymphocyte Leukemia Associated with Sjogren’s Syndrome—An Important but Underrecognized Association

Patients with T-cell (CD3+) large granular lymphocyte (LGL) leukemia have a high prevalence of autoantibodies and associated autoimmune diseases. Sjogren's syndrome may not be diagnosed unless specifically looked for. We set to determine the prevalence of Sjogren's syndrome in LGL leukemia and its cytokine profile. Every patient with a confirmed diagnosis of LGL leukemia diagnosed at a single academic medical center over the last 15 years was evaluated for Sjogren's syndrome by questioning about sicca symptoms. In symptomatic patients, Schirmer's test, rose bengal corneal staining, salivary flow rate measurement, autoantibody screening, and minor salivary gland biopsy were performed. Supernatants obtained from T-LGL leukemic cells following phytohemagglutinin (PHA) activation were analyzed for cytokine production by enzyme-linked immunosorbent assay and patients with or without Sjogren's syndrome were compared with controls. Of 48 patients, 21 reported sicca symptoms and were enrolled in the study. In 8 patients Sjogren's syndrome was ruled out. Thirteen patients had clear evidence of Sjogren's syndrome according to accepted criteria (27%). None had rheumatoid arthritis, but 1 had limited scleroderma. Thus, 12/48 patients had primary Sjogren's syndrome. Other autoimmune diseases were frequently present, in particular, immune cytopenias (n=7) or thyroid autoimmunity (n=6). Supernatants of T-LGL leukemia cells incubated with PHA revealed markedly increased levels of multiple cytokines (especially soluble interleukin 2 receptor, tumor necrosis factor alpha, IL-6, IL-8) compared with healthy controls. However, this increase was common to LGL leukemia patients with or without Sjogren's syndrome. Sjogren's syndrome was commonly identified in the patients with T-cell LGL leukemia in this study. Upregulated cytokine production by the neoplastic cells may underlie some of the immune-mediated disorders common in these patients.

La contribution des micropaléontologues aux Annales de Paléontologie entre 1906 et 2006

The strong involvement of microfossils in applied research, especially in hydrocarbon exploration, has led micropaleontology to a significant progress from the beginning of 1920; micropaleontologists have since rapidly acquired their own publication vehicles or have published in broad Earth Science journals. These are the main reasons invoked to explain why a low number of micropaleontology articles are found nowadays in the Annales de Paléontologie. Only 19 micropaleontology papers were published between 1906 and 2006, though some of them are relevant; they will be analysed herein. Four papers make up the foundations and the references to the acritarch, dinoflagellate and coccolithophorid systematic. One article, dealing with ecologic and paleoecologic implications, questions the use of the rose Bengal staining technique described by Walton in determining living specimens of foraminifers.

Autologous Serum Eye Drops for Dry Eye After LASIK

To evaluate the efficacy of autologous serum eye drops for dry eye after LASIK in a prospective, randomized study. Fifty-four eyes of 27 male patients who underwent LASIK were divided into two groups; patients who used autologous serum eye drops and those who used artificial tears postoperatively. Schirmer test with anesthesia, tear break-up time (BUT), and rose bengal and fluorescein staining for the ocular surface were prospectively compared between the groups. All values were also compared before and after surgery (at 1 week [except for Schirmer test], 1 month, 3 months, and 6 months) in each group. Tear BUT was greater in the autologous serum eye drops group than in the artificial tears group at 6 months postoperatively. Rose bengal score was lower in patients using autologous serum eye drops than in patients using artificial tears at 1 month and 3 months postoperatively. No significant difference was noted between patients using autologous serum eye drops and patients using artificial tears in the value of Schirmer test with anesthesia and fluorescein scores. In the autologous serum eye drops group, tear BUT was increased at 3 months after LASIK, rose bengal score was lower at 1 month and 3 months, and fluorescein score was lower at 1 month after LASIK compared to preoperative values, respectively. In the artificial tears group, all values (Schirmer test, tear BUT, rose bengal score, and fluorescein score) showed no differences between before and after LASIK. No differences were noted in the subjective scores for dryness between the autologous serum eye drops and artificial tears groups. The autologous serum eye drops group showed prolongation of the tear BUT and a reduction in rose bengal staining score.

Atelocollagen Punctal Occlusion in Dry Eye Patients

To evaluate the efficacy and safety of atelocollagen punctal occlusion for dry eye patients. Prospective noncomparative interventional case series. Atelocollagen was injected into the superior and inferior canaliculi of 52 eyes of 28 dry eye patients. Vital staining of the ocular surface, breakup time of tears (BUT), tear volume, and corneal epithelial permeability to fluorescein were examined before and 1, 2, 4, and 8 weeks after treatment. Rose bengal stain, fluorescein stain, BUT, and corneal epithelial permeability to fluorescence were significantly improved 1 week after atelocollagen punctal occlusion, and the improvement was maintained for up to 8 weeks after treatment. Atelocollagen punctal occlusion effectively improves ocular surface disorders in dry eye patients.

Mucin Characteristics of Human Corneal-Limbal Epithelial Cells that Exclude the Rose Bengal Anionic Dye

Rose bengal is an organic anionic dye used to assess damage of the ocular surface epithelium in ocular surface disease. It has been proposed that mucins have a protective role, preventing rose bengal staining of normal ocular surface epithelial cells. The current study was undertaken to evaluate rose bengal staining in a human corneal-limbal epithelial (HCLE) cell line known to produce and glycosylate membrane-associated mucins. HCLE cells were grown to confluence in serum-free medium and switched to DMEM/F12 with 10% serum to promote differentiation. Immunolocalization of the membrane-associated mucins MUC1 and MUC16 and the T-antigen carbohydrate epitope was performed with the monoclonal antibodies HMFG-2 and OC125 and jacalin lectin, respectively. To assess dye uptake, cultures were incubated for 5 minutes with 0.1% rose bengal and photographed. To determine whether exclusion of negatively charged rose bengal requires a negative charge at the cell surface, cells were incubated with fluoresceinated cationized ferritin. The effect of hyperosmotic stress on rose bengal staining in vitro was evaluated by increasing the ion concentration (Ca+2 and Mg+2) in the rose bengal uptake assay. The cytoplasm and nucleus of confluent HCLE cells cultured in media without serum, lacking the expression of MUC16 but not MUC1, as well as human corneal fibroblasts, which do not express mucins, stained with rose bengal. Culture of HCLE cells in medium containing serum resulted in the formation of islands of stratified cells that excluded rose bengal. Apical cells of the stratified islands produced MUC16 and the T-antigen carbohydrate epitope on their apical surfaces. Colocalization experiments demonstrated that fluoresceinated cationized ferritin did not bind to these stratified cells, indicating that rose bengal is excluded from cells that lack negative charges. Increasing the amounts of divalent cations in the media reduced the cellular area protected against rose bengal uptake. These results indicate that stratification and differentiation of corneal epithelial cells, as measured by the capacity to produce the membrane-associated mucin MUC16 and the mucin-associated T-antigen carbohydrate on their apical surfaces provide protection against rose bengal penetrance in vitro and suggest a role for membrane-associated mucins and their oligosaccharides in the protection of ocular surface epithelia.

404 DNA TAKE-UP BY SPERM AND IN VITRO EMBRYO DEVELOPMENT BY SPERM-MEDIATED GENE TRANSFER IN THE PIG

Sperm mediated gene transfer (SMGT) is based on the ability of spermatozoa to bind and internalize exogenous DNA and transfer it into the oocytes at fertilization. The purpose of this study was to assess introducing exogenous DNA into boar spermatozoa by DNA solution or DNA/liposome complex under different conditions (period of incubation, exogenous DNA, liposome, and concentration of spermatozoa). Genomic DNA of sperm loaded with DNA by treatment was isolated by alkaline lysis. Quantitation of exogenous DNA amplified by PCR was analyzed by agarose electrophoresis densitometry. The quality of treated spermatozoa under the best conditions or no treatment (control) was evaluated during incubation (0, 2, 4, and 6 h) for viability (SYBR-14/PI), motility (Makler counting chamber), morphology (rose bengal staining), and acrosomal status (Coomassie staining). Sperm loaded with DNA also were used for in vitro fertilization. Immature oocytes incubated in TCM-199 medium for 44 h were fertilized in mTBM medium for 6 h and cultured in PZM-3. Cleavage and development of embryos were assessed on Days 2 and 7 of culture, respectively. Transfection rates at the blastocyst stage were assessed by PCR analysis. Data were evaluated by Duncan's multiple-range test using the GLM procedure. In the preliminary experiment, DNA uptake of spermatozoa by DNA solution and liposome/DNA complex was completed within 90-120 min. Transfection efficiency of spermatozoa was significantly (P < 0.05) higher in the 105 spermatozoa group than in the other groups (104, 106, and 107 spermatozoa). The transfection efficiency was gradually increased by increasing the concentration of exogenous DNA. On the other hand, viability of transfected spermatozoa by all treatments (control, DNA solution, and DNA/liposome) at 0 h (72.3 � 0.2, 70.8 � 1.8, and 68.0 � 2.2%, respectively) of storage was significantly (P < 0.05) lower than for fresh spermatozoa (83.3 � 1.7%). Survival and motility of all treatments after 4 h of storage were significantly (P < 0.05) lower than at 0 and 2 h. Both abnormality and acrosome reaction of spermatozoa were gradually increased with prolonged storage periods. On the other hand, the cleavage rate of embryos by DNA/liposome complex (56.3 � 2.3%) was significantly (P < 0.05) lower compared to both DNA solution (64.0 � 1.1%) and control (67.8 � 2.3%). The developmental rates of blastocysts were significantly (P < 0.05) lower in the liposome/DNA complex and DNA solution groups (9.1 � 1.3 and 11.3 � 0.8%) than in the control group (22.2 � 0.6%). The transfection rates of blastocysts were higher in the liposome/DNA group (54.3 � 12.0%) than in the DNA solution group (38.7 � 6.6%). These results show that the SMGT method under the control conditions efficiently transfers exogenous DNA into the porcine oocytes. This work was supported by the Research on the Production of Bio-organs (No. 2005 03020302) Ministry of Agriculture and Forestry, Republic of Korea

Atopic Ocular Surface Disease

To describe tear function, mucin alterations, and ocular surface disorder in patients with atopic diseases. Subjects underwent corneal sensitivity measurements, Schirmer test, tear film break-up time (BUT) assay, and fluorescein and rose Bengal staining of the ocular surface. Conjunctival impression cytology and brush cytology were also conducted. Impression cytology samples underwent PAS and immunohistochemical staining for MUC5AC. Brush cytology specimens underwent evaluation for inflammatory cell expression and RT-PCR for MUC5AC mRNA expression. Differences related to tear function and ocular surface examination parameters among patients with and without corneal ulceration and healthy control subjects were studied. Mean corneal sensitivity and BUT values were significantly lower in atopic patients with corneal ulcers compared with patients without ulcers and controls (P<0.001). Brush cytology specimens from patients with corneal ulcers revealed significantly higher expression of inflammatory cells compared with patients without ulcers and controls (P<0.001). Impression cytology samples from eyes with corneal ulcers showed significant squamous metaplasia and reduction of goblet cell density compared with eyes without ulcers and control subjects. Specimens from eyes with corneal ulcers showed PAS (+) mucin pick up and did not stain positive for MUC5AC. MUC5AC mRNA expression was significantly lower in eyes with corneal ulcers compared with in eyes without ulcers and control subjects. Ocular surface inflammation, tear film instability, and decreased conjunctival MUC5AC mRNA expression are important in the pathogenesis of noninfectious corneal shield ulcers in atopic ocular surface disease.

Correlation Between Dry Eye and Rheumatoid Arthritis Activity

To evaluate the incidence of dry eye in rheumatoid arthritis (RA) patients with or without Sjögren syndrome (SS), and to investigate the correlation between dry eye and RA activity. Prospective case-control study. In 72 RA patients, the severity of dry eye was assessed by the Schirmer test, tear break-up time, rose bengal staining, and fluorescein staining. The RA activity was evaluated by the Lansbury index (LI), which is based on the duration of morning stiffness, erythrocyte sedimentation rate (ESR), grip strength, and joint score. Ten percent of patients met the Japanese criteria for SS. No difference in dry eye tests or LI was observed between SS patients and non-SS patients. Even in the non-SS group, 90% of patients were diagnosed with probable dry eye. In SS patients, positive correlations were observed between LI and Schirmer test (P = .048), ESR and Schirmer test (P = .035), ESR and rose bengal staining (P = .001), and grip strength and rose bengal staining (P = .047). No such correlations were observed in the non-SS patients. Dry eye is common in RA patients, including those without SS. We found that there was a correlation between LI and Schirmer test in RA patients with SS, but no correlation when the entire group was analyzed. Dry eye always should be taken into consideration regardless of the RA activity, because the severity of dry eye is independent of RA activity.

Tear clearance measurement in patients with dry eye syndrome using quantitative lacrimal scintigraphy

The aim of this study was to evaluate the tear clearance in patients with dry eye syndrome using quantitative lacrimal scintigraphy. We investigated 21 patients (42 eyes; 18 women, 3 men; mean age, 63.19 +/- 13.33 years) with dry eye syndrome. Additionally, for the sake of comparison, 12 normal subjects of the same age group (24 eyes; 10 women, 2 men; mean age, 68.25 +/- 2.63 years) were included. Lacrimal scintigraphy, Schirmer-1 test, BUT, and rose bengal ocular surface vital staining were performed in these cases. According to the results of lacrimal scintigraphy, the mean value of T 1/2 was 4.16 +/- 1.22 minutes and the mean value of RI was 14.15% +/- 2.30% in normal subjects. However, in patients with dry eye syndrome, these values were 20.59 +/- 1.97 minutes and 55.64% +/- 6.90%, respectively. Consistent with the results of ophthalmologic tests, the mean Schirmer-1 value was 12.46 +/- 2.10 mm, the mean value of BUT was 14.36 +/- 3.40 seconds, and the mean staining value of the rose bengal was 1.98 +/- 0.80 in normal subjects, whereas these values were 1.36 +/- 0.49 mm, 5.46 +/- 1.33 seconds, 6.62 +/- 0.86, respectively, in patients with dry eye syndrome. When we compared the results of lacrimal scintigraphy and the results of ophthalmologic tests, an inverse correlation was noted between both the T1/2 and RI values and both the Schirmer-1 and BUT values in all subjects (p < 0.001). However, there was a greater positive correlation between the rose bengal ocular surface staining value and both the T1/2 and RI values in all cases (p < 0.001). In the current study, it was concluded that although the lacrimal drainage system was normal, tear clearance was significantly delayed in dry eye patients. With this study, we have shown that quantitative lacrimal scintigraphy, which is an objective, practical, and noninvasive method, appears to be useful for the assessment of the tear clearance in patients with dry eye syndrome.

Análise do filme lacrimal e sua relação com a largura da fenda palpebral e a exoftalmia na oftalmopatia de Graves

To evaluate tear film quality by rose bengal staining and its stability by breakup time, relating with palpebral fissure height and exophthalmos in patients with Graves' ophthalmopathy. We studied 54 eyes of 27 patients with Graves' ophthalmopathy, either in the inflammatory or in the chronic phase of the disease. The evaluation consisted of tear film qualitative analysis by rose bengal staining using the van Bijsterveld grading scale, tear film stability analysis by breakup time, measurement of palpebral fissure height and exophthalmometry. Qui square test was used to perform statistical analysis. Among 27 studied patients, 77.8% were females and 22.2% males. Mean age was 44.26 years (SD 12.67). Mean disease time was 5.85 years (SD 4.47) and mean ophthalmopathy time was 5.81 years (SD 5.37). Among 54 studied eyes, 37% had positive test by van Bijsterveld's grading scale, 33.3% tear film breakup time lower than 5 seconds, 57.4% palpebral fissure height greater than 11 mm and 55.6% exophthalmometry greater than 19 mm. When relating tear film breakup time lower than 5 seconds with palpebral fissure height greater than 11 mm we found an odds ratio of 11.2 (p=0.0008). The remaining relationships did not show statistical significance. Dry eye diagnosed by rose bengal staining and tear film breakup time occurs frequently in Graves' ophthalmopathy. Palpebral fissure height correlates with tear film breakup time in Graves' ophthalmopathy. Its increase may lead to tear film instability.

Altered Corneal Nerves in Aqueous Tear Deficiency Viewed by In Vivo Confocal Microscopy

To define the alterations of corneal nerves in aqueous tear deficiency dry eye patients with or without Sjögren syndrome and to identify the relationship between the morphologic changes of corneal nerves and the extent of dry eye. Confocal microscopy was used to examine 38 consecutive aqueous tear deficiency patients (8 Sjögren syndrome and 30 non-Sjögren syndrome) and 30 age- and gender-matched normal controls. Images taken by Confocal2 slit-scanning microscope at subbasal epithelial cell layer of central cornea were analyzed. The number and density of corneal nerves and their size, beads, tortuosity, and branching pattern were compared. These data were correlated with age and the degree of dry eye. Sjögren syndrome patients showed a significant increase in average nerve number and tortuosity as compared with normal controls (P = 0.031 and 0.021, respectively). Severe nerve tortuosity (grade 4) and nerve branching appeared more frequently in aqueous tear deficiency than in normal subjects (P = 0.024 and 0.042, respectively). A decreased nerve number was observed with age in the normal controls (P = 0.002). However, such a correlation did not exist in aqueous tear deficiency. In aqueous tear deficiency, rose bengal staining score correlated positively with nerve density (P = 0.048) and nerve number (P = 0.001). Corneal fluorescein staining score was also positively correlated with nerve number (P = 0.027). Abnormal morphologic changes are observed in aqueous tear deficiency that are more severe in Sjögren syndrome. The distinct changes of corneal nerves include increased nerve number, tortuosity, and chances of branching, suggesting an attempted nerve regeneration. A strong correlation exists between the changes of nerve morphology and the degree of dry eye. These results provide some possible evidence for the abnormal corneal sensation in dry eye.

Topical Combination of NGF and DHA Increases Rabbit Corneal Nerve Regeneration after Photorefractive Keratectomy

To investigate the effect of nerve growth factor (NGF) in combination with docosahexaenoic acid (DHA) on corneal nerve regeneration in a rabbit model after PRK and correlate the findings with functional tear test. Unilateral PRK was performed on 21 New Zealand albino rabbits. Three groups, each consisting of six rabbits, were randomized to receive twice-weekly treatments with DHA, NGF, or NGF plus DHA delivered by collagen shield. A fourth group, the control, received treatment with albumin. Rabbits were observed for 8 weeks, and tear secretion tests were conducted every 15 days. The eyes were prepared for immunostaining. Monoclonal antibodies for class II beta-tubulin, calcitonin gene-related peptide (CGRP), substance P (SP), and Ki-67 were used. Cell nuclei were stained with 4',6'-diamino-2-phenylindole (DAPI). Positive staining areas in relation to total area were calculated with image-analysis software. There were no significant differences in the tear-secretion test results among the four groups. However, none of the eyes treated with NGF plus DHA showed rose bengal staining 30 days after PRK, compared with 50% in the control group and 33% in the DHA-treated group. A higher percentage of Ki-67-positive cells, a marker of cell proliferation, was observed in the DHA plus NGF-and NGF-treated groups compared with DHA alone or the control. Eight weeks after PRK, tubulin-positive and CGRP-positive epithelial and subbasal nerve bundle areas were significantly higher in the DHA plus NGF group than in the control and NGF or DHA alone. No differences were noted in the SP-positive nerve bundles between the different treatments and the control treatment. NGF plus DHA treatment after PRK in rabbits is associated with increased corneal nerve surface area, increased epithelial proliferation, and decreased rose bengal staining compared with NGF, DHA, or vehicle control alone. The combination of NGF plus DHA yields faster nerve recovery after PRK and may have therapeutic usefulness in the treatment of post-PRK dry eye and other neurotrophic keratopathies.

Tear Film Tests in Parkinson’s Disease Patients

Parkinson's disease (PD) has both motor and nonmotor features. Parkinson's disease patients are prone to dry eye due to both autonomic dysfunction and motor symptoms affecting blinking. This study was conducted to investigate the changes in tear functions in PD patients. Nonrandomized, prospective, clinical study. Fifty-six eyes of 56 consecutive patients with PD were studied. Thirty-six eyes of age-matched non-PD patients without pathology affecting tear tests were examined as control subjects. Modified Hoehn-Yahr (H-Y) scale, blink rate (BR), and tear tests were examined. Modified H-Y scale, BR, dry eye assessment questionnaire, meibomian gland evaluation, tear meniscus height, tear breakup time, fluorescein stain, rose bengal stain, Schirmer's test, and phenol red thread test. Overall tear function abnormalities were significantly more common in PD patients (P = 0.001, Mann-Whitney U test). Each test was found to be significantly disturbed in PD patients relative to controls (P<0.05, Mann-Whitney U test). Each PD patient had at least 1 abnormal test. Overall tear function abnormalities as assessed by the total abnormal test count correlated with the H-Y score (P<0.001, Spearman rho correlation). Parkinson's disease patients' mean BR (12.7+/-7.42 per minute) was significantly less than the controls' (21.8+/-7.37) (P<0.01, Student's t test). The abnormality in each tear test, except those for meibomian gland function and tear meniscus height, was significantly related to the H-Y scores (P<0.05, chi2 linear-by-linear association). The results of this study indicate that PD is associated with disturbances in tear function. With the exception of meibomian gland disease and tear meniscus height, the tests were found to have a linear association with the H-Y scale, which may be attributed to associated dysfunctions of PD.

Prevalência de olho seco em portadores de hanseníase de um hospital-colônia em Goiânia

To determine the prevalence of dry eye in Hansen's disease patients from the "Hospital de Dermatologia Sanitária de Goiânia". The sample of the present study included 70 patients with Hansen's disease, from the "Hospital de Dermatologia Sanitária de Goiânia", and 30 controls, from the "Fundação Banco de Olhos de Goiás", both located in Goiânia-GO, Brazil. Ophthalmologic examination and Schirmer I, break-up time (BUT) and rose Bengal staining tests were carried out for all patients in a single evaluation. For the diagnosis of dry eye the Schirmer I equal or less than 5 mm and rose Bengal grade II or III, in at least one eye were considered. Forty-four (63.0%) patients with Hansen's disease were male and 22 (73.3%) controls were female (p=0.001). The mean age of the patients with Hansen's disease was 61.1+/-12.5 years and in the control group, it was 55.7+/-9.6 years. Fifteen (21.4%) patients with Hansen's disease and four (13.3%) controls presented with dry eye diagnosis (p=0.429). The lepromatous type (74.2%) of Hansen's disease was the most prevalent and dry eye (66.7%) was more frequent in this clinical form of the disease. The dry eye disease was more prevalent in patients with Hansen's disease, although the difference was not statistically significant.

Association of Aniridia and Dry Eyes

To study the association between congenital aniridia and dry eyes, and the status of limbal stem cells. Single-center, retrospective, noninterventional, comparative case series. Twenty patients (36 eyes) diagnosed with congenital aniridia. Retrospective review of medical records at the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia to identify all cases of congenital aniridia. Selected patients were requested to undergo further testing, especially for evaluation of dry eyes. Full ocular examinations were performed, including examination of the meibomian gland orifices and dry eye evaluation (by predetermined criteria of tear breakup time, tear meniscus level, presence of mucoid secretions, Schirmer's test with and without anesthesia, and fluorescein and rose Bengal staining patterns of the cornea and conjunctiva). Cytological evaluation was performed in 23 aniridic eyes by impression cytology to determine limbal stem cell status relative to control normal eyes. Abnormal tear film production and stability, meibomian gland dysfunction, severity of corneal involvement, and limbal stem cell deficiency. Twenty patients (36 eyes) diagnosed with congenital aniridia were classified into 3 groups according to the severity of corneal involvement: mild (2 eyes), moderate (21 eyes), and advanced (13 eyes) corneal changes. Tear breakup time was reduced by an average of 5 seconds in 90.7% of cases, tear meniscus levels were reduced to <0.5 mm in 88.6% of cases, and stenosed meibomian orifices were found in 77.8% of patients. Dry eyes (94%) correlated with the severity of corneal involvement (P = 0.001). Impression cytology revealed metaplasia in all tested cases. Furthermore, 8 of 23 eyes (35%) and 15 of 23 eyes (65%) had early and advanced limbal stem cell deficiency, respectively. Abnormal tear film stability and meibomian gland dysfunction are newly identified factors in patients with aniridia. Both correlate to the severity of ocular surface disease. Impression cytology is informative in diagnosing various degrees of limbal stem cell deficiency, which is present in all tested aniridia eyes.

Estudio comparativo entre el hialuronato sódico al 0,15% y el alcohol poliviníco como tratamiento para el ojo seco

To evaluate the efficacy of two artificial tears for the treatment of dry eyes: 0.15% sodium hyaluronate and polyvinyl alcohol. The study included 60 dry eyes in 30 patients. Fifteen of the patients were treated with 0.15% sodium hyaluronate and 15 with polyvinyl alcohol. Five drops a day for one month was given in both groups. Visual acuity, Schirmer's test, tear clearance, dry eye symptoms questionnaire, fluorescein and rose bengal staining, corneal sensibility, bulbar hyperemia, tear detritus, meibomian gland plug, palpebral erythema and edema before and after treatment were evaluated. Symptoms as judged by the dry eye questionnaire, as well as both fluorescein and rose bengal staining, were significantly improved by 0.15% sodium hyaluronate. The polyvinyl alcohol treated patients did not show a significant improvement in any parameter. Sodium hyaluronate was more effective than polyvinyl alcohol in the treatment of patients with dry eyes (Arch Soc Esp Oftalmol 2005; 80: 387-394).

Silicone Versus Collagen Plugs for Treating Dry Eye: Results of a Prospective Randomized Trial Including Lacrimal Scintigraphy

To compare the short-term efficacy of collagen and silicone plugs for treating dry eye using quantitative lacrimal scintigraphy. Prospective randomized clinical trial. In this institutional study, 24 dry eye patients were evaluated in two groups: group I (n = 22 eyes) received collagen plugs and group II (n = 26 eyes) received silicone plugs. Comparisons were made with normal control subjects (n = 22 eyes). Data for the Schirmer I test, tear break-up time, and ocular surface staining with rose bengal dye were recorded before and after punctal occlusion. Lacrimal scintigraphy was performed at each time point, and the time to half maximum activity on the ocular surface (T(1/2)), and the percentage retention of activity on the ocular surface at the end of the dynamic study (RI) were recorded. In both patient groups, Schirmer I results, tear break-up times, and rose bengal staining scores improved significantly after plug insertion. Mean T(1/2) values and RI values increased significantly in both groups (P < .0001 for both). The differences for these values between groups I and II was statistically insignificant (P > .05). Collagen and silicone plugs both resulted in significant increases in aqueous tear volume, half-life of nuclear material on the ocular surface, and percentage of nuclear material retention. The groups' post-insertion values for all parameters were similar. These results suggest that these two plug types have similar efficacy as treatments for dry eye in the short term. Further studies evaluating long-term results are required.

Exérese do segmento vertical do canalículo lacrimal na síndrome do olho seco: estudo preliminar

To demonstrate the efficacy and possible complications of a surgical technique that includes the removal of the vertical portion of the lacrimal canaliculus in patients with dry eye syndrome. A study was performed on six canaliculi of six eyes (four patients). Three patients had dry eye, associated with primary Sjögren syndrome. One of the four patients developed keratoconjuntivitis sicca due to lacrimal gland removal. The criteria included: patients with symptoms of dry eye that did not improve even with the continuous use of artificial tears, low results (less than 5 mm) with the Schirmer test, rose bengal staining and cases of recanalization after thermal occlusion with electrocauterium. The lacrimal puncta were examined after 7, 15, 30, 60, 90 and 180 days after surgery. None of the canaliculus recanalized at this time. Punctate keratitis, corneal filaments, Schirmer and rose bengal tests improved in 5 eyes. Diffuse punctate keratitis was present in the patient with lacrimal gland removal even 2 months after of surgery. Eyelid margin complications were not observed. This technique is simple and effective in permanent lacrimal canaliculus occlusion. We did not note any complications compared to other procedures.

Análise do custo-benefício da avaliação ocular de pacientes portadores de rosácea

To observe the main ocular manifestations of patients with rosacea and to evaluate the cost-benefit of supplementary diagnostic examinations. Twenty patients with acne rosacea from the Dermatology Service of the São Paulo Federal University (UNIFESP) were interviewed through a questionnaire, submitted to ophthalmologic examination and tested with Schirmer I, fluorescein and rose Bengal staining, impression cytology and conjunctival scrub. The costs of these examinations were abstracted from the Public Health System's values (SUS), Brazilian Medical Association values (AMB) and values charged by a private service. Twenty patients were enrolled initially in the study, but only 16 completed it. Eleven patients were female (55%), 19 were white (95%) and the average age was 56 years. All patients had at least one complaint related to rosacea. The most common symptoms were itching (40%), tearing (35%), foreign body sensation (30%). The most common signs were telangiectasis of lid margins (70%), hyperemia of lid margins (70%), meibomitis (65%) and blepharitis (50%). Most subsidiary examination showed normal results. There was difference of costs between the different paying sources. The main ocular manifestations in rosacea were related with meibomian gland disease. Considering the subsidiary examination costs and their results, the ophthalmologic check-up presents the best cost-benefit for the patient with rosacea.

The effect of autologous serum eyedrops in the treatment of severe dry eye disease: A prospective randomized case-control study

To evaluate the effectiveness of the autologous serum eyedrops in the treatment of severe dry eye patients. Prospective randomized case-control study. Thirty-seven eyes of twenty severe dry eye patients without punctal occlusion were enrolled in this study. After 2 weeks of washout, they were randomly assigned to two groups. Group A patients used only preservative-free artificial tears, and group S patients used only autologous serum eyedrops. We evaluated the results of Schirmer test, fluorescein and rose bengal staining scores, tear film breakup time (BUT), and subjective symptom scores before and 2 weeks after treatment. Mean BUT and fluorescein and rose bengal staining scores, as well as subjective symptom scores, showed significant improvement in the patients assigned to autologous serum eyedrops compared with subjects assigned to preservative-free artificial tears after 2 weeks of treatment. Autologous serum eyedrops were found effective in the treatment of severe dry eye disease, as evidenced by improvement of tear stability and ocular surface vital staining scores.