Keratitis In Association Research Articles

Infectious keratitis and orthokeratology lens use: a systematic review.

Myopia is a prevalent condition among Asians. Orthokeratology lens has gained popularity as a method of myopia control. This systematic review is to summarize the clinical profile of infectious keratitis in association with orthokeratology lens wear. We searched in the PubMed and EMBASE for articles adopting the search strategy "(orthokeratology lens OR orthokeratology) AND (bacterial eye infection OR keratitis OR cornea ulcer OR microbial keratitis OR bacterial keratitis)", from the start date of the databases to August 23, 2016. Articles reporting infectious keratitis in orthokeratology lens users with data of individual cases were considered eligible for this systematic review. We recorded the outcome measures including method of diagnosis, etiological agents, duration and mode of treatment and treatment outcomes. Our literature search yielded 172 papers. After removing duplicated and irrelevant reports, we included 29 articles for data analysis, involving 173 eyes. Among all reported cases, the mean age at presentation was 15.4±6.2years, with a female preponderance (male-to-female ratio 1:1.7). Positive microbiological cultures were reported in 69.4% of cases, with Pseudomonas aeruginosa and Acanthamoeba being the most common etiological agents. The mean duration of hospitalization was 7.7±6.7days. Mean LogMAR visual acuity at presentation was 1.17±0.78, increased to 0.33±0.41 at final visit (p<0.001). Despite early intervention and treatment, the majority of infections resulted in the formation of corneal scars and almost 10% of eyes needed surgical treatment. Timely awareness and treatment of keratitis should be emphasized to the users.

Keratitis in association with herpes zoster and varicella vaccines.

The objective of this review was to collect reports of keratitis in association with herpes zoster virus (HZV) or varicella zoster virus (VZV) vaccines. HZV vaccination is intended for at-risk adult populations and VZV vaccination is intended for all pediatric patients. We reviewed the literature and reports of keratitis in association with herpes zoster or varicella vaccine from the National Registry of Drug-Induced Ocular Side Effects and the World Health Organization. Twenty-four cases of unilateral keratitis in association with VZV vaccines were collected from the adverse reaction databases and literature. In most cases, the onset of keratitis occurred within days of vaccination and resolved with topical steroid eye drops and oral acyclovir. Data suggest that keratitis in association with herpes zoster or varicella vaccine is rare, is usually self-limited or resolves with treatment. The mechanism may be the persistence of viral antigens in the cornea after VZV vaccination or herpes zoster ophthalmicus. This reaction is probable, given the plausible biological mechanism, the temporal relationship between vaccination and keratitis, and overall patterns of presentation after vaccination.

Peripheral ulcerative keratitis in association with sarcoidosis

Peripheral ulcerative keratitis (PUK) is a sight-threatening condition characterized by an epithelial defect, crescent-shaped stromal inflammation, and progressive stromal thinning. Peripheral ulcerative keratitis as a purely inflammatory entity is most commonly associated with collagen vascular diseases, including rheumatoid arthritis, polyarteritis nodosa, Wegener granulomatosis, systemic lupus erythematosus, and relapsing polychondritis. PUK can also be associated with infectious and inflammatory conditions such as hepatitis, syphilis, herpes simplex keratitis, fungal keratitis, Mooren ulcer, and marginal keratitis. We describe a case report of PUK associated with the inflammatory condition of sarcoidosis.

Interstitial Keratitis Secondary to Severe Hidradenitis Suppurativa: A Case Report and Literature Review

To report a patient who presented with bilateral interstitial keratitis in association with severe hidradenitis suppurativa. Case report. An 18-year-old African American woman with severe active hidradenitis suppurativa of the axillae and groin presented with a 2-week history of bilateral blurry vision. On examination, best-corrected visual acuity was counting fingers in the right eye and 20/70 in the left eye. Slit-lamp examination revealed diffuse vascularization of the corneal stroma with surrounding infiltrates bilaterally. In the left eye, corneal thinning and an epithelial defect were present in an area of infiltrate. Our clinical impression at that time was bilateral interstitial keratitis with secondary bacterial keratitis in the left eye. Topical therapy, prednisolone acetate 1% in the right eye, and ofloxacin in the left eye, was instituted. A systemic workup, including antinuclear antibody, rheumatoid factor, Lyme titer, cytoplasmatic staining antineutrophil cytoplasmic antibodies, perinuclear staining antineutrophil cytoplasmic antibodies, erythrocyte sedimentation rate, Venereal Disease Research Laboratory, rapid plasma reagin, basic metabolic panel, angiotensin-converting enzyme level, and a chest x-ray was negative. Topical steroids were used in the left eye after resolution of the bacterial keratitis. The interstitial keratitis responded to topical steroids and remained in remission after steroid taper. However, bilateral interstitial keratitis recurred coincident with a severe flare of hidradenitis suppurativa within 1 month of discontinuing the topical steroids. A course of subcutaneous adalimumab injections (40 mg/mL every 2 weeks) for hidradenitis suppurativa was implemented. Both her dermatological and ocular conditions responded to this therapy and have remained in remission through 7 months of follow-up. Hidradenitis suppurativa is a rare cause of bilateral interstitial keratitis. Patients may experience simultaneous exacerbations of both dermatological and ocular manifestations. Systemic treatment with adalimumab can improve both dermatological and ocular conditions.

Bilateral Acanthamoeba Keratitis in Synergeyes Contact Lens Wear: Clinical and Confocal Microscopy Findings

To report three cases of bilateral Acanthamoeba keratitis in association with Synergeyes hybrid contact lens wear. Retrospective case series of six eyes of three patients that developed Acanthamoeba keratitis with Synergeyes hybrid contact lens wear. Acanthamoeba keratitis was diagnosed in six eyes with a previous misdiagnosis of Herpes simplex keratitis in two patients and a misdiagnosis of corneal graft rejection in the third patient. Misdiagnosis in all three patients led to inappropriate topical corticosteroid use. All cases were diagnosed with Acanthamoeba castellanii by culture on nonnutrient agar, corneal scraping, and/or confocal microscopy. The infection ultimately cleared in all eyes with topical therapy using chlorhexidine, propamidine, and antibiotic ointment with neomycin. Cornea transplantation was required in two of six eyes for dense central corneal scarring. Acanthamoeba keratitis can occur in association with SynergEyes contact lens wear. Eye care professionals must take care to avoid potential misdiagnosis of Herpes simplex keratitis, avoid topical corticosteroids in contact lens wearers with an unknown keratitis, and pay special attention to the fellow eye for potential bilateral infection when Acanthamoeba has been diagnosed in one eye.

Rapidly Progressive Cataract and Iris Atrophy during Treatment of Acanthamoeba Keratitis

To identify characteristics associated with cataract occurring during the course of Acanthamoeba keratitis. Retrospective observational case series. Eighty-one laboratory-confirmed patients with Acanthamoeba keratitis. Review of clinical records. Development of cataract during management of Acanthamoeba keratitis. Rapidly progressive crystalline lens opacification occurred in 9 eyes within 4 to 15 weeks after diagnosis of Acanthamoeba keratitis. Three were associated with inflammatory complications, including anterior scleritis (2 eyes) and iridocyclitis (1 eye). Six others had the abrupt onset of a dense cataract, including 5 with iris atrophy, that occurred during the initial 6 months of therapy with chlorhexidine, a diamidine, and adjunctive corticosteroid. Extracapsular cataract extraction was performed with or after penetrating keratoplasty. Secondary glaucoma developed in 6 of 9 eyes subsequent to iris atrophy (4 eyes) or a cyclitic membrane (2 eyes), and 3 eyes underwent trabeculectomy. Cataract may occur and progress during the management of Acanthamoeba keratitis in association with anterior segment inflammation, iris atrophy, and secondary glaucoma.

Neurotrophic keratitis in a patient with dihydroxypyrimidine dehydrogenase deficiency

We describe a case of neurotrophic keratitis in association with dihydroxypyrimidine dehydrogenase (DHPD) deficiency. Ocular manifestations in patients with DHPD are rare and neurotrophic keratitis has never been reported before. A six-year-old boy who was a known case of DHPD deficiency and born of a consanguineous marriage presented to our clinic with non-healing corneal ulcers in both eyes. Reduced corneal sensations were detected and the patient was started on lubricating eye drops. The patient continues to be on lubricant eye drops and there has been no recurrence of the disease.

Síndrome de Cogan: achados oculares em um caso da forma atípica

Cogan's syndrome is an unusual multisystemic disease characterized by interstitial keratitis in association with vestibuloauditory dysfunction and possible irreversible deafness, classified into 2 clinical types: typical and atypical. There is disagreement in the literature about corneal disease in the atypical variety. A 32-year-old woman complaining of ocular hyperemia and ocular pain, photophobia and visual acuity loss in the right eye associated with sudden left hearing loss, vomiting, diarrhea, oliguria, oropharynx pain and fever. Previous history of similar disease in left eye and right hearing. There was intense conjunctival hyperemia, nodular scleritis, episcleritis, and circular infiltrates in the corneal stroma. The patient received pulse-therapy with methylprednisolone and cyclophosphamide. She exhibited significant ocular improvement but poor hearing results. The reported case may be a typical Cogan's syndrome (according to authors that assert the non-existence of corneal disease in the atypical type) with some findings characteristic of the atypical type or an atypical Cogan's syndrome (for those asserting that it is a corneal disease). Differential diagnosis is also discussed.

Incidence of corneal melting in association with systemic disease in the Yorkshire Region, 1995–7

AIMSTo estimate the incidence of corneal melting or necrotising keratitis in association with systemic disease in the Yorkshire Region and to determine the type and duration of the systemic association.METHODSIn...

Capnocytophaga Endophthalmitis

This article presents three patients with endophthalmitis associated with infection with Capnocytophaga species. The medical records of three patients with culture-positive Capnocytophaga endophthalmitis were reviewed. A panel of isolates of Capnocytophaga were then tested for sensitivity to third-generation cephalosporins. Endophthalmitis with Capnocytophaga species developed in three patients. Infection in the setting of sepsis developed in one patient. Two other patients, one with a penetrating injury and another with keratitis in association with a corneal graft, developed mixed infection with Capnocytophaga being the predominant infecting organism by culture. Two patients recovered vision with clearance of the infection. The third patient underwent enucleation. Capnocytophaga was found to be sensitive to several of the third-generation cephalosporins. To the best of the authors' knowledge, these are the first reported cases of endophthalmitis with Capnocytophaga species. Capnocytophaga species, previously shown to cause necrotizing keratitis, is a potential cause of endophthalmitis, either as a single organism or as part of a mixed infection.

Peripheral Ulcerative Keratitis Associated with Hideradenitis Suppurativa

Peripheral ulcerative keratitis (PUK) is a noninfectious inflammation and ulceration of the peripheral cornea. It may be idiopathic--i.e., Mooren's ulcer--or it may be associated with a variety of systemic disorders, including many collagen vascular diseases. We present a patient who had bilateral peripheral infiltrative and ulcerative keratitis in association with severe hideradenitis suppurativa (HS), a suppurative and cicatricial disease of the apocrine glands of the skin. The peripheral ulcerative keratitis was unresponsive to all routine treatment modalities, but it finally responded to immunosuppression by cyclophosphamide, given orally. To the best of our knowledge, there is only one report in the dermatology literature citing the association of hideradenitis suppurativa and interstitial keratitis.