scholarly journals Dupilumab-associated ocular surface disease: incidence, management and long-term sequelae

2020 ◽  
Author(s):  
Magdalena Z Popiela ◽  
Ramez Barbara ◽  
Andrew M J Turnbull ◽  
Emma Corden ◽  
Beatrice Suarez Matinez-Falero ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Disease Incidence ◽  
Ocular Inflammation ◽  
University Hospital ◽  
Ocular Surface Disease ◽  
Prior History ◽  
Topical Steroids ◽  
Long Term Effects ◽  
Skin Changes

AbstractObjectiveTo determine the incidence of ocular surface disease in patients with atopic dermatitis (AD) treated with dupilumab at a tertiary, university hospital. To describe the features of dupilumab-associated ocular surface disease, establish the need for treatment and report any long-term effects on the ocular surface.MethodsA retrospective analysis of consecutive patients treated with dupilumab for AD between January 2017 and August 2019 was undertaken. Data was collected on demographics, incidence and type of ocular disease features, natural history and treatment.Results50% (14/28) patients developed ocular symptoms with a mean time of onset of 6.75 (+/- 6.1) weeks from starting dupilumab. 69% of these (9/13) were diagnosed with conjunctivitis - associated with cicatrisation in two patients and periorbital skin changes in four. Of these nine, four had prior history of atopic keratoconjunctivitis. All were treated with topical steroids; two required additional ciclosporin drops. 67% (6/9) patients developed chronic ocular inflammation requiring maintenance drops at a mean of 16 (+/- 6.9) months of follow up. All patients had improvement in their AD severity; only one patient discontinued dupilumab due to ocular side effects.ConclusionThe rate of dupilumab-associated ocular surface disease was 32%. Periorbital skin changes and conjunctival cicatrisation were noted in association with conjunctivitis. Ocular surface disease improved on topical steroids and ciclosporin but 67% of patients needed on-going treatment. Patients should be referred to an ophthalmologist prior to starting dupilumab as a large proportion develops chronic ocular inflammation.

scholarly journals Dupilumab-associated ocular surface disease: presentation, management and long-term sequelae

Eye ◽  
2021 ◽  
Author(s):  
Magdalena Z. Popiela ◽  
Ramez Barbara ◽  
Andrew M. J. Turnbull ◽  
Emma Corden ◽  
Beatriz Suarez Martinez-Falero ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Past History ◽  
University Hospital ◽  
Ocular Surface Disease ◽  
Prior History ◽  
Topical Steroids ◽  
Long Term Effects ◽  
Skin Changes ◽  
History Of

Abstract Objectives To determine the presenting features of ocular surface disease in patients with atopic dermatitis (AD) treated with dupilumab at a tertiary, university hospital. To establish the need for treatment of dupilumab-associated ocular surface disease and report any long-term effects on the ocular surface. Methods A retrospective analysis of consecutive patients treated with dupilumab for AD between January 2017 and August 2019 was undertaken. Data were collected on demographics, incidence and type of ocular disease features, natural history and treatment. Results A total of 50% (14/28) patients developed ocular symptoms with a mean time of onset of 6.75 (±6.1) weeks from starting dupilumab. Of these, 69% (9/13) were diagnosed with conjunctivitis associated with cicatrisation in two patients and periorbital skin changes in four. Of these nine, four had prior history of atopic keratoconjunctivitis. All were treated with topical steroids; two required additional ciclosporin drops. In all, 67% (6/9) patients went on to have on-going ocular inflammation requiring maintenance drops at a mean of 16 (±6.9) months of follow-up. All patients had improvement in their AD severity; only one patient discontinued dupilumab due to ocular side effects. Conclusion The rate of dupilumab-associated ocular surface disease was 32%. Periorbital skin changes and conjunctival cicatrisation were noted in association with conjunctivitis. Ocular surface disease improved on topical steroids and ciclosporin but 67% of patients needed on-going treatment. Close liaison with an ophthalmologist should be considered in those patients who develop conjunctivitis or have a past history of severe ocular surface disease.

Long-term Progression of Ocular Surface Disease in Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis

Cornea ◽  
2020 ◽  
Vol 39 (6) ◽  
pp. 745-753
Author(s):  
Yamato Yoshikawa ◽  
Mayumi Ueta ◽  
Hideki Fukuoka ◽  
Tsutomu Inatomi ◽  
Isao Yokota ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Ocular Surface ◽  
Ocular Surface Disease ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome

scholarly journals Diagnosis and Treatment Methods for Ocular Surface Disease in Glaucoma

2014 ◽  
Vol 08 (01) ◽  
pp. 40
Author(s):  
Gemma C M Rossi ◽  
Keyword(s):  
Ocular Surface ◽  
Diagnostic Tests ◽  
Benzalkonium Chloride ◽  
Tear Film ◽  
Daily Practice ◽  
Ocular Surface Disease ◽  
Anterior Surface ◽  
Treatment Methods ◽  
Associated Diseases

Glaucoma and ocular surface disease (OSD) are often concomitant disorders (OSD is the consequence of a tear film dysfunction that may be due to several conditions). The aims of the paper are to suggest a sequence of diagnostic tests easy to perform in daily practice, both subjective and objective, to detect the onset of the OSD; and, second, to propose how to prevent and, if the case, how to manage the OSD. Briefly, tear film break-up time (TF-BUT) and corneal/conjunctival staining are suggested to detect the main signs of OSD. In terms of therapy, the long-term exposure to benzalkonium chloride (BAK) should be minimised, preferring non-BAK-preserved or BAK-free glaucoma medications, where available, as well as fixed combinations. The treatment of associated diseases of the anterior surface may reduce signs; use of non BAK-preserved tears may reduce symptoms.

scholarly journals Ocular Myasthenia Gravis with Severe Blepharitis and Ocular Surface Disease: A Case Report

2020 ◽  
Vol 11 (2) ◽  
pp. 322-329
Author(s):  
Roee Arnon ◽  
Tal Yahalomi ◽  
Irit Rozen-Knisbacher ◽  
Joseph Pikkel ◽  
Dina Mostovoy
Keyword(s):  
Myasthenia Gravis ◽  
Ocular Surface ◽  
Immunosuppressive Treatment ◽  
Intravenous Immunoglobulins ◽  
Ocular Surface Disease ◽  
Topical Steroids ◽  
Conjunctival Hyperemia ◽  
Tea Tree ◽  
Ocular Myasthenia ◽  
Ocular Myasthenia Gravis

Ocular myasthenia gravis (OMG) is an autoimmune disease of the neuromuscular junction and commonly associated with other immune diseases. We describe a 16-year-old female who presented to our clinic with 1-month complaints of diplopia and strabismus, visual acuity deterioration, and ocular irritation. Her examination showed crossed diplopia and alternating exotropia of 25 prism diopters, severe blepharitis, conjunctival hyperemia, corneal pannus, epithelial irregularities, and subepithelial opacities. Workup included pediatric neurologic examination, laboratory tests, imaging, and electrophysiological tests. Diagnoses of OMG and blepharitis with ocular surface disease were made. Topical treatment included eyelid hygiene, tea tree oil scrubbing, topical steroids, and tacrolimus ointment. Systemic treatment included corticosteroids, pyridostigmine, azathioprine, intravenous immunoglobulins, amitriptyline, and doxycycline. Both diseases were refractory to intensive immunosuppressive treatment and had simultaneous relapses and an intertwined course. Our hypothesis is that a shared immune mechanism may be the cause of both OMG and ocular surface disease in our patient.

scholarly journals Effect of Autologous Serum Eyedrops on Ocular Surface Disease Caused by Preserved Glaucoma Eyedrops

2020 ◽  
Vol 9 (12) ◽  
pp. 3904
Author(s):  
Ha-Rim So ◽  
Hae Young Lopilly Park ◽  
So-Hyang Chung ◽  
Hyun-Seung Kim ◽  
Yong-Soo Byun
Keyword(s):  
Ocular Surface ◽  
Ocular Surface Disease ◽  
Autologous Serum ◽  
Ocular Surface Disease Index ◽  
Ocular Surface Diseases ◽  
Group 3 ◽  
Baseline Values ◽  
Group 2 ◽  
Group 1

Autologous serum eyedrops (ASE) are effective in treating various ocular surface diseases, including damages induced by long-term use of preserved glaucoma eyedrops. However, there has been no study on whether ASE is effective without stopping the causative eyedrops. This retrospective observational study included 55 patients with ocular-surface diseases caused by long-term use of preserved glaucoma eyedrops: 18 patients who used ASEs for 2 months without discontinuing the use of glaucoma eyedrops (Group 1), 22 patients who used ASEs for 2 months, discontinuing the use of glaucoma eyedrops for the first month (Group 2) and 15 patients who used non-preservative artificial tears for 2 months, discontinuing the use of glaucoma eyedrops for the first month (Group 3). There were no intergroup differences in the baseline values of the Schirmer I test results, tear breakup time (TBUT), ocular surface staining (OSS) score, loss of the meibomian gland, meibum quality and ocular-surface disease index (OSDI). Group 1 showed significant differences in TBUT, OSS score and OSDI at 2 months when compared to the baseline values before treatment, while Group 2 showed significant differences in those values at both 1 and 2 months. There were no differences in any of the parameters at baseline, 1 month or 2 months in Group 3. Our result suggested that ASE is effective for treating ocular surface diseases caused by glaucoma eyedrops containing preservatives and its effects can be expected without interruption of glaucoma eyedrop treatment.

scholarly journals Performance of Five Turfgrasses under Linear Gradient Irrigation

HortScience ◽  
1999 ◽  
Vol 34 (5) ◽  
pp. 893-896 ◽  
Author(s):  
Y.L. Qian ◽  
M.C. Engelke
Keyword(s):  
Drought Resistance ◽  
Irrigation System ◽  
Disease Incidence ◽  
Gray Leaf Spot ◽  
Irrigation Regime ◽  
Long Term Effects ◽  
Weed Invasion ◽  
Continuous Irrigation ◽  
Linear Gradient

Determining the appropriate level of irrigation for turfgrasses is vital to the health of the turfgrass and the conservation of water. The linear gradient irrigation system (LGIS) allows long-term assessment of turf performance under continuous irrigation gradients from excess to no irrigation. The objectives of this study were to: 1) evaluate the minimum irrigation requirements and relative drought resistance of `Rebel II' tall fescue (Festuca arundinacea Schreb.), `Meyer' zoysiagrass (Zoysia japonica Steud.), `Tifway' bermudagrass [Cynodon dactylon (L.) Pers.], `Prairie' buffalograss [Buchloe dactyloides (Nutt.) Engelm], and `Nortam' St. Augustinegrass [Stenotaphrum secundatum (Walt.) Kuntze]; and 2) evaluate the long-term effects of irrigation levels on turf persistence, weed invasion, and disease incidence for the five selected turfgrasses under field conditions. Turf was sodded under LGIS with an irrigation gradient ranging from 120% Class A pan evaporation (Ep) to natural precipitation, along a 20-m turf area. Evaluation during the summers of 1993–96 indicated that grasses differed in drought resistance and persistence under variable irrigation regimes. Irrigation (Ep) required to maintain acceptable turf quality for respective grasses was `Rebel II' (67%), `Meyer' (68%), `Nortam' (44%), `Tifway' (35%), and `Prairie' (26%). Higher dollar spot (Sclerotinia homoeocarpa Bennett) infection was observed at 115% Ep irrigation regime in `Tifway' bermudagrass, whereas gray leaf spot [Pyricularia grisea (Hebert) Barr] was observed only at 10% Ep irrigation regime in St. Augustinegrass plots. An outbreak of brown patch (Rhizoctonia solani Kuehn.) occurred in Sept. 1996 in St. Augustinegrass plots receiving irrigation at >80% Ep.

scholarly journals How Ocular Surface Disease Impacts the Glaucoma Treatment Outcome

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Snježana Kaštelan ◽  
Martina Tomić ◽  
Kata Metež Soldo ◽  
Jasminka Salopek-Rabatić
Keyword(s):  
Ocular Surface ◽  
Microbial Contamination ◽  
Standard Form ◽  
Ocular Surface Disease ◽  
Treatment Goals ◽  
Corneal Epithelial ◽  
Glaucoma Treatment ◽  
Preservative Free

The treatment goals for glaucoma are lowering the intraocular pressure and preservation of vision. Topical hypotensive drops are the standard form of therapy which is often associated with some symptoms of toxicity, ocular inflammation, allergy, or ocular surface disease (OSD). OSD is a common comorbidity in glaucoma patients, and its prevalence with glaucoma increases with age. Use of topical treatment could additionally increase symptoms of OSD mostly due to preservatives added to multidose medication bottles used to reduce the risk of microbial contamination. This toxicity has been particularly associated with BAK, the most commonly used preservative which damages conjunctival and corneal epithelial cells and significantly aggravates OSD symptoms. OSD adversely affects patients’ quality of life causing discomfort and problems with vision which in turn may result in noncompliance, lack of adherence, and eventually visual impairment. In the management of glaucoma patients OSD symptoms should not be overlooked. If they are present, topical glaucoma treatment should be adapted by decreasing the amount of drops instilled daily, using BAK-free or preservative-free medication and lubricants if necessary. Awareness of the presence and importance of OSD will in turn improve patients' adherence and compliance and thus ultimately the preservation of long-term vision.

Health-Related Quality of Life in Long-Term Survivors of Testicular Cancer

2009 ◽  
Vol 27 (35) ◽  
pp. 5993-5999 ◽  
Author(s):  
Philip Blach Rossen ◽  
Anette Fischer Pedersen ◽  
Robert Zachariae ◽  
Hans von der Maase
Keyword(s):  
Quality Of Life ◽  
Testicular Cancer ◽  
University Hospital ◽  
Life Questionnaire ◽  
Long Term Effects ◽  
Number Of Patients ◽  
Health Related ◽  
Long Term Survivors

Purpose A growing number of patients with testicular cancer (TC) become long-term survivors. As a consequence, quality-of-life (QOL) issues become increasingly important. The objective of this study was to investigate QOL among Danish TC survivors. Methods A long-term follow-up assessment of all patients with TC treated at Aarhus University Hospital in Denmark between 1990 and 2000 was conducted. A total of 401 survivors (response rate, 66%) completed questionnaires concerning QOL (European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30), depression (Beck Depression Inventory-II), fatigue (Multidimensional Fatigue Inventory-20), and health-related issues such as neurotoxic symptoms and Raynaud-like phenomena. On the basis of their treatment, participants were categorized as having received surveillance, radiotherapy, or chemotherapy. Results QOL among patients with TC was equal to that of men from the general population. Although patients who received chemotherapy reported higher levels of peripheral sensory neuropathy, ototoxicity, and Raynaud-like phenomena, treatment strategies were generally unrelated to QOL and depressive symptoms. Conclusion Overall, the patients in this study reported high levels of QOL. The results suggest that patients treated for TC should be informed about the anticipated good post-therapeutic QOL and the low risk of psychosocial and physical long-term effects.

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