Change To Improved Biomass Stoves Decreases Ocular Symptoms Among Highlanders In Peru

Object The purpose of this study was to assess the efficacy of Gamma Knife surgery (GKS) for treating cavernous sinus dural arteriovenous fistulas (CSDAVFs). Methods Of the 4123 GKSs performed between May 1992 and March 2009, 890 procedures were undertaken to treat vascular lesions. In 24 cases, the vascular lesion that was treated was a dural arteriovenous fistula, and in 6 of these cases, the lesion involved the cavernous sinus. One of these 6 cases was lost to follow-up, leaving the other 5 cases (4 women and 1 man) to comprise the subjects of this study. All 5 patients had more than 1 ocular symptom, such as ptosis, chemosis, proptosis, and extraocular movement palsy. In all patients, CSDAVF was confirmed by conventional angiography. Three patients were treated by GKS alone and 2 patients were treated by GKS combined with transarterial embolization. The median follow-up period after GKS in these 5 cases was 30 months (range 9–59 months). Results All patients experienced clinical improvement, and their improvement in ocular symptoms was noticed at a mean of 17.6 weeks after GKS (range 4–24 weeks). Two patients received embolization prior to GKS but did not display improvement in ocular symptoms. An average of 20 weeks (range 12–24 weeks) was needed for complete improvement in clinical symptoms. There were no treatment-related complications during the follow-up period. Conclusions Gamma Knife surgery should be considered as a primary, combined, or additional treatment option for CSDAVF in selected cases, such as when the lesion is a low-flow shunt without cortical venous drainage. For those selected cases, GKS alone may suffice as the primary treatment method when combined with close monitoring of ocular symptoms and intraocular pressure.

Download Full-text

Ocular Comorbidities in Rosacea: A Case-Control Study Based on Seven Institutions

Journal of Clinical Medicine ◽

10.3390/jcm10132897 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2897

Author(s):

Yu Ri Woo ◽

Minah Cho ◽

Hyun Jeong Ju ◽

Jung Min Bae ◽

Sang Hyun Cho ◽

...

Keyword(s):

Dry Eye ◽

Case Control Study ◽

Matched Control ◽

Case Control ◽

Dry Eye Syndrome ◽

Data Set ◽

Ocular Symptoms ◽

Inflammatory Dermatosis ◽

Control Study ◽

Surface Changes

Rosacea is a facial inflammatory dermatosis that is linked with various systemic illnesses. With regards to the eye, rosacea patients have been described to manifest ocular surface changes, such as blepharitis and conjunctivitis. However, studies that examine the association of rosacea with a wider array of ocular diseases are limited. Thus, our aim was to identify the range of ocular comorbidities in the Korean patient population and create a reference data set. A multi-institutional, case-control study was conducted, where 12,936 rosacea patients and an equal number of sex- and age-matched control subjects were extracted over a 12-year period. We were able to discover a notable association between rosacea and blepharitis (adjusted odds ratio (aOR) 3.44; 95% confidence interval, 2.71–4.36, p < 0.001), conjunctivitis (aOR 1.65; 95% CI, 1.50–1.82, p < 0.001), glaucoma (aOR 1.93; 95% CI, 1.70–2.20, p < 0.001), dry eye syndrome (aOR 1.89; 95% CI, 1.70–2.09, p < 0.001), and chalazion (aOR 3.26; 95% CI, 1.41–7.57, p = 0.006) from logistic regression analysis. Female subjects and individuals younger than 50 exclusively showed higher odds for chalazion. Our study suggests that ocular comorbidities (i.e., glaucoma, dry eye syndrome, and chalazion as well as blepharitis and conjunctivitis) are more prevalent among Koreans with rosacea. Clinicians should proactively check ocular symptoms in rosacea and employ joint care with an ophthalmologist in cases of need.

Download Full-text

Ocular Involvement of SARS-CoV-2 in a Polish Cohort of COVID-19-Positive Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062916 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2916

Author(s):

Joanna Dolar-Szczasny ◽

Mario D. Toro ◽

Anna Dworzańska ◽

Tomasz Wójtowicz ◽

Izabela Korona-Glowniak ◽

...

Keyword(s):

Genetic Material ◽

Eye Disease ◽

Ocular Infection ◽

Ocular Involvement ◽

Consecutive Series ◽

Respiratory Involvement ◽

Ocular Symptoms ◽

Male Patients ◽

Tight Correlation ◽

Variable Efficiency

The coronavirus SARS-CoV-2 responsible for the current human COVID-19 pandemic has shown tropism toward different organs with variable efficiency, eyes included. The purpose of this study has been to investigate the presence of detectable SARS-CoV-2 infection in ocular swabs in patients affected by COVID-19. A consecutive series of 74 COVID-19-positive patients (age 21–89) were enrolled at two Polish COVID-19 hospitals for 4 months and were characterized by PCR for the presence of the SARS-CoV-2 genetic material in nasopharyngeal (NP) and ocular swabs, while their respiratory and ocular symptoms were noted. Almost 50% of them presented with severe/critical respiratory involvement, and some degree of eye disease. No tight correlation was observed between the presence of ocular and respiratory symptoms. Three male patients presenting with severe/critical lung disease tested positive in ocular swab, however with mild/moderate ocular symptoms. In conclusion, our study lends further support to the view that overt ocular infection by the SARS-CoV-2 virus is not such a frequent occurrence.

Download Full-text

Recurrent keratoconjunctivitis as the sole manifestation of COVID-19 infection: A case report

European Journal of Ophthalmology ◽

10.1177/11206721211006583 ◽

2021 ◽

pp. 112067212110065

Author(s):

Satria Audi Hutama ◽

Firas Farisi Alkaff ◽

Ryan Enast Intan ◽

Citra Dewi Maharani ◽

Luki Indriaswati ◽

...

Keyword(s):

Case Report ◽

Foreign Body ◽

Foreign Body Sensation ◽

Polymerase Chain Reaction Test ◽

Nasopharyngeal Swab ◽

Conjunctival Hyperemia ◽

Blurred Vision ◽

Ocular Symptoms ◽

Body Sensation ◽

Fluorescence Test

Introduction: Ocular symptoms are uncommon manifestations of coronavirus disease 2019 (COVID-19) infection. Earlier study reported that dry eye, blurred vision, foreign body sensation, tearing, itching, conjunctival secretion, conjunctival congestion, ocular pain, and photophobia are among the ocular symptoms that could be found in COVID-19 patients. However, there are only a few reports available regarding corneal involvement in this disease. Here we report a case of keratoconjunctivitis as the only symptom of COVID-19 infection. Case description: A 27-year-old man who worked as an obstetrics and gynecology resident came to the outpatient clinic with the chief complaints of eye discomfort, foreign body sensation, conjunctival hyperemia, lacrimation, and photophobia in his right eye for the past 3 weeks. Fluorescence test showed a small corneal lesion. The patient was then diagnosed with keratoconjunctivitis. A week after the treatment, all symptoms were resolved. A month later, the patient came to the emergency room with the same eye complaints but with a more severe pain. The fluorescence test showed wider corneal lesion compared to last month. The result from the corneal swab is negative for bacterial or fungal infection, indicating a viral infection. Afterwards, reverse transcriptase polymerase chain reaction test from nasopharyngeal swab was performed and revealed that the patient was positive for COVID-19. Conclusions: This case report showed that keratoconjunctivitis may occur as the only manifestation of COVID-19 infection. Thus, patient presented with unexplainable eye symptoms should be evaluated for COVID-19 infection.

Download Full-text

SARS-CoV-2 RNA and antibodies in tear fluid

BMJ Open Ophthalmology ◽

10.1136/bmjophth-2021-000733 ◽

2021 ◽

Vol 6 (1) ◽

pp. e000733

Author(s):

Astrid Muyldermans ◽

Maria Bjerke ◽

Thomas Demuyser ◽

Deborah De Geyter ◽

Ingrid Wybo ◽

...

Keyword(s):

Immune Response ◽

Humoral Immune Response ◽

Spike Protein ◽

Tear Fluid ◽

Local Response ◽

Schirmer Test ◽

Humoral Immune ◽

Non Invasive ◽

Reverse Transcription Pcr ◽

Ocular Symptoms

Background/aimsSARS-CoV-2 is highly contagious. More evidence concerning extrapulmonary transmission routes such as the eyes is urgently needed. Although the humoral immune response is important in the viral containment, the local response in tears has not yet been studied. The aim of our study was twofold: to assess the prevalence of both SARS-CoV-2 RNA and antibodies in tear fluid.MethodsIn a first series, nasopharyngeal sampling and tear sampling by Schirmer test strips were performed in 26 acutely ill patients with COVID-19 to assess the presence of SARS-CoV-2 RNA by reverse transcription PCR. In a second series, IgG and IgA responses to SARS-CoV-2 spike protein in serum and tear fluid of convalescent individuals (n=22) were compared with control individuals (n=15) by ELISA.ResultsSARS-CoV-2 RNA was detected in tears of 7/26 (26.9%) patients with COVID-19. None of them had ocular symptoms. Convalescent individuals displayed a significant higher ratio of IgG (p<0.0001) and IgA (p=0.0068) in tears compared with control individuals. A sensitivity of 77.3% and specificity of 93.3% was observed for IgG, and 59.1% and 100% for IgA.ConclusionsOur results demonstrate the presence of SARS-CoV-2 RNA and a local IgG and IgA immune response in tear fluid. These data confirm the possibility of SARS-CoV-2 transmission through tear fluid and the importance of the eye as a first defence against SARS-CoV-2, indicating the potential of tears as a non-invasive surrogate for serum in monitoring the host immune response.

Download Full-text

Ocular adverse events associated with immune checkpoint inhibitors: a novel multidisciplinary management algorithm

Therapeutic Advances in Medical Oncology ◽

10.1177/1758835921992989 ◽

2021 ◽

Vol 13 ◽

pp. 175883592199298

Author(s):

Orthi Shahzad ◽

Nicola Thompson ◽

Gerry Clare ◽

Sarah Welsh ◽

Erika Damato ◽

...

Keyword(s):

Adverse Events ◽

Checkpoint Inhibitors ◽

Case Reports ◽

Case Series ◽

Simple Algorithm ◽

Cancer Therapeutics ◽

Management Algorithm ◽

Ocular Symptoms ◽

Systemic Corticosteroids ◽

Permanent Loss

Ocular immune-related adverse events (IrAEs) associated with use of checkpoint inhibitors (CPIs) in cancer therapeutics are relatively rare, occurring in approximately 1% of treated patients. Recognition and early intervention are essential because the degree of tissue damage may be disproportionate to the symptoms, and lack of appropriate treatment risks permanent loss of vision. International guidelines on managing ocular IrAEs provide limited advice only. Importantly, local interventions can be effective and may avoid the need for systemic corticosteroids, thereby permitting the continuation of CPIs. We present a single institution case series of eight affected patients managed by our multidisciplinary team. Consistent with previously published series and case reports, we identified anterior uveitis as the most common ocular IrAE associated with CPIs requiring intervention. Based on our experience, as well as published guidance, we generated a simple algorithm to assist clinicians efficiently manage patients developing ocular symptoms during treatment with CPIs. In addition, we make recommendations for optimising treatment of uveitis and address implications for ongoing CPI therapy.

Download Full-text

MP-AzeFlu in Moderate-to-Severe Allergic Rhinitis: A Literature Review

International Archives of Allergy and Immunology ◽

10.1159/000516417 ◽

2021 ◽

pp. 1-10

Author(s):

Ludger Klimek ◽

William E. Berger ◽

Jean Bousquet ◽

Paul K. Keith ◽

Peter Smith ◽

...

Keyword(s):

Quality Of Life ◽

Allergic Rhinitis ◽

Fluticasone Propionate ◽

Treatment Options ◽

Symptomatic Disease ◽

Intranasal Corticosteroids ◽

Need For Treatment ◽

Ocular Symptoms ◽

Symptom Complex

Allergic rhinitis (AR) is prevalent, and many patients present with moderate-to-severe symptomatic disease. The majority of patients are not satisfied with their AR treatment, despite the use of concurrent medications. These gaps underscore the need for treatment with more effective options for moderate-to-severe AR. The authors’ objective was to review systematically the efficacy and safety of MP-AzeFlu for the treatment of AR. The primary outcomes studied were nasal, ocular, and total symptoms. Other outcomes included time to onset and of AR control, quality of life, and safety. Searches of PubMed and Cochrane databases were conducted on May 14, 2020, with no date restrictions, to identify publications reporting data on MP-AzeFlu. Clinical studies of any phase were included. Studies were excluded if they were not in English, were review articles, did not discuss the safety and efficacy of MP-AzeFlu for AR symptoms. Treatment of AR with MP-AzeFlu results in effective, sustained relief of nasal and ocular symptoms, and faster onset and time to control compared with intranasal azelastine or fluticasone propionate. Long-term use of MP-AzeFlu was safe, with benefits in children, adults, and adults aged ≥65 years. Other treatment options, including fluticasone propionate and azelastine alone or the combination of intranasal corticosteroids and oral antihistamine, do not provide the same level of efficacy as MP-AzeFlu in terms of rapid and sustained relief of the entire AR symptom complex. Furthermore, MP-AzeFlu significantly improves patient quality of life. MP-AzeFlu is a currently available combination that may satisfy all these patient needs and expectations.

Download Full-text

Mevalonate Kinase-Associated Diseases: Hunting for Phenotype–Genotype Correlation

Journal of Clinical Medicine ◽

10.3390/jcm10081552 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1552

Author(s):

Guilaine Boursier ◽

Cécile Rittore ◽

Florian Milhavet ◽

Laurence Cuisset ◽

Isabelle Touitou

Keyword(s):

Severe Disease ◽

Compound Heterozygous ◽

Mevalonate Kinase ◽

Kinase Gene ◽

New Associations ◽

Associated Diseases ◽

Ocular Symptoms ◽

Disseminated Superficial Actinic Porokeratosis ◽

Increased Risk ◽

Genotype Correlation

Mevalonate kinase-associated diseases (MKAD) are caused by pathogenic mutations in the mevalonate kinase gene (MVK) and encompass several phenotypically different rare and hereditary autoinflammatory conditions. The most serious is a recessive systemic metabolic disease called mevalonic aciduria, and the most recently recognized is disseminated superficial actinic porokeratosis, a dominant disease limited to the skin. To evaluate a possible correlation between genotypes and (1) the different MKAD clinical subtypes or (2) the occurrence of severe manifestations, data were reviewed for all patients with MVK variants described in the literature (N = 346), as well as those referred to our center (N = 51). The genotypes including p.(Val377Ile) (homozygous or compound heterozygous) were more frequent in mild systemic forms but were also sometimes encountered with severe disease. We confirmed that amyloidosis was more prevalent in patients compound heterozygous for p.(Ile268Thr) and p.(Val377Ile) than in others and revealed new associations. Patients homozygous for p.(Leu264Phe), p.(Ala334Thr) or compound heterozygous for p.(His20Pro) and p.(Ala334Thr) had increased risk of severe neurological or ocular symptoms. All patients homozygous for p.(Leu264Phe) had a cataract. The variants associated with porokeratosis were relatively specific and more frequently caused a frameshift than in patients with other clinical forms (26% vs. 6%). We provide practical recommendations focusing on phenotype–genotype correlation in MKAD that could be helpful for prophylactic management.

Download Full-text

Efficacy of a food supplement Lertal® as an adjuvant therapy of patients with moderate-to-severe seasonal allergic rhinoconjunctivitis

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00117-6 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Aleksandar Perić ◽

Maja Buljčik Čupić ◽

Marija Komadina Vuković ◽

Vesna Gajić Dragović ◽

Vladimir Nešić ◽

...

Keyword(s):

Topical Therapy ◽

Complementary Therapy ◽

Food Supplement ◽

Allergic Rhinoconjunctivitis ◽

Treatment Visit ◽

Ocular Symptoms ◽

Days Of Therapy ◽

Significant Difference ◽

Ocular Itching ◽

Intranasal Spray

Abstract Background Lertal® is an oral food supplement containing 80 mg of dry extract of Perilla frutescens, 150 mg of bioflavonoid quercetin, and 5 μg of vitamin D3. The aim of this study was to evaluate the efficacy of Lertal® as a complementary therapy to topical therapy of patients with moderate-to-severe seasonal allergic rhinoconjunctivitis (SAR). Results Seventy (n=70) adult patients with moderate-to-severe SAR were included in this prospective study and treated by four different procedures: (1) 21 patients received azelastine intranasal spray for 30 days and, after that, azelastine spray and Lertal® tablets for the next 30 days; (2) 19 patients received combined azelastine with fluticasone intranasal spray for 30 days and azelastine with fluticasone spray and Lertal® tablets for the next 30 days; (3) 15 patients received azelastine spray only for 60 days; (4) 15 patients received combined azelastine with fluticasone spray only for 60 days. Levels of SAR symptoms (sneezing, tearing, ocular itching, rhinorrhea, nasal obstruction, hyposmia, and cough), as well as Total Symptom Scores (TSS), were evaluated at the start of this investigation (visit 0), after 30 days of treatment (visit 1), and after 60 days of treatment (visit 2) using a visual analog scale. After 30 days of treatment, better effects were achieved in groups in which patients were treated with combined (antihistamine with corticosteroid) spray. After 60 days of therapy, we found the best effects in procedure 2 and slightly worse effects in procedure 1. The high differences in the reduction of TSS between the 60th and 30th day were found for procedure 2 (p<0.001) and procedure 1 (p<0.001). The worse improvement of symptoms we found was in procedure 4 (p<0.01), and, for the procedure 3, we found no significant difference (p=0.140). None of the patients reported adverse effects during the therapy. Conclusion Our results suggest that addition of food supplement Lertal® to the standard topical therapy of patients with moderate-to-severe SAR increases the effects of intranasal therapy in reducing nasal and ocular symptoms.

Download Full-text