China
Africa
Explore chapters and articles related to this topic
Determination of Antiviral Activity
Published in Adorjan Aszalos, Modern Analysis of Antibiotics, 2020
When evaluating compounds against the type 1 herpesvirus, the type of infection particularly to be targeted should be considered in selecting the system to be used. If treatment for herpetic keratitis is sought, the rabbit eye model has been most widely accepted. Nesburn [52–54] has recently modified the original rabbit eye model of Kaufman et al. [51] by also determining the influence of test compounds on the recovery of virus in the trigeminal ganglion and the midbrain of the rabbits, the former where the latent virus is usually located. Those seeking to treat cutaneous lesions induced by type 1 herpesvirus often use the guinea pig model in which lesions are produced on the shaved back; other models receiving use for studying this type of infection include the mouse ear model [64,65], which can determine effects against the cutaneous infection as well as latent infections of the sensory nerve, and the hairless mouse model [59]. Models for the herpetic infections of the central nervous system (CNS) include infections of mice induced by injection of virus directly into the brain or a more slowly developing infection resulting from intranasal instillation of virus or injection via the intraperitoneal route.
How to master MCQs
Published in Chung Nen Chua, Li Wern Voon, Siddhartha Goel, Ophthalmology Fact Fixer, 2017
In Fuch's heterochromic cyclitis, cells in the anterior chamber do not respond to steroid and their presence should not result in postponement of cataract surgery. However, Fuch's heterochromic cyclitis is associated with certain operative complications due to poor pupillary dilatation and a tendency for the iris to bleed (Amsler's sign). Patients with proliferative diabetic retinopathy and significant macular oedema should undergo laser treatment prior to cataract surgery. In maculopathy, it is recommended that laser is performed 12 weeks before cataract surgery. Retinal detachment following cataract surgery is usually the result of a fresh retinal tear. Prophylactic treatment of lattice degeneration and atrophic holes is not necessary. Active ocular infections, including herpetic keratitis, is a contraindication to cataract surgery. Nasolacrimal duct obstruction in the absence of a mucocele is not a contraindication to cataract surgery.
Infections of the Eye
Published in Keith Struthers, Clinical Microbiology, 2017
The antibacterial agents discussed above are used here as well. Herpetic keratitis can be treated with systemic aciclovir, while fungal keratitis can be treated with topical amphotericin B, fluconazole or itraconazole. Acanthamoeba keratitis is treated with topical chlorhexidine, which has activity against the trophozoites and cysts, and oral itraconazole or voriconazole are used too.
Reports of New and Recurrent Keratitis following mRNA-based COVID-19 Vaccination
Published in Ocular Immunology and Inflammation, 2023
Paras P. Shah, Yoav Glidai, Richard Braunstein, Matthew Gorski, Jung Lee, Farihah Anwar, Amelia Schrier, Jules Winokur, Anne S. Steiner
The associations between keratitis and the BNT162b2 or mRNA-1273 COVID-19 vaccines are a relatively novel finding; our PubMed literature search of the phrase “‘keratitis’AND (‘BNT162b2ʹOR’mRNA-1273’)” revealed two results. The first such study described three cases of herpetic keratitis reactivation that occurred 5–7 days after COVID-19 vaccination.34 All three patients had a history of either herpetic keratitis or herpetic keratouveitis, and two patients experienced symptoms despite taking 1 g of oral valacyclovir for prophylactic therapy. Another report describes two patients who presented with necrotizing stromal keratitis and epithelial keratitis after COVID-19 vaccination, both of whom also had history of herpetic keratitis.35 In these reports, the robust immunological reaction following vaccination is proposed as the possible underlying mechanism. Cases have been reported linking reactivation of herpetic keratitis to COVID-19 vaccination in mRNA vaccines (Pfizer-BioNTech), traditional adenovirus vector vaccines (Oxford-AstraZeneca), and inactivated vaccines (CoronaVac).36–40 The similarities between these reports and our report herein suggest that adequate precautions should be considered in patients with known histories of herpetic keratitis. To the best of our knowledge, our case series is the first report of new-onset keratitis following COVID-19 vaccination.
Bilateral recurrent pseudodendritic keratopathy as the initial manifestation of tyrosinemia type II
Published in Ophthalmic Genetics, 2022
Bruno Avelar Miranda, Anna Christina Higino Rocha, Rodrigo Rezende Arantes, Viviane de Cássia Kanufre, Sabrina Cavaglieri Silva, Daniel Vitor Vasconcelos-Santos
In the context of bilateral corneal dendritic lesions, diagnosis of tyrosinemia type II should be considered, especially if manifesting in the first month of life (10). Ocular lesions, especially bilateral pseudodendritic keratitis, often reveal the disease (6). Like most cases with ocular manifestations so far reported, our patient was also initially treated for presumed “herpetic keratitis.” Diagnosis of tyrosinemia type II was entertained due to bilaterality, lack of terminal bulbs in the epithelial lesions, staining with fluorescein and recurrence even on prophylactic antivirals. In addition, other aspects relevant for the diagnosis were early onset of ocular symptoms (despite normal maternal prenatal screening and serologies) and insufficient response to the empiric antiviral treatment.
Comparison of Comorbid Associations and Ocular Complications in Herpes Simplex and Zoster Keratitis
Published in Ocular Immunology and Inflammation, 2022
Christopher R. Rosenberg, Azin Abazari, Timothy Y. Chou, Sarah B. Weissbart
While HSV and HZO are common, interventions such as vaccination or antiviral medication can reduce recurrence and subsequent corneal and intraocular inflammation. Prospective studies have reported the benefit and safety of prophylactic anti-herpetic medication in some patient populations.7–9 Likewise, prophylactic oral antivirals and topical corticosteroid are commonly used for zoster eye disease, although the first randomized prospective study assessing their effectiveness is ongoing.10 Still, patients treated for HSV and HZO keratitis may have a varied response to treatment, and it is unclear why some patients have worse clinical outcomes than others. Previous studies have reported associations of several patient factors with herpetic keratitis, including diabetes mellitus,11,12 immunodeficiency,13,14 and ocular procedures including laser.15–17 Female gender has been associated with herpetic ulcer recurrence2 and it is well known that corticosteroid therapy and immunosuppressive states may exacerbate herpes simplex keratitis.18 Similarly, HZO has been associated with advanced age, diabetes mellitus, female gender, immunosuppression, and local trauma.4,19,20 Plausibly, patients with these medical or ocular comorbidities may have less favorable outcomes or responses to treatment compared to others without those characteristics. In this study, therefore, we aim to examine the relationship between these previously investigated risk factors and specific complications of HSV and HZO keratitis.