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Hiroshi Fujishima - One of the best experts on this subject based on the ideXlab platform.

  • Conjunctival Injection Reduction in Patients with Atopic Keratoconjunctivitis Due to Synergic Effect of Bovine Enteric-Coated Lactoferrin in 0.1% Tacrolimus Ophthalmic Suspension.
    Journal of clinical medicine, 2020
    Co-Authors: Hiroshi Fujishima, Naoko Okada, Kenji Matsumoto, Eisuke Shimizu, Shinji Fukuda, Masaru Tomita
    Abstract:

    Lactoferrin (LF), a multifunctional glycoprotein found in mammalian milk, is reported to have immunoregulatory effects. The present study aimed to evaluate whether enteric-coated LF (eLF) could improve symptoms in patients with Atopic Keratoconjunctivitis (AKC). This randomized double-blind placebo-controlled single-center trial comprised Japanese patients (n = 20; aged 22–60 years) with AKC. Patients treated with 0.1% tacrolimus ophthalmic suspension (TALYMUS®) were administered eLF (400 mg/d of bovine LF) or placebo tablets for 12 weeks. Conjunctival injection was examined, papillae formation in the palpebral conjunctiva was evaluated, and corneal fluorescein score, itchy sensation in end-point itching scale, and serum allergic parameters were assessed. Conjunctival injection was significantly reduced in the LF group than in the placebo group (p = 0.0017, Mann–Whitney U-test). Papillae formation in the palpebral conjunctiva showed a statistical decrease in the LF group than in the placebo group (p = 0.010, unpaired T-test). LF combined with TALYMUS® could be a promising treatment strategy to mitigate AKC.

  • The efficacy of 0.1% tacrolimus ophthalmic suspension in the treatment of severe Atopic Keratoconjunctivitis.
    Annals of allergy asthma & immunology : official publication of the American College of Allergy Asthma & Immunology, 2019
    Co-Authors: Hiroyuki Yazu, Kazumi Fukagawa, Naoko Okada, Eisuke Shimizu, Naohiko Aketa, Hiroshi Fujishima
    Abstract:

    Abstract Background Severe Atopic Keratoconjunctivitis (AKC) is a relatively rare disease, and some cases are refractory to conventional steroid treatment. Objective To examine the efficacy of 0.1% tacrolimus ophthalmic suspension in treating severe AKC during a 1-year follow-up. Methods This was a single-center, retrospective clinical study. Sixty eyes from 30 patients with severe AKC who were treated with 0.1% tacrolimus ophthalmic suspension 4 times per day, were included. The mean age of the patients was 21.5 ± 13.7 years. The severity of objective signs was observed at baseline (before treatment), at 2 weeks, and at 1, 2, 3, 6, and 12 months after treatment initiation. Ten objective signs of palpebral conjunctiva, bulbar conjunctiva, limbus, and cornea were assessed using 4 grades (0 = normal; 1+ = mild; 2+ = moderate; 3+ = severe). Safety was assessed based on the incidence and the severity of adverse events. Results The total score of the 10 clinical signs significantly decreased from baseline 2 weeks after initiating tacrolimus eye drop treatment, except at 2 months. The mean total score of clinical signs was 13.6 ± 6.6 at the beginning of treatment, and decreased to 5.4 ± 4.8 12 months after initiation. Treatment was gradually tapered, with increasing intervals between applications. Additional medications were required to provide relief in 18 patients during follow-up. No patient discontinued treatment due to adverse drug effects. Herpes keratitis was observed in 3 cases during follow-up. However, these cases were completely controlled. Conclusion The 0.1% tacrolimus ophthalmic suspension is effective for the treatment of severe AKC refractory to standard conventional treatments throughout a full year.

  • Functional Visual Acuity Assessment of Severe Atopic Keratoconjunctivitis
    Cornea, 2014
    Co-Authors: Osama M. A. Ibrahim, Minako Kaido, Takashi Kojima, Hiroshi Fujishima
    Abstract:

    Purpose To evaluate changes in functional visual acuity (FVA) measurements before and after treatment with 0.1% cyclosporine ophthalmic solution for 3 months in patients with severe Atopic Keratoconjunctivitis (AKC). Methods Pairs of eyes were analyzed from 3 boys (mean age 9 ± 3.6 years) who complained of having severe AKC and were recruited for the study. Conventional Landolt visual acuity, FVA, and visual maintenance ratio (VMR) measurements were conducted before and after 3 months of 0.1% cyclosporine eye drop treatment. Tear film lipid layer interferometry, tear film break-up time, fluorescein and rose bengal vital stainings, and the Schirmer test were also performed before and after treatment. Results Eye drop treatment was associated not only with improvement of tear function and ocular surface status but also with better quality of visual function. The mean logarithm of the minimum angle of resolution FVA and Landolt visual acuity values improved from 0.45 ± 0.26 and 0.13 ± 0.17 before treatment to 0.16 ± 0.03 and -0.06 ± 0.05 after treatment, respectively. Similarly, the mean VMR values were markedly improved from 0.88 ± 0.06 to 0.95 ± 0.03 after treatment. Conclusions FVA and VMR are promising parameters in the assessment of dynamic visual acuity changes in AKC-affected patients and evaluation of treatment outcome.

  • Chemotactic responses of peripheral blood eosinophils to prostaglandin D2 in Atopic Keratoconjunctivitis
    Annals of allergy asthma & immunology : official publication of the American College of Allergy Asthma & Immunology, 2013
    Co-Authors: Hiroshi Fujishima, Kazumi Fukagawa, N Okada, Yoji Takano, Kenji Matsumoto, Hiroyuki Hirai, Kinya Nagata, Ryoichi Hashida, Hirohisa Saito
    Abstract:

    Abstract Background Eosinophils appear to be key cells in the pathogenesis of conjunctival inflammation in Atopic Keratoconjunctivitis (AKC). Chemoattractant receptor homologous molecule expressed on T H 2 cells (CRTH2) mediates prostaglandin D 2 (PGD 2 )–dependent migration of eosinophils. However, it is unclear whether CRTH2/PGD 2 -dependent eosinophil migration is upregulated in allergic diseases. Objective To compare the chemotactic responses of peripheral blood eosinophils to prostaglandin D 2 in patients with severe AKC and healthy individuals. Methods We used an enzyme immunoassay system to measure PGD 2 levels in tears and blood samples from healthy individuals and patients with AKC. CRTH2 expression on peripheral blood eosinophils was determined using reverse-transcriptase polymerase chain reaction (RT-PCR), flow cytometry, and an oligonucleotide array system. Chemotaxis experiments were performed using a modified Boyden chamber technique and an optical assay system. Results The PGD 2 concentrations were higher in tears from patients with severe AKC compared with healthy individuals. RT-PCR (severe and mild cases), flow cytometry (mild cases), and GeneChip analyses revealed a significantly higher expression of CRTH2 on peripheral blood eosinophils in patients with AKC than in healthy individuals. PGD 2 and its stable metabolite 13,14-dihydro-15-keto-PGD 2 , a CRTH2 agonist, induced chemotaxis of eosinophils from patients with AKC; chemotaxis was significantly enhanced in eosinophils from patients with severe AKC compared with those from healthy individuals. Conclusion CRTH2 is more abundantly expressed on eosinophils from patients with AKC and promoted PGD 2 -dependent migration to a greater extent than in healthy individuals.

  • in vivo confocal microscopy evaluation of meibomian gland dysfunction in Atopic Keratoconjunctivitis patients
    Ophthalmology, 2012
    Co-Authors: Osama M. A. Ibrahim, Yukihiro Matsumoto, Tais Hitomi Wakamatsu, Jun Shimazaki, Enrique Sato Adan, Hiroshi Fujishima
    Abstract:

    Purpose To clarify meibomian gland (MG) alterations in Atopic Keratoconjunctivitis (AKC) patients and compare the findings with obstructive MG dysfunction (MGD) patients and control subjects using in vivo confocal microscopy (CM). Design Prospective, controlled, single-center study. Participants Twelve AKC patients (10 males, 2 females; mean age, 31.0±16.5 years), 12 obstructive MGD patients (7 males, 5 females; mean age, 37.6±5.6 years), and 26 control subjects (13 males, 13 females; mean age, 32.9±5.7 years) were recruited. No significant age or gender differences were observed between the 3 groups. Methods All subjects underwent assessment of tear evaporation rate from the ocular surface (TEROS), slit-lamp examinations, tear break-up time (BUT) measurements, vital staining, Schirmer test I, meibography, MG expressibility, and CM examination of the MG (HRTII-RCM). Statistical analysis was performed using the Mann–Whitney test. Main Outcome Measures The MG acinar unit density, inflammatory cell density, MG acinar unit longest diameter, MG acinar unit shortest diameter, and MG acinar unit area as observed by in vivo CM, MG drop-out, MG expressibility grading, tear stability, tear evaporation, and vital staining scores. Results The TEROS values, mean BUT, vital staining scores, MG expressibility, and MG dropout grades were significantly worse in AKC patients compared with those in obstructive MGD patients and controls ( P P Conclusions Changes in MG in AKC patients seem to be more severe than in patients with obstructive MGD and controls. In vivo CM is a noninvasive, efficient tool in the assessment of MG status and ocular surface disease in AKC. Financial Disclosure(s) The authors have no proprietary or commercial interest in any of the materials discussed in this article.

Kazumi Fukagawa - One of the best experts on this subject based on the ideXlab platform.

  • The efficacy of 0.1% tacrolimus ophthalmic suspension in the treatment of severe Atopic Keratoconjunctivitis.
    Annals of allergy asthma & immunology : official publication of the American College of Allergy Asthma & Immunology, 2019
    Co-Authors: Hiroyuki Yazu, Kazumi Fukagawa, Naoko Okada, Eisuke Shimizu, Naohiko Aketa, Hiroshi Fujishima
    Abstract:

    Abstract Background Severe Atopic Keratoconjunctivitis (AKC) is a relatively rare disease, and some cases are refractory to conventional steroid treatment. Objective To examine the efficacy of 0.1% tacrolimus ophthalmic suspension in treating severe AKC during a 1-year follow-up. Methods This was a single-center, retrospective clinical study. Sixty eyes from 30 patients with severe AKC who were treated with 0.1% tacrolimus ophthalmic suspension 4 times per day, were included. The mean age of the patients was 21.5 ± 13.7 years. The severity of objective signs was observed at baseline (before treatment), at 2 weeks, and at 1, 2, 3, 6, and 12 months after treatment initiation. Ten objective signs of palpebral conjunctiva, bulbar conjunctiva, limbus, and cornea were assessed using 4 grades (0 = normal; 1+ = mild; 2+ = moderate; 3+ = severe). Safety was assessed based on the incidence and the severity of adverse events. Results The total score of the 10 clinical signs significantly decreased from baseline 2 weeks after initiating tacrolimus eye drop treatment, except at 2 months. The mean total score of clinical signs was 13.6 ± 6.6 at the beginning of treatment, and decreased to 5.4 ± 4.8 12 months after initiation. Treatment was gradually tapered, with increasing intervals between applications. Additional medications were required to provide relief in 18 patients during follow-up. No patient discontinued treatment due to adverse drug effects. Herpes keratitis was observed in 3 cases during follow-up. However, these cases were completely controlled. Conclusion The 0.1% tacrolimus ophthalmic suspension is effective for the treatment of severe AKC refractory to standard conventional treatments throughout a full year.

  • © 2009 Molecular Vision
    2014
    Co-Authors: Tais Hitomi Wakamatsu, Yukihiro Matsumoto, Kazumi Fukagawa, Osama M. A. Ibrahim, Takashi Kojima, Enrique Sato Adan, Naoko Okada, Chikako Katakami
    Abstract:

    Evaluation of conjunctival inflammatory status by confocal scanning laser microscopy and conjunctival brush cytology in patients with Atopic Keratoconjunctivitis (AKC

  • Chemotactic responses of peripheral blood eosinophils to prostaglandin D2 in Atopic Keratoconjunctivitis
    Annals of allergy asthma & immunology : official publication of the American College of Allergy Asthma & Immunology, 2013
    Co-Authors: Hiroshi Fujishima, Kazumi Fukagawa, N Okada, Yoji Takano, Kenji Matsumoto, Hiroyuki Hirai, Kinya Nagata, Ryoichi Hashida, Hirohisa Saito
    Abstract:

    Abstract Background Eosinophils appear to be key cells in the pathogenesis of conjunctival inflammation in Atopic Keratoconjunctivitis (AKC). Chemoattractant receptor homologous molecule expressed on T H 2 cells (CRTH2) mediates prostaglandin D 2 (PGD 2 )–dependent migration of eosinophils. However, it is unclear whether CRTH2/PGD 2 -dependent eosinophil migration is upregulated in allergic diseases. Objective To compare the chemotactic responses of peripheral blood eosinophils to prostaglandin D 2 in patients with severe AKC and healthy individuals. Methods We used an enzyme immunoassay system to measure PGD 2 levels in tears and blood samples from healthy individuals and patients with AKC. CRTH2 expression on peripheral blood eosinophils was determined using reverse-transcriptase polymerase chain reaction (RT-PCR), flow cytometry, and an oligonucleotide array system. Chemotaxis experiments were performed using a modified Boyden chamber technique and an optical assay system. Results The PGD 2 concentrations were higher in tears from patients with severe AKC compared with healthy individuals. RT-PCR (severe and mild cases), flow cytometry (mild cases), and GeneChip analyses revealed a significantly higher expression of CRTH2 on peripheral blood eosinophils in patients with AKC than in healthy individuals. PGD 2 and its stable metabolite 13,14-dihydro-15-keto-PGD 2 , a CRTH2 agonist, induced chemotaxis of eosinophils from patients with AKC; chemotaxis was significantly enhanced in eosinophils from patients with severe AKC compared with those from healthy individuals. Conclusion CRTH2 is more abundantly expressed on eosinophils from patients with AKC and promoted PGD 2 -dependent migration to a greater extent than in healthy individuals.

  • IgE and eosinophil cationic protein (ECP) as markers of severity in the diagnosis of Atopic Keratoconjunctivitis
    The British journal of ophthalmology, 2012
    Co-Authors: Tais Hitomi Wakamatsu, Kazumi Fukagawa, Yoshiyuki Satake, Ayako Igarashi, Osama M. A. Ibrahim, Jun Shimazaki, Naoko Okada, Hiroshi Fujishima
    Abstract:

    Aims To evaluate tear and serum IgE and eosinophil cationic protein (ECP) as severity markers for Atopic Keratoconjunctivitis (AKC). Methods Thirty eyes of 30 patients with AKC and 10 eyes of 10 healthy control subjects were examined in this prospective study. All subjects underwent fluorescein staining, conjunctival injection, conjunctival oedema and papillary formation grading. Tear and serum IgE and ECP levels were measured, and correlations between them investigated with reference to the ocular surface clinical parameters. Results The mean fluorescein scores, conjunctival injection, oedema scores and papillary formation were significantly higher in AKC patients compared to controls (p Conclusion This study suggests the presence of an eosinophilic response in AKC disease independent of IgE sensitisation. Tear ECP was a useful marker delineating the severity of ocular surface disease in AKC.

  • Eosinophil cationic protein as a marker for assessing the efficacy of tacrolimus ophthalmic solution in the treatment of Atopic Keratoconjunctivitis
    Molecular vision, 2011
    Co-Authors: Tais Hitomi Wakamatsu, Kazumi Fukagawa, Mari Tanaka, Yoshiyuki Satake, Ayako Igarashi, Hiroshi Fujishima
    Abstract:

    Purpose To examine the clinical efficacy and anti–inflammatory effects of tacrolimus eye drops; we studied the changes in clinical ocular findings and measured tear eosinophil cationic protein (ECP) levels of Atopic Keratoconjunctivitis (AKC) patients before and after the treatment.

Esen K Akpek - One of the best experts on this subject based on the ideXlab platform.

  • ocular surface disease associated with dupilumab treatment for Atopic diseases
    Ocular Surface, 2021
    Co-Authors: Canan Asli Utine, Penny A. Asbell, Esen K Akpek, Stephen C. Pflugfelder
    Abstract:

    Dupilumab is the first US FDA approved biologic for treatment of Atopic dermatitis. It is a human monoclonal antibody which blocks the shared receptor component, the interleukin (IL)-4α subunit, of IL-4 and IL-13 signaling pathways. Occurrence of "conjunctivitis", mostly in Atopic dermatitis trials, has been the main side effect reported thus far. The etiology of "conjunctivitis" associated with dupilumab treatment is unclear and might be similar to Atopic Keratoconjunctivitis. There is evidence in the published literature that unlike the Th2-like profile in vernal Keratoconjunctivitis, Th1-mediated inflammation is predominant in Atopic Keratoconjunctivitis. Blocking the Th2 pathway with dupilumab therapy might result in a shift towards Th1, causing the ocular findings associated with dupilumab. In addition, blockage of IL-13 might have implications with regards to mucin production and ocular surface health. This review highlights the clinical manifestations, reviews treatment options and offers explanations for pathogenesis of this ocular surface diseases associated with dupilumab treatment.

  • Immunopathological Features of Severe Chronic Atopic Keratoconjunctivitis and Effects of Topical Cyclosporine Treatment.
    Ocular immunology and inflammation, 2018
    Co-Authors: Canan Asli Utine, Michael E. Stern, Esen K Akpek
    Abstract:

    ABSTRACTPurpose: To assess differential roles of inflammatory cells in pathophysiology of severe Atopic Keratoconjunctivitis (AKC) and evaluate immunomodulatory effects of topical cyclosporine A (C...

  • topical calcineurin inhibitors in the treatment of steroid dependent Atopic Keratoconjunctivitis
    Cornea, 2012
    Co-Authors: Jonathan H Tzu, Michael E. Stern, Canan Asli Utine, Esen K Akpek
    Abstract:

    Purpose:To evaluate the long-term effectiveness of the combination of topical cyclosporine drops and tacrolimus ointment in the treatment of steroid-dependent Atopic Keratoconjunctivitis (AKC).Methods:Ten patients with moderate to severe AKC participated in the study. Topical cyclosporine 0.05% was

  • a randomized trial of topical cyclosporin 0 05 in topical steroid resistant Atopic Keratoconjunctivitis
    Ophthalmology, 2004
    Co-Authors: Esen K Akpek, John K G Dart, Stephanie L Watson, William G Christen, Dilek Dursun, Sonia H Yoo, Terrence P Obrien, Oliver D Schein, John D Gottsch
    Abstract:

    Abstract Objective To evaluate the short-term efficacy and safety of topical cyclosporin A 0.05% in the treatment of patients with severe, steroid-resistant Atopic Keratoconjunctivitis (AKC). Design Multicenter, placebo-controlled, double-masked, randomized trial. Participants Twenty-two patients with AKC refractory to topical steroid treatment. Intervention Patients were randomly assigned (1:1) to treatment with topical 0.05% cyclosporin A eyedrops or a placebo (artificial tears) for a period of 28 days, 6 times daily during the first 2 weeks and 4 times daily during the last 2 weeks. Main outcome measures Symptoms (itching, tearing, discomfort, mucous discharge, and photophobia) and signs (bulbar conjunctival hyperemia, upper tarsal conjunctival papillae, punctate keratitis, corneal neovascularization, cicatrizing conjunctivitis, and blepharitis) of AKC recorded on the day of enrollment and at the end of the treatment period. Results A composite score computed by summing the severity grade over all 5 symptoms and 6 signs of AKC for each patient indicated a greater improvement in the cyclosporin A group relative to the placebo at the end of the 4-week treatment period ( P = 0.048 and P = 0.002, for symptoms and signs, respectively). No adverse effects of the treatment with cyclosporin A 0.05% eyedrops were observed. Conclusions Topical cyclosporin A 0.05% seems to be safe and have some effect in alleviating signs and symptoms of severe AKC refractory to topical steroid treatment.

Yukihiro Matsumoto - One of the best experts on this subject based on the ideXlab platform.

  • © 2009 Molecular Vision
    2014
    Co-Authors: Tais Hitomi Wakamatsu, Yukihiro Matsumoto, Kazumi Fukagawa, Osama M. A. Ibrahim, Takashi Kojima, Enrique Sato Adan, Naoko Okada, Chikako Katakami
    Abstract:

    Evaluation of conjunctival inflammatory status by confocal scanning laser microscopy and conjunctival brush cytology in patients with Atopic Keratoconjunctivitis (AKC

  • in vivo confocal microscopy evaluation of meibomian gland dysfunction in Atopic Keratoconjunctivitis patients
    Ophthalmology, 2012
    Co-Authors: Osama M. A. Ibrahim, Yukihiro Matsumoto, Tais Hitomi Wakamatsu, Jun Shimazaki, Enrique Sato Adan, Hiroshi Fujishima
    Abstract:

    Purpose To clarify meibomian gland (MG) alterations in Atopic Keratoconjunctivitis (AKC) patients and compare the findings with obstructive MG dysfunction (MGD) patients and control subjects using in vivo confocal microscopy (CM). Design Prospective, controlled, single-center study. Participants Twelve AKC patients (10 males, 2 females; mean age, 31.0±16.5 years), 12 obstructive MGD patients (7 males, 5 females; mean age, 37.6±5.6 years), and 26 control subjects (13 males, 13 females; mean age, 32.9±5.7 years) were recruited. No significant age or gender differences were observed between the 3 groups. Methods All subjects underwent assessment of tear evaporation rate from the ocular surface (TEROS), slit-lamp examinations, tear break-up time (BUT) measurements, vital staining, Schirmer test I, meibography, MG expressibility, and CM examination of the MG (HRTII-RCM). Statistical analysis was performed using the Mann–Whitney test. Main Outcome Measures The MG acinar unit density, inflammatory cell density, MG acinar unit longest diameter, MG acinar unit shortest diameter, and MG acinar unit area as observed by in vivo CM, MG drop-out, MG expressibility grading, tear stability, tear evaporation, and vital staining scores. Results The TEROS values, mean BUT, vital staining scores, MG expressibility, and MG dropout grades were significantly worse in AKC patients compared with those in obstructive MGD patients and controls ( P P Conclusions Changes in MG in AKC patients seem to be more severe than in patients with obstructive MGD and controls. In vivo CM is a noninvasive, efficient tool in the assessment of MG status and ocular surface disease in AKC. Financial Disclosure(s) The authors have no proprietary or commercial interest in any of the materials discussed in this article.

  • evaluation of conjunctival inflammatory status by confocal scanning laser microscopy and conjunctival brush cytology in patients with Atopic Keratoconjunctivitis akc
    Molecular Vision, 2009
    Co-Authors: Tais Hitomi Wakamatsu, Yukihiro Matsumoto, Kazumi Fukagawa, Osama M. A. Ibrahim, Takashi Kojima, Enrique Sato Adan, Naoko Okada, Chikako Katakami
    Abstract:

    PURPOSE To elucidate the status of the conjunctival inflammation in Atopic Keratoconjunctivitis (AKC) using laser scanning confocal microscopy and compare the relevant findings with conjunctival brush cytology in a prospective controlled study. METHODS Twenty eyes from 20 AKC patients as well as 16 eyes from 16 age and sex matched normal subjects were studied. The subjects underwent tear film break-up time (BUT), fluorescein and Rose Bengal staining of the ocular surface, conjunctival confocal microscopy, Schirmer test, and brush cytology. Brush cytology specimens and in vivo confocal microscopy scans underwent evaluation for inflammatory cell densities. RESULTS Brush cytology specimens and in vivo confocal microscopy scans from AKC patients revealed significantly higher numbers of inflammatory cells (p<0.05). Conjunctival inflammatory cell density showed a negative correlation with tear stability and a positive correlation with vital staining scores and conjunctival injection grades. The extent of conjunctival inflammation assessed by in vivo confocal microscopy showed a strong positive linear correlation with the inflammation status evaluated by brush cytology. The corneal inflammatory cell density assessed by in vivo confocal microscopy showed a significant negative correlation with tear stability and a positive linear correlation with corneal fluorescein staining. CONCLUSIONS Confocal scanning laser microscopy is an efficient, noninvasive, and a promising tool for the quantitative assessment of conjunctival inflammation, a parameter of this new technology which correlated well with subjective and objective ocular surface clinical findings.

  • alterations of the ocular surface epithelial muc16 and goblet cell muc5ac in patients with Atopic Keratoconjunctivitis
    Allergy, 2008
    Co-Authors: Yukihiro Matsumoto, Kazumi Fukagawa, N Okada, A Igarashi, Jun Shimazaki, Hiroshi Fujishima
    Abstract:

    Background:  An increased understanding of the ocular surface at cellular level in the conjunctiva and the cornea may help explain the pathogenesis and the subsequent clinical appearance of Atopic ocular allergies, which may be potentially blinding. Purpose:  To investigate the MUC16 and MUC5AC alterations, tear function and the ocular surface disorder in patients with Atopic Keratoconjunctivitis (AKC). Methods:  Thirty-six eyes of 18 AKC patients as well as 28 eyes of 14 age- and sex-matched normal subjects were studied. The subjects underwent corneal sensitivity measurements, Schirmer test, tear film break-up time (BUT), fluorescein and Rose-Bengal staining of the ocular surface, conjunctival impression cytology and brush cytology. Impression cytology samples underwent periodic acid schiff and immunohistochemical staining with MUC16 and MUC5AC antibodies. Brush cytology specimens underwent evaluation for inflammatory cell numbers and quantitative real-time polymerase chain reaction (PCR) for MUC16 and MUC5AC mRNA expression. Results:  The mean corneal sensitivity and BUT values were significantly lower in patients with AKC, compared with controls (P < 0.001). Brush cytology specimens from AKC patients revealed significantly higher numbers of inflammatory cells (P < 0.001). Specimens from patient eyes showed positive staining for MUC5AC and MUC16. MUC16 mRNA expression was significantly upregulated with significant downregulation of MUC5AC mRNA expression in eyes with AKC compared with the eyes of control subjects. Conclusion:  Ocular surface inflammation, decline in corneal sensitivity, tear film instability, changes in conjunctival epithelial MUC5AC and MUC16 mRNA expressions were thought to be important in the pathogenesis of Atopic ocular surface disease.

  • Corneal In Vivo Confocal Scanning Laser Microscopy in Patients with Atopic Keratoconjunctivitis
    Ophthalmology, 2008
    Co-Authors: Yukihiro Matsumoto, Kazumi Fukagawa, Enrique Sato Adan, Hiroshi Fujishima
    Abstract:

    Objective To elucidate the morphologic alterations of the cornea in Atopic Keratoconjunctivitis (AKC) using confocal microscopy (Heidelberg Retina Tomograph II-Rostock Cornea Module: HRT-II RCM). Design Prospective comparative study. Participants We studied 21 right eyes of 21 AKC patients (11 males, 10 females; mean age, 26.3 years) as well as 19 right eyes of 19 normal subjects (12 males, 7 females; mean age, 28.4 years). Methods All subjects underwent corneal sensitivity measurements, Schirmer test, tear film break-up time, fluorescein and Rose Bengal stainings, and HRT-II confocal laser scanning microscopy of the central cornea. Main Outcome Measures The epithelial and endothelial cell densities of the central cornea, the density of subbasal long nerve fibers (LNFs) and total nerve branches (NBs) of the subbasal nerve plexus were calculated. The morphologic characteristics of the corneal nerves were studied. Correlation between nerve density, tear functions, and ocular surface examination parameters were investigated. Results The corneal sensitivity, tear stability and vital staining scores were significantly worse in eyes with AKC ( P Conclusions The corneal disease in AKC was associated with significant alterations of the basal epithelium, and subbasal and stromal corneal nerves, which related to the changes in tear functions and corneal sensitivity. Confocal scanning laser microscopy was useful to study the pathological in vivo corneal changes in AKC. Financial Disclosure(s) The authors have no proprietary or commercial interest in any materials discussed in this article.

Enrique Sato Adan - One of the best experts on this subject based on the ideXlab platform.

  • © 2009 Molecular Vision
    2014
    Co-Authors: Tais Hitomi Wakamatsu, Yukihiro Matsumoto, Kazumi Fukagawa, Osama M. A. Ibrahim, Takashi Kojima, Enrique Sato Adan, Naoko Okada, Chikako Katakami
    Abstract:

    Evaluation of conjunctival inflammatory status by confocal scanning laser microscopy and conjunctival brush cytology in patients with Atopic Keratoconjunctivitis (AKC

  • in vivo confocal microscopy evaluation of meibomian gland dysfunction in Atopic Keratoconjunctivitis patients
    Ophthalmology, 2012
    Co-Authors: Osama M. A. Ibrahim, Yukihiro Matsumoto, Tais Hitomi Wakamatsu, Jun Shimazaki, Enrique Sato Adan, Hiroshi Fujishima
    Abstract:

    Purpose To clarify meibomian gland (MG) alterations in Atopic Keratoconjunctivitis (AKC) patients and compare the findings with obstructive MG dysfunction (MGD) patients and control subjects using in vivo confocal microscopy (CM). Design Prospective, controlled, single-center study. Participants Twelve AKC patients (10 males, 2 females; mean age, 31.0±16.5 years), 12 obstructive MGD patients (7 males, 5 females; mean age, 37.6±5.6 years), and 26 control subjects (13 males, 13 females; mean age, 32.9±5.7 years) were recruited. No significant age or gender differences were observed between the 3 groups. Methods All subjects underwent assessment of tear evaporation rate from the ocular surface (TEROS), slit-lamp examinations, tear break-up time (BUT) measurements, vital staining, Schirmer test I, meibography, MG expressibility, and CM examination of the MG (HRTII-RCM). Statistical analysis was performed using the Mann–Whitney test. Main Outcome Measures The MG acinar unit density, inflammatory cell density, MG acinar unit longest diameter, MG acinar unit shortest diameter, and MG acinar unit area as observed by in vivo CM, MG drop-out, MG expressibility grading, tear stability, tear evaporation, and vital staining scores. Results The TEROS values, mean BUT, vital staining scores, MG expressibility, and MG dropout grades were significantly worse in AKC patients compared with those in obstructive MGD patients and controls ( P P Conclusions Changes in MG in AKC patients seem to be more severe than in patients with obstructive MGD and controls. In vivo CM is a noninvasive, efficient tool in the assessment of MG status and ocular surface disease in AKC. Financial Disclosure(s) The authors have no proprietary or commercial interest in any of the materials discussed in this article.

  • evaluation of conjunctival inflammatory status by confocal scanning laser microscopy and conjunctival brush cytology in patients with Atopic Keratoconjunctivitis akc
    Molecular Vision, 2009
    Co-Authors: Tais Hitomi Wakamatsu, Yukihiro Matsumoto, Kazumi Fukagawa, Osama M. A. Ibrahim, Takashi Kojima, Enrique Sato Adan, Naoko Okada, Chikako Katakami
    Abstract:

    PURPOSE To elucidate the status of the conjunctival inflammation in Atopic Keratoconjunctivitis (AKC) using laser scanning confocal microscopy and compare the relevant findings with conjunctival brush cytology in a prospective controlled study. METHODS Twenty eyes from 20 AKC patients as well as 16 eyes from 16 age and sex matched normal subjects were studied. The subjects underwent tear film break-up time (BUT), fluorescein and Rose Bengal staining of the ocular surface, conjunctival confocal microscopy, Schirmer test, and brush cytology. Brush cytology specimens and in vivo confocal microscopy scans underwent evaluation for inflammatory cell densities. RESULTS Brush cytology specimens and in vivo confocal microscopy scans from AKC patients revealed significantly higher numbers of inflammatory cells (p<0.05). Conjunctival inflammatory cell density showed a negative correlation with tear stability and a positive correlation with vital staining scores and conjunctival injection grades. The extent of conjunctival inflammation assessed by in vivo confocal microscopy showed a strong positive linear correlation with the inflammation status evaluated by brush cytology. The corneal inflammatory cell density assessed by in vivo confocal microscopy showed a significant negative correlation with tear stability and a positive linear correlation with corneal fluorescein staining. CONCLUSIONS Confocal scanning laser microscopy is an efficient, noninvasive, and a promising tool for the quantitative assessment of conjunctival inflammation, a parameter of this new technology which correlated well with subjective and objective ocular surface clinical findings.

  • Corneal In Vivo Confocal Scanning Laser Microscopy in Patients with Atopic Keratoconjunctivitis
    Ophthalmology, 2008
    Co-Authors: Yukihiro Matsumoto, Kazumi Fukagawa, Enrique Sato Adan, Hiroshi Fujishima
    Abstract:

    Objective To elucidate the morphologic alterations of the cornea in Atopic Keratoconjunctivitis (AKC) using confocal microscopy (Heidelberg Retina Tomograph II-Rostock Cornea Module: HRT-II RCM). Design Prospective comparative study. Participants We studied 21 right eyes of 21 AKC patients (11 males, 10 females; mean age, 26.3 years) as well as 19 right eyes of 19 normal subjects (12 males, 7 females; mean age, 28.4 years). Methods All subjects underwent corneal sensitivity measurements, Schirmer test, tear film break-up time, fluorescein and Rose Bengal stainings, and HRT-II confocal laser scanning microscopy of the central cornea. Main Outcome Measures The epithelial and endothelial cell densities of the central cornea, the density of subbasal long nerve fibers (LNFs) and total nerve branches (NBs) of the subbasal nerve plexus were calculated. The morphologic characteristics of the corneal nerves were studied. Correlation between nerve density, tear functions, and ocular surface examination parameters were investigated. Results The corneal sensitivity, tear stability and vital staining scores were significantly worse in eyes with AKC ( P Conclusions The corneal disease in AKC was associated with significant alterations of the basal epithelium, and subbasal and stromal corneal nerves, which related to the changes in tear functions and corneal sensitivity. Confocal scanning laser microscopy was useful to study the pathological in vivo corneal changes in AKC. Financial Disclosure(s) The authors have no proprietary or commercial interest in any materials discussed in this article.

  • conjunctival in vivo confocal scanning laser microscopy in patients with Atopic Keratoconjunctivitis
    Molecular Vision, 2007
    Co-Authors: Enrique Sato Adan, Kazumi Fukagawa, Yukihiro Matsumoto, Yoji Takano, Hiroshi Fujishima
    Abstract:

    PURPOSE To elucidate the morphological alterations of the conjunctiva in Atopic Keratoconjunctivitis (AKC) using the new generation Heidelberg Retina Tomograph II (HRT II)/Rostock Cornea Module confocal microscope in a prospective controlled study. METHODS Sixteen eyes from AKC patients (eight males, mean age: 20.3+/-5.9 years) were treated with 0.05% topical cyclosporine A (CsA) in addition to topical steroid and anti-allergic eye drops and 12 eyes from patients with AKC were treated using topical steroids and anti-allergic drops (six males, mean age: 22.2+/-10.0 year). These two groups, as well as 14 eyes from normal subjects (six males, one female, average age 30.4+/-6.8 years) were studied. All subjects underwent corneal sensitivity measurements, the Schirmer test, tear film break-up time (BUT), fluorescein, Rose Bengal staining of the ocular surface, and confocal laser scanning microscopy of the tarsal palpebral conjunctiva. The density of conjunctival inflammatory infiltrates was calculated. Morphological characteristics of the papillary lesions were also studied. RESULTS Corneal sensitivity, tear stability, and vital staining scores were significantly worse in patients with AKC compared to control subjects (p<0.01). Eyes of AKC patients using CsA showed a significantly lower density of inflammatory infiltrates compared to eyes on topical steroid and anti-allergic drops. Conjunctival inflammatory cell density showed a negative correlation with tear stability and corneal sensitivity and a positive correlation with the vital staining scores. Papillary lesions revealed remarkable fibrosis in patients using CsA. CONCLUSIONS Confocal scanning laser microscopy was an efficient and a noninvasive tool for the quantitative assessment of the conjunctival inflammation and evaluation of pathological alterations in the papillary lesions and their relation to the ocular surface disease in patients with AKC.