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C. Stephen Foster - One of the best experts on this subject based on the ideXlab platform.

  • Increasing the Diagnostic Yield of Conjunctival Biopsy in Patients with Suspected Ocular Cicatricia1 Pemphigoid
    Ophthalmology, 1995
    Co-Authors: William J. Power, Alejandro Rodriguez, James E. Dutt, C. Stephen Foster
    Abstract:

    Background: Ocular cicatricial pemphigoid is a chronic, progressive, autoimmune disease that scars mucous membranes and may lead to blindness. It is of critical importance to be able to make the diagnosis as early as possible to allow early treatment. Conjunctival Biopsy facilitates the early diagnosis of this condition. Materials and Methods: Conjunctival Biopsy results of 166 consecutive patients seen over a 7-year period, in whom the diagnosis of ocular cicatricial pemphigoid was considered, were reviewed. Results: One hundred twenty-one patients ultimately received a diagnosis of ocular cicatricial pemphigoid. Immunofluorescence studies demonstrated characteristic deposition of immunoreactants at the epithelial basement membrane zone in 63 patients (sensitivity = 52%). When immunofluorescent-negative or inconclusive biopsies were processed further using an immunoperoxidase technique an additional 37 diagnoses were made. This represented an increase in sensitivity from 52% with immunofluorescence only to 83% with the addition of the immunoperoxidase technique. Conclusion: The routine use of the immunoperoxidase technique in immunofluorescent-negative biopsies, allied with appropriate harvesting and handling of biopsied conjunctiva, should significantly increase the diagnostic yield in patients with clinically suspect ocular cicatricial pemphigoid.

  • Atypical Ocular Atopy
    Ophthalmology, 1993
    Co-Authors: Yonca Aydin Akova, Nada S. Jabbur, Ron Neumann, C. Stephen Foster
    Abstract:

    Background: Atopic keratoconjunctivitis (AKC) is defined as a chronic keratoconjunctivitis associated with atopic dermatitis, but severe progressive keratoconjunctivitis as a sole manifestation of atopy also may occur. The authors report three patients with a longstanding history of chronic conjunctivitis with bilateral pannus formation. These patients denied any history of major atopy at the time of presentation. Methods: All patients were evaluated for collagen vascular disease and for evidence of atopy. Conjunctival Biopsy was obtained in each case and was analyzed by light microscopy and by immunohistochemical techniques. Results: Systemic evaluation for collagen vascular disease was negative. Serum IgE levels were elevated in one patient. Conjunctival Biopsy suggested atopy in all patients with characteristic histopathologic findings. Referral to an allergist showed wheal and flare reactions to multiple ubiquitous environmental allergens. Two patients then disclosed a history of atopic dermatitis and another confessed a history of asthma. Each patient responded well to environmental control of allergens, topical cromolyn sodium 4%, and systemic antihistamine therapy with subsequent resolution of the chronic conjunctivitis. The corneal complications were managed with pannus resection and postoperative mitomycin C drops in two patients. Conclusion: These patients suffered from the progressive blinding consequences of a chronic keratoconjunctivitis, which we believe is an atypical form of AKC. In this report, it is suggested that atopy should be considered in some cases of external ocular inflammation, even in the absence of the characteristic findings of systemic atopy. Conjunctival Biopsy is a valuable diagnostic tool in such cases.

E A King - One of the best experts on this subject based on the ideXlab platform.

  • repeat Conjunctival Biopsy after immunomodulatory therapy for ocular mucous membrane pemphigoid
    Ocular Immunology and Inflammation, 2018
    Co-Authors: Paul A Gaudio, John H. Sinard, David R Shield, Joh J Huang, E A King
    Abstract:

    ABSTRACTPurpose: To evaluate whether Conjunctival Biopsy findings in patients with ocular mucous membrane pemphigoid (MMP) persist as positive or revert to negative following treatment with immunomodulatory therapy (IMT).Methods: Patients with Biopsy-proven MMP were treated with IMT for at least 2 years before undergoing repeat Conjunctival Biopsy for immunofluorescence microscopy. Their records were reviewed and findings evaluated to ascertain which patients’ biopsies showed antibody deposition on the Conjunctival basement membrane.Results: Following 2 years of IMT, Conjunctival biopsies showed persistent antibody deposition in two patients, and were negative in four patients.Conclusions: Conjunctival biopsies in patients with ocular MMP may show reversion to inactive disease following IMT. Post-treatment Biopsy might be clinically useful as a means of evaluating the efficacy of therapy in this chronic disease.

J. Bronwyn Bateman - One of the best experts on this subject based on the ideXlab platform.

  • Conjunctival Biopsy in Infantile Neuroaxonal Dystrophy
    American journal of ophthalmology, 1997
    Co-Authors: Rosane Da Cruz Ferreira, Gary W. Mierau, J. Bronwyn Bateman
    Abstract:

    Purpose To describe a case of infantile neuroaxonal dystrophy with optic nerve atrophy and to discuss the diagnostic role of Conjunctival Biopsy. Methods We performed a complete ophthalmologic examination and a diagnostic Conjunctival Biopsy on a girl with a neurodegenerative disease. Results On the basis of “spheroid” inclusions unmyelinated axons, we diagnosed infantile neuoroaxonal dystrophy. Conclusions Optic atrophy is an important finding in infantile neuroaxonal dystrophy, and Conjunctival Biopsy is a reliable and very convenient diagnostic test.

José M. Herreras - One of the best experts on this subject based on the ideXlab platform.

  • Usefulness of Conjunctival Biopsy as diagnostic technique
    Archivos de la Sociedad Espanola de Oftalmologia, 2001
    Co-Authors: H Sánchez-tocino, Maria A. Saornil, José M. Herreras, G Blanco, M Calonge, E Rodríguez De La Rúa
    Abstract:

    Purpose The conjuctival Biopsy is described as a useful technique in the diagnosis of some chronic conjunctivitis, with low specific signs and with poor response to the conventional treatment. Furthermore it is quite important in the diagnosis of Conjunctival diseases with potential dangerous treatment. Patients and methods Three clinical cases are described. Case 1: A 37 years old woman with a chronic lesion of conjuctiva and the suspicion of blepharoconjunctivitis. There was no improvement with treatment. Case 2: A 58 years old woman with a chronic conjunctivitis and follicular reaction. Case 3: A 66 years old man who suffers from a cicatricial conjunctivis in both eyes with corneal lesion in one eye. A Conjunctival Biopsy was perfomed and studied under light microscopy and immunohistochemistry. There is a description of the technique. Results The results of every clinical case are described. In the first case the Biopsy established the diagnosis of Conjunctival lymphoma. In the second, the Biopsy showed the appearance of granulomas and a diagnosis of Conjunctival sarcoidosis was performed. In the third case a diagnosis of ocular cicatricial pemphigoid was established. Conclusion Conjunctival Biopsy is a useful and effective technique in the diagnosis of chronic conjunctivitis.

  • Conjunctival Biopsy in the diagnosis of ocular sarcoidosis.
    Ocular immunology and inflammation, 2001
    Co-Authors: Enrique Dios, Maria A. Saornil, José M. Herreras
    Abstract:

    Sarcoidosis is a multisystem granulomatous disease of unknown etiology that can affect almost every organ in the body, particularly the lungs, skin, eyes, and thoracic lymph nodes. A definitive diagnosis of sarcoidosis requires that a Biopsy be performed. A specimen can be obtained from any affected ocular structure, including conjunctiva, lacrimal gland, eyelid skin, and orbit. Among them, Conjunctival Biopsy has been suggested as a sensible and safe procedure for confirming suspected sarcoidosis. We describe three patients in whom ocular symptoms were the sole initial manifestations of sarcoidosis and who were diagnosed based on the results of a Conjunctival Biopsy. We also discuss the efficacy of and indications for Conjunctival Biopsy.

Mark T Keegan - One of the best experts on this subject based on the ideXlab platform.

  • Conjunctival Biopsy to diagnose neurosarcoidosis in patients with inflammatory nervous system disease of unknown etiology p1 339
    Neurology, 2015
    Co-Authors: Michael Pichler, Jacqueline A. Leavitt, Eoin P Flanagan, Allen J Aksamit, Diva Salomao, Mark T Keegan
    Abstract:

    OBJECTIVE: To assess the usefulness of Conjunctival Biopsy in diagnosing neurosarcoidosis in patients with inflammatory nervous system disorders of unknown etiology. BACKGROUND: Neurosarcoidosis mimics many neurologic diseases and poses a major diagnostic challenge. Blind Conjunctival Biopsy is often used to help diagnose neurosarcoidosis when Biopsy of affected nervous system tissue is not feasible. While this test is relatively inexpensive and well tolerated, the diagnostic yield in patients with inflammatory nervous system disease of unknown etiology remained uncertain. DESIGN/METHODS: We retrospectively identified patients from January 1, 1997, through February 14, 2013 with the following inclusion criteria: 1) inflammatory neurological disease of uncertain etiology, 2) documentation from a neurologist indicating concern for neurosarcoidosis, and 3) Conjunctival Biopsy performed. Exclusion criteria were: Conjunctival Biopsy not done to evaluate possible neurosarcoidosis. Conjunctival Biopsy reports were reviewed for the presence or absence of non-necrotizing granulomas consistent with ocular sarcoidosis. Neurosarcoidosis was categorized as definite (neurological tissue confirmation), probable (suggestive neurological syndrome with pathological evidence of extra-neurologic sarcoidosis) or possible (suggestive neurological syndrome without pathological confirmation). The final diagnosis was determined by the final clinical notes following Conjunctival Biopsy. RESULTS: Four-hundred-forty patients were included and 13 had biopsies consistent with Conjunctival sarcoidosis (3[percnt]). Nine patients had both positive Conjunctival Biopsy and a final diagnosis of neurosarcoidosis (2[percnt]) (8 probable, 1 definite) while the remaining four with positive Conjunctival Biopsy had alternative neurological diagnoses. Sixty patients (14[percnt]) with negative Conjunctival biopsies had a final diagnosis of neurosarcoidosis (15 definite, 22 probable, 23 possible). CONCLUSIONS: This study demonstrates that Conjunctival Biopsy has low diagnostic yield to discover neurosarcoidosis in patients with presumed inflammatory nervous system disease and suggests that alternative diagnostic means should be pursued. Disclosure: Dr. Pichler has nothing to disclose. Dr. Flanagan has nothing to disclose. Dr. Aksamit has nothing to disclose. Dr. Leavitt has nothing to disclose. Dr. Salomao has nothing to disclose. Caridian BCT