The Experts below are selected from a list of 312 Experts worldwide ranked by ideXlab platform
Soham Basak - One of the best experts on this subject based on the ideXlab platform.
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descemet membrane endothelial keratoplasty in irreversible corneal edema due to herpes simplex virus endotheliitis
Cornea, 2020Co-Authors: Samar K Basak, Soham BasakAbstract:PURPOSE: To report the clinical outcome and postoperative course of Descemet membrane endothelial keratoplasty (DMEK) in irreversible corneal edema due to herpes simplex virus (HSV) endotheliitis. METHODS: This is a retrospective, noncomparative, interventional case series. Nineteen Eyes of 19 patients underwent standard DMEK combined with cataract surgery (triple DMEK) between May 2016 and April 2018. All patients received perioperative oral acyclovir (ACV) and prednisolone. Patients were followed up on day 1, on day 7, at 1 month, and then at 3 monthly intervals. Preoperative and postoperative best spectacle-corrected visual acuity (BSCVA), graft clarity, pachymetry, and endothelial cell loss after 1 year were recorded. Postoperative complications and HSV recurrence were noted until the last follow-up visit. RESULTS: All Eyes were phakic with variable grades of cataract with a preoperative BSCVA of 1.0 logarithm of the minimum angle of resolution or worse. The mean follow-up period was 19.3 +/- 5.4 months. After 1 year, 14 (73.7%) Eyes achieved a BSCVA of 0.3 or better. Seventeen (89.5%) patients had a clear graft at the last visit without any rejection episode. One graft failed after 16 months. After 3 months, the mean pachymetry reduced from 667.1 +/- 62.1 to 512.8 +/- 27.1 mum (P < 0.001). The mean endothelial cell loss after 1 year was 36.7 +/- 13.4%. Three (15.8%) Eyes had recurrence: one with recurrent endotheliitis and 2 with dendritic keratitis despite oral ACV, which responded to oral valacyclovir and ACV Eye Ointment. One patient had re-recurrence of endotheliitis after 20 months. CONCLUSIONS: DMEK in persistent corneal edema after HSV endotheliitis remains challenging but has encouraging outcomes. The postoperative course may be complicated by HSV recurrence. Prophylactic oral antivirals for 1 year or more and topical antivirals are useful for the prevention of recurrence.
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descemet membrane endothelial keratoplasty in irreversible corneal edema due to herpes simplex virus endotheliitis
Cornea, 2020Co-Authors: Samar K Basak, Soham BasakAbstract:PURPOSE: To report the clinical outcome and postoperative course of Descemet membrane endothelial keratoplasty (DMEK) in irreversible corneal edema due to herpes simplex virus (HSV) endotheliitis. METHODS: This is a retrospective, noncomparative, interventional case series. Nineteen Eyes of 19 patients underwent standard DMEK combined with cataract surgery (triple DMEK) between May 2016 and April 2018. All patients received perioperative oral acyclovir (ACV) and prednisolone. Patients were followed up on day 1, on day 7, at 1 month, and then at 3 monthly intervals. Preoperative and postoperative best spectacle-corrected visual acuity (BSCVA), graft clarity, pachymetry, and endothelial cell loss after 1 year were recorded. Postoperative complications and HSV recurrence were noted until the last follow-up visit. RESULTS: All Eyes were phakic with variable grades of cataract with a preoperative BSCVA of 1.0 logarithm of the minimum angle of resolution or worse. The mean follow-up period was 19.3 +/- 5.4 months. After 1 year, 14 (73.7%) Eyes achieved a BSCVA of 0.3 or better. Seventeen (89.5%) patients had a clear graft at the last visit without any rejection episode. One graft failed after 16 months. After 3 months, the mean pachymetry reduced from 667.1 +/- 62.1 to 512.8 +/- 27.1 mum (P < 0.001). The mean endothelial cell loss after 1 year was 36.7 +/- 13.4%. Three (15.8%) Eyes had recurrence: one with recurrent endotheliitis and 2 with dendritic keratitis despite oral ACV, which responded to oral valacyclovir and ACV Eye Ointment. One patient had re-recurrence of endotheliitis after 20 months. CONCLUSIONS: DMEK in persistent corneal edema after HSV endotheliitis remains challenging but has encouraging outcomes. The postoperative course may be complicated by HSV recurrence. Prophylactic oral antivirals for 1 year or more and topical antivirals are useful for the prevention of recurrence.
Samar K Basak - One of the best experts on this subject based on the ideXlab platform.
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descemet membrane endothelial keratoplasty in irreversible corneal edema due to herpes simplex virus endotheliitis
Cornea, 2020Co-Authors: Samar K Basak, Soham BasakAbstract:PURPOSE: To report the clinical outcome and postoperative course of Descemet membrane endothelial keratoplasty (DMEK) in irreversible corneal edema due to herpes simplex virus (HSV) endotheliitis. METHODS: This is a retrospective, noncomparative, interventional case series. Nineteen Eyes of 19 patients underwent standard DMEK combined with cataract surgery (triple DMEK) between May 2016 and April 2018. All patients received perioperative oral acyclovir (ACV) and prednisolone. Patients were followed up on day 1, on day 7, at 1 month, and then at 3 monthly intervals. Preoperative and postoperative best spectacle-corrected visual acuity (BSCVA), graft clarity, pachymetry, and endothelial cell loss after 1 year were recorded. Postoperative complications and HSV recurrence were noted until the last follow-up visit. RESULTS: All Eyes were phakic with variable grades of cataract with a preoperative BSCVA of 1.0 logarithm of the minimum angle of resolution or worse. The mean follow-up period was 19.3 +/- 5.4 months. After 1 year, 14 (73.7%) Eyes achieved a BSCVA of 0.3 or better. Seventeen (89.5%) patients had a clear graft at the last visit without any rejection episode. One graft failed after 16 months. After 3 months, the mean pachymetry reduced from 667.1 +/- 62.1 to 512.8 +/- 27.1 mum (P < 0.001). The mean endothelial cell loss after 1 year was 36.7 +/- 13.4%. Three (15.8%) Eyes had recurrence: one with recurrent endotheliitis and 2 with dendritic keratitis despite oral ACV, which responded to oral valacyclovir and ACV Eye Ointment. One patient had re-recurrence of endotheliitis after 20 months. CONCLUSIONS: DMEK in persistent corneal edema after HSV endotheliitis remains challenging but has encouraging outcomes. The postoperative course may be complicated by HSV recurrence. Prophylactic oral antivirals for 1 year or more and topical antivirals are useful for the prevention of recurrence.
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descemet membrane endothelial keratoplasty in irreversible corneal edema due to herpes simplex virus endotheliitis
Cornea, 2020Co-Authors: Samar K Basak, Soham BasakAbstract:PURPOSE: To report the clinical outcome and postoperative course of Descemet membrane endothelial keratoplasty (DMEK) in irreversible corneal edema due to herpes simplex virus (HSV) endotheliitis. METHODS: This is a retrospective, noncomparative, interventional case series. Nineteen Eyes of 19 patients underwent standard DMEK combined with cataract surgery (triple DMEK) between May 2016 and April 2018. All patients received perioperative oral acyclovir (ACV) and prednisolone. Patients were followed up on day 1, on day 7, at 1 month, and then at 3 monthly intervals. Preoperative and postoperative best spectacle-corrected visual acuity (BSCVA), graft clarity, pachymetry, and endothelial cell loss after 1 year were recorded. Postoperative complications and HSV recurrence were noted until the last follow-up visit. RESULTS: All Eyes were phakic with variable grades of cataract with a preoperative BSCVA of 1.0 logarithm of the minimum angle of resolution or worse. The mean follow-up period was 19.3 +/- 5.4 months. After 1 year, 14 (73.7%) Eyes achieved a BSCVA of 0.3 or better. Seventeen (89.5%) patients had a clear graft at the last visit without any rejection episode. One graft failed after 16 months. After 3 months, the mean pachymetry reduced from 667.1 +/- 62.1 to 512.8 +/- 27.1 mum (P < 0.001). The mean endothelial cell loss after 1 year was 36.7 +/- 13.4%. Three (15.8%) Eyes had recurrence: one with recurrent endotheliitis and 2 with dendritic keratitis despite oral ACV, which responded to oral valacyclovir and ACV Eye Ointment. One patient had re-recurrence of endotheliitis after 20 months. CONCLUSIONS: DMEK in persistent corneal edema after HSV endotheliitis remains challenging but has encouraging outcomes. The postoperative course may be complicated by HSV recurrence. Prophylactic oral antivirals for 1 year or more and topical antivirals are useful for the prevention of recurrence.
Tetsuro Oshika - One of the best experts on this subject based on the ideXlab platform.
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time course of changes in ocular wavefront aberration after administration of Eye Ointment
Eye, 2012Co-Authors: Takahiro Hiraoka, Toshiya Yamamoto, Fumiki Okamoto, Tetsuro OshikaAbstract:To investigate the influence of an Eye Ointment on ocular aberration. Prospective, comparative study. In 10 normal volunteers, ocular aberration was assessed before and 5, 30 min, 1, 2, 3, 6, and 12 h after administration of ofloxacin Eye Ointment. Ocular aberration was sequentially measured over a period of 10 s, and the root mean square (RMS) of the second-, third-, fourth-, and total higher-order aberrations (HOAs) were determined. From the sequential changes in total HOAs during 10 s, the fluctuation index (FI) and stability index (SI) were calculated. The obtained data were compared with those of another 17 normal volunteers who received timolol maleate gel-forming ophthalmic solution. No significant changes in second-order RMS were observed after administration of the Ointment. HOAs such as third-, fourth-, and total higher-order RMS significantly changed during the study period (P<0.05, repeated-measures analysis of variance). The RMS of each HOA component significantly increased 5 min after administration compared with the baseline values (P<0.05, Dunnett test). FI also increased significantly 5 min after administration (P<0.05), but SI did not change significantly. When compared with the results of the gel-forming solution group, HOAs and FI showed significantly higher values at several time points during 6 h after application (P<0.05, Mann–Whitney U-test). Administration of Eye Ointment significantly degrades optical quality of the Eye by increasing and oscillating HOAs. These changes were more pronounced than those after instillation of gel-forming ophthalmic solution for at least several hours.
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changes in functional visual acuity and ocular wavefront aberration after administration of Eye Ointment
Investigative Ophthalmology & Visual Science, 2012Co-Authors: Takahiro Hiraoka, Toshiya Yamamoto, Fumiki Okamoto, Tetsuro OshikaAbstract:Abstract Purpose: To investigate the influence of an Eye Ointment on functional visual acuity (FVA) and ocular wavefront aberration. Methods: In 11 healthy volunteers (6 men and 5 women), visual function parameters, such as FVA, visual maintenance ratios (VMR), and minimal visual acuity (minVA), were assessed by the FVA measurement system before and 2, 5, 10, 20, 30, 40, 50, 60, 90, 120, 180, and 240 min after administration of ofloxacin Eye Ointment. Ocular aberration was also measured, and the root mean square (RMS) of second-, third-, fourth-, and total higher-order aberrations was determined. The time course of changes in each parameter was statistically analyzed by using repeated-measures analysis of variance and the Dunnett post hoc test, and relationships between visual function and ocular aberration parameters were also analyzed by the Pearson correlation test. Results: FVA, VMR, and minVA showed significant deteriorations at 2-, 5-, 10-, and 20 min after administration of Eye Ointment compared wi...
Prodip Kumar Singh - One of the best experts on this subject based on the ideXlab platform.
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efficacy of topical application of 0 03 tacrolimus Eye Ointment in the management of allergic conjunctivitis
Journal of natural science biology and medicine, 2015Co-Authors: Ajit Kumar Hazarika, Prodip Kumar SinghAbstract:Background: Allergic conjunctivitis is commonly observed Eye diseases in Sikkim, India due to the abundance of seasonal pollens, environmental pollutants, and house dust. We evaluated the efficacy of topical 0.03% tacrolimus Eye Ointment in the management of simple allergic conjunctivitis. Materials and Methods: A prospective observational study was designed consisting of 41 patients with refractory simple allergic conjunctivitis, whose condition responded very poorly to conventional anti-allergic Eye drops (azelastine, olopatadine, chlorpheniramine maleate, sodium chromoglycate). Simple allergic conjunctivitis cases were diagnosed and followed up evaluating both subjective and objective findings (itching, photophobia, tearing, chemosis, conjunctival congestion, tarsal papilla, and Eyelid edema). Existing ocular treatment was discontinued at enrolment and 0.03% tacrolimus Ointment was applied into the conjunctival sac of the affected Eyes twice daily for 4 weeks followed by a 2 weeks washout period. Patients were followed up at the end of 1 st week, 4 th week, and at 7 th week (2 weeks washout period). Results: Symptoms of simple allergic conjunctivitis (itching, tearing and photophobia) were significantly reduced at the end of 1 st week. Signs such as conjunctival chemosis, congestion, tarsal papillae, and Eyelid edema were effectively treated in all cases at the end of 1 st week. At the end of 4 th week, all cases were fully cured and none of the patient had any recurrences up to 7 th week. Mean score at 1 st day (9.6 ± 3.27) was significantly ( P th day (1.35 ± 1.19) of treatment. Conclusion: Topical application of tacrolimus Ointment is an excellent alternative to anti-allergic and steroids Eye drops for the treatment of simple allergic conjunctivitis as it significantly reduces recurrences.
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efficacy of topical application of 0 03 tacrolimus Eye Ointment in the management of allergic conjunctivitis
Journal of natural science biology and medicine, 2015Co-Authors: Ajit Kumar Hazarika, Prodip Kumar SinghAbstract:Background: Allergic conjunctivitis is commonly observed Eye diseases in Sikkim, India due to the abundance of seasonal pollens, environmental pollutants, and house dust. We evaluated the efficacy of topical 0.03% tacrolimus Eye Ointment in the management of simple allergic conjunctivitis. Materials and Methods: A prospective observational study was designed consisting of 41 patients with refractory simple allergic conjunctivitis, whose condition responded very poorly to conventional anti-allergic Eye drops (azelastine, olopatadine, chlorpheniramine maleate, sodium chromoglycate). Simple allergic conjunctivitis cases were diagnosed and followed up evaluating both subjective and objective findings (itching, photophobia, tearing, chemosis, conjunctival congestion, tarsal papilla, and Eyelid edema). Existing ocular treatment was discontinued at enrolment and 0.03% tacrolimus Ointment was applied into the conjunctival sac of the affected Eyes twice daily for 4 weeks followed by a 2 weeks washout period. Patients were followed up at the end of 1 st week, 4 th week, and at 7 th week (2 weeks washout period). Results: Symptoms of simple allergic conjunctivitis (itching, tearing and photophobia) were significantly reduced at the end of 1 st week. Signs such as conjunctival chemosis, congestion, tarsal papillae, and Eyelid edema were effectively treated in all cases at the end of 1 st week. At the end of 4 th week, all cases were fully cured and none of the patient had any recurrences up to 7 th week. Mean score at 1 st day (9.6 ± 3.27) was significantly (P < 0.0001) reduced by 7 th day (1.35 ± 1.19) of treatment. Conclusion: Topical application of tacrolimus Ointment is an excellent alternative to anti-allergic and steroids Eye drops for the treatment of simple allergic conjunctivitis as it significantly reduces recurrences.
Yoshikazu Shimomura - One of the best experts on this subject based on the ideXlab platform.
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Neurotrophic Keratopathy after Trigeminal Nerve Block for Treatment of Postherpetic Neuralgia.
Case reports in ophthalmological medicine, 2018Co-Authors: Aya Kodama-takahashi, Tomoko Sato, Koji Sugioka, Masahiko Fukuda, Koichi Nishida, Keiichi Aomatsu, Yoshikazu ShimomuraAbstract:Purpose. To report a case of persistent corneal epithelial defect that had occurred after a trigeminal nerve block. Case Presentation. A 75-year-old female had suffered from postherpetic neuralgia for 8 years. She underwent Gasserian ganglion block surgery and noticed declining visual acuity in the right Eye on the following day. She presented with severe hyperemia and corneal epithelial defects in the right Eye and experienced remarkable reduction of sensitivity in the right cornea. She was diagnosed with neurotrophic keratopathy. Ofloxacin Eye Ointment and rebamipide ophthalmic suspension ameliorated the corneal epithelial defects but superficial punctate keratopathy, corneal superficial neovascularization, and Descemet’s fold persisted. Although the epithelial defects occasionally recurred, the corneal sensation and epithelial defects, Descemet’s fold, and corneal superficial neovascularization all improved around 5 months after trigeminal nerve block. The HRT II Rostock Cornea Module (RCM) could not detect any corneal subbasal nerve fibers at postoperative 4 months; however, it could detect them at postoperative 6 months. Conclusions. As the nerve block effect wore off, the corneal subbasal nerve fibers slowly regenerated. As the corneal sensation improved, the corneal epithelial defects and superficial neovascularization also improved. The HRT II RCM appeared useful for observing loss and regeneration of the corneal subbasal nerve fibers.
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ARTICLE Effect of Oral Valaciclovir on Herpetic Keratitis
2015Co-Authors: Yoshikazu ShimomuraAbstract:Purpose: To examine the efficacy of valaciclovir (VACV) oral formulation as an alternative to topical treatments in a case of herpetic keratitis. Methods: The patient was a 61-year-old man who presented with dendritic keratitis in his left Eye. After recognizing his difficulty in using Eye Ointment, we prescribed oral VACV 500 mg tablets twice daily for 7 days. We also describe our experiments with orally admini-stered VACV in a mouse model of this disease. In this study, 143 Balb/c mice were inoculated with herpes simplex virus type 1 (HSV)-1 in each Eye and treated with oral VACV 50 or 100 mg/kg twice daily, oral acyclovir (ACV) 50 mg/kg 5 times/d, 3 % ACVEye Ointment (ACV-O) 5 times/d, 3 % ACV Eye drops 5 times/d, or control for 5 days. Results: After 7 days, the patient’s lesion was observed healed. Corrected left visual acuity was also improved, and HSV DNA was below detectable level. In the mouse study, slit-lamp examination on days 3, 4, 5, and 7 revealed that all 5 ACV and VACV treatment groups were significantly more effective in improving symptoms of herpetic epithelial keratitis versus control (P, 0.05). Moreover, VACV 100 mg/kg was superior to other treatments. Viral titers in mouse Eyeball and trigeminal ganglia were lowest in the VACV 100 mg/kg group versus other treatment groups. Conclusion: Our case example suggests that when frequent appli-cation, blurred vision, and foreign body sensation after ACV-O appli-cation cause difficulty for patients to follow treatment, oral VACVmight be an effective and safe option for patients with herpetic keratitis. Key Words: valaciclovir, acyclovir, herpes simplex virus type 1, herpetic keratitis, murine mode
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effects of anti herpetic drugs on mice with herpetic epithelial keratitis after reactivation of herpes simplex virus type 1
Seminars in Ophthalmology, 2008Co-Authors: Motoki Itahashi, Shiro Higaki, Yoshikazu ShimomuraAbstract:To compare the efficacies of valacyclovir (VCV) and acyclovir (ACV) on murine herpetic epithelial keratitis, mice inoculated with herpes simplex virus type 1(HSV-1) strain McKrae were divided into 6 treatment groups: oral VCV 50 mg/kg and 100 mg/kg, oral ACV 50 mg/kg, ACV Eye Ointment (EO), ACV Eye drops (ED), and placebo. Keratitis scores showed that oral VCV 50 mg/kg, oral ACV, and ACV ED had equivalent efficacies, while oral VCV 100 mg/kg was as efficacious as ACV EO during acute infection. Each treatment group was further divided into the stimulated group with HSV-1 reactivation by immunosuppressant drugs and hyperthermia, and the non-stimulated group without reactivation. We assessed the virus titers in tissues by plaque assay and HSV DNA copy number in the trigeminal ganglia (TG) by real time polymerase chain reaction (PCR). Results showed that the virus titers in the tissues were lowered after reactivation, and the oral VCV group with reactivation had significantly reduced DNA copy number in the TG...
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herpes simplex virus latency reactivation and a new antiviral therapy for herpetic keratitis
Japanese Journal of Ophthalmology, 2008Co-Authors: Yoshikazu ShimomuraAbstract:Although many factors that trigger the herpes simplex virus (HSV) reactivation from latency have been reported, how HSV resides in a latent state in the normal human cornea still needs to be defined. We therefore conducted a series of studies regarding various aspects of HSV infections. To understand how patients subjectively perceived changes in their daily life that could have induced HSV reactivation, we first performed a comprehensive survey on the subjective factors in patients who had experienced recurrent herpetic keratitis. The result of our survey revealed that stress, lack of sleep, shoulder stiffness, and physical fatigue were the key factors. There were various causes for stress, and stress associated with reactivation often occurred between spring and summer. Regarding HSV latency in the normal cornea, we used real-time polymerase chain reaction (PCR) to determine the presence of HSV in the donor and host corneas. The findings showed that on average, those host corneas with a history of HSV keratitis had 1.6 x 10(4) copies/mg of HSV DNA, while the host corneas without a history and the donor corneas had 8.7 and 4.9 x 10(2) copies/mg of HSV DNA, respectively. Based on these observations, it is reasonable to infer that latent viruses could have resided in a normal cornea without a history and were transmitted to a host cornea through corneal transplantation. We also quantified the virus load in tears before and after ocular surgery (one week after corneal transplantation or the next day after vitreous surgery). Our results indicated that both the detection rate and the average copy number of HSV DNA had a tendency to increase postperatively. Moreover, we tried to differentiate the HSV strains that were involved in the recurrent lesions. In only one of the studied cases, could we find a single different nucleotide between two HSV strains. It seemed possible that two different strains of HSV had set off the same episode of reactivation. In recent years, chemokines have become known for their action in mediating inflammatory diseases. We suspected that chemokines might also play a role in the antiviral mechanism and examined the chemokine-derived antiviral activity. We used eight chemokines, including RANTES/CCL5, MIP-lalpha/ CCL3, and MIP-1beta/CCL4, in a murine HSK model with Vero cells. These chemokines directly bound to HSV and the chemokine-bound HSV was later resisted by the neutralizing antibody of envelope protein gB. Furthermore, by electron microscope analysis, it became clear that these chemokines had cut an opening in the HSV envelope. Consequently, these chemokines had significantly inhibited the HSV infection on Vero cells. In addition, the virus load in tears was decreased and the corneal opacity was less severe. We concluded in that study that during early infection, chemokines accumulated in the corneal stroma have the ability to protect cells and tissues from HSV infection. As for antiviral therapy, acyclovir (ACV) Eye Ointment has been effective for patients with herpetic keratitis. However, patients often find it difficult to successfully follow the treatment due to the required frequent application and the blurred vision after application. On the other hand, valaciclovir (VCV), which is the oral prodrug of ACV, has become commercially available in recent years for treating nonocular herpetic diseases. We therefore examined and compared the efficacies of oral VCV, oral ACV, ACV Eye Ointment, and ACV Eye drops in a murine keratitis model; the group treated with oral VCV did show a significantly good antiviral effect. We have proved that oral VCV can be a beneficial alternative antiviral therapy for patients with difficulty in complying with the ACV Eye Ointment treatment.
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effect of oral valaciclovir on herpetic keratitis
Cornea, 2006Co-Authors: Shiro Higaki, Masahiko Fukuda, Motoki Itahashi, Tatsunori Deai, Yoshikazu ShimomuraAbstract:Purpose: To examine the efficacy of valaciclovir (VACV) oral formulation as an alternative to topical treatments in a case of herpetic keratitis. Methods: The patient was a 61-year-old man who presented with dendritic keratitis in his left Eye. After recognizing his difficulty in using Eye Ointment, we prescribed oral VACV 500 mg tablets twice daily for 7 days. We also describe our experiments with orally administered VACV in a mouse model of this disease. In this study, 143 Balb/c mice were inoculated with herpes simplex virus type 1 (HSV)-1 in each Eye and treated with oral VACV 50 or 100 mg/kg twice daily, oral acyclovir (ACV) 50 mg/kg 5 times/d, 3% ACV Eye Ointment (ACV-O) 5 times/d, 3% ACV Eye drops 5 times/d, or control for 5 days. Results: After 7 days, the patient's lesion was observed healed. Corrected left visual acuity was also improved, and HSV DNA was below detectable level. In the mouse study, slit-lamp examination on days 3, 4, 5, and 7 revealed that all 5 ACV and VACV treatment groups were significantly more effective in improving symptoms of herpetic epithelial keratitis versus control (P < 0.05). Moreover, VACV 100 mg/kg was superior to other treatments. Viral titers in mouse Eyeball and trigeminal ganglia were lowest in the VACV 100 mg/kg group versus other treatment groups. Conclusion: Our case example suggests that when frequent application, blurred vision, and foreign body sensation after ACV-O application cause difficulty for patients to follow treatment, oral VACV might be an effective and safe option for patients with herpetic keratitis.
