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Dimitrios G. Mikropoulos - One of the best experts on this subject based on the ideXlab platform.
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treatment of Superior Limbic Keratoconjunctivitis with topical tacrolimus 0 03 ointment
Cornea, 2013Co-Authors: George D. Kymionis, Nektarios E. Klados, George A. Kontadakis, Dimitrios G. MikropoulosAbstract:PURPOSE: To report 2 cases of Superior Limbic Keratoconjunctivitis (SLK) treated with topical tacrolimus 0.03% ointment (Protopic; Fujisawa Healthcare). METHODS: A female patient aged 52 years and a male patient aged 21 years presented with SLK in both eyes. Both patients had previously received several treatments [such as topical steroids and lubrication, contact lenses, silicone punctal plugs, and vitamin A eye drops], with no improvement. Because of poor response to initial management, the authors started treatment with topical tacrolimus 0.03% twice a day. Objective tarsal conjunctiva inflammation, bulbar conjunctiva findings (such as hyperemia and thickening), cornea staining, and subjective symptoms were evaluated. RESULTS: A week later, both patients were symptomatically better. Four weeks after treatment initiation, the signs of thickened and hyperemic Superior conjunctiva, papillary reaction, and punctate keratopathy were almost resolved. Tacrolimus was successfully tapered in both the patients. There were no side effects. CONCLUSIONS: Topical tacrolimus 0.03% ointment may be considered an additional treatment option for SLK.
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Treatment of Superior Limbic Keratoconjunctivitis with topical tacrolimus 0.03% ointment.
Cornea, 2013Co-Authors: George D. Kymionis, Nektarios E. Klados, George A. Kontadakis, Dimitrios G. MikropoulosAbstract:PURPOSE: To report 2 cases of Superior Limbic Keratoconjunctivitis (SLK) treated with topical tacrolimus 0.03% ointment (Protopic; Fujisawa Healthcare). METHODS: A female patient aged 52 years and a male patient aged 21 years presented with SLK in both eyes. Both patients had previously received several treatments [such as topical steroids and lubrication, contact lenses, silicone punctal plugs, and vitamin A eye drops], with no improvement. Because of poor response to initial management, the authors started treatment with topical tacrolimus 0.03% twice a day. Objective tarsal conjunctiva inflammation, bulbar conjunctiva findings (such as hyperemia and thickening), cornea staining, and subjective symptoms were evaluated. RESULTS: A week later, both patients were symptomatically better. Four weeks after treatment initiation, the signs of thickened and hyperemic Superior conjunctiva, papillary reaction, and punctate keratopathy were almost resolved. Tacrolimus was successfully tapered in both the patients. There were no side effects. CONCLUSIONS: Topical tacrolimus 0.03% ointment may be considered an additional treatment option for SLK.
George D. Kymionis - One of the best experts on this subject based on the ideXlab platform.
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treatment of Superior Limbic Keratoconjunctivitis with topical tacrolimus 0 03 ointment
Cornea, 2013Co-Authors: George D. Kymionis, Nektarios E. Klados, George A. Kontadakis, Dimitrios G. MikropoulosAbstract:PURPOSE: To report 2 cases of Superior Limbic Keratoconjunctivitis (SLK) treated with topical tacrolimus 0.03% ointment (Protopic; Fujisawa Healthcare). METHODS: A female patient aged 52 years and a male patient aged 21 years presented with SLK in both eyes. Both patients had previously received several treatments [such as topical steroids and lubrication, contact lenses, silicone punctal plugs, and vitamin A eye drops], with no improvement. Because of poor response to initial management, the authors started treatment with topical tacrolimus 0.03% twice a day. Objective tarsal conjunctiva inflammation, bulbar conjunctiva findings (such as hyperemia and thickening), cornea staining, and subjective symptoms were evaluated. RESULTS: A week later, both patients were symptomatically better. Four weeks after treatment initiation, the signs of thickened and hyperemic Superior conjunctiva, papillary reaction, and punctate keratopathy were almost resolved. Tacrolimus was successfully tapered in both the patients. There were no side effects. CONCLUSIONS: Topical tacrolimus 0.03% ointment may be considered an additional treatment option for SLK.
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Treatment of Superior Limbic Keratoconjunctivitis with topical tacrolimus 0.03% ointment.
Cornea, 2013Co-Authors: George D. Kymionis, Nektarios E. Klados, George A. Kontadakis, Dimitrios G. MikropoulosAbstract:PURPOSE: To report 2 cases of Superior Limbic Keratoconjunctivitis (SLK) treated with topical tacrolimus 0.03% ointment (Protopic; Fujisawa Healthcare). METHODS: A female patient aged 52 years and a male patient aged 21 years presented with SLK in both eyes. Both patients had previously received several treatments [such as topical steroids and lubrication, contact lenses, silicone punctal plugs, and vitamin A eye drops], with no improvement. Because of poor response to initial management, the authors started treatment with topical tacrolimus 0.03% twice a day. Objective tarsal conjunctiva inflammation, bulbar conjunctiva findings (such as hyperemia and thickening), cornea staining, and subjective symptoms were evaluated. RESULTS: A week later, both patients were symptomatically better. Four weeks after treatment initiation, the signs of thickened and hyperemic Superior conjunctiva, papillary reaction, and punctate keratopathy were almost resolved. Tacrolimus was successfully tapered in both the patients. There were no side effects. CONCLUSIONS: Topical tacrolimus 0.03% ointment may be considered an additional treatment option for SLK.
Kazuo Tsubota - One of the best experts on this subject based on the ideXlab platform.
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Influence of Meibomian Gland Dysfunction and Friction-Related Disease on the Severity of Dry Eye.
Ophthalmology, 2018Co-Authors: Motoko Kawashima, Norihiko Yokoi, Masakazu Yamada, Kazuhisa Suwaki, Miki Uchino, Chika Shigeyasu, Yoshimune Hiratsuka, Kazuo TsubotaAbstract:Purpose To evaluate the effect of meibomian gland dysfunction (MGD) and friction-related disease (FRD) on the severity of dry eye disease (DED). Design Cross-sectional observational study. Participants This study enrolled 449 patients with DED (63 men and 386 women; mean age, 62.6±15.7 years [range, 21–90 years]) for analysis. Methods Subjective symptoms, the ocular surface, tear function, and the presence of MGD and FRD (Superior Limbic Keratoconjunctivitis, conjunctivochalasis, and lid wiper epitheliopathy) were investigated. Main Outcome Measures Schirmer value, tear film breakup time (TBUT), and keratoconjunctival score. Results We classified the participants into aqueous-deficient dry eye (ADDE; n = 231 [51.4%]) and short TBUT dry eye subtype (TBUT-DE; n = 109 [24.3%]) subgroups. The TBUT was shorter in patients with MGD than in those without MGD, whereas other ocular signs showed no difference (TBUT: MGD present, 1.97±1.02 seconds; MGD absent, 2.94±1.63 seconds [ P P P = 0.01]). The ADDE patients with FRD showed a worse TBUT than ADDE patients without FRD (TBUT: ADDE/FRD present, 2.08±1.39 seconds; ADDE/FRD absent, 2.92±1.54 seconds; P Conclusions This study showed associations between MGD, FRD, or both and ocular signs in DED. In the presence of MGD, FRD, or both, TBUT was significantly shortened regardless of the dry eye status or subtype.
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In vivo evaluation of Superior Limbic Keratoconjunctivitis using laser scanning confocal microscopy and conjunctival impression cytology.
Investigative ophthalmology & visual science, 2010Co-Authors: Takashi Kojima, Yukihiro Matsumoto, Osama M. A. Ibrahim, Enrique Adan Sato, Murat Dogru, Kazuo TsubotaAbstract:PURPOSE To investigate the cytologic findings of Superior bulbar conjunctiva in Superior Limbic Keratoconjunctivitis (SLK) using laser scanning confocal microscopy and impression cytology in a prospective controlled study. METHODS Twenty-one eyes of 11 SLK patients (9 women, 2 men; mean age, 49.3 +/- 17.9 years) and 18 eyes of 9 control subjects (6 women, 3 men; mean age, 46.4 +/- 8.7 years) underwent tear function tests including vital stainings, Schirmer test, tear clearance test, digital confocal laser scanning microscopy, and conjunctival impression cytology. After confocal microscopy and impression cytology images were obtained, the mean individual epithelial cell area (MIECA), nucleocytoplasmic (N/C) ratio, and inflammatory cell density were analyzed. The correlation between confocal microscopy and impression cytology parameters was investigated. RESULTS The MIECA of SLK patients and control subjects in confocal microscopy was 786.54 +/- 463.88 microm(2) and 311.50 +/- 78.30 microm(2), respectively. The mean N/C ratio was 0.356 +/- 0.090 and 0.490 +/- 0.038, respectively. The MIECA and N/C ratio in impression cytology showed significant correlation with the corresponding confocal microscopy parameters (MIECA, P = 0.0028; N/C, P = 0.0051). The inflammatory cell density in confocal microscopy significantly correlated with Superior bulbar conjunctival Rose-Bengal scores (P = 0.0264). CONCLUSIONS Laser scanning confocal microscopy seems to be an efficient noninvasive tool in the evaluation of phenotypic alterations of the conjunctival epithelium in SLK and may serve as an alternative for impression cytology. N/C ratio and inflammatory cell density appear to be two new promising parameters of in vivo confocal microscopy in the assessment of ocular surface disease in SLK.
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Autologous serum eye drops for the treatment of dry eye diseases.
Cornea, 2008Co-Authors: Takashi Kojima, Eiki Goto, Yukihiro Matsumoto, Murat Dogru, Akihiro Higuchi, Kazuo TsubotaAbstract:Conventional treatment of dry eye mainly consists of the use of preservative-free artificial eye drops and punctal occlusion. None of the commercially available artificial tear preparations include essential tear components such as epidermal growth factor, hepatocyte growth factor, fibronectin, neurotrophic growth factor, and vitamin A-all of which have been shown to play important roles in the maintenance of a healthy ocular surface epithelial milieu. We reported previously that autologous serum (AS) eye drops contain these essential factors and that AS eye drops are beneficial in the treatment of ocular surface diseases such as persistent epithelial defects, Superior Limbic Keratoconjunctivitis, Keratoconjunctivitis sicca, and neurotrophic keratopathy. However, there is some controversy regarding the efficacy of AS treatment. We demonstrated that this modality is more effective than artificial tears in a randomized control study. In in vivo and in vitro experiments, AS eye drops showed marked suppression of apoptosis in the conjunctival and corneal epithelium. Albumin, the major protein in serum, improved ocular surface damage in vivo and rescued apoptosis after serum deprivation in vitro. The biological background of AS eye drops and previous clinical studies of these medications for the treatment of dry eye are discussed.
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Treatment of Superior Limbic Keratoconjunctivitis by application of autologous serum.
Cornea, 2001Co-Authors: Eiki Goto, Jun Shimazaki, Shigeto Shimmura, Kazuo TsubotaAbstract:Purpose.To determine the efficacy of autologous serum drops in the treatment of Superior Limbic Keratoconjunctivitis (SLK).Methods.Twenty-two eyes of 11 patients were diagnosed with SLK. All eyes were treated with 20% diluted autologous serum eyedrops 10 times a day in addition to ongoing treatment
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Lacrimal punctal occlusion for the treatment of Superior Limbic Keratoconjunctivitis.
American journal of ophthalmology, 1997Co-Authors: Hao-yung Yang, Hiroshi Fujishima, Ikuko Toda, Jun Shimazaki, Kazuo TsubotaAbstract:Purpose To test the hypothesis that Superior Limbic Keratoconjunctivitis is caused by insufficient tear supply to the Superior keratoconjunctiva. Methods We used cautery and sutures to permanently occlude the lacrimal puncta of 11 patients (22 eyes) with Superior Limbic Keratoconjunctivitis for whom topical treatment was ineffective. Results All 11 patients (22 eyes) responded favorably to lacrimal punctal occlusion. After lacrimal punctal occlusion, rose bengal and fluorescein staining (both on a scale of 0 [no staining] to 9 [complete staining]) were reduced (mean ± SD, 2.7 ± 1.6 to 1.1 ± 1.8 and 1.4 ± 1.2 to 0.4 ± 0.8, respectively). Impression cytology disclosed improvement of squamous metaplasia in the Superior conjunctiva as well as increased goblet cells in nine of 13 eyes (69%) examined. Subjective symptoms improved in all 22 eyes (100%). Conclusions Improvement of local tear deficiency to the Superior Limbic portion by punctal occlusion was an effective treatment in this small series. Superior Limbic Keratoconjunctivitis might be caused by the insufficient local tear supply.
George A. Kontadakis - One of the best experts on this subject based on the ideXlab platform.
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treatment of Superior Limbic Keratoconjunctivitis with topical tacrolimus 0 03 ointment
Cornea, 2013Co-Authors: George D. Kymionis, Nektarios E. Klados, George A. Kontadakis, Dimitrios G. MikropoulosAbstract:PURPOSE: To report 2 cases of Superior Limbic Keratoconjunctivitis (SLK) treated with topical tacrolimus 0.03% ointment (Protopic; Fujisawa Healthcare). METHODS: A female patient aged 52 years and a male patient aged 21 years presented with SLK in both eyes. Both patients had previously received several treatments [such as topical steroids and lubrication, contact lenses, silicone punctal plugs, and vitamin A eye drops], with no improvement. Because of poor response to initial management, the authors started treatment with topical tacrolimus 0.03% twice a day. Objective tarsal conjunctiva inflammation, bulbar conjunctiva findings (such as hyperemia and thickening), cornea staining, and subjective symptoms were evaluated. RESULTS: A week later, both patients were symptomatically better. Four weeks after treatment initiation, the signs of thickened and hyperemic Superior conjunctiva, papillary reaction, and punctate keratopathy were almost resolved. Tacrolimus was successfully tapered in both the patients. There were no side effects. CONCLUSIONS: Topical tacrolimus 0.03% ointment may be considered an additional treatment option for SLK.
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Treatment of Superior Limbic Keratoconjunctivitis with topical tacrolimus 0.03% ointment.
Cornea, 2013Co-Authors: George D. Kymionis, Nektarios E. Klados, George A. Kontadakis, Dimitrios G. MikropoulosAbstract:PURPOSE: To report 2 cases of Superior Limbic Keratoconjunctivitis (SLK) treated with topical tacrolimus 0.03% ointment (Protopic; Fujisawa Healthcare). METHODS: A female patient aged 52 years and a male patient aged 21 years presented with SLK in both eyes. Both patients had previously received several treatments [such as topical steroids and lubrication, contact lenses, silicone punctal plugs, and vitamin A eye drops], with no improvement. Because of poor response to initial management, the authors started treatment with topical tacrolimus 0.03% twice a day. Objective tarsal conjunctiva inflammation, bulbar conjunctiva findings (such as hyperemia and thickening), cornea staining, and subjective symptoms were evaluated. RESULTS: A week later, both patients were symptomatically better. Four weeks after treatment initiation, the signs of thickened and hyperemic Superior conjunctiva, papillary reaction, and punctate keratopathy were almost resolved. Tacrolimus was successfully tapered in both the patients. There were no side effects. CONCLUSIONS: Topical tacrolimus 0.03% ointment may be considered an additional treatment option for SLK.
Nektarios E. Klados - One of the best experts on this subject based on the ideXlab platform.
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treatment of Superior Limbic Keratoconjunctivitis with topical tacrolimus 0 03 ointment
Cornea, 2013Co-Authors: George D. Kymionis, Nektarios E. Klados, George A. Kontadakis, Dimitrios G. MikropoulosAbstract:PURPOSE: To report 2 cases of Superior Limbic Keratoconjunctivitis (SLK) treated with topical tacrolimus 0.03% ointment (Protopic; Fujisawa Healthcare). METHODS: A female patient aged 52 years and a male patient aged 21 years presented with SLK in both eyes. Both patients had previously received several treatments [such as topical steroids and lubrication, contact lenses, silicone punctal plugs, and vitamin A eye drops], with no improvement. Because of poor response to initial management, the authors started treatment with topical tacrolimus 0.03% twice a day. Objective tarsal conjunctiva inflammation, bulbar conjunctiva findings (such as hyperemia and thickening), cornea staining, and subjective symptoms were evaluated. RESULTS: A week later, both patients were symptomatically better. Four weeks after treatment initiation, the signs of thickened and hyperemic Superior conjunctiva, papillary reaction, and punctate keratopathy were almost resolved. Tacrolimus was successfully tapered in both the patients. There were no side effects. CONCLUSIONS: Topical tacrolimus 0.03% ointment may be considered an additional treatment option for SLK.
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Treatment of Superior Limbic Keratoconjunctivitis with topical tacrolimus 0.03% ointment.
Cornea, 2013Co-Authors: George D. Kymionis, Nektarios E. Klados, George A. Kontadakis, Dimitrios G. MikropoulosAbstract:PURPOSE: To report 2 cases of Superior Limbic Keratoconjunctivitis (SLK) treated with topical tacrolimus 0.03% ointment (Protopic; Fujisawa Healthcare). METHODS: A female patient aged 52 years and a male patient aged 21 years presented with SLK in both eyes. Both patients had previously received several treatments [such as topical steroids and lubrication, contact lenses, silicone punctal plugs, and vitamin A eye drops], with no improvement. Because of poor response to initial management, the authors started treatment with topical tacrolimus 0.03% twice a day. Objective tarsal conjunctiva inflammation, bulbar conjunctiva findings (such as hyperemia and thickening), cornea staining, and subjective symptoms were evaluated. RESULTS: A week later, both patients were symptomatically better. Four weeks after treatment initiation, the signs of thickened and hyperemic Superior conjunctiva, papillary reaction, and punctate keratopathy were almost resolved. Tacrolimus was successfully tapered in both the patients. There were no side effects. CONCLUSIONS: Topical tacrolimus 0.03% ointment may be considered an additional treatment option for SLK.
