Twenty years of acanthamoeba diagnostics in Austria.

Acanthamoebae are the causative agents of an often seriously progressing keratitis (AK) occurring predominantly in contact lens wearers and can cause several disseminating infections potentially resulting in granulomatous amoebic encephalitis (GAE) in the immunocompromised host. Our institution is the Austrian reference laboratory for Acanthamoeba diagnostics and the aim of this study was to give an overview of proven cases of Acanthamoeba infections in Austria during the past 20 yr. All samples of patients with suspected AK or GAE were screened for Acanthamoeba spp.

Influence of single-fraction Gamma-Knife radiosurgery on ocular surface and tear function in choroidal melanoma patients.

Aim: To evaluate ocular surface and tear function in patients with choroidal melanoma treated with single-fraction radiosurgery.

Methods: 36 patients (median age 62 years; range 26-84 years) were enrolled between 2001 and 2006 at a single institution. They were treated with the Leksell Gamma Knife in one fraction with a median dose of 30 Gy (range 25-35 Gy).

Long-term follow-up of punctal and proximal canalicular stenoses after silicone punctal plug treatment in dry eye patients.

Purpose: To determine the clinical value and relevance of punctal and proximal canalicular stenoses after punctal plug therapy in moderate to severe dry eye syndrome.

Design: Retrospective, observational case series.

Methods: Seventeen eyes were determined to have punctum or proximal canalicular stenoses after spontaneous loss of a collared silicone punctal plug.

Multiplex bead analysis of vitreous and serum concentrations of inflammatory and proangiogenic factors in diabetic patients.

Purpose: To investigate the role of inflammatory and angiogenic factors in the pathogenesis of diabetic retinopathy, we determined, in diabetic patients and controls, vitreous and serum concentrations of interferon-induced protein (IP)-10, monocyte chemoattractant protein (MCP)-1, macrophage inflammatory protein (MIP)-1alpha, MIP-1beta, regulated upon activation, normal T-expressed and secreted (RANTES), and vascular endothelial growth factor (VEGF).

Methods: We recruited 36 probands with type 2 diabetes mellitus (15 noninsulin-dependent and 21 insulin-dependent) and 69 normal controls. Using Cytometric Bead Array Technology, we measured vitreous and serum concentrations of IP-10, MCP-1, MIP-1alpha, MIP-1beta, RANTES, and VEGF.

Application of multiplex cytometric bead array technology for the measurement of angiogenic factors in the vitreous.

Purpose: This study was carried out to compare cytometric bead array (CBA) technology with conventional enzyme linked immunosorbent assay (ELISA) for the measurement of both vitreous and serum concentrations of interleukin-8 (IL-8), vascular endothelial growth factor (VEGF), and angiogenin (ANG) in diabetic and non-diabetic patients.

Methods: Measurement of vitreous and serum concentrations of IL-8, VEGF, and ANG using both ELISA and CBA was performed in 26 probands (13 diabetics and 13 non-diabetic control subjects).

Results: Vitreous and serum concentrations of IL-8, VEGF, and ANG determined by CBA showed a strong correlation with those measured by ELISA.

Role of the CCL2/MCP-1 -2518A>G gene polymorphism in HLA-B27 associated uveitis.

Purpose: Acute anterior uveitis (AAU) is the most common form of uveitis. Up to 50% of patients with AAU are HLA-B27 positive. Since HLA B27 itself plays only a minor role in the overall genetic background, other genetic variants are likely to contribute to the susceptibility to AAU.

TNF-alpha promoter polymorphisms and primary open-angle glaucoma.

Purpose: Primary open-angle glaucoma (POAG) is a multifactorial optic neuropathy with a strong hereditary component. Recent studies suggested a role for tumour necrosis factor-alpha(TNF-alpha) in the pathogenesis of POAG. The purpose of the present study was to investigate a hypothesized association between the TNF-alpha-308G>A and -238G>A gene polymorphisms and the presence of POAG in a Caucasian population.

Evaluating an impression cytology grading system (IC score) in patients with dry eye syndrome.

Purpose: To evaluate the IC score, a newly developed grading system for the morphological alterations of the ocular surface as a diagnostic tool in relation to type and severity of dry eye disease.

Methods: Impression cytological specimens of 309 patients with simple dry eye (S-DE), 50 patients with Sjögren's syndrome and dry eye (SS-DE), and 39 patients with connective tissue disease and dry eye (CTD-DE) were examined. In all, 10 different morphological parameters were judged with points (IC subscores) and summarized to the IC score.

Iodide iontophoresis as a treatment for dry eye syndrome.

Background/aims: Among the causes related to the development or perpetuation and aggravation of dry eye disease, oxidative reactions may have a role in the pathogenesis of this disorder. Antioxidants, such as iodide, have shown a strong effect in preventing the oxidative damage to constituents of the anterior part of the eye. In this clinical trial the effectiveness of iodide iontophoresis and iodide application without current in moderate to severe dry eye patients was compared.

One- and two-step hydrogen peroxide contact lens disinfection solutions against Acanthamoeba: how effective are they?

Purpose: Effective contact lens disinfection solutions are important to keep the storage case free of acanthamoebae and thus prevent an infection of the eye. The aim of our study was to evaluate the effectivity of two new one-step hydrogen peroxide disinfecting solutions against Acanthamoeba spp. and compare it to the effectivity of other commercially available systems.

Characterisation and differentiation of pathogenic and non-pathogenic Acanthamoeba strains by their protein and antigen profiles.

Free-living amoebae of the genus Acanthamoeba are the causative agents of Acanthamoeba keratitis (AK) and granulomatous amoebic encephalitis. Acanthamoebae occur ubiquitously in the environment and are thus a constant cause of antigenic stimulation. In a previous study we have shown that compared to control sera, AK patients exhibit markedly lower immunoreactivities to whole cell antigen of Acanthamoeba spp.

Evaluation of the clinical course of dry eye syndrome.

Objective: To assess subjective symptoms, tear function factors, and ocular surface morphology in the clinical course of patients with dry eye syndrome under treatment within an observation period of up to 8 years.

Methods: In 97 patients (78 women and 19 men) with ocular discomfort, a clinical diagnosis of dry eye syndrome was made based on typical symptoms and a reduced tear film breakup time of less than 10 seconds. Subsequent evaluations revealed a diagnosis of aqueous tear deficiency in 9 patients, meibomian gland dysfunction in 32 patients, and aqueous tear deficiency combined with meibomian gland dysfunction in 30 patients, aqueous tear deficiency associated with Sjögren syndrome in 12 patients, and aqueous tear deficiency and meibomian gland dysfunction associated with Sjögren syndrome in 14 patients.

A conservative blepharoplasty may be a means of alleviating dry eye symptoms.

Purpose: Patients with dermatochalasis often complain of dry eye symptoms. In a prospective study, the influence of upper eyelid blepharoplasty on dry eye symptoms, tear film parameters and ocular surface morphology was evaluated.

Methods: Patients with upper eyelid dermatochalasis were studied before and 3 months after upper eyelid blepharoplasty.

Botulinum toxin A treatment in patients suffering from blepharospasm and dry eye.

Background: Many patients with essential blepharospasm also show dry eye signs and symptoms. Botulinum toxin A is an effective treatment for reducing spasms in these patients. In this investigation, the effect of botulinum toxin A injections on tear function and on the morphology of the ocular surface in patients suffering from blepharospasm in combination with a dry eye syndrome was investigated.

Chlamydial conjunctivitis (in adults), uveitis, and reactive arthritis, including SARA. Sexually acquired reactive arthritis.

This chapter deals with Chlamydia -induced ocular and rheumatic diseases of the adult. All of these may follow a primary urogenital infection with Chlamydia trachomatis in genetically predisposed patients. Besides the infection with Chlamydia trachomatis, infections with Chlamydia pneumoniae and Chlamydia psittaci are also discussed as possible causative agents.

[A clinico-pathological case report of necrotizing ulcerating keratopathy due to topical anaesthetic abuse].

Background: Topical anesthetic abuse is rare, but difficult to diagnose since most patients deny its use and the clinical changes are very similar to other corneal diseases.

Case Report: A 45-year-old medical doctor with a 30-year history of soft contact lens wear and recurrent corneal erosion was admitted to our clinic with a ring-shaped keratitis and intense ocular pain. A corneal smear was negative for bacterial infections and acanthamoeba but the contact lens box contained a few dead acanthamoeba and many cocci.

Chlamydia pneumoniae seropositivity and the risk of nonarteritic ischemic optic neuropathy.

Objective: To determine whether IgG antibodies to Chlamydia pneumoniae are associated with nonarteritic ischemic optic neuropathy (NAION).

Design: Retrospective case-control study.

Participants: The study cohort consisted of 71 consecutive patients with NAION and 71 controls matched for age and gender.

[Intracorneal silicone oil deposits].

Background: A patient with intraocular silicone oildeposits underwent paracentral corneal incision but the corneal sutures were never removed and 7 years later a perforating corneal transplantation was performed due to corneal opacification.

Methods: The corneal button was fixed in 10% buffered paraformaldehyde, embedded in celloidin and sections 200 microns thick were cut and stained with van Gieson. Some of these sections were embedded in paraffin and 5 microns thick sections were cut.

Viability of Acanthamoeba after exposure to a multipurpose disinfecting contact lens solution and two hydrogen peroxide systems.

Background/aim: Contact lens cases contaminated with Acanthamoeba are a major risk factor for an infection of the eye. In this study the anti-Acanthamoeba activity of three different contact lens storage solutions was tested.

Methods: A new multipurpose contact lens storage solution (Meni Care Plus) and a two step (Titmus H(2)O(2)) and one step (Oxysept Comfort) hydrogen peroxide system were tested for their effects on trophozoites and cysts of three different Acanthamoeba species: A castellanii, A hatchetti, and A lenticulata.

Anti-Acanthamoeba IgG, IgM, and IgA immunoreactivities in correlation to strain pathogenicity.

Several representatives of the genus Acanthamoeba are known as causative agents of Acanthamoeba keratitis and granulomatous amoebic encephalitis. These occur predominantly in the immunocompromised host, but it is still unclear what primes the amoebae for pathogenicity. The aim of this study was to assess possible immunological differences between a highly pathogenic and a nonpathogenic Acanthamoeba strain.

Microwave treatment of contact lens cases contaminated with acanthamoeba.

Purpose: Microbially contaminated contact lens cases are a predisposing risk factor for Acanthamoeba keratitis. Several findings have shown that microwave irradiation kills the six Food and Drug Administration test challenge microorganisms. We aimed to determine what effect microwave irradiation has on Acanthamoeba trophozoites and cysts.

[[Candida endophthalmitis in drug abuse. case report].

Background: Endogenous fungal endophthalmitis is mostly seen as opportunistic infection, particularly in immunocompromised patients and under special risk factors. The therapeutical approach and the value of vitrectomy in diagnosis and therapy are discussed.

Patient: A 42-years-old intravenous heroin addicted male patient with unilateral Candida albicans endophthalmitis, determined by cultivation is presented.