Herpetic Eye Disease Study: A Controlled Trial of Topical Corticosteroids for Herpes Simplex Stromal Keratitis.

Purpose: To evaluate the efficacy of topical corticosteroids in treating herpes simplex stromal keratitis.

Methods: The authors performed a randomized, double-masked, placebo-con- trolled, multicenter clinical trial of 106 patients with active herpes simplex stromal keratitis who had not received any corticosteroids for at least 10 days before study enrollment. Patients were assigned to the placebo group (n = 49) or the steroid group (topical prednisolone phosphate; n = 57); both regimens were tapered over 10 weeks.

Clinical outcomes of combined versus separate carbachol and brimonidine drops in correcting presbyopia.

Background: To test and compare in a masked fashion the efficacy of using a parasympathomimetic drug (3% carbachol) and an alpha-2 agonist (0.2% brimonidine) in both combined and separate forms to create optically beneficial miosis to pharmacologically improve vision in presbyopia.

Methods: A prospective, double-masked, randomized, controlled clinical trial was conducted.

The practical detection of mmp-9 diagnoses ocular surface disease and may help prevent its complications.

Purpose: To evaluate the importance and practicality of testing for matrix metalloproteinase 9 (MMP-9) in dry eye and ocular surface disease. This enzyme, which can cause tissue damage, seems also to be the most reliable diagnostic indicator of ocular surface disease.

Methods: Enzyme-linked immunosorbent assay, polymerase chain reaction, diffusion, and InflammaDry, a new rapid immunoassay by RPS (Rapid Pathogen Screening Inc).

Ganciclovir ophthalmic gel 0.15%: safety and efficacy of a new treatment for herpes simplex keratitis.

Background: Until the availability of ganciclovir ophthalmic gel in 2009, the only option for treating herpes simplex (HSV) keratitis in the USA has been trifluridine (TFT), a compound with tolerability issues related to its nonselective inhibition of DNA replication in both normal cells and virus-infected cells. Ganciclovir has selective pharmacologic activity on viral thymidine kinase and a lower potential for toxicity to healthy human cells. Our objective was to evaluate safety and efficacy findings reported with the use of ganciclovir ophthalmic gel, both for HSV keratitis and other potential clinical indications.

Descemetic versus pre-descemetic lamellar keratoplasty: clinical and confocal study.

Purpose: To compare the clinical findings and confocal microscopic features of the lamellar interface after 2 types of deep anterior lamellar keratoplasty (DALK): Descemetic with total stromal resection versus pre-Descemetic with deep stromal dissection.

Methods: Twenty eyes of 20 patients who had corneal disease with healthy endothelium were treated by DALK using the air technique. Baring of Descemet membrane (DM) was achieved for 12 eyes (Descemetic group).

Ocular herpes simplex virus: how are latency, reactivation, recurrent disease and therapy interrelated?

Most humans are infected with herpes simplex virus (HSV) type 1 in early childhood and remain latently infected throughout life. While most individuals have mild or no symptoms, some will develop destructive HSV keratitis. Ocular infection with HSV-1 and its associated sequelae account for the majority of corneal blindness in industrialized nations.

Adenovirus advances: new diagnostic and therapeutic options.

Purpose Of Review: Adenoviral infection is common, can be severe, and may cause significant morbidity.

Recent Findings: Ophthalmologists and optometrists are often guilty of spreading adenovirus because it is highly contagious and has 53 serotypes with variable morphology. Adenovirus is often difficult to diagnose based on clinical appearance and, in the early stages, is associated with a red eye or superficial keratitis common to herpes and other infections.

In vitro synergism of trifluorothymidine and ganciclovir against HSV-1.

Purpose: To determine whether trifluorothymidine (TFT) and ganciclovir (GCV) are synergistic against herpes simplex virus type 1 (HSV-1).

Methods: TFT and GCV activity against 12 strains of HSV-1 (including an acyclovir-resistant strain) was measured by plaque-forming unit (PFU) inhibition. Cellular toxicity was assessed with an MTT dye reduction assay.

Effect of high versus low oral doses of valacyclovir on herpes simplex virus-1 DNA shedding into tears of latently infected rabbits.

Purpose: To assess the effect of high doses of valacyclovir (VCV) on HSV-1 DNA shedding into tears of latently infected rabbits.

Methods: Three oral doses of VCV were tested. Corneas were inoculated with HSV-1, and latent infection was allowed to establish.

Confocal microscopy of corneal wound healing after deep lamellar keratoplasty in rabbits.

Objective: To compare wound healing and morphologic characteristics of the host-donor interface in rabbit corneas after maximum-depth and near-Descemet membrane anterior lamellar keratoplasty.

Design: Descriptive analysis of confocal microscopy images after 2 types of deep lamellar keratoplasty (deep stromal dissection vs total stromal resection).

Methods: Deep anterior lamellar keratoplasty (DALK) was performed in 16 rabbit eyes, with exposure of the Descemet membrane in 8 eyes (deep group) and deep stromal dissection to near the Descemet membrane in 8 eyes (near group).

A double-blind placebo-controlled study to evaluate valacyclovir alone and with aspirin for asymptomatic HSV-1 DNA shedding in human tears and saliva.

Purpose: To test the effect of valacyclovir alone and with aspirin on the asymptomatic shedding of HSV-1 DNA in tears and saliva of healthy individuals. METHOD. The subjects (n = 45) were randomized into three groups without regard to age, sex, or race.

Slitlamp biomicroscopy and photographic image analysis of herpes simplex virus stromal keratitis.

Objective: To validate photographic bioimaging for evaluating the severity of herpes simplex virus keratitis.

Methods: Stromal keratitis of patients in the Herpetic Eye Disease Study was clinically measured with a slitbeam micrometer and then photographed at trial entry. Calibrated images of 169 eyes were analyzed for the size, location, and density of stromal keratitis and endotheliitis, with shape factor as a function of area and perimeter.

WITHDRAWN: Synergistic interaction of aciclovir and a helicase-primase inhibitor, BAY 57-1293, against herpes simplex virus type 1.

This article has been withdrawn at the request of the author(s). The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.

Heat-induced reactivation of HSV-1 in latent mice: upregulation in the TG of CD83 and other immune response genes and their LAT-ICP0 locus.

Purpose: To determine changes in host gene expression in HSV-1 latent trigeminal ganglia (TG) after hyperthermic stress.

Methods: Scarified corneas of 6-week-old female BALB/c mice were inoculated with either HSV-1 17Syn(+) (high phenotypic reactivator) or 17DeltaPst(LAT(-)) (low phenotypic reactivator) at 10(4) plaque-forming units/eye. At 28 days after infection, viral reactivation was induced in some of the infected mice with hyperthermic stress, and the mice were killed after 1 hour.

Ocular HSV-1 latency, reactivation and recurrent disease.

Ocular infection with HSV-1 continues to be a serious clinical problem despite the availability of effective antivirals. Primary infection with HSV-1 can involve ocular and adenaxial sites and can manifest as blepharitis, conjunctivitis, or corneal epithelial keratitis. After initial ocular infection, HSV-1 can establish latent infection in the trigeminal ganglia for the lifetime of the host.

The high prevalence of herpes simplex virus type 1 DNA in human trigeminal ganglia is not a function of age or gender.

The purpose of this study was to determine the presence and copy numbers of herpes simplex virus type 1 (HSV-1) DNA in human trigeminal ganglia (TG) with respect to age, gender, and postmortem interval (PMI). Human TG (n = 174, obtained from the Oregon Brain Bank, with data on age, gender, and PMI) were analyzed for HSV-1 DNA copies (HSV-1 DNA polymerase gene) by using real-time PCR. We found that 89.

Effective treatment of ocular HSK with a human apolipoprotein E mimetic peptide in a mouse eye model.

Purpose: To evaluate efficacy of the small apolipoprotein E (apoE) mimetic dimer peptide (apoEdp) in the treatment of herpetic stromal keratitis in a mouse ocular model and determine its therapeutic effects against HSV-1-induced inflammatory cytokines.

Methods: Female C57Bl/6 mice were corneally infected with HSV-1 strain KOS-GFP; topical treatment was initiated 24 hours after infection and continued for 10 consecutive days. Treatment groups were 1% apoEdp, 1% trifluorothymidine (TFT), and phosphate-buffered saline (PBS).

Efficacy of a helicase-primase inhibitor in animal models of ocular herpes simplex virus type 1 infection.

Purpose: The aim of this study was to evaluate the effect of BAY 57-1293, a helicase-primase inhibitor, on herpes simplex virus type 1 (HSV-1) reactivation in mice and its efficacy on established disease in rabbits.

Methods: BALB/c mice latent for McKrae-strain HSV-1 were reactivated via heat stress, treated with BAY 57-1293, and their corneas were swabbed for virus or the trigeminal ganglia (TG) obtained for quantification of viral DNA. New Zealand white rabbits were infected and treated topically or orally in comparison with trifluridine or valacyclovir.

Healing process at the flap edge in its influence in the development of corneal ectasia after LASIK.

Purpose: Post-laser in situ keratomileusis (LASIK) corneal ectasia is a progressive deformation of the gross corneal anatomy that occurs after surgery. However, this is a rare event even after deep lamellar keratoplasty. We hypothesize that the strength of the lamellar keratoplasty wound is derived from the sutures that enhance the wound edge healing response.

A new surgical technique for anterior segment ectasia: tectonic lamellar sclerokeratoplasty.

A 41-year-old patient with severe anterior segment ectasia and a previous history of failed corneal graft was treated by placing a 14-mm tectonic corneoscleral allograft in the eye to support both the corneal and the scleral thinning. Nylon 10-0 interrupted sutures were used at the sclero-scleral junction. The host conjunctiva, including the limbal area, was carefully sutured to the donor limbal area.

Clinical corneal confocal microscopy.

Confocal microscopy allows non-invasive in vivo imaging of the ocular surface. Its unique physical properties enable microscopic examination of all layers of the cornea and have been used to investigate numerous corneal diseases: epithelial changes, numerous stromal degenerative or dystrophic diseases, endothelial pathologies, corneal deposits, infections, and traumatic lesions. It offers a new approach to study the physiological reactions of the cornea to different stimuli and the pathophysiologic events leading to corneal dysfunction in certain diseases.

How has confocal microscopy helped us in refractive surgery?

Purpose Of Review: To summarize the known uses of in-vivo confocal microscopy in refractive surgery, highlighting the current developments in the field.

Recent Findings: Examination of the cornea after laser in-situ keratomileusis demonstrated that the keratocyte density within the laser in-situ keratomileusis flap and anterior residual corneal bed continued to decline during the entire 3-year period of the study. The progressive loss of keratocytes in the flap and anterior portion of the residual corneal bed could have long-term implications in terms of corneal stability, refractive stability and cellular integrity after laser in-situ keratomileusis.

The use of the Fugo Blade in corneal surgery: a preliminary animal study.

Purpose: To evaluate the performance of the Fugo Blade in cutting corneal tissue in animals, both in vitro and in vivo.

Methods: Corneal incisions were made on pig eyes using the Fugo Blade. The histologic characteristics of these cuts were then evaluated.