Combination management by C-arm fluoroscopy and extraocular muscle severance for penetrating ocular trauma with a retrobulbar foreign body.

We report here the successful removal of a retrobulbar metallic foreign body in a patient with penetrating ocular trauma by a transconjunctival approach and combination management with C-arm fluoroscopy and extraocular muscle severance. A 37-year-old man sustained a penetrating injury to the right eye while using an iron hammer. Initial slitlamp examination revealed a corneoscleral laceration, iridocele, anterior chamber collapse, and a traumatic cataract.

Methotrexate-associated orbital lymphoproliferative disorder in a patient with rheumatoid arthritis: a case report.

Purpose: Lymphoproliferative disorders (LPDs) can develop in patients treated with methotrexate (MTX) and usually respond well to MTX withdrawal. Mucosa-associated lymphoid tissue (MALT) lymphoma is a relatively rare type of MTX-LPD. The development of MTX-LPD in the orbit has not been previously described.

Inhibition by female sex hormones of collagen gel contraction mediated by retinal pigment epithelial cells.

Purpose: Collagen contraction mediated by retinal pigment epithelial (RPE) cells contributes to the pathogenesis of proliferative vitreoretinopathy (PVR). We examined the effects of sex hormones on this process.

Methods: Mouse RPE cells were cultured in a type I collagen gel and exposed to 17β-estradiol, progesterone, or dehydro-epiandrosterone.

Autoantibodies to transient receptor potential cation channel, subfamily M, member 1 in a Japanese patient with melanoma-associated retinopathy.

Purpose: To report a case of melanoma-associated retinopathy (MAR) in a Japanese patient found to have autoantibodies to transient receptor potential cation channel, subfamily M, member 1 (TRPM1).

Case: An 82-year-old man presented with blurred vision OS as well as night blindness and photopsia OU. Fundus photography, fluorescein angiography, and spectral domain-optical coherence tomography findings were essentially normal.

Identification of common secreted factors in human corneal fibroblasts exposed to LPS, poly(I:C), or zymosan.

Infection of the cornea with bacteria, viruses, or fungi can result in corneal ulceration. Corneal stromal cells participate in the immune and inflammatory responses to such infection in part by producing various cytokines and chemokines. The effects of lipopolysaccharide (LPS), polyinosinic-polycytidylic acid [poly(I:C)], and zymosan as surrogates for bacteria, viruses, and fungi, respectively, on the release of cytokines and chemokines from cultured human corneal fibroblasts were examined in order to identify common factors in infectious corneal keratitis.

Device for cataract analysis: development and relevance to cataract surgery.

Purpose: To evaluate the relationship between World Health Organization (WHO) cataract grade determined with a new device and (1) preoperative visual acuity and (2) the difficulty of specific steps in cataract surgery.

Setting: Yamaguchi University Hospital, Yamaguchi, Japan.

Methods: Patients who had cataract surgery between January 2006 and September 2008 were enrolled in this prospective study.

[Remodeling in ocular allergic diseases].

Vernal keratoconjunctivitis (VKC), a chronic and severe form of ocular allergic disease, is characterized by tissue remodeling such as the formation of giant papillae at the upper tarsal conjunctiva and the development of corneal plaques. Giant papillae develop as a result of infiltration of inflammatory cells, changes in the epithelial layer, increased deposition of extracellular matrix molecules, proliferation of conjunctival fibroblasts, and an increase in the number of blood vessels. Corneal plaques form subsequent to corneal epithelial defects, and their surface remains uncovered by the corneal epithelium; consequensly, corneal epithelial cells are not able to attach to or migrate over the plaques.

Fibroblasts as local immune modulators in ocular allergic disease.

Vernal keratoconjunctivitis (VKC), a severe form of ocular allergic disease, is characterized by the formation of giant papillae at the upper tarsal conjunctiva and corneal lesions that threaten vision. Recent evidence indicates that resident fibroblasts function as immune modulators in the pathogenesis of the chronic allergic inflammation associated with VKC. The T helper 2 (Th2) cell-derived cytokines interleukin (IL)-4 and IL-13 stimulate the migration and proliferation of conjunctival fibroblasts as well as protecting these cells from apoptotic cell death, effects that likely underlie the hyperplasia of fibroblasts that contributes to the formation of giant papillae.

Inhibition of matrix metalloproteinase-3 synthesis in human conjunctival fibroblasts by interleukin-4 or interleukin-13.

Purpose: Fibroproliferative lesions of the conjunctiva known as giant papillae are a characteristic of vernal keratoconjunctivitis (VKC). The abundance of T helper 2 (Th2) cells and cytokines is increased in the giant papillae and tear fluid of individuals with VKC, and the Th2 cytokines interleukin (IL)-4 and IL-13 each stimulate the production of extracellular matrix (ECM) proteins by conjunctival fibroblasts. The role of Th2 cytokines in the development of giant papillae was further examined by determination of the effects of these molecules on the production by conjunctival fibroblasts of matrix metalloproteinase (MMP)-3, a key enzyme in ECM degradation.

Activation of corneal fibroblast-derived matrix metalloproteinase-2 by tryptase.

Purpose: The presence of the active form of matrix metalloproteinase (MMP)-2 and an increased concentration of tryptase are characteristics of tear fluid of individuals with vernal keratoconjunctivitis. Although tryptase does not mediate the activation of purified MMP-2, we have now examined whether it might activate MMP-2 in the presence of cultured human corneal fibroblasts.

Methods: Corneal fibroblasts were cultured in the absence or presence of tryptase, and the activation status of MMP-2 was determined by gelatin zymography.

Role of structural cells of the cornea and conjunctiva in the pathogenesis of vernal keratoconjunctivitis.

Vernal keratoconjunctivitis (VKC) is a severe type of allergic conjunctival disease characterized by the presence both of various corneal epithelial and stromal lesions as well as of conjunctival proliferative changes such as giant papillae of the upper tarsal conjunctiva and limbal lesions. These clinical findings as well as various pathophysiological characteristics of VKC are distinct from those of other types of ocular allergy and allergic diseases of other organs. The outer eye possesses specific allergological characteristics, one of which is communication between the cornea and conjunctiva through a thin layer of tear fluid.

Potentiation of lipopolysaccharide-induced chemokine and adhesion molecule expression in corneal fibroblasts by soluble CD14 or LPS-binding protein.

Purpose: The detection of bacterial lipopolysaccharide (LPS) by human cells is facilitated by LPS-binding protein (LBP) and soluble (s)CD14. The effects of these proteins on chemokine release and adhesion molecule expression in cultured human corneal fibroblasts were examined.

Methods: The release of chemokines into culture supernatants and the expression of the intercellular adhesion molecule (ICAM)-1 on the cell surface were determined by enzyme-linked immunosorbent assays.

Protection of human conjunctival fibroblasts from NO-induced apoptosis by interleukin-4 or interleukin-13.

Purpose: To examine the possible roles of T helper type 2 (Th2) cell-derived cytokines in formation of the giant papillae characteristic in individuals with vernal keratoconjunctivitis, the effects of these cytokines on the proliferation and apoptosis of cultured human conjunctival fibroblasts were investigated.

Methods: Apoptosis was induced by the NO donor sodium nitroprusside. Cell viability was determined by measurement of mitochondrial metabolic activity, and apoptotic cells were identified on the basis either of nuclear morphology after staining with 4',6-diamidino-2-phenylindole or of TUNEL staining.

Lipopolysaccharide-induced expression of intercellular adhesion molecule-1 and chemokines in cultured human corneal fibroblasts.

Purpose: Invasion of bacteria into the corneal stroma induces the infiltration of leukocytes and subsequent corneal ulceration. The role of corneal fibroblasts in the detection of bacterial invasion into the stroma was investigated by examining the in vitro expression of the receptor complex for lipopolysaccharide (LPS), a common component of Gram-negative bacteria, as well as the possible effects of LPS on both the expression of adhesion molecules and the release of chemokines in cultured human corneal fibroblasts.

Methods: Expression of the LPS receptor complex, intercellular adhesion molecule (ICAM)-1, and the chemokines interleukin (IL)-8 and monocyte chemotactic protein (MCP)-1 was examined by reverse transcription-polymerase chain reaction, enzyme-linked immunosorbent assay, or immunofluorescence analysis.

Synergistic effect of TNF-alpha and either IL-4 or IL-13 on VCAM-1 expression by cultured human corneal fibroblasts.

Purpose: To examine the role of corneal fibroblasts in the pathogenesis of vernal keratoconjunctivitis, we investigated the effects of tumor necrosis factor (TNF)-alpha, interleukin (IL)-4, and IL-13 on the expression of vascular cell adhesion molecule (VCAM)-1 by cultured human corneal fibroblasts.

Methods: Cultured human corneal fibroblasts were incubated with various combinations and concentrations of TNF-alpha, IL-4, and IL-13. The cell surface expression of VCAM-1 was subsequently evaluated by whole-cell enzyme-linked immunosorbent assay and immunocytochemistry, and the abundance of VCAM-1 mRNA in cell lysates was determined by quantitative reverse transcription and polymerase chain reaction analysis.

Expression of functional ICAM-1 on cultured human keratocytes induced by tumor necrosis factor-alpha.

Purpose: Leukocytes such as neutrophils contribute to the pathogenesis of corneal ulcer. The effect of the proinflammatory cytokine tumor necrosis factor (TNF)-alpha on the expression of intercellular adhesion molecule (ICAM)-1 by cultured human keratocytes was investigated because the interaction of leukocytes with ICAM-1 expressed on the surface of structural cells mediates leukocyte infiltration into tissue at sites of inflammation.

Methods: Cultured human keratocytes were incubated with various concentrations of TNF-alpha.

Differential expression of thymus- and activation-regulated chemokine (CCL17) and macrophage-derived chemokine (CCL22) by human fibroblasts from cornea, skin, and lung.

Background: Allergic diseases of the ocular surface, skin, and lung are triggered by T(H)2 cells, which are recruited by thymus- and activation-regulated chemokine (TARC; CCL17) and macrophage-derived chemokine (MDC; CCL22). Resident fibroblasts are thought to contribute to inflammatory cell infiltration through chemokine production.

Objective: We sought to provide insight into the clinical differences apparent among these allergic diseases of the eye, skin, and lung, and we compared the abilities of corneal, dermal, and lung fibroblasts to produce TARC and MDC.

IL-4-induced cell proliferation and production of extracellular matrix proteins in human conjunctival fibroblasts.

Giant papillae, characteristic lesions of vernal keratoconjunctivitis, are formed as a result of the proliferation of conjunctival fibroblasts, the deposition of extracellular matrix, and the infiltration of inflammatory cells. The concentration of interleukin (IL)-4 is also increased in the tear fluid of individuals with ocular allergic diseases. The possible role of IL-4 in the development of giant papillae was investigated by examining the effects of this cytokine on cultured human conjunctival fibroblasts.

Inhibition of eotaxin expression in human corneal fibroblasts by interferon-gamma.

Background: The chemokine eotaxin is a potent and selective chemoattractant for eosinophils. The production of eotaxin by corneal fibroblasts likely contributes to eosinophil infiltration into the corneal stroma. The regulation of eotaxin synthesis in these cells was investigated by examining the effect of interferon-gamma (IFN-gamma), a T helper cell 1-derived cytokine, on eotaxin expression in cultured human corneal fibroblasts.

Active matrix metalloproteinases in the tear fluid of individuals with vernal keratoconjunctivitis.

Corneal epithelial lesions distinguish vernal keratoconjunctivitis (VKC) from other ocular allergic diseases. Such lesions result from degradation of the corneal epithelial basement membrane, which comprises mostly type IV collagen and laminin. Matrix metalloproteinase 2 (MMP-2) and MMP-9 catalyze the degradation of these 2 extracellular matrix proteins.

Characterization of the interleukin-4 receptor complex in human corneal fibroblasts.

Purpose: To characterize the interleukin (IL)-4 receptor (IL-4R) complex in human corneal fibroblasts.

Methods: The presence of IL-4R subunit mRNAs and proteins in cultured human corneal fibroblasts was examined by reverse transcription-polymerase chain reaction and flow cytometry, respectively. The interaction of 125I-labeled IL-4 with specific cell surface receptors was characterized by saturation binding and Scatchard analysis.