RESUMO
Air pollution is a serious environmental issue worldwide in developing countries' megacities, affecting the population's health, including the ocular surface, by predisposing or exacerbating other ocular diseases. Herpes simplex keratitis (HSK) is caused by the herpes simplex virus type 1 (HSV-1). The primary or recurring infection in the ocular site causes progressive corneal scarring that may result in visual impairment. The present study was designed to study the immunopathological changes of acute HSK under urban polluted air, using the acute HSK model combined with an experimental urban polluted air exposure from Buenos Aires City. We evaluated the corneal clinical outcomes, viral DNA and pro-inflammatory cytokines by RT-PCR and ELISA assays, respectively. Then, we determined the innate and adaptive immune responses in both cornea and local lymph nodes after HSV-1 corneal by immunofluorescence staining and flow cytometry. Our results showed that mice exposed to polluted air develop a severe form of HSK with increased corneal opacity, neovascularization, HSV-1 DNA and production of TNF-α, IL-1ß, IFN-γ, and CCL2. A high number of corneal resident immune cells, including activated dendritic cells, was observed in mice exposed to polluted air; with a further significant influx of bone marrow-derived cells including GR1+ cells (neutrophils and inflammatory monocytes), CD11c+ cells (dendritic cells), and CD3+ (T cells) during acute corneal HSK. Moreover, mice exposed to polluted air showed a predominant Th1 type T cell response over Tregs in local lymph nodes during acute HSK with decreased corneal Tregs. These findings provide strong evidence that urban polluted air might trigger a local imbalance of innate and adaptive immune responses that exacerbate HSK severity. Taking this study into account, urban air pollution should be considered a key factor in developing ocular inflammatory diseases.
Assuntos
Poluição do Ar/efeitos adversos , Exposição Ambiental/efeitos adversos , Ceratite Herpética/etiologia , Ceratite Herpética/patologia , Animais , Biomarcadores , Córnea/imunologia , Córnea/metabolismo , Córnea/patologia , Opacidade da Córnea/diagnóstico por imagem , Opacidade da Córnea/etiologia , Opacidade da Córnea/metabolismo , Opacidade da Córnea/patologia , Citocinas/metabolismo , Modelos Animais de Doenças , Progressão da Doença , Suscetibilidade a Doenças , Imunofluorescência , Herpesvirus Humano 1 , Humanos , Imunofenotipagem , Ceratite Herpética/diagnóstico por imagem , Ceratite Herpética/metabolismo , Camundongos , Subpopulações de Linfócitos T/imunologia , Subpopulações de Linfócitos T/metabolismoRESUMO
ABSTRACT Lisch corneal dystrophy is a rare corneal disease characterized by the distinctive feature of highly vacuolated cells. Although this feature is important, the nature of these vacuoles within corneal cells remains unknown. Here, we sought to analyze corneal cells from a patient diagnosed with Lisch dystrophy to characterize the vacuoles within these cells. Analyses using histopathology examination, confocal microscopy, and transmission electron microscopy were all consistent with previous descriptions of Lisch cells. Importantly, the vacuoles within these cells appeared to be autophagosomes and autolysosomes, and could be stained with an anti-microtubule-associated protein 1A/1B-light chain 3 (LC3) antibody. Taken together, these findings indicate that the vacuoles we observed within superficial corneal cells of a patient with Lisch corneal dystrophy constituted autophagosomes and autolysosomes; this finding has not been previously reported and suggests a need for further analyses to define the role of autophagy in this ocular disease.
RESUMO A distrofia corneana de Lisch é uma doença rara, caracterizada principalmente pela presença de células altamente vacuoladas. Embora esta característica seja importante, a natureza desses vacúolos dentro das células da córnea permanece des conhecida. Aqui, procuramos analisar as células da córnea de um paciente diagnosticado com distrofia de Lisch para caracte rizar os vacúolos dentro dessas células. Análises utilizando exame histopatológico, microscopia confocal e microscopia eletrônica de transmissão foram todas consistentes com descrições previas de células de Lisch. Importante, os vacúolos dentro dessas células pareciam ser autofagossomos e autolisossomos, e po deriam ser corados com um anticorpo proteico 1A/1B-cadeia leve 3 (LC3) da proteína anti-microtúbulo associado a microtúbulos. Em conjunto, esses achados indicam que os vacúolos observados nas células superficiais da córnea de um paciente com distrofia corneana de Lisch constituíram autofagossomos e autolisossomos. Esse achado não foi relatado anteriormente e sugere a necessidade de mais análises para definir o papel da autofagia nessa doença ocular.
Assuntos
Humanos , Feminino , Adulto , Vacúolos/patologia , Distrofias Hereditárias da Córnea/patologia , Autofagossomos/patologia , Distrofias Hereditárias da Córnea/diagnóstico por imagem , Microscopia Confocal/métodos , Opacidade da Córnea/patologia , Opacidade da Córnea/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Microscopia Eletrônica de Transmissão/métodos , MicroautofagiaRESUMO
Lisch corneal dystrophy is a rare corneal disease characterized by the distinctive feature of highly vacuolated cells. Although this feature is important, the nature of these vacuoles within corneal cells remains unknown. Here, we sought to analyze corneal cells from a patient diagnosed with Lisch dystrophy to characterize the vacuoles within these cells. Analyses using histopathology examination, confocal microscopy, and transmission electron microscopy were all consistent with previous descriptions of Lisch cells. Importantly, the vacuoles within these cells appeared to be autophagosomes and autolysosomes, and could be stained with an anti-microtubule-associated protein 1A/1B-light chain 3 (LC3) antibody. Taken together, these findings indicate that the vacuoles we observed within superficial corneal cells of a patient with Lisch corneal dystrophy constituted autophagosomes and autolysosomes; this finding has not been previously reported and suggests a need for further analyses to define the role of autophagy in this ocular disease.
Assuntos
Autofagossomos/patologia , Distrofias Hereditárias da Córnea/patologia , Vacúolos/patologia , Adulto , Distrofias Hereditárias da Córnea/diagnóstico por imagem , Opacidade da Córnea/diagnóstico por imagem , Opacidade da Córnea/patologia , Feminino , Humanos , Microautofagia , Microscopia Confocal/métodos , Microscopia Eletrônica de Transmissão/métodos , Tomografia de Coerência Óptica/métodosRESUMO
PURPOSE: To describe the clinical signs of Descemet membrane (DM) detachment due to forceps-related birth injury and its subsequent management using optical coherence tomography. METHODS: Case report. RESULTS: A 3-day-old term infant presented with left eye corneal clouding and a definitive history of traumatic forceps-assisted delivery. Despite topical therapy, corneal clouding persisted, necessitating an examination under anesthesia using ultrasound and handheld optical coherence tomography. This revealed not only a tear in DM but also a large detachment. Injection of air alone failed to achieve apposition of DM to the posterior stroma. Apposition was achieved only after penetration of the overlying cornea with the needle of a 10-0 nylon suture and release of clear viscous fluid. The cornea cleared within the first week and continued in the months to follow. CONCLUSIONS: Prolonged corneal edema should alert the physician to probable DM detachment after forceps-related birth injury. Injecting air alone may not be sufficient to reattach the detached DM.
Assuntos
Traumatismos do Nascimento/cirurgia , Edema da Córnea/cirurgia , Opacidade da Córnea/cirurgia , Lâmina Limitante Posterior/lesões , Traumatismos Oculares/cirurgia , Forceps Obstétrico/efeitos adversos , Traumatismos do Nascimento/diagnóstico por imagem , Traumatismos do Nascimento/etiologia , Edema da Córnea/diagnóstico por imagem , Edema da Córnea/etiologia , Opacidade da Córnea/diagnóstico por imagem , Opacidade da Córnea/etiologia , Lâmina Limitante Posterior/diagnóstico por imagem , Traumatismos Oculares/diagnóstico por imagem , Traumatismos Oculares/etiologia , Seguimentos , Humanos , Recém-Nascido , Masculino , Procedimentos Cirúrgicos Oftalmológicos , Tomografia de Coerência ÓpticaRESUMO
La opacidad de la cápsula posterior (OCP) es actualmente uno de los aspectos más importantes en la cirugía de catarata de los tiempos modernos. Sigue siendo la complicación posoperatoria tardía más frecuente tras la cirugía de catarata asociada con disminución de la agudeza visual, deterioro de la sensibilidad al contraste y problemas de deslumbramiento que conllevan importantes repercusiones sociales, médicas y económicas. El software PANDOC provee al oftalmólogo de una herramienta por medio de la cual este es capaz de cuantificar numéricamente y detectar diferencias de opacidad (a veces imperceptibles para el ojo humano), logrando así una evaluación objetiva del grado de opacidad y de esta forma minimizar el sesgo de observación entre un médico y otro. Por ello surge la necesidad de identificar automáticamente la OCP en estas imágenes, para lo cual se diseña un sistema basado en casos. La presente investigación se enmarca en la aplicación de un sistema basado en casos integrado al software PANDOC, para identificar y cuantificar objetivamente OCP mediante el uso de las imágenes resultantes de la cámara Scheimpflug del Pentacam(AU)
The posterior capsule opacity (PCO) is nowadays one of the most important aspects in cataract surgery of modern times. It´s still the most frequent post operatory complication associated with visual acuity diminution, deterioration of contrast sensitivity and blinding problems that lead to social, medical and economic repercussions. PANDOC software is a tool for numerical quantification and detection of opacity differences (sometimes imperceptible for human eyes), reaching an objective evaluation of opacity degree and minimizing the observation bias between one doctor and another. For that reason is necessary to identify automatically PCO in these images, for which is designed a case-based system. The present research is oriented to the application of a case-based system for the PANDOC software, to identify and quantify objectively PCO using the resulting images of the Pentacam´sScheimpflug camera(AU)
Assuntos
Humanos , Masculino , Feminino , Catarata/complicações , Catarata/diagnóstico , Processamento de Imagem Assistida por Computador/métodos , Software/normas , Extração de Catarata/métodos , Opacidade da Córnea/diagnóstico por imagemRESUMO
If the ocular media are clear, indirect binocular ophthalmoscopy allows retinal detachment and retinal tear identification and treatment under direct visualization. However, if opacities are present preventing direct fundus examination, ultrasonography becomes the most important tool for evaluating the posterior segment. In addition, ultrasonography can be useful in retinal tear treatment by guiding cryotherapy. In this article we describe a rhegmatogenous retinal detachment treatment technique applied to a patient with corneal opacity. Cryopexy and circumferential and radial buckle positioning were guided by ultrasonography, resulting in retinal attachment during the 6-month follow-up period.
Assuntos
Opacidade da Córnea/cirurgia , Descolamento Retiniano/cirurgia , Ultrassonografia de Intervenção , Opacidade da Córnea/complicações , Opacidade da Córnea/diagnóstico por imagem , Criocirurgia/métodos , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Descolamento Retiniano/complicações , Descolamento Retiniano/diagnóstico por imagem , Recurvamento da Esclera/métodos , Resultado do TratamentoRESUMO
We report the optical and ultrasonic biomicroscopy and confocal microscopy findings in bilateral stromal keratitis (keratoendotheliitis), a rare ocular manifestation of systemic lupus erythematosus (SLE). Examination revealed deposits with polyrefringent crystals. Topical corticosteroid produced regression of the corneal edema, but there was an increase in corneal opacity. Ultrasound biomicroscopy images confirmed the deep location of the corneal opacities, and confocal microscopy showed a disruption of the corneal stroma and crystal-like bodies.
Assuntos
Substância Própria/patologia , Ceratite/etiologia , Lúpus Eritematoso Sistêmico/complicações , Adulto , Edema da Córnea/diagnóstico , Edema da Córnea/tratamento farmacológico , Edema da Córnea/etiologia , Opacidade da Córnea/diagnóstico por imagem , Opacidade da Córnea/etiologia , Feminino , Glucocorticoides/uso terapêutico , Humanos , Ceratite/diagnóstico , Microscopia Confocal , UltrassonografiaRESUMO
PURPOSE: Maroteaux-Lamy syndrome is one of the mucopolysaccharidoses caused by enzyme deficiency (arylsulfatase B) that leads to incomplete degradation and storage of dermatan sulfate. We report a case of mucopolysaccharidosis type VI (MPS VI; Maroteaux-Lamy syndrome) with corneal involvement and introduce ultrasound biomicroscopy (UBM) as an examination with which to follow disease progression in relation to deposition in cornea, angle, and iris. METHODS: We describe a 11-year-old boy with a clinical and laboratorial diagnosis of MPS VI who developed increasing bilateral corneal opacification and decreased visual acuity. He underwent two seriate UBM (50-MHz transducer) evaluations. RESULTS: UBM examination showed diffuse and homogeneous stromal hyper-reflective deposit in both eyes and an increase in peripheral corneal thickness throughout time. CONCLUSION: High-frequency ultrasound documentation of corneal deposit and anterior segment involvement in a patient with Maroteaux-Lamy syndrome is unique, and follow-up revealed thickening of the corneal periphery, which may be related to the progression of the disease (continuous mucopolysaccharide deposits in corneal stroma). UBM was used to locate and document the deposit, as well as to accompany the deposit's evolution, characterizing corneal changes and angle structure involvement.