| 1. |
- Tabery, Helena
(författare)
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Corneal epithelial keratitis in herpes zoster ophthalmicus: "delayed" and "sine herpete". A non-contact photomicrographic in vivo study in the human cornea.
- 2002
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Ingår i: European Journal of Ophthalmology. - 1120-6721. ; 12:4, s. 267-275
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE. To investigate the origin of corneal epithelial keratitis occurring without accompanying herpes zoster ophthalmicus (HZO) cutaneous rash. METHODS. Corneal epithelial lesions in seven patients (four with a history of classical HZO with cutaneous rash, one of herpes zoster oticus, and two with no history of herpes zoster, were examined with the slit lamp and photographed by non-contact in vivo photomicrography. The findings were compared with lesions in classical acute HZO. Polymerase chain reaction (PCR) was done in three patients. RESULTS. Slit lamp appearance, morphology at higher magnification, and kinetics of the lesions were indistinguishable from classical acute HZO. PCR was positive for varicella-zoster virus DNA in all three samples. CONCLUSIONS. The findings strongly suggest that HZO typical corneal epithelial lesions occurring in the absence of cutaneous rash are in fact recurrent episodes of virus shedding.
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| 2. |
- Tabery, Helena
(författare)
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Corneal surface changes in keratoconjunctivitis sicca. Part I: the surface proper. A non-contact photomicrographic in vivo study in the human cornea
- 2003
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Ingår i: Eye. - : Springer Science and Business Media LLC. - 0950-222X .- 1476-5454. ; 17:4, s. 482-487
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To describe corneal surface changes in keratoconjunctivitis sicca (KCS). Methods In all 23 patients with KCS were examined with the slit lamp and photographed by non-contact photomicrography. Results Without staining, grey surface cells and small epithelial cysts were visible. Application of fluorescein sodium resulted in two types of micropunctuate (15-30 mum) staining, a nonfluorescent (yellow/brown) and a fluorescent ( green) one, in brilliantly green staining of cysts, and in enlarging fluorescent (green) flecks (70 - 1600 mum) with propensity to confluence. The flecks often developed in inconspicuous areas and showed abnormal subsurface cells. Application of rose bengal resulted in more or less intensively red-stained cells measuring about 30 mum in diameter, often less ( 15 - 20 mum), with or without a centrally located nucleus, individual or gathered in small groups or larger patches, and in confluent staining. Smaller and larger cells, with or without nuclei, weakly or strongly stained, were often located close to each other. The smaller green flecks showed a few centrally located red-stained cells, and the larger ones showed many almost uniform small red-stained nucleated ones. Conclusions Corneal epithelial surface disease in the present KCS patients consisted of unspecific features-such as increased light-reflecting property ( grey cells), disruptions of intercellular junctions ( micropunctuate green fluorescein staining), pathological dye uptake (micropunctuate yellow/brown fluorescein and red rose bengal stainings), and epithelial oedema (microcysts) -and also of features that seemed to be disease specific. Such features were, with fluorescein sodium, focal disruptions of the epithelial barrier function manifesting in enlarging green flecks, and, with rose bengal, abundant nucleated cells, particularly small ones organised in foci. The nature of the abnormal subsurface cells present in the areas of the green flecks, and the mechanisms behind the focal involvement are unclear.
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| 3. |
- Tabery, Helena
(författare)
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Corneal surface changes in keratoconjunctivitis sicca. Part II: the mucus component. A non-contact photomicrographic in vivo study in the human cornea
- 2003
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Ingår i: Eye. - : Springer Science and Business Media LLC. - 0950-222X .- 1476-5454. ; 17:4, s. 488-491
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Description of mucus on the corneal surface and in the precorneal tear film in keratoconjunctivitis sicca (KCS). Methods In all, 24 patients with KCS examined with slit lamp and by non-contact photomicrography. Results Material interpreted as mucus seemed to exist in three varieties: one optically dense, light reflecting, and with definite forms ( fine threads, variously thick and long strands, sheet-like structures); one appearing as small clumps or patches of light-reflecting material adhering to the corneal surface; and one amorphous. All were present either per se, or in various combinations, with or without adherent cell debris. The mucus attached to abnormal ( stainable) corneal surface cells. Conclusions The formed material strongly resembles formed mucus found in samples from normal conjunctival surface; the light-reflecting clumps or patches adhering to the surface are possibly of the same origin. The nature of the amorphous material is unclear. Adherence of formed mucus to the corneal surface seems to be related to the presence of abnormal ( stainable) surface cells.
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| 4. |
- Tabery, Helena
(författare)
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Corneal surface changes in Thygeson's superficial punctate keratitis: a clinical and non-contact photomicrographic in vivo study in the human cornea
- 2004
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Ingår i: European Journal of Ophthalmology. - 1120-6721. ; 14:2, s. 85-93
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE. To elucidate mechanisms behind the morphology of Thygeson's superficial punctate keratitis (TSPK). METHODS. Sixteen patients were examined with the slit lamp and photographed by non-contact photomicrography. The results were compared with morphology of epithelial keratitis in herpes simplex type 1 (HSV1), varicella zoster (VZV), and adenovirus type 8 (Ad8) infections, all previously studied by the same method, and with published histologic findings in TSPK. RESULTS. In the photographs, the corneal epithelium showed various numbers of abnormal subsurface cells measuring about 10-15 mum in diameter, present individually, in small groups, or aggregated in larger lesions (coarse lesions with the slit lamp). The surface epithelium was well preserved, except in larger lesions, which showed surface debris. The morphology was unlike HSV1 and VZV epithelial keratitis, but strongly resembled epithelial changes occurring in Ad8 infections on day 5, and later, after the onset of symptoms. CONCLUSIONs. TSPK shows a more widespread epithelial involvement than suspected with the slit lamp. Its morphology seems to reflect an action of a noxious agent targeted at the deeper epithelial layers, with the appearance of abnormal cells as a result. These might represent invading inflammatory cells, damaged intraepithelial ones, or both. The coarse lesions visualize areas of major involvement showing discernible signs of cell destruction. The similarity to Ad8 keratitis suggests that the source of the noxious agent might be located outside the cornea. The morphology, in conjunction with clinical features, is compatible with an immunologically mediated injury. The etiology remains unknown. (Eur J Ophthalmol 2004; 14: 85-93)
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| 5. |
- Tabery, Helena
(författare)
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Filamentary keratopathy: A non-contact photomicrographic in vivo study in the human cornea
- 2003
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Ingår i: European Journal of Ophthalmology. - 1120-6721. ; 13:7, s. 599-605
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE. To investigate in vivo morphology of corneal filaments. MATERIALS AND METHODS. Over a 12-year period, 19 patients with corneal filaments (7 with keratoconjunctivitis sicca and 12 with other surface diseases) were examined with the slit lamp and photographed by non-contact photomicrography. RESULTS. The filaments appeared as variously long and thick threads, attached at one or both ends to the surface and carrying various amounts of granular and amorphous material. The attachment points and their surroundings showed abnormal cells and diffusion of tear fluid stained green with fluorescein sodium. The underlying stroma appeared normal. The remaining epithelium often showed abnormal surface cells and/or edematous or cystic changes. CONCLUSIONS. The in vivo morphology of filamentary keratopathy is consistent with aggregations of mucus and cell debris adhering to the corneal surface. The underlying diseases seem to have in common corneal epithelial edema. The nature of additional factors, or their combination, precipitating mucus adherence to the surface is not clear.
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| 6. |
- Verbaan, Hans, et al.
(författare)
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Extrahepatic manifestations of chronic hepatitis C infection and the interrelationship between primary Sjogren's syndrome and hepatitis C in Swedish patients
- 1999
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Ingår i: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 245:2, s. 127-132
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To analyse the frequency of some extrahepatic manifestations of chronic hepatitis C virus (HCV) infection in northern European patients, including a postulated association between HCV and primary Sjogren's syndrome (SS). DESIGN: Cohort study. SETTING: Department of Medicine, Malmo University Hospital, Sweden. PATIENTS: Twenty-one patients with HCV infection and 53 with primary SS (according to the Copenhagen criteria). MAIN OUTCOME MEASURES: Cryoglobulins were analysed in all patients, while patients with primary SS were investigated with regard to markers of HCV infection, and HCV patients with objective tests of SS (Schirmer-1 test, break-up time, van Bijsterveld score, sialometry, labial salivary gland biopsy) and antibodies against nuclear antigens, smooth muscle (SMA) and mitochondria (AMA). HCV antigens in small salivary glands from lower lip biopsies were detected by immunohistochemical analysis. RESULTS: Only one of the SS patients had detectable cryoprecipitates, while another was HCV-positive. None of the 21 HCV patients had cryoprecipitates. A total of 14/21 (67%) patients with HCV infection had at least one abnormal objective test suggestive of xerostomia or keratoconjunctivitis sicca, while eight (38%) had objective evidence of both eye and salivary gland involvement. HCV antigens were not detected in affected glands. Only two patients had clinical symptoms of SS, and two fulfilled the Copenhagen criteria for SS. None of the HCV-positive patients had detectable antibodies against SS-A, SS-B, RNP, Jo-1, PCNA or Scl-70, and the frequency of ANA/SMA/AMA was low. CONCLUSIONS: While involvement of salivary and lacrimal glands was common in Swedish patients with HCV infection, cryoglobulinaemia was not observed. The pathogenetic mechanism responsible for glandular inflammation appears to be different from that in primary SS. HCV infection does not seem to be an aetiological factor for primary SS in this population. These observations suggest that viral, genetic or possibly environmental factors may be responsible for the reported high frequencies of systemic complications associated with chronic hepatitis C infection in southern Europe.
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