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Advances in Corneal Research pp 57–64Cite as

Clinical Assessment of Conjunctival Damage and Tear Film Stability in Drug-Induced Epithelial Keratopathy

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Abstract

In this study 26 eyes of 14 patients diagnosed with drug-induced epithelial kera- topathy, 10 eyes of five patients with Sjögren’s syndrome, and 10 eyes of five normal volunteers were examined for damages to conjunctival epithelium using sulforhodamine B (SRB) and rose bengal (RB). In both stainings the damage at the nasal and temporal bulbar conjunctiva was scored (0 to 3) on the basis of severity; the values were totaled for the eye. In drug-induced keratopathy, precorneal tear film changes were also examined using a new tear surface observing system.

In drug-induced epithelial keratopathy, conjunctival epithelial damage was disclosed in two eyes of two patients by both SRB and RB (both score 1). In Sjögren’s syndrome, prominent conjunctival epithelial damage was detected (SRB score: 5.1 [mean]; RB score: 4.8 [mean]), with no staining in normal eyes. Precorneal tear instability was seen in 15 eyes of nine patients with drug-induced epithelial keratopathy (out of 18 eyes in 10 patients); this finding disappeared after corneal damage resolution.

Results of this study reveal that in drug-induced epithelial keratopathy conjunctival epithelial damage is minimal, even when the corneal epithelium is severely damaged and tear/corneal surface interaction is deteriorated.

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References

  1. F.M. Wilson, II, Adverse external ocular effects of topical ophthalmic medications. Surv. Ophthalmol. 24:57 (1979).

    Article  PubMed  Google Scholar 

  2. M. Gobbels, and Spitznas, M., Influence of artificial tears on corneal epithelium in dry-eye syndrome. Graefe’sArch. Clin. Exp. Ophthalmol. 227:139 (1989).

    Article  CAS  Google Scholar 

  3. N.L. Burstein, Corneal cytotoxicity of topically applied drugs, vehicles and preservatives. Surv. Ophthalmol. 25:15 (1980).

    Article  PubMed  CAS  Google Scholar 

  4. R. Marsh, and Maurice, D.M., The influence of non-ionic detergents and other surfactants on human corneal permeability. Exp. Eye. Res. 11:43 (1971).

    Article  PubMed  CAS  Google Scholar 

  5. N.L. Burstein, Preservative alteration of corneal permeability in humans and rabbits. Invest. Ophthalmol Vis. Sci. 25:1453 (1984).

    PubMed  CAS  Google Scholar 

  6. E. Kuppens, Stolwijk, T., van Best J., and de Keizer, R., Topical timolol, corneal epithelial permeability and autofluorescence in glaucoma by fluorophotometry. Graefes Arch. Clin. Exp. Ophthalmol. 232;215 (1994).

    Article  PubMed  CAS  Google Scholar 

  7. J.M. Herreras, Pastor, J.C., Calonge, M., and Asensio, V.M., Ocular surface alteration after long-term treatment with an antiglaucomatous drug. Ophthalmology 99:1082 (1992).

    PubMed  CAS  Google Scholar 

  8. M. Boljka, Kolar, G., and Vidensek J., Toxic side effects of local anaesthetics on the human cornea. Br. J. Ophthalmol. 78:386 (1994).

    Article  PubMed  CAS  Google Scholar 

  9. D. Broadway, Grierson, I., and Hitchings, R., Adverse effects of topical antiglaucomatous medications on the conjunctiva. Br. J. Ophthalmol. 77:590 (1993).

    Article  PubMed  CAS  Google Scholar 

  10. J.A. Eliason, and Maurice, D.M., Staining of the conjunctiva and conjunctival tear film. Br. J. Ophthalmol. 74:519 (1990).

    Article  PubMed  CAS  Google Scholar 

  11. O.P. van Bijsterveld, Diagnostic tests in the sicca syndrome. Arch. Ophthalmol. 82:10 (1969).

    Article  PubMed  Google Scholar 

  12. R.P.G. Feenstra, and Tseng, S.C.G., Comparison of fluorescein and rose bengal staining. Ophthalmology 99:605 (1992).

    PubMed  CAS  Google Scholar 

  13. M. Doane, An instrument for in vivo tear film interferometry. Optom Vis. Sci. 66:383 (1989).

    Article  PubMed  CAS  Google Scholar 

  14. O. Schirmer, Studien zur physiologie und pathologie der traãnenabsonderung un traãnenabfuhr. Arch. Klin. Exp. Ophthalmol. 59:197 (1903).

    Article  Google Scholar 

  15. K. Miyamoto, Inoue, Y., and Ohashi, Y., Three cases of drug-induced keratitis with remarkably increased corneal epithelial permeability. J. Jpn. CL. Soc. 35:317 (1993).

    Google Scholar 

  16. L.S. Mengher, Bron, A.J., Tonge, S.R., and Gilbert, D.J., A non-invasive instrument for clinical assessment of the pre-corneal tear film stability. Curr. Eye Res. 4:1 (1985).

    Article  PubMed  CAS  Google Scholar 

  17. I.R. Schwab, and Abbott, R.L., Toxic ulcerative keratopathy: an unrecognised problem. Ophthalmology 96:1187 (1989).

    PubMed  CAS  Google Scholar 

  18. J.T. Patten, Cavanagh, H.D., and Allansmith, M.R. Induced ocular pseudopemphigoid. Am. J. Ophthalmol. 82:272 (1976).

    PubMed  CAS  Google Scholar 

  19. P.M. Fiore, Jacobs, I.H., and Goldberg, D.B., Drug-induced pemphigoid. A spectrum of diseases. Arch. Ophthalmol. 105:1660 (1987).

    Article  PubMed  CAS  Google Scholar 

  20. A.J.W. Huang, Tseng, S.C.G., and Kenyon, K.R., Paracellular permeability of corneal and conjunctival epithelia. Invest. Ophthalmol. Vis. Sci. 30:684 (1989).

    PubMed  CAS  Google Scholar 

  21. H. Watanabe, Fabricant, M., Tisdale, A.S., et al., Human corneal and conjunctival epithelia produce a mucin-like glycoprotein for the apical surface. Invest. Ophthalmol. Vis. Sci. 36:337 (1995).

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Norihiko Yokoi, Aoi Komuro, Yoko Takehisa & Shigeru Kinoshita

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  1. Norihiko Yokoi
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  2. Aoi Komuro
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  3. Yoko Takehisa
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  4. Shigeru Kinoshita
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Editors and Affiliations

  1. Case Western Reserve University and University Hospitals of Cleveland, Cleveland, Ohio, USA

    Jonathan H. Lass

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© 1997 Springer Science+Business Media New York

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Yokoi, N., Komuro, A., Takehisa, Y., Kinoshita, S. (1997). Clinical Assessment of Conjunctival Damage and Tear Film Stability in Drug-Induced Epithelial Keratopathy. In: Lass, J.H. (eds) Advances in Corneal Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-5389-2_6

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  • DOI: https://doi.org/10.1007/978-1-4615-5389-2_6

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-7460-2

  • Online ISBN: 978-1-4615-5389-2

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