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    In Vivo Confocal Microscopic Evaluation of the Inflammatory Response in Non-Epithelial Herpes Simplex Keratitis
    (Informa Healthcare, 2012) Mocan, M. C.; Irkec, M.; Mikropoulos, D. G.; Bozkurt, B.; Orhan, M.; Konstas, A. G. P.
    Purpose: To investigate the characteristics of the inflammatory response detected in corneas with active non-epithelial herpes simplex virus (HSV) keratitis. Materials and methods: The study was designed as a cross-sectional study undertaken at a university setting. Twenty-one eyes of 21 patients with a mean age of 40.1 +/- 13.0 years (range: 18-70 years) and whose corneal findings were compatible with active HSV keratitis were included. All patients were evaluated with in vivo confocal microscopy (Confoscan 3, Nidek). Fifty healthy, age-matched subjects served as controls. The features and extent of corneal inflammation, degree of involvement of subbasal nerve plexus and endothelial cell density were evaluated. Results: Seven eyes (33.3%) demonstrated stromal keratitis, six (28.6%) endotheliitis and eight (38.1%) presented with keratouveitis. Intraepithelial inflammatory cell infiltration, consisting of dendritic and small round cells, was observed in 11 eyes (52.4%). Stromal involvement was detected in 95.2% of eyes in the form of focal and diffuse cellular infiltrates; of these, anterior, posterior and pan stromal infiltration was observed in 85.7, 71.4 and 47.6% of cases, respectively. No particular keratic precipitate morphology was found to be diagnostic for HSV keratitis. The mean endothelial cell density of eyes with HSV keratitis (2437 +/- 599 cells/mm(2)) was significantly lower (-18.8%) than that of controls (3003 +/- 250 cells/mm(2)); (p < 0.001). The mean subbasal nerve density of patients with HSV keratitis (474.5 +/- 227.8 mu m/frame) was significantly lower than that of controls (1589.6 +/- 499.0 mu m/frame) (p < 0.001). Conclusions: Non-epithelial HSV keratitis related inflammatory response is characterized by cellular infiltration of all corneal layers, attenuation of the subbasal nerve plexus and endothelial cell loss.
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    Serum allergen specific immunoglobulin E levels in patients with allergic conjunctivitis
    (SAGE PUBLICATIONS LTD, 2008) Kocabeyoglu, S.; Bozkurt, B.; Bilen, O.; Irkec, M.; Orhan, M.
    PURPOSE. To evaluate serum allergen specific immunoglobulin E (IgE) levels in patients with various types of allergic conjunctivitis. METHODS. Twenty-five patients with seasonal allergic conjunctivitis (SAC), 17 patients with perennial allergic conjunctivitis (PAC), and 10 patients with vernal conjunctivitis, (VC) were included in the study. Specific IgE levels to Dermatophagoides pteronyssinus (Dp), Dermatophagoides farinae (Df), mixed grass pollens, and animal epithelia were measured using Pharmacia CAP system (Pharmacia Diagnostic AB, Uppsala, Sweden). RESULTS. The percentage of subjects with specific IgE against Dp and,Df was statistically higher in VC (30%) compared to PAC (5.9%) and SAC (0%) (p=0.03). Specific IgE against mixed grass pollens was found in 30% of VC and 40% of SAC, whereas: 10% of VC and 8% of SAC patients were found to be hypersensitive to animal epithelia. CONCLUSIONS. Allergic reaction against house dust mites and pollens was common in VC, whereas specific IgE against grass pollens was remarkable in SAC. IgE levels specific to various antigens might be measured by UNICAP system, which is a rapid and practical technology. (Eur J Ophthalmol 2008; 18: 675-9)