allopurinol and Dry-Eye-Syndromes

Previous papers examined lipid peroxidase levels and myeloperoxidase activity as products of oxidative and inflammatory reactions in the tear fluid of patients suffering from dry eye. The aim of the present paper was to investigate whether the enzymes xanthine oxidoreductase/xanthine oxidase known to generate reactive oxygen species contribute to oxidative reactions on the ocular surface. Xanthine oxidoreductase/xanthine oxidase were examined immunohistochemically as well as histochemically in conjunctival epithelial cells of patients suffering from dry eye. Patients with verified autoimmune dry eye (Sjögren's syndrome) participated in our study; normal eyes served as controls. Conjunctival epithelial cells were obtained by the method of impression cytology using Millicell membranes. The results revealed a pronounced expression, as well as activity of xanthine oxidoreductase/xanthine oxidase in the conjunctival epithelium of dry eye. It is suggested that reactive oxygen species which are generated by this enzymatic system, contribute to oxidative reactions on the eye surface of patients with ocular manifestations of autoimmune disease (Sjögren's syndrome).

Topics: Adult; Conjunctiva; Dry Eye Syndromes; Epithelial Cells; Female; Fluorescein; Fluorescent Dyes; Histocytochemistry; Humans; Immunohistochemistry; Male; Middle Aged; Oxidation-Reduction; Severity of Illness Index; Sjogren's Syndrome; Tears; Xanthine Oxidase

Stevens-Johnson syndrome (SJS) is an extreme, systemic allergic reaction with potentially morbid ocular complications. The main ocular complications include severe dry eyes, corneal scarring, symblepharon, and keratopathy.. Stevens-Johnson syndrome developed in a 69-year old man as a result of a hypersensitivity reaction to the drug allopurinol three years before his referral to our clinic. He had been treated, but was left with corneal scarring, hyperemia, and sore, chronic dry eyes, which necessitated continuous lubrication. The patient was fit with RGP sealed scleral contact lenses of high oxygen permeability, which produced a remarkable improvement of his signs and symptoms and allowed him to completely cease the use of artificial tears.. Stevens-Johnson syndrome is a serious systemic condition in which the foremost ocular complication is severe dry eyes. This report shows that it can be managed successfully with RGP sealed scleral lenses of high permeability.

Topics: Aged; Allopurinol; Contact Lenses; Drug Hypersensitivity; Dry Eye Syndromes; Enzyme Inhibitors; Gout Suppressants; Humans; Male; Prosthesis Fitting; Stevens-Johnson Syndrome