tetracycline and Corneal-Diseases

Recurrent corneal erosion is a common cause of disabling ocular symptoms and predisposes the cornea to infection. It may follow corneal trauma. Measures to prevent the development of recurrent corneal erosion following corneal trauma have not been firmly established. Once recurrent corneal erosion develops, simple medical therapy (standard treatment) may lead to resolution of the episode. However, some people continue to suffer when such therapy fails and repeated episodes of erosion develop. A number of treatment and prophylactic options are then available but there is no agreement as to the best option. This review version is an update to the original version published in 2007 and a previous update published in 2012.. To assess the effectiveness and adverse effects of regimens for the prophylaxis of further recurrent corneal erosion episodes, the treatment of recurrent corneal erosion and prophylaxis of the development of recurrent corneal erosion following trauma.. We searched CENTRAL, which contains the Cochrane Eyes and Vision Trials Register; MEDLINE; Embase; LILACS; the ISRCTN registry; ClinicalTrials.gov and the ICTRP. The date of the search was 14 December 2017.. We included randomised and quasi-randomised trials that compared a prophylactic or treatment regimen with another prophylaxis/treatment or no prophylaxis/treatment for people with recurrent corneal erosion.. We used standard methods expected by Cochrane. Two authors independently screened search results, extracted data and assessed risk of bias in the included studies using the Cochrane tool for assessing risk of bias. We considered the following outcome measures: resolution of symptoms after treatment; recurrence after complete or partial resolution; symptoms (pain); adverse effects (corneal haze, astigmatism). We graded the certainty of the evidence using GRADE for the three most clinically relevant comparisons.. We included eight randomised and two quasi-randomised controlled trials in the review, encompassing 505 participants. Seven studies were from Europe (Germany, Sweden and the UK), two from East Asia (Hong Kong and Japan) and one from Australia. Nine of the studies examined treatments for episodes of recurrent corneal erosions and one study considered prophylaxis to prevent development of recurrent corneal erosions after injury. Two of the nine treatment studies also enrolled participants in a study of prophylaxis to prevent further episodes of recurrent corneal erosions. The studies were poorly reported; we judged only one study low risk of bias on all domains.Two studies compared therapeutic contact lens with topical lubrication but one of these studies was published over 30 years ago and used a therapeutic contact lens that is no longer in common use. The more recent study was a two-centre UK study with 29 participants. It provided low-certainty evidence on resolution of symptoms after treatment with similar number of participants in both groups experiencing resolution of symptoms at four months (risk ratio (RR) 0.97, 95% confidence interval (CI) 0.62 to 1.53). There was very low-certainty evidence on recurrence after partial or total resolution at seven months' follow-up (RR 1.07, 95% CI 0.07 to 15.54). There was no evidence of an important difference in pain score (score of 3 in the contact lens group and score of 2 in the topical lubrication group, low-certainty evidence) and no adverse effects were reported. The older study, using a contact lens no longer in common use, found an increased risk of pain and complications with the contact lens compared with hypromellose drops and paraffin ointment at night.A single-centre, Australian study, with 33 participants, provided low-certainty evidence of an increased risk of recurrence with phototherapeutic keratectomy compared with alcohol delamination but with wide confidence intervals, compatible with increased or decreased risk (RR 1.27, 95% CI 0.48 to 3.37). Time to recurrence was similar in both groups (6.5 and 6 months, low-certainty evidence). On average people receiving phototherapeutic keratectomy reported less pain but confidence intervals included no difference or greater pain (mean difference (MD) -0.70, 95% CI -2.23 to 0.83, low-certainty evidence). No adverse effects were reported.A 48-participant study in Hong Kong found recurrences were less common in people given diamond burr superficial kerat. Well-designed, masked, randomised controlled trials using standardised methods are needed to establish the benefits of new and existing prophylactic and treatment regimes for recurrent corneal erosion. Studies included in this review have been of insufficient size and quality to provide firm evidence to inform the development of management guidelines. International consensus is also needed to progress research efforts towards evaluation of the major effective treatments for recurrent corneal erosions.

Topics: Anti-Bacterial Agents; Contact Lenses; Corneal Diseases; Corneal Injuries; Debridement; Eye Infections; Glucocorticoids; Humans; Keratectomy; Lubricant Eye Drops; Pain Measurement; Prednisolone; Randomized Controlled Trials as Topic; Recurrence; Secondary Prevention; Tetracycline

Recurrent corneal erosion is a common cause of disabling ocular symptoms and predisposes the cornea to infection. It may follow corneal trauma. Measures to prevent the development of recurrent corneal erosion following corneal trauma have not been firmly established. Once recurrent corneal erosion develops simple medical therapy (standard treatment) may lead to resolution of the episode. However, some patients continue to suffer when such therapy fails and once resolved further episodes of recurrent erosion may occur. A number of treatment and prophylactic options are then available but there is no agreement as to the best option.. To assess the effectiveness and safety of prophylactic and treatment regimens for recurrent corneal erosion.. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 6), MEDLINE (January 1946 to June 2012), EMBASE (January 1980 to June 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to June 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 13 June 2012. We also contacted researchers in the field.. We included randomised and quasi-randomised trials that compared a prophylactic or treatment regimen with another prophylaxis/treatment or no prophylaxis/treatment for patients with recurrent corneal erosion.. Two authors independently extracted data and assessed trial quality. We contacted study authors for additional information.. Seven randomised and one quasi-randomised controlled trial were included in the review. The trials were heterogenous and of poor quality. Safety data presented were incomplete. For the treatment of recurrent corneal erosion, a single-centre trial in the UK with 30 participants showed that oral tetracycline 250 mg twice daily for 12 weeks or topical prednisolone 0.5% four times daily for one week, or both, in addition to standard treatment, accelerated healing rates and improved symptoms. A single-centre trial in Sweden with 56 participants showed that excimer laser ablation in addition to mechanical debridement may reduce the number of erosions and improve symptoms. Furthermore, in a single-centre trial in Germany with 100 participants, transepithelial technique for excimer laser ablation had the same efficacy as the traditional subepithelial excimer laser technique but caused less pain. In a small study of 24 participants in UK, therapeutic contact lens wear was inferior to lubricant drops and ointment in abolishing the symptoms of recurrent corneal erosion and had a high complication rate, although the contact lenses used were the older generation with low oxygen permeability. A recent study in Hong Kong with 48 participants found diamond burr polishing to reduce episodes of recurrent corneal erosion. For prophylaxis of further episodes of recurrent corneal erosion, there was no difference in the occurrence of objective signs of recurrent erosion between hypertonic saline ointment versus tetracycline ointment or lubricating ointment in a small Japanese study with 26 participants. Also, in a single-centre study in the UK with 117 participants, there was no difference in symptom improvement between hypertonic saline versus paraffin ointment when used for prophylaxis. In a UK study with 42 participants, lubricating ointment at night in addition to standard treatment to prevent recurrence following traumatic corneal abrasion (erosion) caused by fingernail injury led to increased symptoms of recurrent corneal erosion compared to standard therapy alone.. Well-designed, masked, randomised controlled trials using standardised methods are needed to establish the benefits of new and existing prophylactic and treatment regimes for recurrent corneal erosion. International consensus is also needed to progress research efforts towards evaluation of the major effective treatments for recurrent corneal erosions.

Topics: Anti-Bacterial Agents; Contact Lenses; Corneal Diseases; Corneal Injuries; Debridement; Eye Infections; Glucocorticoids; Humans; Prednisolone; Randomized Controlled Trials as Topic; Secondary Prevention; Tetracycline

Recurrent corneal erosion is a common cause of disabling ocular symptoms and predisposes the cornea to infection. It may follow corneal trauma. Measures to prevent the development of recurrent corneal erosion following corneal trauma have not been firmly established. Once recurrent corneal erosion develops simple medical therapy (standard treatment) may lead to resolution of the episode. However some patients continue to suffer when such therapy fails and once resolved further episodes of recurrent erosion may occur. A number of treatment and prophylactic options are then available but there is no agreement as to the best option.. To assess the effectiveness and safety of prophylactic and treatment regimens for recurrent corneal erosion.. We searched CENTRAL, MEDLINE, EMBASE and LILACS in June 2007. The NRR was searched in April 2005. We also contacted researchers in the field.. We included randomised and quasi-randomised trials that compared a prophylactic or treatment regimen with another prophylaxis/ treatment or no prophylaxis/ treatment for patients with recurrent corneal erosion.. Both authors independently extracted data and assessed trial quality. We contacted study authors for additional information.. Five randomised and one quasi-randomised controlled trial were included in the review. The trials were heterogenous and of poor quality. Safety data presented were incomplete. For the treatment of recurrent corneal erosion there was limited evidence that oral tetracycline 250 mg twice daily for 12 weeks or topical prednisolone 0.5% four times daily for one week or both in addition to standard treatment; and excimer laser ablation in addition to mechanical debridement may be effective. Therapeutic contact lens wear was inferior to lubricant drops and ointment in abolishing the symptoms of recurrent corneal erosion and had a high complication rate. For prophylaxis of further episodes of recurrent corneal erosion there was no difference in the occurrence of objective signs of recurrent erosion between hypertonic saline ointment versus tetracycline ointment or lubricating ointment. Lubricating ointment at night in addition to standard treatment following traumatic corneal abrasion (erosion) caused by fingernail injury to prevent recurrence led to increased symptoms of recurrent corneal erosion compared to standard therapy alone.. Well-designed masked randomised controlled trials using standardised methods are needed to establish the benefits of new and existing prophylactic and treatment regimes for recurrent corneal erosion.

Topics: Anti-Bacterial Agents; Contact Lenses; Corneal Diseases; Corneal Injuries; Debridement; Glucocorticoids; Humans; Prednisolone; Randomized Controlled Trials as Topic; Secondary Prevention; Tetracycline

OBJECTIVE To compare the efficacy of various concentrations and combinations of serum, EDTA, 3 tetracyclines, and N-acetylcysteine (NAC) for collagenase inhibition in an in vitro corneal degradation model. SAMPLE Grossly normal corneas from recently euthanized dogs and horses and fresh serum from healthy dogs and horses. PROCEDURES Serum was pooled by species for in vitro use. For each species, sections of cornea were dried, weighed, and incubated with clostridial collagenase (800 U/mL) in 5 mL of a 5mM calcium chloride-saline (0.9% NaCl) incubation solution and 500 μL of 1 of 19 treatments (homologous serum; 0.3%, 1.0%, or 2% EDTA; 0.1%, 0.5%, or 1.0% tetracycline, doxycycline, or minocycline; 0.5%, 1.0%, or 5.0% NAC; serum with 0.5% tetracycline; serum with 1.0% EDTA; or 1.0% EDTA with 0.5% tetracycline). Positive and negative control specimens were incubated with 5 mL of incubation solution with and without collagenase, respectively. Each control and treatment was replicated 4 times for each species. Following incubation, corneal specimens were dried and reweighed. The percentage corneal degradation was calculated and compared among treatments within each species. RESULTS Treatments with tetracyclines at concentrations ≥ 0.5%, with EDTA at concentrations ≥ 0.3%, and with NAC at concentrations ≥ 0.5% were more effective at preventing corneal degradation than serum in both species. The efficacy of each combination treatment was equal to or less than that of its components. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested EDTA, tetracyclines, and NAC may be beneficial for topical treatment of keratomalacia, but in vivo studies are required.

Topics: Acetylcysteine; Animals; Anti-Bacterial Agents; Collagenases; Cornea; Corneal Diseases; Disease Models, Animal; Dogs; Doxycycline; Edetic Acid; Horses; Matrix Metalloproteinase Inhibitors; Minocycline; Serum; Tetracycline

The Tet-mev-1 mouse expressing a mitochondrial complex-II mutated SDHC(V69E) gene controlled by a tetracycline (Tet)-On/Off system can overproduce O(2)(·-) and is a versatile whole-animal model for studying mitochondrial oxidative stress. Here we report a series of age-dependent variations in corneal epithelium, endothelium, and parenchymal cells of the Tet-mev-1 mice relative to wild-type C57BL/6j mice.. Measurements of (1) mitochondrial electron transport enzyme activities; (2) O(2)(·-) production; (3) carbonylated protein, and 8-hydroxydeoxyguanosine (8-OHdG) levels as markers of oxidative stress; (4) pathologic analyses under optical and electron microscopy; (5) hematoxylin-eosin or toluidine-blue staining; and (6) immunohistochemistry with an anti-β-catenin antibody were performed in the eye, especially the cornea.. Complex II-III activity was decreased by electron leakage between complex II and CoQ. This resulted in increased age-dependent intracellular oxidative stress in the eye of Tet-mev-1 mice. Corneal epithelialization was delayed in Tet-mev-1 mice after 20% ethanol treatment, as the number of cells and mitotic cells decreased in the corneal epithelium of Tet-mev-1 mice compared with that of wild type. The age-dependent decrease in cell number accelerated in the corneal endothelium cells. Moreover, it was suggested that the corneal thickness was decreased by thinning of parenchymal cells with age in Tet-mev-1 mice.. These results suggest that mitochondrial oxidative stress with electron transport chain dysfunction can influence pathogenesis and progression of age-related corneal diseases, as well as generalized corneal aging acceleration.

Topics: 8-Hydroxy-2'-Deoxyguanosine; Aging; Animals; Blotting, Western; Caenorhabditis elegans Proteins; Catalase; Cell Count; Corneal Diseases; Cytochromes b; Deoxyguanosine; Electron Transport Complex II; Endothelium, Corneal; Fluorescent Antibody Technique, Indirect; Mice; Mice, Inbred C57BL; Mice, Transgenic; Microscopy, Electron; Microscopy, Fluorescence; Mitochondria; Oxidative Stress; Protein Carbonylation; Succinate Dehydrogenase; Superoxides; Tetracycline

The purpose of this paper is to report a case of corneal staining after treatment with topical tetracycline.. A patient with crystalline keratopathy caused by Streptococcus viridans after corneal transplantation was treated topically with tetracycline eye drops, based on results of bacterial sensitivity testing. After 3 weeks of intensive treatment, the donor cornea was stained with a brownish hue, which was ascribed to the tetracycline drops.. One patient with crystalline keratopathy developed corneal staining after intensive treatment with topical tetracycline eye drops. After a year of follow-up, the staining of the cornea had not changed significantly.. Hourly topical tetracycline eye drops may induce corneal pigmentation. To our knowledge, this is the first published case report of corneal staining caused by tetracycline eye drops.

Topics: Administration, Topical; Aged; Anti-Bacterial Agents; Cornea; Corneal Diseases; Corneal Transplantation; Corneal Ulcer; Eye Infections, Bacterial; Female; Humans; Ophthalmic Solutions; Pigmentation Disorders; Streptococcal Infections; Tetracycline; Viridans Streptococci

Topics: Anti-Bacterial Agents; Corneal Diseases; Humans; Recurrence; Tetracycline

Rosacea is an uncommon disease of the eye and facial skin. Ocular rosacea is often undiagnosed by the ophthalmologist especially when skin manifestations are not evident yet. Early diagnosis and treatment is important to decrease morbidity of this potentially blinding disease. A case of ocular rosacea in a 14-year-old Chinese girl is reported. Our patient presented with chronic non-specific keratoconjunctivitis. Only much later did the characteristic corneal and facial skin lesions appear. She responded to guttae prednisolone, oral and guttae tetracycline. This case illustrates the difficulty of early diagnosis when ocular manifestations precede those of the skin. We believe this is the first case of ocular rosacea reported in Singapore.

Topics: Adolescent; Anti-Bacterial Agents; Anti-Inflammatory Agents; Corneal Diseases; Female; Humans; Prednisolone; Rosacea; Tetracycline

The objective was to describe the complications and outcomes of herpes zoster ophthalmicus in a population of young Africans with a high seroprevalence of human immunodeficiency virus type 1 in which treatment often is delayed and in which antiviral drugs are not available.. Twenty-seven patients with herpes zoster ophthalmicus presenting consecutively to a large urban hospital were examined and followed. Treatment was limited to that which was locally available.. Visual outcomes were poor. Sixty-six percent of eyes had final visual acuity less than 20/60. Forty percent had light perception or no light perception visual acuity. Severe keratouveitis and corneal perforation were common and responsible for most poor visual outcomes.. Young Africans with herpes zoster ophthalmicus are at a high risk for significant visual loss.

Topics: Adolescent; Adrenal Cortex Hormones; Adult; Chloramphenicol; Corneal Diseases; Eyelid Diseases; Female; Follow-Up Studies; Herpes Zoster Ophthalmicus; Hospitals, Urban; Humans; Malawi; Male; Middle Aged; Ointments; Ophthalmic Solutions; Tetracycline; Time Factors; Uveitis; Vision Disorders; Visual Acuity

In four patients with an adult chlamydial ophthalmia small, marginal corneal abscesses were detected. These corneal abscesses were associated with unilateral papillary and follicular conjunctivitis and punctate keratitis. In these patients no bacteria was isolated from the abscesses, but Chlamydia trachomatis was isolated from materials collected from the abscesses and from the conjunctival swabbings. In addition all patients had microbiologically proved concomitant chlamydial genital infections. The clinical signs resolved after topical treatment with rifampicin or tetracycline eye ointment for six weeks or systemic treatment with tetracycline for two weeks. Because of concomitant chlamydial genital infection it is advisable to treat patients with adult chlamydial ophthalmia with systemic tetracycline and to refer these patients and their consorts for investigation and treatment of their genital infection.

Topics: Abscess; Adult; Chlamydia Infections; Chlamydia trachomatis; Conjunctivitis, Inclusion; Corneal Diseases; Female; Humans; Keratitis; Male; Middle Aged; Rifampin; Tetracycline

Topics: Corneal Diseases; Humans; Tetracycline

Recent evidence shows tetracyclines have anticollagenolytic activity that may be clinically effective in disease treatment. This led us to use systemic tetracycline (oral tetracycline hydrochloride 1 g daily divided into 4 doses) as adjunctive therapy in treating 18 patients with persistent corneal epithelial defects. Fourteen of 18 patients healed their defects; within 48 hours (9 patients) and within two weeks (the other 5 responding patients). Two patients showed no effect and two showed disease progression.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cornea; Corneal Diseases; Drug Evaluation; Epithelium; Female; Gastrointestinal Diseases; Humans; Keratitis, Dendritic; Male; Middle Aged; Tetracycline

Ocular rosacea was diagnosed in 6.3% of a cornea/external disease referral practice where more than half of the patients referred are for corneal surgery. The most common signs and symptoms are also common to many patients in the general practice of ophthalmology, i.e., foreign body sensation, burning, superficial punctate erosions, chalazia and blepharitis. Less common but dangerous to the vision was corneal thinning, vascularization and infiltrates. Three new associated symptoms were described. These were map dot subepithelial opacities, recurrent erosions and moderately severe foreign body sensation, pain or burning with minimal associated signs. Oral tetracycline 250 mg q.i.d. resulted in improvement in almost all patients from 4 to 17 days after initiation of therapy. Although most of the patients have been able to taper and stop therapy, those with foreign body sensation, burning and pain have had recurrences of their symptoms with all attempts at stopping therapy.

Topics: Adult; Aged; Conjunctival Diseases; Corneal Diseases; Eyelid Diseases; Female; Humans; Male; Middle Aged; Rosacea; Tetracycline; Time Factors

Topics: Anti-Bacterial Agents; Cornea; Corneal Diseases; Disease; Humans; Tetanus; Tetracycline