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1. Cenegermin for treating neurotrophic keratitis

Cenegermin for treating neurotrophic keratitis Cenegermin for treating neurotrophic Cenegermin for treating neurotrophic k ker eratitis atitis T echnology appraisal guidance Published: 18 July 2018 nice.org.uk/guidance/ta532 © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility The recommendations in this guidance represent the view of NICE, arrived at after careful consideration (...) to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Cenegermin for treating neurotrophic keratitis (TA532) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 15Contents Contents 1 Recommendations 4 2 Information about cenegermin 5 3 Committee discussion 6 Unmet need 6 Current management 6 Clinical

2018 National Institute for Health and Clinical Excellence - Technology Appraisals

2. Keratitis

Keratitis Keratitis - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Keratitis Last reviewed: February 2019 Last updated: March 2018 Summary This disorder is an ocular emergency and remains one of the major causes of blindness around the world. Main risk factors include corneal trauma, contact lens wear, and breakdown of the corneal epithelium. The diagnosis depends on a careful history, slit-lamp examination (...) , and corneal scraping cultures. Treatment consists of topical antimicrobial agents that may be supplemented by pupil-dilating agents, analgesics, corticosteroids, and systemic antimicrobials as needed. Complications include corneal scarring, perforation, and endophthalmitis. Definition Infectious keratitis refers to microbial invasion of the cornea causing inflammation and damage to the corneal epithelium, stroma, or endothelium. Non-infectious keratitis is, for the most part, rare. History and exam

2018 BMJ Best Practice

3. Ciclosporin (Verkazia) - Conjunctivitis, Keratitis

Ciclosporin (Verkazia) - Conjunctivitis, Keratitis 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5555 Send a question via our website www.ema.europa.eu/contact © European Medicines Agency, 2018. Reproduction is authorised provided the source is acknowledged. 20 July 2017 EMA/505143/2017 Committee for Medicinal Products for Human Use (CHMP) Assessment report Verkazia International non (...) conjunctivitis, infectious conjunctivitis or ocular rosacea in children. Clinically, VKC is characterised by both conjunctival (hyperaemia, oedema, discharge) and corneal signs (superficial keratitis, corneal ulcerations, plaques, scars). Patients have a characteristic ropey, stringy mucous and/or serous discharge. Typical symptoms include photophobia, burning, pruritus, and blepharospasm. Intense ocular itching, followed by tearing and ropey, stringy mucous and/or serous discharge, and foreign body

2018 European Medicines Agency - EPARs

4. Herpes Simplex Keratitis

Herpes Simplex Keratitis Herpes Simplex Keratitis (HSK) submit The College submit You're here: Herpes Simplex Keratitis (HSK) Herpes Simplex Keratitis (HSK) The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Please login to view the images or . Aetiology Herpes simplex virus (HSV) infection is extremely common, though usually latent up to 90 (...) % of UK population is seropositive for HSV HSV-1 generally infects ‘above the waist’ (lips, face, eyes) primary infection usually in childhood, then virus lies dormant in trigeminal ganglion when virus reactivates it travels along branches of the trigeminal nerve to cause local infection (e.g. cold sore or herpes keratitis) HSV-2 generally infects ‘below the waist’ and is usually sexually acquired but may also be a cause of herpetic keratitis Ocular HSV infection (of which the incidence of new cases

2019 College of Optometrists

5. In vitro antimicrobial activity of diacerein on 76 <b>gram-positive cocci isolates from bacterial keratitis patients and an in vivo study of diacerein eye drops on <i>Staphylococcus aureus</i> keratitis in mice</b>. (PubMed)

In vitro antimicrobial activity of diacerein on 76 gram-positive cocci isolates from bacterial keratitis patients and an in vivo study of diacerein eye drops on Staphylococcus aureus keratitis in mice. Bacterial keratitis is an aggressive infectious corneal disease. With the continuing rise in antibiotic resistance and a decline in the discovery of new antibiotics, new antimicrobial drugs are now required. In the present study, we determined the antibacterial activity of diacerein (...) , an anti-inflammatory drug, against 76 Gram-positive cocci isolated from bacterial keratitis patients in vitro and anti-Staphylococcus aureus activity in mouse bacterial keratitis model in vivo. The minimum inhibitory concentrations (MICs) of diacerein were tested using the broth microdilution method in vitro. A BALB/c Staphylococcus aureus keratitis animal model was selected and the corneal clinical observation, viable bacteria and Hematoxylin-eosin and Gram staining of infected corneas were measured

2019 Antimicrobial Agents and Chemotherapy

6. Human adenoviral type 54 keratoconjunctivitis accompanied by stellate keratitis and keratic precipitates: two cases. (PubMed)

Human adenoviral type 54 keratoconjunctivitis accompanied by stellate keratitis and keratic precipitates: two cases. Of the 10 patients with adenoviral type 54 keratoconjunctivitis examined at Nojima Hospital, 2 developed stellate keratitis and mutton-fat keratic precipitates (KPs) following acute symptoms.We encountered 10 cases of epidemic keratoconjunctivitis from August to October 2017. All patients were adults with a mean age of 60.9 ± 10.0 years. The species D human adenovirus (HAdV)-54 (...) was detected in the conjunctival scrapings of these patients. Fluorometholone instillation was administered during the first week for acute symptomatic relief. Case 1: A 64-year-old female was prescribed with fluorometholone instillation, which was discontinued after 1 week when her symptoms alleviated. One week after discontinuation of the instillation, she presented with blurred vision in her left eye with KPs and multiple stellate keratitis. The anterior chamber had no apparent cells. Her symptoms

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2019 BMC Ophthalmology

7. Epithelial keratitis mimicking herpes simplex keratitis in a patient after cataract surgery: A case report. (PubMed)

Epithelial keratitis mimicking herpes simplex keratitis in a patient after cataract surgery: A case report. Epithelial keratitis is a common complication after cataract surgery. Many factors have been attributed to this clinical phenomenon.An 82-year-old woman without previous herpes simplex keratitis (HSK) underwent an uncomplicated clear corneal phacoemulsification procedure in the right eye. In the late postoperative period, epithelial keratitis developed in this same eye.An initial (...) diagnosis of HSK was made clinically. The lesion was refractory to antiviral treatment and had progressed. After topical acyclovir cessation and vigorous lubrication, a diagnosis of toxic keratitis was finally made.The corneal epithelial defect and dendritic lesion presented initially. Responding to antiviral treatment, this corneal lesion aggravated and revealed large epithelial erosion. After topical acyclovir cessation and initiation of vigorous lubrication, the toxic keratitis was completely

2019 Medicine

8. Microbial keratitis (amoebic)

Microbial keratitis (amoebic) Microbial keratitis (Acanthamoeba sp.) submit The College submit You're here: Microbial keratitis (Acanthamoeba sp.) Microbial keratitis (Acanthamoeba sp.) The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Please login to view the images or . Aetiology Acanthamoebae are ubiquitous free-living protozoans, present (...) in: well water, drains, soil, dust may be present in domestic tap water (especially from storage tanks) Can exist in two forms motile, feeding and replicating form: trophozoite (most common form found in water and easily destroyed) dormant form: cyst (highly resistant to disinfection, can survive for long periods in hostile environments) Acanthamoeba keratitis is rare in the general population (estimated annual incidence: 1.4 per million per annum) but much commoner in contact lens wearers In the UK

2018 College of Optometrists

9. Microbial keratitis (bacterial, fungal)

Microbial keratitis (bacterial, fungal) Microbial keratitis (bacterial, fungal) submit The College submit You're here: Microbial keratitis (bacterial, fungal) Microbial keratitis (bacterial, fungal) The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Please login to view the images or . Aetiology The commonest bacterial corneal pathogens (...) are: Pseudomonas sp. (Gram -ve) Staphylococcus sp. (Gram +ve) Streptococcus sp. (Gram +ve) other Gram -ve organisms Note: severe contact lens-related infections tend to be Gram -ve, particularly Pseudomonas species Fungal keratitis is rare in the UK but common in some other parts of the world. The most common fungal corneal pathogens are: Candida sp. (yeast-like) Fusarium sp. (filamentous) Aspergillus sp (filamentous) Predisposing factors Bacterial keratitis is usually associated with one or more

2018 College of Optometrists

10. Keratitis, CL-associated infiltrative

Keratitis, CL-associated infiltrative Keratitis, CL-associated infiltrative submit The College submit You're here: Keratitis, CL-associated infiltrative Keratitis, CL-associated infiltrative The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Aetiology Contact lens-associated infiltrative events, including: contact lens-associated peripheral ulcer (...) (CLPU) contact lens-associated infiltrative keratitis The aetiology of this condition is inflammatory, not infective. Though it is bacteria-related, bacteria do not invade or replicate in the cornea and there is no progression to infection, nor is the condition a marker for increased risk of microbial keratitis, which is a separate disease entity CL-associated infiltrative keratitis is considered to be a response to microbial (usually Staphylococcal ) antigens, derived from bacteria on the lens

2018 College of Optometrists

11. Keratitis (photokeratitis)

Keratitis (photokeratitis) Photokeratitis (Ultraviolet [UV] burn, Arc eye, Snow Blindness) submit The College submit You're here: Photokeratitis (Ultraviolet [UV] burn, Arc eye, Snow Blindness) Photokeratitis (Ultraviolet [UV] burn, Arc eye, Snow Blindness) The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Aetiology Exposure to UVB (290 to 320nm (...) keratitis Contact lens overwear Dry eye Foreign body Management by optometrist Practitioners should recognise their limitations and where necessary seek further advice or refer the patient elsewhere GRADE* Level of evidence and strength of recommendation always relates to the statement(s) immediately above Non pharmacological Reassure patient that damage is transitory symptoms will be gone within 24 to 48 hours (mild photophobia and blurring may persist for a week or longer) Cold compresses, sunglasses

2018 College of Optometrists

12. Keratitis (marginal)

Keratitis (marginal) Keratitis (marginal) submit The College submit You're here: Keratitis (marginal) Keratitis (marginal) The CMGs are guidelines on the diagnosis and management of a range of common and rare, but important, eye conditions that present with varying frequency in primary and first contact care. Share options Aetiology Toxic or hypersensitivity response to bacterial (e.g. Staphylococcal ) exotoxins Predisposing factors Bacterial (e.g. Staphylococcal ) blepharitis Current or recent (...) of the peripheral cornea: microbial keratitis contact lens-associated corneal infiltrate rosacea keratitis Mooren’s ulcer peripheral keratitis associated with rheumatoid arthritis or other systemic collagen vascular disease corneal phlyctenulosis Terrien’s marginal degeneration marginal herpes simplex keratitis Management by optometrist Practitioners should recognise their limitations and where necessary seek further advice or refer the patient elsewhere GRADE* Level of evidence and strength of recommendation

2018 College of Optometrists

13. Oral antivirals for preventing recurrent herpes simplex keratitis in people with corneal grafts. (PubMed)

Oral antivirals for preventing recurrent herpes simplex keratitis in people with corneal grafts. Ocular herpes is a viral infection of the eye caused by the herpes simplex virus (HSV), a double-stranded DNA virus. Corneal scarring caused by herpes simplex keratitis (HSK) is the leading infectious cause of penetrating corneal graft in high-income countries. Acyclovir is an antiviral drug known to have a protective effect against recurrences in herpetic eye disease. While there are some studies (...) which have evaluated the effects of intervention with oral antiviral in preventing such recurrences in people with corneal grafts, a systematic review of all comparative clinical trials has not been previously undertaken.To assess the efficacy of oral antivirals such as acyclovir in any dosage when taken for six months or more, in preventing recurrence of herpetic keratitis in people having corneal graft surgery for herpetic keratitis.We searched CENTRAL (which contains the Cochrane Eyes and Vision

2016 Cochrane

14. What Is the Most Effective Treatment of Herpes Simplex Keratitis?

What Is the Most Effective Treatment of Herpes Simplex Keratitis? TAKE-HOME MESSAGE Treatmentofherpessimplexviruskeratitiscanbeaccomplishedwitheithertopical tri?uridineorganciclovir,whichhavesimilaref?cacy.Oralacyclovirisanacceptable treatment option in cases for which compliance with a topical ophthalmic regimen may be of concern. What Is the Most Effective Treatment of Herpes Simplex Keratitis? EBEM Commentators Joshua Bucher, MD Rutgers–Robert Wood Johnson Medical School New Brunswick, NJ (...) % con?dence interval [CI] 0.8 to 1.1). 1 Similarly, there was no difference in the primary outcome between interferon treatment and antivirals (RR 1.2; 95% CI 0.9 to 1.6). Commentary It is estimated that herpes simplex virus keratitis has an incidence of approximately12to31peopleper 100,000 annually. 2,3 Although it is a relatively uncommon diagno- sis in the emergency department setting, initiation of appropriate treatment is critical, given the potential to lead to serious visual impairment

2016 Annals of Emergency Medicine Systematic Review Snapshots

15. Atypical presentation of diffuse lamellar keratitis after small-incision lenticule extraction: Sterile multifocal inflammatory keratitis. (PubMed)

Atypical presentation of diffuse lamellar keratitis after small-incision lenticule extraction: Sterile multifocal inflammatory keratitis. We describe a case of atypical diffuse lamellar keratitis (DLK) following small-incision lenticule extraction (SMILE). The patient presented with multiple focal white infiltrates 1 day after routine small-incision lenticule extraction surgery. An interface washout was performed, and the patient was managed with intensive topical steroids. Potential infectious (...) keratitis was also investigated (by culture and Gram stain) and treated aggressively with steroids and antibiotics. The cultures were all negative with no growth, and the focal infiltrates gradually resolved, with no relapses at the 15-month postoperative follow-up and a faint 0.7 mm superior scar in the right eye. This case highlights the importance of using intensive topical steroids as well as performing an interface washout in such cases because of the higher risk for corneal melting associated

2018 Journal of cataract and refractive surgery

16. Comparison of anterior segment optical coherence tomography findings in acanthamoeba keratitis and herpetic epithelial keratitis (PubMed)

Comparison of anterior segment optical coherence tomography findings in acanthamoeba keratitis and herpetic epithelial keratitis This study is to investigate the characteristic features of Acanthamoeba keratitis (AK) that differentiating it from herpetic epithelial keratitis (HEK) using anterior segment optical coherence tomography (AS-OCT). Medical records of three eyes of each AK and herpetic keratitis who had AS-OCT examination were reviewed in this study. Slit-lamp biomicroscopy and AS-OCT

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2018 International journal of ophthalmology

17. The Asia Cornea Society Infectious Keratitis Study: A Prospective Multicenter Study Of Infectious Keratitis In Asia. (PubMed)

The Asia Cornea Society Infectious Keratitis Study: A Prospective Multicenter Study Of Infectious Keratitis In Asia. To survey the demographics, risk factors, microbiology, and outcomes for infectious keratitis in Asia.Prospective, nonrandomized clinical study.Thirteen study centers and 30 sub-centers recruited consecutive subjects over 12-18 months, and performed standardized data collection. A microbiological protocol standardized the processing and reporting of all isolates. Treatment (...) of the infectious keratitis was decided by the managing ophthalmologist. Subjects were observed for up to 6 months. Main outcome measures were final visual acuity and the need for surgery during infection.A total of 6626 eyes of 6563 subjects were studied. The majority of subjects were male (n = 3992). Trauma (n = 2279, 34.7%) and contact lens wear (n = 704, 10.7%) were the commonest risk factors. Overall, bacterial keratitis was diagnosed in 2521 eyes (38.0%) and fungal keratitis in 2166 eyes (32.7

2018 American Journal of Ophthalmology

18. Tacrolimus interacts with voriconazole to reduce the severity of fungal keratitis by suppressing IFN-related inflammatory responses and concomitant FK506 and voriconazole treatment suppresses fungal keratitis (PubMed)

Tacrolimus interacts with voriconazole to reduce the severity of fungal keratitis by suppressing IFN-related inflammatory responses and concomitant FK506 and voriconazole treatment suppresses fungal keratitis To investigate the expression and roles of type I and II interferons (IFNs) in fungal keratitis, as well as the therapeutic effects of tacrolimus (FK506) and voriconazole on this condition.The mRNA and protein expression levels of type I (IFN-α/β) and II (IFN-γ) IFNs, as well as of related (...) downstream inflammatory cytokines (interleukin (IL)-1α, IL-6, IL-12, and IL-17), were detected in macrophages, neutrophils, lymphocytes, and corneal epithelial cells (A6(1) cells) stimulated with zymosan (10 mg/ml) for 8 or 24 h. A fungal keratitis mouse model was generated through intrastromal injection of Aspergillus fumigatus, and the mice were then divided into four groups: group I, the PBS group; group II, the voriconazole group; group III, the FK506 group; and group IV, the voriconazole plus 0.05

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2018 Molecular vision

19. Incidence and Outcomes of Sterile Multifocal Inflammatory Keratitis and Diffuse Lamellar Keratitis After SMILE. (PubMed)

Incidence and Outcomes of Sterile Multifocal Inflammatory Keratitis and Diffuse Lamellar Keratitis After SMILE. To report the incidence outcomes of sterile multifocal inflammatory keratitis and diffuse lamellar keratitis (DLK) after small incision lenticule extraction (SMILE) in a large population.This was a retrospective review of a population of 4,000 consecutive eyes treated by SMILE at the London Vision Clinic using the VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany (...) ). The inclusion criterion was to have presented with inflammatory keratitis after SMILE. In some cases after SMILE, the inflammatory keratitis presented as sterile multifocal interface keratitis uncharacteristic of classic DLK. The incidence was measured and categorized as primary or secondary by presenting appearance, grade, and time to presentation. Patients were observed for 1 year after surgery and standard outcomes analysis was performed.Of the 4,000 eye population, there were 18 cases (0.45%) of DLK

2018 Journal of Refractive Surgery

20. Simultaneous Noncentered Photoactivated Chromophore for Keratitis-Corneal Collagen Cross-Linking and Penetrating Keratoplasty for Treatment of Severe Marginal Fusarium spp. Keratitis: A Description of a New Surgical Technique (PubMed)

Simultaneous Noncentered Photoactivated Chromophore for Keratitis-Corneal Collagen Cross-Linking and Penetrating Keratoplasty for Treatment of Severe Marginal Fusarium spp. Keratitis: A Description of a New Surgical Technique The purpose of this article is to describe the use of simultaneous noncentered photoactivated chromophore for keratitis-corneal collagen cross-linking (PACK-CXL) combined with penetrating keratoplasty in the treatment of a severe marginal Fusarium spp. keratitis case (...) and effective way of treating patients with fungal marginal keratitis with corneal perforation, in which regular penetrating keratoplasty alone would leave fungal elements in the receptor corneal tissue, which would predispose to infection of the graft.

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2017 Case reports in ophthalmological medicine

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