Introduction: Ocular symptoms are uncommon manifestations of coronavirus disease 2019 (COVID-19) infection. Earlier study reported that dry eye, blurred vision, foreign body sensation, tearing, itching, conjunctival secretion, conjunctival congestion, ocular pain, and photophobia are among the ocular symptoms that could be found in COVID-19 patients. However, there are only a few reports available regarding corneal involvement in this disease. Here we report a case of keratoconjunctivitis as the only symptom of COVID-19 infection. Case description: A 27-year-old man who worked as an obstetrics and gynecology resident came to the outpatient clinic with the chief complaints of eye discomfort, foreign body sensation, conjunctival hyperemia, lacrimation, and photophobia in his right eye for the past 3 weeks. Fluorescence test showed a small corneal lesion. The patient was then diagnosed with keratoconjunctivitis. A week after the treatment, all symptoms were resolved. A month later, the patient came to the emergency room with the same eye complaints but with a more severe pain. The fluorescence test showed wider corneal lesion compared to last month. The result from the corneal swab is negative for bacterial or fungal infection, indicating a viral infection. Afterwards, reverse transcriptase polymerase chain reaction test from nasopharyngeal swab was performed and revealed that the patient was positive for COVID-19. Conclusions: This case report showed that keratoconjunctivitis may occur as the only manifestation of COVID-19 infection. Thus, patient presented with unexplainable eye symptoms should be evaluated for COVID-19 infection.
Introduction: High recurrence of a fibrotic disease, pterygium, following the surgical procedure is perceived as the primary challenge of its management. As the standard procedure, adjuvant therapy of using mitomycin C could dramatically reduce the recurrence of pterygium but could cause multiple serious complications. Our study aimed to investigate curcumin and fibrin glue as alternative candidates for adjuvant therapy in pterygium surgery. Methods: Human pterygium fibroblast (HPF) was isolated from the patient and cultured in-vitro. The HPF culture was then exposed with mitomycin C (0.4 mg/mL), curcumin (200 μmol/L), and fibrin glue, respectively, for 48 hours. The outcomes were determined by the proliferation of HPF and the expression of transforming growth factor-beta (TGF-β) which were obtained from 2,5-diphenyl-2H-tetrazolium bromide assay and immunofluorescence staining analysis with TGF-β antibody. Results: The experiment revealed that mitomycin C, curcumin, and fibrin glue could significantly inhibit the proliferation of HPF (p<0.05) suggesting their antifibrotic effect. Further analysis with immunofluorescence staining showed that mitomycin C, curcumin, and fibrin glue could significantly reduce the level of TGF-β as compared with control group (p<0.05). Conclusion: Mitomycin C was the most potent adjuvant agent to reduce the recurrence of pterygium, followed by curcumin and fibrin glue. Taken altogether, curcumin and fibrin glue have role as adjuvant therapy to prevent recurrence in pterygium surgery.
BACKGROUND: Pterygium is an ocular surface disease that often occurs in tropical countries with a high recurrence rate. Matrix metalloproteinase-3 (MMP-3) play a key role in the inflammatory process of pterygium. This study aims to investigate the ability of curcumin and fibrin glue (FG) in suppressing the expression of MMP-3, and whether can be expected as adjuvant therapy to reduce pterygium recurrence.METHODS: Human pterygium fibroblasts (HPF) obtained from primary cultured of pterygium were treated with no treatment, curcumin, mitomycin-C (MMC), and FG. MMP-3 expression was analyzed using immunocytochemistry and the intensity measurement was done using ImageJ software. Cell migration was measured by scratching and stratification of fibroblast culture after cell confluence, and assessed for 48 hours.RESULTS: The expression of MMP-3 were lower in the HPF treated with 100 mol/mL curcumin, 200 mol/mL, and FG (2205.84±86.1 pg/mL, 1002.51±25.22 pg/mL, 1131.55±17.71 pg/mL, respectively) in comparison with untreated HPF (4703.49±108.9 pg/mL). The expression of MMP-3 were significantly different between groups (p<0.001). Cell migration of HPF after scratching with curcumin intervention at 200 mol/mL decrease from 178.67±2.85 (24 hours) to 88.83±1.48 (48 hours). Meanwhile the migration in FG group also decrease from 180.4±2.56 (24 hours) to 72.45±1.25 (48 hours).CONCLUSION: Curcumin and FG able to reduce the expression of MMP-3 and inhibit the migration of HPF cells.KEYWORDS: curcumin, mitomycin C, fibrin glue, human pterygium fibroblast, MMP-3
BACKGROUND: Usually, surgical intervention is needed to eradicate the fungal microorganism that cause fungal corneal ulcers. However, since surgical intervention is invasive, the latest technology uses cryotherapy in treating it. Cryotherapy plays a vital role in the wound healing process. We aimed to evaluate is to study the decreased expression of matrix metalloproteinase 9 (MMP-9) and transforming growth factor β1 (TGF-β1) in fungal corneal ulcers after the administration of cryotherapy.METHODS: Aspergillus flavus fungus was injected to the intrastromal corneas of all Sprague Dawley rats. The rats were divided into four groups, the first group was not given any therapy, the second group was given topical natamycin therapy, the third group was given cryotherapy, and the fourth group was given a combination between cryotherapy and topical natamycin therapy. Therapy was given after five days of follow up on the formation of a corneal ulcer. After four days of therapy, the eyes were enucleated to determine MMP-9 and TGF-β1 expression.RESULTS: The result in the third group showed lower MMP-9 expression (20.0±10.0% cells per field of view) compared to the second group (40.0±20.0% cells per field of view) and the fourth group (30.0±25.0% cells per field of view), but had the same MMP-9 expression value as the first group. There was no significant difference in MMP-9 expression between the four groups (p=0.356). The third group reduced more TGF-β1 expression (10.0±12.50% cells per field of view) compared to the fourth group (30±27.5% cells per field of view) and the first group (30±32.5% cells per field of view). There was also no significant difference in TGF-β1 between the four groups (p=0.315).CONCLUSION: There is no significant difference in the expression of TGF-β1 and MMP-9 after the cryotherapy treatment.KEYWORDS: corneal ulcer, cryotherapy, MMP-9, TGF-β1
Purpose: To investigate the relationship between blood parameters and platelet-rich fibrin (PRF) membrane size for ocular graft. Methods: Total of 12 New Zealand white rabbits, 6.5 ml of blood samples was taken for each rabbit, including 5 ml for platelet-rich fibrin membrane production using L-PRF protocol (centrifugation at 2700 rpm for 12 minutes) 1.5 ml for evaluation of blood parameters. Measurement of blood parameters consists of fibrinogen, haemoglobin, hematocrit, red blood cell (RBC), white blood cell (WBC) and platelet. Measurement of the platelet-rich fibrin membrane area was done using a calibrated photograph and ImageJ software. The Pearson correlation coefficient (r) was used to evaluate each scattergram statistically. Results: Linear regression analysis found a significant positive effect on the PRF membrane area on the fibrinogen (r = 0.802, p = 0.02), WBC (r = 0.625, p = 0.03) and platelet (r = 0.839, p = 0.001). However, there was no apparent correlation to haemoglobin (r = 0.514, p = 0.087), RBC (r = 0.548, p = 0.065) and hematocrit (r = 0.454, p = 0.138). Conclusions: The area of the PRF membrane has a positively significant relation to the fibrinogen, WBC and platelets. The data in this study can be used to estimate the size of the PRF membrane as an ocular graft.
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