Wang Zhiqun

Acanthamoeba keratitis as a complication of orthokeratology.

PURPOSE To present four cases of Acanthamoeba keratitis as a complication of orthokeratology. DESIGN Observational case report. METHODS Four patients with Acanthamoeba keratitis had histories of overnight orthokeratology lens wear of 6 months to 2 years. RESULTS Three cases were diagnosed with Acanthamoeba keratitis by corneal scraping and one by confocal microscopy examination. The patients were treated with chlorhexidine, metronidazole, and neomycin sulfate, resulting in a rapid resolution of ocular inflammation. CONCLUSION Overnight wear of orthokeratology lenses may induce Acanthamoeba keratitis.

Arg124Cys Mutation of the TGFBI Gene in 2 Chinese Families With Thiel-Behnke Corneal Dystrophy

OBJECTIVE To analyze transforming growth factor beta-induced (TGFBI) gene mutations in 2 Chinese families with Thiel-Behnke corneal dystrophy (TBCD). METHODS Forty-five individuals in 2 Chinese families with TBCD were examined using slitlamp biomicroscopy. Genomic DNA was extracted from peripheral leukocytes of affected and unaffected family members. Molecular genetic analysis of the TGFBI gene was performed using polymerase chain reaction and standard automated sequencing methods. RESULTS In 17 family members with TBCD, an Arg124Cys (R124C) mutation of the TGFBI gene was identified, whereas the Arg555Gln (R555Q) mutation was absent. The Arg124Cys mutation was absent in all unaffected individuals. CONCLUSIONS The Arg124Cys mutation was associated with TBCD in 2 Chinese families. This mutation in the TGFBI gene may induce different phenotypes of corneal dystrophy. Clinical Relevance Thiel-Behnke corneal dystrophy may be caused by an Arg124Cys mutation of the TGFBI gene.

Multidrug-resistant bacteria induce recurrent keratoconjunctivitis in a patient with common variable immunodeficiency: case report and literature review.

Purpose: We present a case study regarding a patient with recurrent keratoconjunctivitis that presented as an initial manifestation of common variable immunodeficiency (CVID). Methods: We describe a case and review the recent relevant medical literature. Results: A 33-year-old male had recurrent keratoconjunctivitis induced by multidrug-resistant bacteria. Topical vancomycin treatment was effective, but infection recurred when the vancomycin treatment was stopped. The patient was transferred to the Department of Medicine to rule out potential systemic immune diseases and was finally diagnosed with CVID. Intravenous immunoglobulin (IVIG) was administered, and the patient was followed up monthly without any recurrence of infection to date. IVIG will be administered monthly for the patients lifetime. Conclusions: Keratoconjunctivitis is a CVID-associated manifestation, sometimes appearing as the first presentation. CVID should be considered when unexplained recurrent conjunctival and/or corneal bacterial infections are observed. Topical therapy is not sufficient to treat this infection and IVIG is necessary.

Clinical and experimental findings in Acanthamoeba keratitis with Heidelberg Retina Tomograph III-RCM

Purpose:  To observe Acanthamoeba cysts and trophozoites in the corneal tissue of patients and rabbits with Acanthamoeba keratitis (AK), using the Heidelberg Retina Tomograph III Rostock‐cornea‐module (HRTIII‐RCM).

Coming National Program of Epidemiological Survey for Trachoma in China: Prevalence of Trachoma in Northern China

Purpose: To assess the prevalence of and risk factors for trachoma among primary school children in three north districts of China. Methods: The survey was carried out in three north districts of China (Wuqiang county of Hebei province, Yinchuan city of Ningxia Huizu province, and Datong city of Shanxi province). Chester sampling survey was employed in this study. The general state of health and case history of those children were recorded. Sanitation status and habits of both respondent and household, knowledge of health-related issues and the condition of inhabitancy were also questioned. Trachoma was clinically diagnosed according to the simplified classification for trachoma proposed by the World Health Organization (WHO). At the same time, Chlamydia trachomatis (C. trachomatis) was detected by polymerase chain reaction (PCR) when the child was clinically diagnosed as trachoma. Results: In Wuqiang county, out of 1622 primary school children, 333 children were clinically diagnosed as trachoma and the prevalence of trachoma was 20.5% (95%CI 18.5% to 22.5%). In Yinchuan city, out of 1883 primary school children, 577 children were diagnosed as trachoma and the prevalence was 30.6% (95% CI 28.6% to 32.7%). Out of 1236 primary school children in Datong city, 135 person of trachoma were found, the prevalence of trachoma was 10.9% (95%CI 9.2%-12.6%). The prevalence of trachoma in primary school children from countryside is higher than that in cities (P<0.01). The positive rate of PCR for C. trachomatis was 64.9% (in 333), 48.9% (in 577), and 63.7% (in 135) in the 3 districts respectively. Narrow living condition, short of clean water and poor personal sanitation habits, and poor knowledge of trachoma were the independent risk factors for active trachoma. Conclusions: Trachoma is still now a remarkable eye health problem in north China. It is necessary to have a nationwide survey for the prevalence of whole country and evaluate mass interventions, both medical and educational, in the community.