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VIRAL CONJUNCTIVITIS PGI Maria Joane Faye C. Lim

Viral Conjunctivitis

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Viral ConjunctivitisPGI Mariaedit MasterC. Lim Click to Joane Faye subtitle style

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Viral Conjunctivitisv

Most common type of conjunctivitis worldwide Adenovirus is the most common cause of viral

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conjunctivitisv

Usually benign and self-limited Longer course (2-4weeks) than acute bacterial

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conjunctivitisv

Characterized by acute follicular conjunctival reaction

and preauricular adenopathy 6/28/12

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Pathophysiology

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Prominent tarsal follicles and papillae on the upper and lower eyelids 6/28/12

Adenoviral Conjunctivitisv

Epidemic keratoconjunctivitis Pharyngoconjunctival fever

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Etiology: This highly contagious conjunctivitis is

Epidemic Keratoconjunctivitis

usually caused by type 8 or 19 adenovirus and is spread by direct contactv

Incubation period: 8 to 10 days usually bilateral

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Manifestationsv

Preauricular adenopathy Epiphora Hyperemia Chemosis Follicular conjunctival reaction Pseudomembranous conjunctival reaction Corneal epithelial defect (in severe cases)

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Thick white membrane of upper palpebral conjunctiva6/28/12

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Diagnostic considerations: Characteristic findings

Epidemic Keratoconjunctivitis

include reddening and swelling of the plica semilunaris and lacrimal caruncle and nummular keratitis after 8 15 days, during the healing phase.

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Epidemic Keratoconjunctivitis

Acute unilateral reddening of the conjunctiva accompanied by 6/28/12 pseudoptosis.v

coin-like infiltrates (nummular keratitis) appear in the superficial Corneal stroma 6/28/12

Pharyngoconjunctival Feverv

characterized by fever of 38.340 C, sore throat, and

a follicular conjunctivitis in one or both eyesv

The syndrome may be incomplete, consisting of only

one or two of the cardinal signs (fever, pharyngitis, and conjunctivitis).v

caused regularly by adenovirus 3 and 7 Usually lasts for 10 days

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Manifestationsv

Prominent follicles on conjunctiva and pharyngeal

mucosav

Injection Tearing Transient superficial epithelial keratitis Subepithelial opacities Nontender preauricular lymphadenopathy

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Unilateral injection, irritation, mucoid discharge, photophobiav

Herpes simplex Conjunctivitis

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Usually associated with Herpes simplex keratitis

dendritic keratitis with typical features of linear branching and dendritic figures

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Cytology: mononuclear cells Usually self limited

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Manifestationsv

Vesicles on the eyelid or face Swollen eyelids Ulcerative blepharitis

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Ocular Herpes

Varicella-Zoster Virusv

generalized vesicular eruption, fever, and

constitutional symptoms.v

unilateral presents as small, papular lesions that erupt along the

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lid margin or at the limbus and may be accompanied by a mild follicular conjunctivitisv

Scrapings may contain: giant cells and monocytes

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reactivation of latent VZV infection of the trigeminal

Herpes zoster ophthalmicus

ganglionv

prodrome of fever, malaise, nausea, vomiting, and

severe pain and skin lesions along the ophthalmic division of the trigeminal nervev

Conjunctival involvement includes hyperemia,

follicular or papillary conjunctivitis, and a serous or mucopurulent discharge, multiple fine, dendritic corneal lesions 6/28/12

Picornavirusv

Enterovirus 70 and Coxsackievirus A24 Acute hemorrhagic conjunctivitis Mostly affects children and young adults in lower

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socioeconomic classv

rapid onset of watery discharge, foreign body

sensation, burning, and photophobia within 24 hours of exposure

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Acute Hemorrhagic Conjunctivitis6/28/12

Treatmentv

Supportive management

Cold compress Lubricants

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VZV infection

Acyclovir, 600-800 mg, 5 times daily for 7-10 days

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HSV infection

idoxuridine solution and ointment, vidarabine ointment, and trifluridine solution

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Prophylaxisv

refrain from rubbing eyes despite severe itching

sensationv

avoid direct contact with other people Patients with epidemic keratoconjunctivitis should not

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be seated in the same waiting room as other patients.v

Examination should be by indirect means only,

avoiding applanation tonometry, contact lens examination, or gonioscopy.v

After examination, the examiner should clean his or

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An Antiviral Small-Interfering RNA Simultaneously Click to edit Master subtitle style Effective against the Most Prevalent Enteroviruses Causing Acute Hemorrhagic ConjunctivitisFrom the Jun, Min Ah Won, Jeonghyun Ahn, Ara Eun JungDepartments of Microbiology, Ophthalmology, and Biomedical Institute of Technology, University of Ulsan College of Ko, Haein Moon, Hungwon Tchah, Yoo Kyum Medicine; and 4Asan Medical Center, Seoul, Korea August Kim, and Heuiran Lee 3, 2010

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PurposeTo develop a novel small interfering RNA-based anti-AHC agent effective against both EV70 and CVA24.

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MethodologyConcurrent CAPSID program screening identified of five the entire viral siRNA genome sequences of EV70 and CVA24 using the different candidates complementary to genome regions of both viruses. The antiviral potentials of these siRNAs were assessed by treating MRC5 and primary human conjunctival cells with the siRNAs and following this with viral challenge.

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Data were explored by ANOVA making use of the SPSS

program and were next compared using the paired ttest or descriptive statistics

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ResultAmong the five siRNAs, AHCe-3D-3 siRNA showed excellent cytoprotective effects and dramatic decreases in virus replication and virus protein synthesis. This siRNA, targeting the virus polymerase 3D gene, also induced similar antiviral effects in primary human conjunctival cells.

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ConclusionThe AHCe-3D-3 siRNA can provide equivalent antiviral activities against enterovirus 70 and coxsackievirus A24. Such an siRNA may be developed as a clinically valuable AHC control agent.

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