WordNet

of or relating to interstices
inflammation of the cornea causing watery painful eyes and blurred vision

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/02/18 13:58:57」(JST)

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Interstitial Keratitis (IK) is corneal scarring due to chronic inflammation of the corneal stroma. Interstitial means space between cells i.e. corneal stroma which lies between the epithelium and the endothelium. Keratitis means corneal inflammation.

PathophysiologyEdit

The corneal scarring is the end result of the initial invasion of blood vessels into the corneal stroma as part of the inflammatory response. Since normal corneal tissue should be avascular (no blood vessel) and therefore clear to allow light to pass, the presence of blood vessel and the infiltration of cells as part of the inflammatory process results in scarring or hazing of the cornea.^[1]

AetiologyEdit

By far the most common cause of IK is syphilitic disease. However, there are two possible causes of the corneal inflammatory response: an infection and/or an immunological response, such as a hypersensitivity type reaction, or (rarely) Cogan syndrome.^[2] Infectious causes include syphilis (commonest), followed by other bacterial infections (TB, Leprosy and Lyme disease) and parasitic infections (Acanthamoeba, Onchocerciasis or river blindness, Leishmaniasis, Trypanosoma cruzi or Chagas disease, Trypanosoma brucei or African sleeping sickness and microsporidia)^[3]

HistoryEdit

Previous long-standing eye infection which possibly during childhood time recalled as being treated with antibiotic and/or hospitalized over long period of time.

Symptoms and signsEdit

Acutely or at the early sign includes painful, photophobic, red and watery eye. This is due to active corneal inflammation resulting in vascular invasion and stromal necrosis which can be diffuse or localized. This cause the pinkish discoloration of what was a clear transparent normal corneal tissue (called Salmon patch of Hutchinson).

Chronically or the end result will cause blurring of vision secondary to corneal stromal scarring, presence of ghost vessel and thinning of the cornea especially if it involves the visual axis.

TreatmentEdit

The underlying cause must be treated as soon as possible to stop the disease process. Corticosteroid drop can be used to minimize the scarring on the cornea along with antibiotic cover. However, residual scarring cannot be avoided which can result in long term visual impairment and corneal transplantation is not suitable due to high rejection rate from the corneal vascularization.^[4]

ReferencesEdit

^ Dr Khairul Nazri Mohammad (Articles' Author), Waterford General Hospital, IRELAND
^ Ramachandran, Tarakad. "Cogan Syndrome". Medlink. MedLink Corporation. Retrieved 1/11/2012. Check date values in: |access-date= (help)
^ Majmudar PA. "Keratitis, Interstitial" emedicine Dec 07
^ Kanski JJ. "Clinical Ophthalmology 5th ed"

UpToDate Contents

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1. コーガン症候群 cogans syndrome
2. 先天梅毒：臨床的特徴および診断 congenital syphilis clinical features and diagnosis
3. 単純ヘルペス性角膜炎 herpes simplex keratitis
4. 結核と眼 tuberculosis and the eye
5. 神経梅毒 neurosyphilis

English Journal

The Importance of FDG-PET/CT in Cogan's Syndrome.

Orsal E1, Uğur M2, Seven B1, Ayan AK1, Içyer F2, Yıldız A1.
Molecular imaging and radionuclide therapy.Mol Imaging Radionucl Ther.2014 Jun;23(2):74-5. doi: 10.4274/mirt.349. Epub 2014 Jun 5.
in

English, TurkishÇalışmamızda sensorinöral işitme kaybı ve üveiti olan atipik Cogan sendromlu bir hastayı detaylı bir şekilde ele aldık. Cogan sendromu nonsifilitik interstisyel keratit ve odiovestibuler disfonksiyon ile karakterize bir hastalıktır. Interstisyel keratitin varlı�

PMID 24963451

Cogan's syndrome: anti-Hsp70 antibodies are a serological marker in the typical form.

Bonaguri C, Orsoni J, Russo A, Rubino P, Bacciu S, Lippi G, Melegari A, Zavota L, Ghirardini S, Mora P.
The Israel Medical Association journal : IMAJ.Isr Med Assoc J.2014 May;16(5):285-8.
BACKGROUND: Cogan's syndrome (CS) is a rare autoimmune vasculitis characterized by ocular inflammation and sensorineural hearing loss. CS is divided into a "typical" form with non-syphilitic interstitial keratitis and audiovestibular symptoms, and an "atypical" form with ocular involvement affecting
PMID 24979832

Cogan syndrome--pathogenesis, clinical variants and treatment approaches.

Kessel A1, Vadasz Z1, Toubi E2.
Autoimmunity reviews.Autoimmun Rev.2014 Apr-May;13(4-5):351-4. doi: 10.1016/j.autrev.2014.01.002. Epub 2014 Jan 10.
Non-syphilitic keratitis, coexisting with vestiboloauditory symptoms namely hearing loss and dizziness was first reported by Morgan and Baumgartner back in 1934. It was then ten years later when D.G. Cogan, an ophthalmologist (1908-1993) described 4 patients having the same symptoms but in addition,
PMID 24418297

Japanese Journal

両眼性デスメ膜剥離を繰り返した梅毒性角膜白斑合併白内障症例

西村栄一,谷口重雄,石田千晶,後藤英樹
IOL & RS : Japanese journal of cataract and refractive surgery : 日本眼内レンズ屈折手術学会誌 24(1), 100-106, 2010-03-01
NAID 10029690624

Immunohistochemical localisation of d-β-aspartic acid-containing proteins in climatic droplet keratopathy

Kaji Y,Oshika T,Takazawa Y,Fukayama M,Fujii N,加治優一,大鹿哲郎
British journal of ophthalmology 93(7), 977-979, 2009-03
… with climatic droplet keratopathy (CDK), one of the ocular changes related to the ageing process.Methods: Immunohistochemical localisation of D-β-Asp-containing proteins using polyclonal antibodies raised against D-β-Asp-containing peptides was examined in three corneas with CDK, three corneas with interstitial keratitis, six corneas with bullous keratopathy, and three corneas without any corneal diseases.Results: Strong immunoreactivity to D-β-Asp-containing peptide was detected in all the surgical specimens with …
NAID 120001437948

Atypical Cogan's Syndrome with Aortitis

Kondo Yuya,Ito Satoshi,Ohi Yuichi,Satou Hideki,Hiraoka Takahiro,Tsuboi Hiroto,Sugihara Makoto,Hayashi Taichi,Goto Daisuke,Matsumoto Isao,Sumida Takayuki
Internal Medicine 48(12), 1093-1097, 2009
… Cogan's syndrome is characterized by non syphilitic interstitial keratitis and Meniere's syndrome-like audiovestibular function disorder, as well as various systemic manifestations, including fever, arthralgia, vasculitis, and aortitis. …
NAID 130000121915