Immunization with uv-light inactivated EV70 elicits a classical humoral immune response in rabbits. The protective activity of serum in EV70-infected human conjunctival cells, but not lens cells, was increased by IFN-alpha. Adjuvant MDP-induced conjunctivitis, increased blood-conjunctival barrier (BCB) permeability and anti-EV70 neutralizing activity in tear of seropositive rabbits. The results suggest immunization with inactivated EV70 could provide systemic as well as ocular protection during natural EV70 infection.

Tear samples were collected from 37 residents of the Dominican Republic <5 d post onset (p.o.) of symptoms (mean 1.73±1.17 d p.o.) of acute hemorrhagic conjunctivitis (AHC). Sixty-two percent (23/37) of the patients had bilateral infections. Anti-enterovirus 70 (EV70) tear neutralizing activity (TNA) (10(2->3.5) U/ml) and anti-Coxsackievirus A24 variant (CA24v) TNA (10(<1-3) U/ml), but no anti-poliovirus (PV) TNA was detected. The anti-EV70 TNA in pooled tear samples sedimented in sucrose density gradient fractions that corresponded to 19-7S serum anti-PV immunoglobulin (1g). Anti-CA24v TNA sedimented as 7S1g. 1gG levels (mean, 3.13±4.2mg/ml) were higher than 1gA levels (mean, 0.92±0.98 mg/ml) in 21 of 27 tear samples. 1gG levels in tears from six patients with bilateral AHC were associated with total tear protein (p=0.003), but not with the levels of TNA or interferon (IFN). The total protein in AHC tears (5.13±1.72 mg/ml) was two-fold less than the total protein in normal tears (11.2±3.25 mg/ml). 1gA levels increased from 0.31±.3 to 1.34±1.28 mg/ml in tears collected up to 3 d p.o. of AHC. 1gM was not detected (<0.01 mg/ml). EV70 was isolated from the tears of one patient. Taken together, our results suggest that EV70 and CA24v are endemic in the Dominican Republic and that the 1992 epidemic of AHC was due to EV70. The detection of 19S (IgM) and high levels of 7S (IgG) TNA to EV70<1 d p.o. of AHC indicate a rapid ocular immune response to EV70 and suggests that virus-specific TNAs inhibit AHC virus infection.

JOURNAL dysthyroid ophthalmopathy. 9 Muscle thickening due to myositis usually does involve the tendon, but the lack of pain is inconsistent with this diagnosis since the condition is usually of acute onset and painfu1.8 Extraocular muscles involved by tumours usually have irregular borders or areas of focal thickening on C T.9 , I O Tumours of the lung are the second most common cause of metastasis to the eye and orbit, the most common being breast. 10-12 In previous reports 1-5 the orbital masses appeared to involve other orbital tissues, but in our case there was discrete infiltration of the lateral rectus muscle, as visualised at surgery. Biopsy of the involved muscle under local anaesthesia was straightforward, and con sidered to carry less morbidity than liver biopsy. The 'smudged' appearance of the biopsy on histology (Fig. 2) is typical of oat cell carcinoma. Sputum cytology was con firmatory, although the chest radiograph was still con sidered normal on review. Metastatic carcinoma to the orbit is probably more common than the literature would indicate,7 although dis crete metastasis to an extraocular muscle is rare. This is the first report of oat cell carcinoma of the bronchus asso ciated with a discrete metastasis to an extraocular muscle.