Recovery From Amiodarone-Induced Cornea Verticillata by Application of Topical Heparin

Фрингс, Андреас; Schargus, Marc

doi:10.1097/ico.0000000000001306

Cited by 8 publications

(8 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Heparin eye drops have been used to treat patients with ligneous conjunctivitis (5,000 IU/ml 6 times a day for 5 years), 159,160 paraquat-induced ocular injury, 161 posterior capsular opacification (heparin 5% ~ 5,000 IU/ml tid for 3 months) 162 and amiodaroneinduced vortex keratopathy (1,300 IU/mL tid for 3 months). 163 Heparin added into the infusion fluid has been used to reduce postoperative inflammation in patients with Diabetes 164 and in pediatric eyes undergoing cataract surgery with IOL implantation. [165][166][167] Given that heparin have been used topically and intraocularly in several settings, the use of subanticoagulant dose heparin as eye drops to treat oGVHD is likely to be safe.…”

Section: Sub-anticoagulant Dose Of Heparinmentioning

confidence: 99%

Neutrophil extracellular traps (NETs) contribute to pathological changes of ocular graft-vs.-host disease (oGVHD) dry eye: Implications for novel biomarkers and therapeutic strategies

Ilangovan

Surenkhuu

et al. 2019

The Ocular Surface

View full text Add to dashboard Cite

Purpose: To investigate the role of neutrophil extracellular traps (NETs) and NET-associated proteins in the pathogenesis of oGVHD and whether dismantling of NETs with heparin reduces those changes. Methods: Ocular surface washings from oGVHD patients and healthy subjects were analyzed. Isolated peripheral blood human neutrophils were stimulated to generate NETs and heparinized NETs. We performed in vitro experiments using cell lines (corneal epithelial, conjunctival fibroblast, meibomian gland (MG) epithelial and T cells), and in vivo experiments using murine models, and compared the effects of NETs, heparinized NETs, NET-associated proteins and neutralizing antibodies to NET-associated proteins. Results: Neutrophils, exfoliated epithelial cells, NETs and NET-associated proteins (extracellular DNA, Neutrophil Elastase, Myeloperoxidase, Oncostatin M (OSM), Neutrophil gelatinaseassociated lipocalin (NGAL) and LIGHT/TNFSF14) are present in ocular surface washings (OSW) and mucocellular aggregates (MCA). Eyes with high number of neutrophils in OSW have more severe signs and symptoms of oGVHD. NETs (and OSM) cause epitheliopathy in murine corneas. NETs (and LIGHT/TNFSF14) increase proliferation of T cells. NETs (and NGAL) inhibit proliferation and differentiation of MG epithelial cells. NETs enhance proliferation and myofibroblast transformation of conjunctival fibroblasts. Sub-anticoagulant dose Heparin (100 IU/mL) dismantles NETs and reduces epithelial, fibroblast, T cell and MG cell changes induced by NETs.

show abstract

Section: Sub-anticoagulant Dose Of Heparinmentioning

confidence: 99%

Neutrophil extracellular traps (NETs) contribute to pathological changes of ocular graft-vs.-host disease (oGVHD) dry eye: Implications for novel biomarkers and therapeutic strategies

Ilangovan

Surenkhuu

et al. 2019

The Ocular Surface

View full text Add to dashboard Cite

show abstract

“…For example, topical heparin eyedrops, prepared with a sterile phosphate-free solution of 0.1% sodium hyaluronate, has been reported as a possible treatment for amiodarone-induced vortex keratopathy. 76 Otherwise, local therapies such as topical lubricants or corticosteroids may provide an improvement in symptoms.…”

Section: Drug Classes Overviewmentioning

confidence: 99%

“…Furthermore, topical heparin may cause cornea verticillata. 76 Long-term use of topical epinephrine may lead to pigmented adenochrome deposits. 84 …”

Section: Drug Classes Overviewmentioning

confidence: 99%

Drug-induced corneal deposits: an up-to-date review

2022

View full text Add to dashboard Cite

This review assesses different clinical aspects of the various known drug-induced corneal deposits, based on the corneal layer involved (epithelium, stroma and/or endothelium), and based on the drug class. The most well-known condition caused by drug deposits is vortex keratopathy, or corneal verticillata, which is a whorl-like opacity in the corneal epithelium. Vortex keratopathy is commonly caused by certain cationic amphiphilic drugs such as amiodarone, antimalarials, suramin, tamoxifen, chlorpromazine and non-steroidal anti-inflammatory drugs. These deposits usually occur once a certain dose of the drug is reached. Most cases present with mild to moderate symptoms with minimal visual impairment. Most of these deposits resolve automatically, after months to years of drug cessation. Notably, other drug classes can cause deposits in all three layers of the cornea. Chlorpromazine, gold, rifabutin, indomethacin and tyrosine kinase inhibitors can cause stromal deposits, with reduced visual acuity when the anterior stroma is involved. Chlorpromazine and rifabutin can also cause deposits in the endothelial layer of the cornea. Regardless of the type of corneal deposit, local therapies such as topical lubricants or corticosteroids may help improve symptoms. Drug cessation or modification can also be helpful but should be weighed against the systemic risks of the underlying disease.

show abstract

“…It has also other advantages such as it blocks the complement cascade reaction near the inflammatory zone in the eye. Essentially it has antiallergic and immunoregulatory properties which are vital for Covid-19 application [28] , [29] . Literature evidence suggested that viral envelope proteins bind to the negatively charged glycosaminoglycans (GAG), contribute to its overall activity.…”

Section: Evaluation Of the Hypothesismentioning

confidence: 99%

Smart polymeric eye gear: A possible preventive measure against ocular transmission of COVID-19

et al. 2020

View full text Add to dashboard Cite

The angiotensin-converting enzyme 2(ACE-2) receptors with approx. 0.8% congestion in conjunctival surface, leads to increase susceptibility of Covid-19 transmission through ocular surface. It has been observed that prophylactic measures such as goggle or face shield are unable to offer complete protection against ocular transmission of SRS-CoV-2. Hence, it is hypothesized that topical ocular prophylaxis using biocompatible polymers with reported in-vitro and in-vivo evidence of ACE inhibition and antiviral activity appears to be a promising strategy for preventing ocular transmission of Covid-19 to healthcare workers. They are capable of binding to ACE-2 receptors which may provide highly potential trails to block virus entry to host cells. Further biopolymers imparting antiviral activities greatly improve their protective performance. They not only provide prolong protection but also are safe for long-term use. This article discusses the description of structural and functional attributes of ACE-2 to identify appropriate polymer with better binding affinity. Furthermore, potential polymers with appropriate concentration are suggested for evaluation through a hypothesis to consider them for Covid-19 implication.

show abstract

Recovery From Amiodarone-Induced Cornea Verticillata by Application of Topical Heparin

Abstract: In patients using amiodarone, clearing of cornea verticillata may be achieved by topical use of unpreserved eye drops of a sterile, phosphate-free solution of 0.1% sodium hyaluronate with 1300 IU/mL heparin sodium.

Cited by 8 publications

References 26 publications

Neutrophil extracellular traps (NETs) contribute to pathological changes of ocular graft-vs.-host disease (oGVHD) dry eye: Implications for novel biomarkers and therapeutic strategies

Neutrophil extracellular traps (NETs) contribute to pathological changes of ocular graft-vs.-host disease (oGVHD) dry eye: Implications for novel biomarkers and therapeutic strategies

Drug-induced corneal deposits: an up-to-date review

Smart polymeric eye gear: A possible preventive measure against ocular transmission of COVID-19

Contact Info

Product

Resources

About