Trachoma

Abstract

Purpose of review To review recent clinical and epidemiological studies regarding the prevention, diagnosis, and treatment of trachoma. Recent Findings Newer studies propose novel diagnostic tests that appear sensitive for the detection of ocular chlamydial infection. Immunologic studies suggest that chronic inflammation can lead to progressive scarring, even in the absence of chlamydia. Confocal microscopy can obtain accurate grading of scarring progression. Mass oral azithromycin distributions remain a mainstay of treatment; studies have assessed the appropriate frequency and duration of treatment programs. Current studies have also explored ancillary effects of azithromycin distribution on mortality and bacterial infections. Summary Trachoma programs have had remarkable success at reducing chlamydial infection and clinical signs of trachoma. Recent work suggests improved methods to monitor infection and scarring, and better ways to distribute treatment. While studies continue to demonstrate reduction in infection in hyperendemic areas, more work will need to be done to achieve elimination of this blinding disease.

Will the SAFE Strategy Be Sufficient to Eliminate Trachoma by 2020? Puzzlements and Possible Solutions

“…A review [126] of recent research in the prevention, diagnosis, and treatment of trachoma concluded that the SAFE strategy's mass treatment with antibiotics is the mainstay of trachoma treatment and is why community-targeted strategies are key to program success. Future research could focus on optimizing mass treatment by investigating integrated monitoring and treatment strategies at a community level.…”

“…Future research could focus on optimizing mass treatment by investigating integrated monitoring and treatment strategies at a community level. While the review covers a narrower timeframe and scope of literature, the most important conclusion reflects an overall finding of this current review—that trachoma elimination is possible even in hyperendemic communities [126]. …”

Chlamydial eye infections: Current perspectives

“…[420] With the implementation of SAFE strategy, trachoma has decreased in significance as a major cause of blindness. [212223] In 2002 and 2003, 84 million people across the world were suffering from active trachoma and ~1.3 million people were blind from trachoma. In 2002, ~3.6% of the total visual impairment was due to trachoma, which was the fourth major cause of blindness.…”

“…In 2002, ~3.6% of the total visual impairment was due to trachoma, which was the fourth major cause of blindness. [2122232425] In 2005, as per the WHO report, ~60 million people were suffering from trachoma and in 2008, 40 million people were suffering from active trachoma (WHO report, 2005 and 2008).…”

Host Defense at the Ocular Surface

“…Acanthamoeba keratitis is less well understood, although there is an important role for Acanthamoeba lectins, proteases and possibly intracellular bacteria [10, 11]. As there are recent reviews on river blindness [4], trachoma [12], fungal keratitis [13] Acanthamoeba keratitis [10, 11] and HSV keratitis, the current review will focus on the mechanisms of innate immunity that underlie corneal inflammation and bacterial keratitis, primarily Pseudomonas aeruginosa keratitis. This review will also examine how P. aeruginosa virulence factors impair the host response and mediate bacterial replication in the cornea.…”