Osmo Kari - Academia.edu (original) (raw)
Papers by Osmo Kari
Acta Ophthalmologica, Mar 1, 2010
This study examines the histology of conjunctival biopsy samples from patients with persistent al... more This study examines the histology of conjunctival biopsy samples from patients with persistent allergic eosinophilic conjunctivitis (AEC) or non-allergic eosinophilic conjunctivitis (NAEC). Fourteen patients with conjunctivitis and eosinophilia in cytology samples were included in the study. Seven had positive skin-prick tests (the AEC group) and seven had negative skin-prick tests (the NAEC group). Eight asymptomatic subjects with negative skin-prick tests served as a control group. In conjunctival biopsies eosinophils were identified with monoclonal antibodies. Mast cells were identified by specific immunostaining and tryptase-positive granules were counted around them. The percentage of degranulated mast cells was used as a measure of cell activation. Eosinophil and goblet cell numbers were counted, epithelial thickness was measured, and the symptoms were characterized and graded. The numbers of eosinophils in biopsies were higher in patients with AEC than in healthy controls (p = 0.010). The proportion of activated mast cells tended to be higher in AEC patients (65%) than in NAEC patients (48%) or control subjects (40%). Patients with AEC had more goblet cells than control subjects (p = 0.049) and their epithelial layer was thicker (p = 0.054). Patients with AEC had more severe symptoms than control subjects (p = 0.0005), whereas the symptoms of NAEC patients did not differ statistically from those of controls (p = 0.065). Patients with NAEC were characterized by mild eosinophilic inflammation and only minor structural conjunctival changes. The condition seems to run a relatively mild but persistent clinical course.
Duodecim; lääketieteellinen aikakauskirja, 2000
Graefe's Archive for Clinical and Experimental Ophthalmology, 1985
Tear histamine was measured in 14 patients with allergic conjunctivitis during a challenge test p... more Tear histamine was measured in 14 patients with allergic conjunctivitis during a challenge test performed at a symptom-free point in time. The allergen challenge caused a rapid increase in the amount of tear histamine in only two-thirds of the patients, but there was a clinical reaction in all. The increase in the tear histamine content occurred in both the challenged and contralateral non-challenged eye, and the increase was also equally high in both. It is probable that the histamine release in the challenged eye takes place in the conjunctiva, whereas in the contralateral eye it is possibly induced by some sympathetic mechanism in the lacrimal gland.
Examination by an ophthalmologist is always required if the patient has prolonged eye symptoms.
Allergy, 1992
We studied the tolerance of soft contact lenses (CL) in 24 atopic (16 with hay fever) and 52 non-... more We studied the tolerance of soft contact lenses (CL) in 24 atopic (16 with hay fever) and 52 non-atopic subjects with a mean age of 20 years. They were examined when they first came to an ophthalmologist to have CL and re-examined after an average of 1.7 years. All subjects were allowed to use CL throughout the year, including the pollen season. Of the 76 subjects, 31 (41%) reported some kind of eye symptoms during the use of CL. Six subjects (8%) had stopped using CL because of symptoms. Altogether, in 29/76 subjects (38%) some objective sign was detected in the examination, confirming the subjective symptoms (conjunctivitis 16, keratoconjunctivitis 8, increased limbal blood vessels 4, and eczema palpebrae 1). Fourteen of the 24 atopics (58%) had experienced symptoms compared with 17 of the 52 non-atopics (33%) (p = 0.034). Eleven atopics had seasonal eye symptoms, and eight of them (73%) had problems with CL use. Eosinophils and neutrophils found in the conjunctival scrapings at the first examination appeared to predict poor CL tolerance when the occurrence of symptoms in different groups was first compared by bivariate analysis. The risk factors that could predict poor CL tolerance were also evaluated, with logistic regression analysis controlling potential confounders. History of an atopic condition increased 5-fold the risk of experiencing various external eye symptoms during the use of CL. We conclude that seasonal atopic allergy is a especially risk factor for wearing soft contact lenses, and their use should be restricted during the season.
Acta Ophthalmologica, 2009
Abstract. Tarsal conjunctival scrapings of the lower and upper eyelids of 21 atopic, pollen aller... more Abstract. Tarsal conjunctival scrapings of the lower and upper eyelids of 21 atopic, pollen allergic patients with conjunctivitis were examined three times; during a symptom‐free period, during a challenge test and during the pollen season. Eosinophils were also counted from the conjunctival fluid of 17 patients, but only of 12 patients during the challenge. The controls were 10 atopic patients without conjunctivitis (K0), 31 normal persons (K1), who were examined routinely in the course of a spectacle prescription and 45 patients with acute conjunctivitis (K2) of other than allergic origin. A statistically significant difference in the occurrence of eosinophils in the scrapings was found between the pollen allergic patients and the normal control patients but not between patients with atopic or non‐atopic conjunctivitis. During the challenge test, the occurrence of eosinophils in the scrapings increased for at least an hour after the challenge had become positive. In the pollen allergic patients eosinophils were equally abundant during the symptom‐free and pollen seasons. It is concluded that the occurrence of eosinophils in the conjunctival scraping is not a reliable clinical indicator of allergy.
Acta Ophthalmologica, 2009
We studied the occurrence in an ophthalmological office practice of conjunctival eosinophilia in ... more We studied the occurrence in an ophthalmological office practice of conjunctival eosinophilia in 333 normal subjects (mean age 26 years) and in 152 atopic and 484 non-atopic patients (mean age 40 years) with various external eye symptoms. Eosinophils were present in 131/636 patients (21%) and in 221333 asymptomatic normal subjects (7%). In those patients with conjunctival eosinophilia, a history of some kind of atopic condition was obtained only in 53/131 (40%). When the patients were characterized according to the presence of both eosinophilia and atopy, eosinophilia without signs of atopy was observed in 7-15% in different diagnostic groups. Patients with conjunctivitis or blepharoconjunctivitis had a fourfold risk for eosinophilia compared to normal subjects (odds ratios 4.52 and 4.09, confidence intervals 2.02, 10.12 and 2.40, 6.99), when atopy, sex, age, time of the examination and presence of bacteria were included as potential confounders in the regression model. We conclude that a considerable portion of patients with external eye symptoms, and especially with various forms of conjunctivitis, show eosinophilic inflammation without any evidence of atopic background. They can be labelled as having 'intrinsic' eosinophilic conjunctivitis andogously to the classification used in patients with intrinsic rhinitis and asthma. The etiology of this common nonatopic syndrom remains to be established.
Acta Ophthalmologica Scandinavica, 2002
Journal of Allergy and Clinical Immunology, 2008
Non-allergic eosinophilic conjunctivitis (NAEC) is a fairly common but poorly known ailment, ofte... more Non-allergic eosinophilic conjunctivitis (NAEC) is a fairly common but poorly known ailment, often associated with dry eye syndrome. The majority of patients are middle-aged or elderly women. The symptoms are similar to those in allergic conjunctivitis, whereas atopic allergy cannot be found. Eosinophilic inflammation is first eased by instillation of glucocorticoid antibiotic eye drops, and the treatment is usually continued with mast cell stabilizer and moistening drops for a long time. Short courses of glucocorticoid drops and, sometimes, immunosuppressive medication of longer duration are required as additional therapies.
Duodecim; laaketieteellinen aikakauskirja, 2015
The up-date of the Finnish Current Care Guideline for glaucoma is based primarily on systematic r... more The up-date of the Finnish Current Care Guideline for glaucoma is based primarily on systematic reviews searched up by March 2014. The recommendations are presented in nine tables, which are based on 95 graded statements with evidence summaries. The online availability (www.kaypahoito.fi) of the English translation of guideline and evidence summaries enables the verification of the evidence and recommendations. Ten external stakeholders gave a mean value of 1.8 (range of 1 = completely agree to 4 = completely disagree) for the structured questions (e.g. definitions, goals, questions, target users) and judged the evidence and the recommendations.
Acta Ophthalmol, 2009
... eye. Gonioscopy confirmed an open angle without rubeosis. With three anti-glaucoma eyedrops (... more ... eye. Gonioscopy confirmed an open angle without rubeosis. With three anti-glaucoma eyedrops (Timo-lol, Alphagon and Xalatan), his IOP was under control. Seven months after injection, his IOP increased to 28mmHg. Oral ...
The Clao Journal Official Publication of the Contact Lens Association of Ophthalmologists Inc, Aug 1, 2001
To study tolerance to three types of soft and onetype of rigid gas permeable (RGP) contact lens i... more To study tolerance to three types of soft and onetype of rigid gas permeable (RGP) contact lens in young atopic and non-atopic subjects starting to wear contact lenses. A prospective study was conducted in 73 young subjects (mean age: 18.7 years, range: 11-37 years). Each subject was allotted at random to one of four groups. Each group of subjects used a different type of contact lens for a year. Tolerance was determined by means of self-assessment by the subjects, ophthalmologic methods, and cytology. The study was conducted on a blind basis. The investigators assessing tolerance did not know what kind of lens a patient had been wearing. Fifty-six percent of subjects who had used soft contact lenses, but only 14% of RGP lens users described their lenses as very comfortable to wear. Sixty-three percent of non-atopic subjects but only 47% of atopic subjects described their lenses as very comfortable to wear. No differences were found between the three types of soft contact lens. Four cases of giant papillary conjunctivitis (GPC) and two cases of macropapillary reaction were recorded. No connections with atopy, type of lens, or lens care solution were found. Higher percentages of users of soft contact lenses than users of RGP contact lenses described their lenses as very comfortable to wear. Wearing of all types of lenses was associated with follicular or papillary reactions in some subjects. Young people can wear contact lenses safely only if monitoring takes place at least twice a year.
Acta Ophthalmologica, Mar 1, 2010
This study examines the histology of conjunctival biopsy samples from patients with persistent al... more This study examines the histology of conjunctival biopsy samples from patients with persistent allergic eosinophilic conjunctivitis (AEC) or non-allergic eosinophilic conjunctivitis (NAEC). Fourteen patients with conjunctivitis and eosinophilia in cytology samples were included in the study. Seven had positive skin-prick tests (the AEC group) and seven had negative skin-prick tests (the NAEC group). Eight asymptomatic subjects with negative skin-prick tests served as a control group. In conjunctival biopsies eosinophils were identified with monoclonal antibodies. Mast cells were identified by specific immunostaining and tryptase-positive granules were counted around them. The percentage of degranulated mast cells was used as a measure of cell activation. Eosinophil and goblet cell numbers were counted, epithelial thickness was measured, and the symptoms were characterized and graded. The numbers of eosinophils in biopsies were higher in patients with AEC than in healthy controls (p = 0.010). The proportion of activated mast cells tended to be higher in AEC patients (65%) than in NAEC patients (48%) or control subjects (40%). Patients with AEC had more goblet cells than control subjects (p = 0.049) and their epithelial layer was thicker (p = 0.054). Patients with AEC had more severe symptoms than control subjects (p = 0.0005), whereas the symptoms of NAEC patients did not differ statistically from those of controls (p = 0.065). Patients with NAEC were characterized by mild eosinophilic inflammation and only minor structural conjunctival changes. The condition seems to run a relatively mild but persistent clinical course.
Duodecim; lääketieteellinen aikakauskirja, 2000
Graefe's Archive for Clinical and Experimental Ophthalmology, 1985
Tear histamine was measured in 14 patients with allergic conjunctivitis during a challenge test p... more Tear histamine was measured in 14 patients with allergic conjunctivitis during a challenge test performed at a symptom-free point in time. The allergen challenge caused a rapid increase in the amount of tear histamine in only two-thirds of the patients, but there was a clinical reaction in all. The increase in the tear histamine content occurred in both the challenged and contralateral non-challenged eye, and the increase was also equally high in both. It is probable that the histamine release in the challenged eye takes place in the conjunctiva, whereas in the contralateral eye it is possibly induced by some sympathetic mechanism in the lacrimal gland.
Examination by an ophthalmologist is always required if the patient has prolonged eye symptoms.
Allergy, 1992
We studied the tolerance of soft contact lenses (CL) in 24 atopic (16 with hay fever) and 52 non-... more We studied the tolerance of soft contact lenses (CL) in 24 atopic (16 with hay fever) and 52 non-atopic subjects with a mean age of 20 years. They were examined when they first came to an ophthalmologist to have CL and re-examined after an average of 1.7 years. All subjects were allowed to use CL throughout the year, including the pollen season. Of the 76 subjects, 31 (41%) reported some kind of eye symptoms during the use of CL. Six subjects (8%) had stopped using CL because of symptoms. Altogether, in 29/76 subjects (38%) some objective sign was detected in the examination, confirming the subjective symptoms (conjunctivitis 16, keratoconjunctivitis 8, increased limbal blood vessels 4, and eczema palpebrae 1). Fourteen of the 24 atopics (58%) had experienced symptoms compared with 17 of the 52 non-atopics (33%) (p = 0.034). Eleven atopics had seasonal eye symptoms, and eight of them (73%) had problems with CL use. Eosinophils and neutrophils found in the conjunctival scrapings at the first examination appeared to predict poor CL tolerance when the occurrence of symptoms in different groups was first compared by bivariate analysis. The risk factors that could predict poor CL tolerance were also evaluated, with logistic regression analysis controlling potential confounders. History of an atopic condition increased 5-fold the risk of experiencing various external eye symptoms during the use of CL. We conclude that seasonal atopic allergy is a especially risk factor for wearing soft contact lenses, and their use should be restricted during the season.
Acta Ophthalmologica, 2009
Abstract. Tarsal conjunctival scrapings of the lower and upper eyelids of 21 atopic, pollen aller... more Abstract. Tarsal conjunctival scrapings of the lower and upper eyelids of 21 atopic, pollen allergic patients with conjunctivitis were examined three times; during a symptom‐free period, during a challenge test and during the pollen season. Eosinophils were also counted from the conjunctival fluid of 17 patients, but only of 12 patients during the challenge. The controls were 10 atopic patients without conjunctivitis (K0), 31 normal persons (K1), who were examined routinely in the course of a spectacle prescription and 45 patients with acute conjunctivitis (K2) of other than allergic origin. A statistically significant difference in the occurrence of eosinophils in the scrapings was found between the pollen allergic patients and the normal control patients but not between patients with atopic or non‐atopic conjunctivitis. During the challenge test, the occurrence of eosinophils in the scrapings increased for at least an hour after the challenge had become positive. In the pollen allergic patients eosinophils were equally abundant during the symptom‐free and pollen seasons. It is concluded that the occurrence of eosinophils in the conjunctival scraping is not a reliable clinical indicator of allergy.
Acta Ophthalmologica, 2009
We studied the occurrence in an ophthalmological office practice of conjunctival eosinophilia in ... more We studied the occurrence in an ophthalmological office practice of conjunctival eosinophilia in 333 normal subjects (mean age 26 years) and in 152 atopic and 484 non-atopic patients (mean age 40 years) with various external eye symptoms. Eosinophils were present in 131/636 patients (21%) and in 221333 asymptomatic normal subjects (7%). In those patients with conjunctival eosinophilia, a history of some kind of atopic condition was obtained only in 53/131 (40%). When the patients were characterized according to the presence of both eosinophilia and atopy, eosinophilia without signs of atopy was observed in 7-15% in different diagnostic groups. Patients with conjunctivitis or blepharoconjunctivitis had a fourfold risk for eosinophilia compared to normal subjects (odds ratios 4.52 and 4.09, confidence intervals 2.02, 10.12 and 2.40, 6.99), when atopy, sex, age, time of the examination and presence of bacteria were included as potential confounders in the regression model. We conclude that a considerable portion of patients with external eye symptoms, and especially with various forms of conjunctivitis, show eosinophilic inflammation without any evidence of atopic background. They can be labelled as having 'intrinsic' eosinophilic conjunctivitis andogously to the classification used in patients with intrinsic rhinitis and asthma. The etiology of this common nonatopic syndrom remains to be established.
Acta Ophthalmologica Scandinavica, 2002
Journal of Allergy and Clinical Immunology, 2008
Non-allergic eosinophilic conjunctivitis (NAEC) is a fairly common but poorly known ailment, ofte... more Non-allergic eosinophilic conjunctivitis (NAEC) is a fairly common but poorly known ailment, often associated with dry eye syndrome. The majority of patients are middle-aged or elderly women. The symptoms are similar to those in allergic conjunctivitis, whereas atopic allergy cannot be found. Eosinophilic inflammation is first eased by instillation of glucocorticoid antibiotic eye drops, and the treatment is usually continued with mast cell stabilizer and moistening drops for a long time. Short courses of glucocorticoid drops and, sometimes, immunosuppressive medication of longer duration are required as additional therapies.
Duodecim; laaketieteellinen aikakauskirja, 2015
The up-date of the Finnish Current Care Guideline for glaucoma is based primarily on systematic r... more The up-date of the Finnish Current Care Guideline for glaucoma is based primarily on systematic reviews searched up by March 2014. The recommendations are presented in nine tables, which are based on 95 graded statements with evidence summaries. The online availability (www.kaypahoito.fi) of the English translation of guideline and evidence summaries enables the verification of the evidence and recommendations. Ten external stakeholders gave a mean value of 1.8 (range of 1 = completely agree to 4 = completely disagree) for the structured questions (e.g. definitions, goals, questions, target users) and judged the evidence and the recommendations.
Acta Ophthalmol, 2009
... eye. Gonioscopy confirmed an open angle without rubeosis. With three anti-glaucoma eyedrops (... more ... eye. Gonioscopy confirmed an open angle without rubeosis. With three anti-glaucoma eyedrops (Timo-lol, Alphagon and Xalatan), his IOP was under control. Seven months after injection, his IOP increased to 28mmHg. Oral ...
The Clao Journal Official Publication of the Contact Lens Association of Ophthalmologists Inc, Aug 1, 2001
To study tolerance to three types of soft and onetype of rigid gas permeable (RGP) contact lens i... more To study tolerance to three types of soft and onetype of rigid gas permeable (RGP) contact lens in young atopic and non-atopic subjects starting to wear contact lenses. A prospective study was conducted in 73 young subjects (mean age: 18.7 years, range: 11-37 years). Each subject was allotted at random to one of four groups. Each group of subjects used a different type of contact lens for a year. Tolerance was determined by means of self-assessment by the subjects, ophthalmologic methods, and cytology. The study was conducted on a blind basis. The investigators assessing tolerance did not know what kind of lens a patient had been wearing. Fifty-six percent of subjects who had used soft contact lenses, but only 14% of RGP lens users described their lenses as very comfortable to wear. Sixty-three percent of non-atopic subjects but only 47% of atopic subjects described their lenses as very comfortable to wear. No differences were found between the three types of soft contact lens. Four cases of giant papillary conjunctivitis (GPC) and two cases of macropapillary reaction were recorded. No connections with atopy, type of lens, or lens care solution were found. Higher percentages of users of soft contact lenses than users of RGP contact lenses described their lenses as very comfortable to wear. Wearing of all types of lenses was associated with follicular or papillary reactions in some subjects. Young people can wear contact lenses safely only if monitoring takes place at least twice a year.