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Year : 1983  |  Volume : 31  |  Issue : 4  |  Page : 405-407

'Morphology of fungal corneal ulcers'-influence of immunosuppression

A.M.U. Institute of Ophthalmology, Aligarh, India

Correspondence Address:
R Gogi
A.M.U. Institute of Ophthalmology, Aligarh
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Source of Support: None, Conflict of Interest: None

PMID: 6610636

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How to cite this article:
Gogi R, Hajela R, Nath K. 'Morphology of fungal corneal ulcers'-influence of immunosuppression. Indian J Ophthalmol 1983;31:405-7

How to cite this URL:
Gogi R, Hajela R, Nath K. 'Morphology of fungal corneal ulcers'-influence of immunosuppression. Indian J Ophthalmol [serial online] 1983 [cited 2020 Oct 28];31:405-7. Available from: https://www.ijo.in/text.asp?1983/31/4/405/27566

In our previous paper we have reportec that immuno-stimulation can cut short the course of fungal corneal ulcer in experimenta animals'. In the present work an attemp has been made to produce B-lymphocyt( suppression by systemic use of cyclophospha. mide and a local immuno-suppression b) Dexamethasone sodium.

  Material and method Top

This study was carried out on twenty foul rabbits divided into the following groups.

Group A (8 rabbits)

This group underwent systemic B-lymphocyte suppression.

Method of Systemic Immunosuppression:

Rabbits were treated with an intraperil toneal injection of cyclophosphamide, (200 mg/kg body weight). In both eyes ulcer were produced on the third day.

Ulcer Production

In both eyes of the animal, corneal ulcer was produced as described in our previous communication[1] and was painted twice daily with Candida albicans suspension (contain­ing 1 million yeast particles/ml) for two days.

Both eyes were clinically examined every day. Two eyes (one rabbit) were enucleated after every twenty four hours till eighth day. These eyes were histopatholgically examined.

Group B (8 rabbits)

This group underwent local immuno­suppression.

Method of Local Immunosuppression:

In all 8 rabbits (16 eyes) subconjunctival injections of Dexamethasone sodium (0.5 mg) were given for four days. Ulcer was produ­ced on the third day.

The method of ulcer production and rest of the procedure was same as for group A.

Group C (8 rabbits):

This group served as control where no systemic or local immunosuppression was produced. Rest of the procedure was same as in other groups.

  Observations Top

Group A:

In cyclophosphamide treated animals there was intense inflammatory reaction during the first four days which subsided very quickly during the next four days. Complete healing could be observed on the 7th day.

Microscopic changes:

Corneal stroma and perilimbal area was densly populated by large number of lympho­cytes and polymorphonuclear cells [Figure - 1]. However, there was a marked fall in the leucocytic concentration after four to five days. Presence of fungus at the site of the ulcer could be seen during the first three days.

Group B

In dexamethasone treated eyes the infla­mmatory reaction declined sharply from second day onward. Healing could not take place even with antifungal treatment till the end of 8th day.

Histopathological examination showed the presence of fungus in the stroma and leucocytic infiltration [Figure - 2]. Intensity of inflammatory cells was more during first 24 hours and started subsiding afterwards.

Group C

In the control group inflammatory reac­tion was of mild to moderate intensity which subsided gradually and ulcers were comple­tely healed by sixth day. Intensity of this reaction was much milder is eyes where antifungal treatment was given.

Microscopic cytology consisted of lesser number of fungi and mild polymorphs and lymphocytic infilteration.

  Discussion Top

The inflammatory reaction in cyclophos­phamide treated animals was very severe during the first three days and declined very sharply during the next four to five days. Whenever a tissue is exposed to an antigen `T' lymphocytes are stimulated in the local lymph nodes (fornix and perilimbal lymph nodes in case of eye). The soluble antigen at the same time is released to stimulate B lymphocytes. These stimulated B lymphocytes have suppressive action on the T-lymphocy­tes[2]. This modulating effect can be removed completely by treatment with cyclophospha­mide, therefore permitting the T lympho­cytes to undergo proliferation. In the present experiment suppression of B lympho­cytes was induced, this resulted in stimulation of T-cells that brought in rapid control of inflammatory reaction. It is, therefore, suggested that direct or indirect stimulation of `T' lymphocytes can help in the rapid healing of the corneal ulcer.

Local suppression by corticosteroids affects both T and B lymphocytes as seen in this experiment which gave rise to delayed healing. Appropriate concentration of infla­mmatory cells at the site of inflammatory reaction is very essential for quick recovery.

  Summary Top

1. Immunosuppressants like cyclophos­phamide produce B-cell depression and therefore T-cell proliferation.

2. T-cell proliferation has favourable effect on the healing of fungal corneal ulcer.

3. Local corticosteroids (Dexamethasone) lead to suppression of both types of lympho­cytes, checks the inflammatory reaction and subsequent delayed healing.

  References Top

Gogi, R., Hajela, R., Nath, K. and Maheshwari, R., 1982, Proc. All Ind. Ophth. Soc. (In pressi).  Back to cited text no. 1
Turk, J.L., Parker, D. and Poulter, L.W., 1972 Immunology, 23: 493.  Back to cited text no. 2


  [Figure - 1], [Figure - 2]


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