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Clinical & Experimental Optometry May 2023Central serous chorioretinopathy is often associated with a "classic" presentation of unilateral, macular lesions that result in blur, metamorphopsia and/or scotoma of...
Central serous chorioretinopathy is often associated with a "classic" presentation of unilateral, macular lesions that result in blur, metamorphopsia and/or scotoma of the affected eye. The condition features serous retinal detachments with or without focal serous retinal pigment epithelium detachments. This report presents two cases of non-macular chronic serous chorioretinopathy. In both cases, the patient was asymptomatic, and the lesions identified incidentally. This report alerts providers to the possibility of chronic serous chorioretinopathy in non-macular locations with subtle or no symptomatology.
Topics: Humans; Fluorescein Angiography; Tomography, Optical Coherence; Central Serous Chorioretinopathy; Retinal Detachment; Choroid Diseases
PubMed: 36598139
DOI: 10.1080/08164622.2022.2153584 -
Journal of Medical Microbiology Oct 2021can produce a complex, dynamic and resistant biofilm on the surface of dental materials, especially denture base acrylic resins and temporary soft liners. This biofilm... (Comparative Study)
Comparative Study
can produce a complex, dynamic and resistant biofilm on the surface of dental materials, especially denture base acrylic resins and temporary soft liners. This biofilm is the main aetiological factor for denture stomatitis, an oral inflammatory condition characterized by chronic and diffuse erythema and oedema of the denture bearing mucosa. There is no consensus in the literature regarding the best method to detach biofilms from dental materials. In order to assess the antifungal efficacy of new materials and treatments, the biofilm needs to be properly detached and quantified. This study compared different methods of detaching biofilm from denture base acrylic resin (Vipi Cril) and temporary soft liner (Softone) specimens. Specimens of each material were immersed in an inoculum of SC5314 and remained for 90 min in orbital agitation at 75 r.p.m. and 37 °C. After the removal of non-adherent cells, the specimens were immersed in RPMI-1640 medium for 48 h. Biofilm formation was evaluated with confocal laser scanning microscopy (=5). Then, other specimens (=7) were fabricated, contaminated and immersed in 3 ml of sterile phosphate-buffered saline (PBS) and vortexed or sonicated for 1, 2, 5, or 10 min to detach the biofilm. The quantification of detached biofilm was performed by colony-forming unit (c.f.u.) ml count. Results were submitted to one-way analysis of variance (ANOVA)/Tukey HSD test (α=0.05). A mature and viable biofilm was observed on the surfaces of both materials. For both materials, there was no significant difference (>0.05) among detachment methods. Any of the tested methods could be used to detach biofilm from hard and soft acrylic materials.
Topics: Acrylic Resins; Antifungal Agents; Biofilms; Candida albicans; Colony Count, Microbial; Decontamination; Dental Materials; Dentures; Humans; Polymethacrylic Acids
PubMed: 34623230
DOI: 10.1099/jmm.0.001436 -
Ophthalmology. Retina Jul 2022To determine the practice pattern for treating giant retinal tear (GRT) related detachments, and their anatomic and visual outcomes with pars plana vitrectomy (PPV) with...
PURPOSE
To determine the practice pattern for treating giant retinal tear (GRT) related detachments, and their anatomic and visual outcomes with pars plana vitrectomy (PPV) with or without scleral buckling (SB).
DESIGN
Retrospective cohort study.
SUBJECTS
Eyes with GRT detachments repaired from 2008 to 2020 with at least 6 months of follow-up from 7 institutions in North and South America, Europe, and Asia.
METHODS
Eyes repaired using PPV versus PPV/SB were compared.
MAIN OUTCOME MEASURES
Anatomic and functional outcomes.
RESULTS
A comparable number of eyes underwent PPV (n = 101) and PPV/SB (n = 99). Except for history of developmental abnormalities, prior intraocular surgery, and lens status, no differences in baseline demographics, ocular characteristics, or intraoperative surgical adjuncts were observed. The overall single surgery anatomic success (SSAS) at 6 months and 1 year were similar between the groups (82.2% and 77.2% of PPV, and 87.9% and 85.7% of PPV/SB). When stratified by age, the 1-year SSAS rate was higher for PPV/SB (88.5%) than PPV (56.3%) (P = 0.03) for children <18 years. For both children and adults, the mean best-corrected visual acuity (BCVA) at baseline did not differ between the PPV and PPV/SB groups. However, for children, mean BCVA at 1 year was better in the PPV/SB than PPV groups (P = 0.001) while for adults, no difference was found between the 2 groups. The mean time to the first redetachment was 7.9 months in the PPV group and 5.5 months in the PPV/SB group (P = 0.8). Proliferative vitreoretinopathy was the most common cause for redetachment (70.4% of PPV and 93.8% of PPV/SB in redetached eyes; P = 0.1). Postoperative complications were also similar between the 2 groups, including ocular hypertension, epiretinal membrane, and cataract formation.
CONCLUSIONS
PPV and PPV/SB are equally popular among surgeons globally for managing GRT detachments and have comparable anatomic and visual outcomes in adults. In children, PPV/SB is superior to PPV for anatomic and functional success at 1 year. In adults, the relief of traction by the GRT may reduce peripheral traction and obviate the need for an SB. However, in children, a supplemental SB can be beneficial as complete vitreous shaving and posterior hyaloid detachment, and postoperative positioning, are difficult in this group.
Topics: Adult; Child; Humans; Infant; Retinal Detachment; Retinal Perforations; Retrospective Studies; Scleral Buckling; Treatment Outcome; Visual Acuity; Vitrectomy
PubMed: 35304304
DOI: 10.1016/j.oret.2022.03.004 -
Retinal Cases & Brief Reports 2014To describe a patient who presented with bilateral serous retinal detachments without the other retinal vascular or ocular inflammatory signs, and who was ultimately... (Review)
Review
BACKGROUND
To describe a patient who presented with bilateral serous retinal detachments without the other retinal vascular or ocular inflammatory signs, and who was ultimately diagnosed with acute leukemia.
METHODS
Case report and review of the literature.
RESULTS
This patient presented with isolated bilateral serous retinal detachments as the initial manifestation of hematologic malignancy.
CONCLUSION
Acute leukemia may present with serous retinal detachments without the signs of other retinopathy or ocular inflammation. Incorrect diagnosis may delay detection and proper management of the malignancy. Leukemia should be considered in the differential diagnosis of isolated serous retinal detachments.
Topics: Acute Disease; Humans; Leukemia; Male; Retinal Detachment; Young Adult
PubMed: 25372528
DOI: 10.1097/ICB.0000000000000074 -
Indian Journal of Ophthalmology Nov 2023Aggressive retinopathy of prematurity (AROP) is a severe and progressive variant of retinopathy of prematurity (ROP) rapidly forming fibrous tissue extending from the...
INTRODUCTION
Aggressive retinopathy of prematurity (AROP) is a severe and progressive variant of retinopathy of prematurity (ROP) rapidly forming fibrous tissue extending from the disc toward the posterior lens surface progressing to Stage 5 disease without traversing the classical course that includes Stages 1 to 3. Since AROP behaves differently from type 1 ROP, this study was undertaken to evaluate the surgical outcome of AROP-related detachments.
METHODS
Retrospective analysis of data from electronic medical records of babies diagnosed with AROP-related detachments who underwent micro-incision vitrectomy surgery (MIVS) was included. The demographic data, details of primary intervention (laser and/or intravitreal bevacizumab), and surgery were noted. In a subset of patients, surgical intervention was planned early at the onset of fibrovascular tissue.
RESULTS
43 eyes of 26 babies with median birth weight 1175 g and median gestational age of 29 weeks were analyzed. 42/43 eyes underwent primary intervention in form of laser and/or anti-VEGF injection before surgery. 41.8%, 25.5%, and 32.5% eyes progressed to stages 4A, 4B, and 5, respectively, requiring surgical intervention. 66% eyes underwent lensectomy and vitrectomy (LV), and 44% eyes underwent lens sparring vitrectomy (LSV). 58% eyes had attached macula. 44% eyes that had a relatively less vascular diseases had better anatomical outcome (P = 0.019). At final follow-up, 53.4% eyes followed or at least had light fixation, and 77.7% eyes undergoing LSV fixated and/or followed light compared to 33% for LV (P = 0.04).
CONCLUSION
Challenges in AROP include rapid progression to advanced stages of ROP requiring close monitoring and multiple interventions. Surgeries for AROP have a favorable anatomical and functional outcome in 58% and 53%, respectively. Eyes undergoing lens sparing vitrectomy had better visual outcomes.
Topics: Infant, Newborn; Infant; Humans; Retinal Detachment; Retinopathy of Prematurity; Follow-Up Studies; Treatment Outcome; Retrospective Studies; Vitrectomy; Gestational Age
PubMed: 37870006
DOI: 10.4103/IJO.IJO_2999_22 -
MSphere May 2024Biofilm formation is an important virulence factor for methicillin-resistant (MRSA). The extracellular matrix of MRSA biofilms contains significant amounts of...
Biofilm formation is an important virulence factor for methicillin-resistant (MRSA). The extracellular matrix of MRSA biofilms contains significant amounts of double-stranded DNA that hold the biofilm together. MRSA cells secrete micrococcal nuclease (Nuc1), which degrades double-stranded DNA. In this study, we used standard methodologies to investigate the role of Nuc1 in MRSA biofilm formation and dispersal. We quantified biofilm formation and extracellular DNA (eDNA) levels in broth and agar cultures. In some experiments, cultures were supplemented with sub-MIC amoxicillin to induce biofilm formation. Biofilm erosion was quantitated by culturing biofilms on rods and enumerating detached colony-forming units (CFUs), and biofilm sloughing was investigated by perfusing biofilms cultured in glass tubes with fresh broth and measuring the sizes of the detached cell aggregates. We found that an MRSA mutant strain produced significantly more biofilm and more eDNA than a wild-type strain, both in the absence and presence of sub-MIC amoxicillin. mutant biofilms grown on rods detached significantly less than wild-type biofilms. Detachment was restored by exogenous DNase or complementing the mutant. In the sloughing assay, mutant biofilms released cell aggregates that were significantly larger than those released by wild-type biofilms. Our results suggest that Nuc1 modulates biofilm formation, biofilm detachment, and the sizes of detached cell aggregates. These processes may play a role in the spread and subsequent survival of MRSA biofilms during biofilm-related infections.IMPORTANCEInfections caused by antibiotic-resistant bacteria known as methicillin-resistant (MRSA) are a significant problem in hospitals. MRSA forms adherent biofilms on implanted medical devices such as catheters and breathing tubes. Bacteria can detach from biofilms on these devices and spread to other parts of the body such as the blood or lungs, where they can cause life-threatening infections. In this article, researchers show that MRSA secretes an enzyme known as thermonuclease that causes bacteria to detach from the biofilm. This is important because understanding the mechanism by which MRSA detaches from biofilms could lead to the development of procedures to mitigate the problem.
Topics: Biofilms; Methicillin-Resistant Staphylococcus aureus; Micrococcal Nuclease; Anti-Bacterial Agents; Bacterial Proteins; DNA, Bacterial; Virulence Factors; Microbial Sensitivity Tests; Amoxicillin
PubMed: 38695568
DOI: 10.1128/msphere.00126-24 -
Current Opinion in Ophthalmology May 2023To highlight the recent work published from the Primary Retinal Detachment Outcomes (PRO) Study Group. (Review)
Review
PURPOSE OF REVIEW
To highlight the recent work published from the Primary Retinal Detachment Outcomes (PRO) Study Group.
RECENT FINDINGS
The PRO database was a large dataset made up of patients with primary rhegmatogenous retinal detachments (RRD) who had surgical repair during 2015. The database was constituted of nearly 3000 eyes from 6 centers across the United States and included 61 vitreoretinal surgeons. Nearly 250 metrics were collected for each patient, creating one of the richest datasets of patients with primary rhegmatogenous detachments and their outcomes. The importance of scleral buckling was demonstrated, particularly for phakic eyes, elderly patients, and those with inferior breaks. 360° laser may result in poorer outcomes. Cystoid macular edema was common, and risk factors were identified. We also found risk factors for vision loss in eyes presenting with good vision. A PRO Score was devised, to predict outcomes based on presenting clinical characteristics. We also identified characteristics of surgeons with the highest single surgery success rates. Overall, there were no major outcome differences between viewing systems, gauges, buckles sutured vs. scleral tunnels, drainage method, and techniques to address proliferative vitreoretinopathy. All incisional techniques were found to be very cost-effective treatment modalities.
SUMMARY
Numerous studies resulted from the PRO database that significantly added to the literature regarding the repair of primary RRDs in the current era of vitreoretinal surgery.
Topics: Humans; Aged; Retinal Detachment; Vitrectomy; Visual Acuity; Scleral Buckling; Treatment Outcome; Retrospective Studies
PubMed: 36866845
DOI: 10.1097/ICU.0000000000000942 -
Microbiology Spectrum Feb 2022Patients with chronic respiratory diseases use home nebulizers that are often contaminated with pathogenic microbes to deliver aerosolized medications. The conditions...
Patients with chronic respiratory diseases use home nebulizers that are often contaminated with pathogenic microbes to deliver aerosolized medications. The conditions under which these microbes leave the surface as bioaerosols during nebulization are not well characterized. The objectives of this study were to (i) determine whether different pathogens detach and disperse from the nebulizer surface during aerosolization and (ii) measure the effects of relative humidity and drying times on bacterial surface detachment and aerosolization. Bacteria were cultured from bioaerosols after Pari LC Plus albuterol nebulization using two different sources, as follows: (i) previously used nebulizers donated by anonymous patients with cystic fibrosis (CF) and (ii) nebulizers inoculated with bacteria isolated from the lungs of CF patients. Fractionated bioaerosols were collected with a Next-Generation Impactor. For a subset of bacteria, surface adherence during rewetting was measured with fluorescence microscopy. Bacteria dispersed from the surface of used CF patient nebulizers during albuterol nebulization. Eighty percent (16/20) of clinical isolates inoculated on the nebulizer in the laboratory formed bioaerosols. Detachment from the plastic surface into the chamber solution predicted bioaerosol production. Increased relative humidity and decreased drying times after inoculation favored bacterial dispersion on aerosols during nebulized therapy. Pathogenic bacteria contaminating nebulizer surfaces detached from the surface as bioaerosols during nebulized therapies, especially under environmental conditions when contaminated nebulizers were dried or stored at high relative humidity. This finding emphasizes the need for appropriate nebulizer cleaning, disinfection, and complete drying during storage and informs environmental conditions that favor bacterial surface detachment during nebulization. Studies from around the world have demonstrated that many patients use contaminated nebulizers to deliver medication into their lungs. While it is known that using contaminated medications in a nebulizer can lead to a lung infection, whether bacteria on the surface of a contaminated nebulizer detach as bioaerosols capable of reaching the lung has not been studied. This work demonstrates that a subset of clinical bacteria enter solution from the surface during nebulization and are aerosolized. Environmental conditions of high relative humidity during storage favor dispersion from the surface. We also provide results of an assay conducted to monitor bacterial surface detachment during multiple cycles of rewetting that correlate with the results of nebulizer/bacterial surface interactions. These studies demonstrate for the first time that pathogenic bacteria on the nebulizer surface pose a risk of bacterial inhalation to patients who use contaminated nebulizers.
Topics: Aerosols; Bacteria; Bacterial Adhesion; Cystic Fibrosis; Equipment Contamination; Humans; Nebulizers and Vaporizers
PubMed: 35107362
DOI: 10.1128/spectrum.02535-21 -
Retina (Philadelphia, Pa.) Jan 2023Patients with Stickler syndrome are at high risk of giant retinal tears (GRTs) and detachments. Vitreoretinal interventions can reduce this risk, but there is presently...
PURPOSE
Patients with Stickler syndrome are at high risk of giant retinal tears (GRTs) and detachments. Vitreoretinal interventions can reduce this risk, but there is presently no consensus about the optimal prophylactic approach. The aim of our study was to determine whether 360° laser prophylaxis is a safe and effective procedure to prevent GRT detachments in patients with Stickler syndrome.
METHODS
Study subjects were recruited retrospectively through the databases of the vitreoretinal and ophthalmic genetic tertiary services in Manchester, United Kingdom. Clinical data were collected including on prophylactic intervention, the occurrence of retinal detachment, and the presence/type of retinal breaks.
RESULTS
One hundred thirteen eyes from 63 patients with Stickler syndrome were studied; 72.6% (82/113) of these eyes received 360° laser prophylaxis. Of these, 9% had a retinal detachment, but no GRTs occurred. Among the 27.4% (31/113) of eyes that had no prophylactic treatment, 23% suffered a retinal detachment and 42.9% of these were associated with a GRT.
CONCLUSION
Patients who underwent laser prophylaxis had fewer retinal detachments and no GRTs during an average of 6.1 years of follow-up (median 5 years), suggesting that this is a safe and effective approach for individuals with Stickler syndrome.
Topics: Humans; Retinal Detachment; Retrospective Studies; Connective Tissue Diseases; Eye Diseases, Hereditary; Retinal Perforations; Lasers
PubMed: 36165842
DOI: 10.1097/IAE.0000000000003634 -
BMJ Case Reports Feb 2022Here is presented a unique case of bilateral serous macular detachments as a side effect of topical travoprost (0.004%) therapy. Only three other cases in the literature...
Here is presented a unique case of bilateral serous macular detachments as a side effect of topical travoprost (0.004%) therapy. Only three other cases in the literature have definitively associated this side effect with other topical prostaglandins. The aetiological and pathophysiological pathways remain to be clearly elucidated but are potentially related to increased choroidal vascular permeability. In this case, the subretinal fluid resolved rapidly and completely after cessation of travoprost drops, showing it to be a reversible pathology similar to prostaglandin-associated cystoid macular oedema. This uncommon association is therefore important to consider in the differential diagnosis of serous macular detachment. Increasing ophthalmic awareness could help to prevent unnecessary investigations in undifferentiated patients without other guiding historical or examination features. This may save time and expense for the patient and health systems.
Topics: Fluorescein Angiography; Humans; Retinal Detachment; Subretinal Fluid; Tomography, Optical Coherence; Travoprost
PubMed: 35110285
DOI: 10.1136/bcr-2021-246712