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JAMA Ophthalmology Jan 2016
Topics: Adult; Animals; Asymptomatic Infections; Cysticercosis; Cysticercus; Cysts; Diagnosis, Differential; Eye Infections, Parasitic; Humans; Male; Microscopy, Acoustic; Retinal Diseases; Retinoschisis; Ultrasonography
PubMed: 26540359
DOI: 10.1001/jamaophthalmol.2015.2522 -
The British Journal of Ophthalmology Feb 1984A case of intraocular paragonimiasis is reported in a 13-year-old Chinese boy. The disease manifested as repeated attacks of acute intraocular pain associated with...
A case of intraocular paragonimiasis is reported in a 13-year-old Chinese boy. The disease manifested as repeated attacks of acute intraocular pain associated with panuveitis. A combination of inflammatory reaction and ocular findings mimicking both perforating and contusion injuries caused by the migration of the fluke within the eye characterises the infection. The living fluke was successfully extracted from the anterior chamber and identified as Paragonimus westermani.
Topics: Adolescent; Eye Diseases; Humans; Male; Paragonimiasis; Uveitis
PubMed: 6691960
DOI: 10.1136/bjo.68.2.85 -
Experimental Eye Research Jun 2017Bacterial endophthalmitis is a potentially blinding intraocular infection. The bacterium Bacillus cereus causes a devastating form of this disease which progresses...
Bacterial endophthalmitis is a potentially blinding intraocular infection. The bacterium Bacillus cereus causes a devastating form of this disease which progresses rapidly, resulting in significant inflammation and loss of vision within a few days. The outer surface of B. cereus incites the intraocular inflammatory response, likely through interactions with innate immune receptors such as TLRs. This study analyzed the role of B. cereus pili, adhesion appendages located on the bacterial surface, in experimental endophthalmitis. To test the hypothesis that the presence of pili contributed to intraocular inflammation and virulence, we analyzed the progress of experimental endophthalmitis in mouse eyes infected with wild type B. cereus (ATCC 14579) or its isogenic pilus-deficient mutant (ΔbcpA-srtD-bcpB or ΔPil). One hundred CFU were injected into the mid-vitreous of one eye of each mouse. Infections were analyzed by quantifying intraocular bacilli and retinal function loss, and by histology from 0 to 12 h postinfection. In vitro growth and hemolytic phenotypes of the infecting strains were also compared. There was no difference in hemolytic activity (1:8 titer), motility, or in vitro growth (p > 0.05, every 2 h, 0-18 h) between wild type B. cereus and the ΔPil mutant. However, infected eyes contained greater numbers of wild type B. cereus than ΔPil during the infection course (p ≤ 0.05, 3-12 h). Eyes infected with wild type B. cereus experienced greater losses in retinal function than eyes infected with the ΔPil mutant, but the differences were not always significant. Eyes infected with ΔPil or wild type B. cereus achieved similar degrees of severe inflammation. The results indicated that the intraocular growth of pilus-deficient B. cereus may have been better controlled, leading to a trend of greater retinal function in eyes infected with the pilus-deficient strain. Although this difference was not enough to significantly alter the severity of the inflammatory response, these results suggest a potential role for pili in protecting B. cereus from clearance during the early stages of endophthalmitis, which is a newly described virulence mechanism for this organism and this infection.
Topics: Animals; Aqueous Humor; Bacillus cereus; Disease Models, Animal; Electroretinography; Endophthalmitis; Eye Infections, Bacterial; Mice; Mice, Inbred C57BL; Mice, Mutant Strains; Retina
PubMed: 28336259
DOI: 10.1016/j.exer.2017.03.007 -
BMC Infectious Diseases Nov 2020To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the... (Review)
Review
BACKGROUND
To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the clinical profile, treatment modalities, and visual outcomes among patients with NTM endophthalmitis.
METHODS
Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE, EMBASE, and CENTRAL was performed. The clinical information and type of NTM from the previous studies and our cases were summarized.
RESULTS
We reported three cases of NTM endophthalmitis caused by M. haemophilum, M. fortuitum and M. abscessus and a summarized review of 112 additional cases previously published. Of 115 patients, there were 101 exogenous endophthalmitis (87.8%) and 14 endogenous endophthalmitis (12.2%). The patients' age ranged from 13 to 89 years with mean of 60.5 ± 17.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (67.3%). In contrast, almost all endogenous endophthalmitis patients were immunocompromised. Among all patients, previous history of tuberculosis infection was identified in 4 cases (3.5%). Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Treatment regimens consisted of macrolides, fluoroquinolones or aminoglycosides, which were continued for up to 12 months. Initial and final vision were generally worse than 6/60.
CONCLUSIONS
NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner's suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Aminoglycosides; Anti-Bacterial Agents; Cataract Extraction; Endophthalmitis; Female; Fluoroquinolones; Humans; Immunocompromised Host; Macrolides; Male; Middle Aged; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Postoperative Complications; Thailand; Treatment Outcome; Young Adult
PubMed: 33228593
DOI: 10.1186/s12879-020-05606-2 -
Arquivos Brasileiros de Oftalmologia 2021To identify ocular manifestations in patients with Chikungunya fever in the chronic phase and describe their sociodemographic profile.
PURPOSE
To identify ocular manifestations in patients with Chikungunya fever in the chronic phase and describe their sociodemographic profile.
METHODS
Patients with serologic confirmation of Chikungunya infection were included in this transverse study. All subjects underwent a comprehensive ophthalmologic evaluation, including specific lacrimal function tests (tear break-up time test, Schirmer test, and lissamine green).
RESULTS
Overall, 64 eyes of 32 patients were evaluated. Most patients were women (71.9%), with the mean age of 50.0 ±13.7 years. The mean interval between serologic confirmation and the examination was 12.7 ±7.7 months. Twenty patients (62%) presented with dry eye. No statistically significant association was observed between dry eye and infection diagnosis time (p=0.5546), age (p=0.9120), sex (p=1.00), race (p=0.2269), arthralgia in acute infection (p=0.7930), retro-orbital pain (p=0.3066), and conjunctivitis (p=1.00).
CONCLUSION
Dry eye was the most prevalent manifestation observed. No signs of intraocular inflammation and affected visual acuity were observed.
Topics: Adult; Chikungunya Fever; Dry Eye Syndromes; Eye; Female; Humans; Middle Aged; Tears
PubMed: 34320111
DOI: 10.5935/0004-2749.20210081 -
Ocular Immunology and Inflammation 2018Infectious endophthalmitis is an important cause of vision loss worldwide. This entity most often occurs as a complication of intraocular surgery especially following... (Review)
Review
Infectious endophthalmitis is an important cause of vision loss worldwide. This entity most often occurs as a complication of intraocular surgery especially following cataract surgery or intravitreal injection. Endophthalmitis is regarded as a serious complication following ocular surgery and the final visual outcome is fundamentally contingent on timely recognition and intervention. Intravitreal and oral antibiotics in combination with pars plana vitrectomy or vitreous aspiration remain the mainstay in the management of endophthalmitis. However, significant inflammation may persist even after sterilization of the intraocular cavities with appropriate antibiotics resulting in failure of treatment. This forms the basis for the use of intravitreal corticosteroids as an adjuvant to antibiotics in the management of infectious endophthalmitis. In the index manuscript, we review the existing literature to determine the role of intravitreal corticosteroids as an adjuvant to antibiotics in treating infectious endophthalmitis, and discuss their beneficial effects and controversial concerns.
Topics: Animals; Anti-Bacterial Agents; Antifungal Agents; Chemotherapy, Adjuvant; Endophthalmitis; Eye Infections, Bacterial; Eye Infections, Fungal; Glucocorticoids; Humans; Intravitreal Injections
PubMed: 27849402
DOI: 10.1080/09273948.2016.1245758 -
The British Journal of Ophthalmology Aug 1998To report the patient characteristics, causative organisms, and clinical outcomes in patients with recurrent bleb related ocular infections.
AIM
To report the patient characteristics, causative organisms, and clinical outcomes in patients with recurrent bleb related ocular infections.
METHODS
The medical records of all patients diagnosed with bleb related ocular infection at the New York Eye and Ear Infirmary over a 10 year period were reviewed. Recurrent bleb infection was defined as at least two episodes of bleb purulence with or without associated intraocular inflammation separated by a quiescent period of at least 3 months.
RESULTS
Recurrent bleb infections developed in 12 eyes of 12 patients (10 men, two women) a mean of 16.3 (SD 17.9) months (range 3-51 months) after the initial infection. Two patients developed a third episode 3 and 20 months, respectively, after the second infection, yielding a total of 14 recurrent infection episodes. Recurrent infection developed after trabeculectomy in 11 eyes (adjunctive 5-fluorouracil, nine eyes; mitomycin C, one eye; no antifibrosis agent, one eye) and following cataract extraction with inadvertent bleb formation in one eye. Four (36.4%) of the filtered eyes had undergone trabeculectomy at the inferior limbus. The mean follow up time from filtering surgery to the first bleb related infection was 28 months for the nine patients treated with 5-fluorouracil and 14 months for the single patient treated with mitomycin C. 11 (78.6%) cases had a documented bleb leak in the 4 week period before or at the time of recurrent infection. Topical, prophylactic antibiotics had been used in 7/14 (50%) cases. The same organism was cultured from the initial and recurrent infections in 2/14 (14.3%) cases.
CONCLUSION
Eyes that have been successfully treated for bleb related infection remain at risk for recurrent infection. No apparent correlation exists between organisms responsible for the initial and recurrent infections. The increased rate of recurrent bleb related infection in patients receiving adjunctive 5-fluorouracil compared to mitomycin C may have been related to the longer follow up of the 5-fluorouracil eyes.
Topics: Adult; Aged; Aged, 80 and over; Antimetabolites; Blister; Eye Infections, Bacterial; Female; Filtering Surgery; Follow-Up Studies; Humans; Intraocular Pressure; Male; Middle Aged; Postoperative Complications; Recurrence; Treatment Outcome; Visual Acuity
PubMed: 9828779
DOI: 10.1136/bjo.82.8.926 -
Indian Journal of Ophthalmology Feb 2022To compare the clinicomicrobiological features and outcomes in patients with infectious endophthalmitis caused by biofilm-positive (BP) and biofilm-negative (BN)...
PURPOSE
To compare the clinicomicrobiological features and outcomes in patients with infectious endophthalmitis caused by biofilm-positive (BP) and biofilm-negative (BN) bacteria.
METHODS
This was a prospective, interventional, comparative, nonrandomized, consecutive case series. Culture-positive bacterial endophthalmitis cases from August 1, 2018 to July 31 31, 2019 were included. All vitreous samples were tested for biofilm using crystal violet plate and XTT (2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) methods and classified as BN and BP. The antibiotic susceptibility of all organisms was determined. Anatomic and functional success was defined as intraocular pressure >5 mm Hg and final best-corrected vision ≥20/400, respectively, at last visit.
RESULTS
There were 50 eyes in the BN group and 33 eyes in the BP group. BN group eyes required 2.86 ± 1.45 surgical interventions, and BP group eyes needed surgical 6.36 ± 2.89 interventions, P < 0.0001, 95% Confidence Interval, CI: 2-4. Median follow-up was 6 and 5 months, respectively (P = 0.33). Final logMAR vision was a median of 1.2 and 1.9 respectively; P = 0.0005, 95% C.I.: 0.4-1.7. Functional success was achieved in 44% and 21.2% (P = 0.03, 95% C.I.: 1.86%-40.08%) and anatomic success was achieved in 68% and 42.42%, respectively (P = 0.02, 95% C.I.: 3.85%-45.47%). The antimicrobial resistance patterns between the two groups were comparable.
CONCLUSION
Endophthalmitis caused by the biofilm-forming bacteria needs a greater number of surgical interventions. The anatomic and functional outcomes are poorer than non-biofilm-forming bacterial endophthalmitis. The increased virulence and poorer outcomes can be hypothesized to be due to the physical barrier effect of the biofilm on the antibiotics.
Topics: Anti-Bacterial Agents; Biofilms; Endophthalmitis; Eye Infections, Bacterial; Humans; Prospective Studies; Retrospective Studies; Visual Acuity; Vitrectomy
PubMed: 35086219
DOI: 10.4103/ijo.IJO_1872_21 -
Indian Journal of Ophthalmology Sep 2020Intraocular inflammation in patients with human immunodeficiency virus (HIV) infection is commonly due to infectious uveitis. Ocular lesions due to opportunistic... (Review)
Review
Intraocular inflammation in patients with human immunodeficiency virus (HIV) infection is commonly due to infectious uveitis. Ocular lesions due to opportunistic infections (OI) are the most common and have been described extensively in the pre highly active antiretroviral therapy (HAART) era. Many eye lesions were classified as acquired immunodeficiency syndrome (AIDS) defining illnesses. HAART-associated improvement in immunity of the individual has changed the pattern of incidence of these hitherto reported known lesions leading to a marked reduction in the occurrence of ocular OI. Newer ocular lesions and newer ocular manifestations of known agents have been noted. Immune recovery uveitis (IRU), the new menace, which occurs as part of immune recovery inflammatory syndrome (IRIS) in the eye, can present with significant ocular inflammation and can pose a diagnostic and therapeutic challenge. Balancing the treatment of inflammation with the risk of reactivation of OI is a task by itself. Ocular involvement in the HAART era can be due to the adverse effects of some systemic drugs used in the management of HIV/AIDS. Drug-associated retinal toxicity and other ocular side effects are being increasingly reported. In this review, we discuss the ocular manifestations in HIV patients and its varied presentations following the introduction of HAART, drug-associated lesions, and the current treatment guidelines.
Topics: AIDS-Related Opportunistic Infections; Antiretroviral Therapy, Highly Active; Cytomegalovirus Retinitis; HIV; HIV Infections; Humans; Inflammation; Uveitis
PubMed: 32823395
DOI: 10.4103/ijo.IJO_1248_20 -
American Journal of Ophthalmology Feb 1991We reviewed 19 cases of delayed-onset pseudophakic endophthalmitis in which diagnostic cultures were performed at one month or more after cataract extraction with...
We reviewed 19 cases of delayed-onset pseudophakic endophthalmitis in which diagnostic cultures were performed at one month or more after cataract extraction with posterior chamber intraocular lens implantation. We isolated four different organisms in these 19 cases: 12 Propionibacterium species (63%), three Candida parapsilosis (16%), three Staphylococcus epidermidis (16%), and one Corynebacterium species (5%). Because of the unusual delayed-onset features of these cases and the retrospective nature of this study, a variety of treatment regimens were used. Twelve patients had recurrence of marked inflammation despite an apparent initial cure, and ten of these patients had positive culture results on repeat examination of intraocular fluids. Nine patients continued to be treated with topical corticosteroids postoperatively to suppress low-grade inflammation. Of the 19 patients, 16 had final visual acuity of 20/400 or better. Delayed-onset pseudophakic endophthalmitis had a more favorable visual prognosis, compared to acute-onset endophthalmitis.
Topics: Adrenal Cortex Hormones; Anti-Bacterial Agents; Aphakia, Postcataract; Bacterial Infections; Candidiasis; Corynebacterium Infections; Endophthalmitis; Humans; Propionibacterium; Staphylococcal Infections; Visual Acuity; Vitreous Body
PubMed: 1992736
DOI: 10.1016/s0002-9394(14)72254-8